A description of the Griffiths III scores in a cohort of HIV-exposed and HIV-unexposed South African children at 9 months of age
Article Sidebar
Main Article Content
Abstract
Background. The Griffiths Mental Developmental Scales (GMDS) is a developmental tool commonly used in South Africa (SA). The most recent version, the GMDS III (Griffiths III) was standardised in the UK and the Republic of Ireland and published in 2016.
Objectives. To describe neurodevelopmental scores using the Griffiths III, demographics and confounding variables, in children aged 8 - 10 months, living in an urban setting in Cape Town, SA. To compare the scores between children who were HIV-exposed and -uninfected (CHEU) and children who were HIV-unexposed and -uninfected (CHUU).
Method. We conducted a retrospective cross-sectional data analysis of 85 infants with completed Griffiths III assessments at 8 to 10 months of age. This is a substudy of a prospective, longitudinal descriptive study describing neuroimaging and neurodevelopmental outcomes in 31 CHUU and 54 CHEU.
Results. Across all Griffiths III subscales, SA infants tested between average and very superior ranges in raw and quotient scores and between 63rd and 76th percentiles. They outperformed the UK normative sample. Caregivers of CHUUs highest level of education was significantly higher than caregivers of CHEU (p=0.002). CHUU scored higher on the eye and hand coordination scale compared with CHEU (p=0.02).
Conclusion. Due to favourable developmental scores achieved by South African children in comparison to the standardised sample, the revision of the Griffiths Scales to the Griffiths III is likely to have clinical use in SA infants.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The SAJCH is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
How to Cite
References
1. Lawn JE, Kinney MV, Black RE, et al. Newborn survival: A multi-country analysis of a decade of change. Health Policy Plan 2012;27(Suppl_3):iii6-iii28. https://doi.org/10.1093%2Fheapol%2Fczs053
2. Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. The Lancet 2007;369(9555):60-70. https://doi.org/10.1016%2 Fs0140-6736%2807%2960032-4
3. Laughton B, Cornell M, Grove D, et al. Early antiretroviral therapy improves neurodevelopmental outcomes in infants. AIDS 2012;26(13):1685-1690. https://doi.org/10.1097%2Fqad.0b013e328355d0ce
4. Scherzer AL, Chhagan M, Kauchali S, Susser E. Global perspective on early diagnosis and intervention for children with developmental delays and disabilities. Dev Med Child Neurol 2012;54(12):1079-1084. https://doi. org/10.1111%2Fj.1469-8749.2012.04348.x
5. Joint United Nations Programme on HIV/AIDS. Country Factsheets: South Africa. Geneva: UNAIDS, 2021. https://www.unaids.org/en/regionscountries/ countries/southafrica (accessed 24 January 2023).
6. Wedderburn CJ, Weldon E, Bertran-Cobo C, et al. Early neurodevelopment of HIV-exposed uninfected children in the era of antiretroviral therapy: a systematic review and meta-analysis. Lancet Child Adolesc Health 2022;6(6):393-408. https:// doi.org/10.1016%2Fs2352-4642%2822%2900071-2
7. AizireJ,SikorskiiA,OgwangLW,etal.Decreasedgrowthamongantiretroviraldrug and HIV-exposed uninfected versus unexposed children in Malawi and Uganda. Aids 2020;34(2):215-225. https://doi.org/10.1097%2Fqad.0000000000002405
8. Wedderburn CJ, Evans C, Yeung S, Gibb DM, Donald KA, Prendergast AJ. Growth and neurodevelopment of HIV-exposed uninfected children: A conceptual framework. Current HIV/AIDS Reports 2019;16(6):501-513. https://doi.org/10.10 07%2Fs11904-019-00459-0
9. Wedderburn CJ, Yeung S, Rehman AM, et al. Neurodevelopment of HIV-exposed uninfected children in South Africa: Outcomes from an observational birth cohort study. Lancet Child Adolescent Health 2019;3(11):803-813. https://doi.org/10.1016 %2Fs2352-4642%2819%2930250-0
10. McHenry MS, McAteer CI, Oyungu E, et al. Neurodevelopment in young children Born to HIV-infected mothers: A meta-analysis. Pediatrics 2018;141(2):e20172888. https://doi.org/10.1542%2Fpeds.2017-2888
11. StroudL,FoxcroftC,GreenE,etal.GriffithsIIIPart1:Overview,Developmentand Psychometric Properties. 3rd ed. Oxford: Hogrefe Ltd., 2016:1-76.
12. Lowick S, Sawry S, Meyers T. Neurodevelopmental delay among HIV-infected preschool children receiving antiretroviral therapy and healthy preschool children in Soweto, South Africa. Psychol Health Med 2012;17(5):599-610. https://doi.org/1 0.1080%2F13548506.2011.648201
13. Association for Research in Infant and Child Development. Griffiths III. London: ARICD, 2024. https://www.aricd.ac.uk/about-the-griffiths-scales/griffiths-iii/ (accessed 24 January 2023).
14. Luiz DM, Foxcroft CD, Stewart R. The construct validity of the Griffiths Scales of Mental Development. Child Care Health Dev 2001;1:73-83. https://doi. org/10.1046%2Fj.1365-2214.2001.00158.x
15. Green E, Stroud L, O’Connell R, et al. Griffiths III Part 2: Administration and scoring. 3rd ed. Oxford: Hogrefe Ltd., 2016:1-12.
16. Mutapi F, Pfavayi L, Osakunor D, et al. Assessing early child development and its association with stunting and schistosome infections in rural Zimbabwean children using the Griffiths Scales of Child Development. PLoS Neglected Trop Dis 2021;15(8):1-21. https://doi.org/10.1371/journal.pntd.0009660
17. Ibrahim A, Warton FL, Fry S, et al. Maternal ART throughout gestation prevents caudate volume reductions in neonates who are HIV exposed but uninfected. Front Neurosci 2023;17:1-14.https://doi.org/10.3389/fnins.2023.108558
18. WorldHealthOrganization.ChildGrowthStandards.Geneva:WHO,2024.https:// www.who.int/tools/child-growth-standards/standards/ (accessed 27 April 2023).
19. Amod Z, Cockcroft K, Soellaart B. Use of the 1996 Griffiths Mental Development Scales for infants: A pilot study with a Black, South African sample. J Child Adolesc Ment Health 2007;19(2):123-130. https://doi.org/10.2989%2F17280580709486647
20. Le Doaré K, Bland R, Newell ML. Neurodevelopment in children born to HIV- infected mothers by infection and treatment status. Pediatrics 2012;130(5):e1326- 1344. https://doi.org/10.1542%2Fpeds.2012-0405
21. ChaudhuryS,WilliamsPL,MayondiGK,etal.NeurodevelopmentofHIV-Exposed and HIV-Unexposed Uninfected Children at 24 Months. Pediatrics 2017;140(4):1- 10 https://doi.org/10.1542%2Fpeds.2017-0988
22. Msellati P, Lepage P, Hitimana DG, et al. Neurodevelopmental testing of children born to human immunodeficiency virus type 1 seropositive and seronegative mothers: a prospective cohort study in Kigali, Rwanda. Pediatrics 1993;92(6):843- 848. https://doi.org/10.1542%2Fpeds.92.6.843
23. Boivin MJ, Green SD, Davies AG, Giordani B, Mokili JK, Cutting WA. A preliminary evaluation of the cognitive and motor effects of pediatric HIV infection in Zairian children. Health Psychol 1995;14(1):13-21. https://doi. org/10.1037%2F0278-6133.14.1.13
24. Van Rie A, Mupuala A, Dow A. Impact of the HIV/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo. Pediatrics 2008;122(1):e123-e128. https://doi. org/10.1542%2Fpeds.2007-2558