Objectives. To investigate the effect of HIV disease on the receptive and expressive language of children and the relationship between CT scan brain abnormalities and language functioning.Methods. Thirty-six children (mean age, 5.5 years; range, 1 through 10 years; 75% vertical transmission; 58% classified as encephalopathic) with symptomatic HIV infection and 20 uninfected siblings (mean age, 7.8 years; range, 3 through 15 years) were administered an age-appropriate comprehensive language test assessing both receptive and expressive language (Reynell Developmental Language Scales or Clinical Evaluation of Language Fundamentals-Revised). Each HIV-infected child had a CT scan of the brain as part of the baseline evaluation, which was rated independently and blindly by two neurologists, for presence and severity of brain abnormalities using a semiquantitative rating system.Results. Expressive language was significantly more impaired than receptive language in the overall sample of HIV-infected children. The encephalopathic children scored significantly lower than the non-encephalopathic children, however, the degree of discrepancy between mean receptive and expressive language scores was not significantly different between these two groups. The uninfected sibling control group did not have a significant discrepancy between receptive and expressive language, and they scored significantly higher than the infected patient group. Greater severity of CT scan abnormalities was significantly correlated with poorer receptive and expressive language functioning in the overall HIV-infected sample and a higher discrepancy between receptive and expressive language in the encephalopathic group.Conclusion. Pediatric HIV disease is associated with differential receptive and expressive language functioning in which expressive language is significantly more impaired than receptive language. The sibling data and CT scan correlations suggest that the observed language impairments are associated with the direct effects of HIV-related central nervous system disease.

The developmental outcome of 2- and 4-year-old children who had been exposed as infants to chloride-deficient formula was studied. A negative dose-response relationship was demonstrated between use of the formula without additional nutritional supplementation and cognitive outcome as measured by the Bayley Scales of Infant Development (Pearson r = -.55, P = .01) at 2 years of age. A similar negative relationship was demonstrated between this exclusive use of the defective formula and perceptual (Pearson r = -.51, P less than .05), motor (Pearson r = -.52, P less than .05), and fine motor (Pearson r = -.75, P less than .002) ability as measured by the McCarthy Scales of Children's Abilities at 4 years of age. When other know predictors of developmental outcome were taken into account by means of multiple linear regression analyses, exclusive formula use emerged as an important predictor of the children's cognitive functioning at 2 years (model R2 = .59, P less than .005) and of quantitative (model R2 = .58, P less than .006), perceptual (model R2 = .63, P less than .009), and fine motor ability (model R2 = .74, P less than .003) at 4 years of age. These data raise concern about the developmental outcome of the children exposed to chloride-deficient formula.

During 1978-1979, more than 20,000 infants may have been exposed to chloride-deficient formula (CDF). A number of these children were noted to suffer from severe metabolic alterations, principally hypochloremic metabolic alkalosis (HMA). The present study examined 21 children who were exposed to CDF and developed HMA. Pediatric records were reviewed, medical and feeding histories were obtained from the parents, and children were administered the Bayley Scales of Infant Development (BSID). The range of age at testing was 13 to 29 months (mean=23.2). The Bayley Mental Development Index (MDI) ranged from 67 to 127 (mean=98.5) Length of exclusive use of CDF without supplementation with solids or other milk/formula (LENEXC) had a significant negative correlation with MDI (r=-.55, p=.01). When length of exclusive use of CDF, age of onset of CDF use and age at testing were entered into a multiple regression analysis, LENEXC remained associated with MDI (R2=.39, p<.05). Sixteen of these children were re-examined at ages ranging from 40 to 51 months (mean=43.8) using the McCarthy Scales of Children's Abilities. There was a significant negative correlation between LENEXC and the perceptual-performance scale (r=-.51, p<.05) and between LENEXC and the motor scale (r=-.52, p<.05). These data raise concern about the long-term outcome of these children.

Journal Article WISC-R Verba/Performance Discrepancy in Children with Cancer: A Statistical Quirk? Get access Jonathan Kellerman, Jonathan Kellerman 2 Department of PediatricsUniversity of Southern California School of Medicine, Division of Hematology-Oncology, Childrens Hospital of Los Angeles, and Laboratory of Developmental Psychology, National Institute of Mental Health 2All correspondence should be addressed to Jonathan Kellerman, Division of Hematology-Oncology, Children's Hospital of Los Angeles, 4650 Sunset Boulevard, Los Angeles, California 90027. Search for other works by this author on: Oxford Academic PubMed Google Scholar Howard A. Moss, Howard A. Moss Department of PediatricsUniversity of Southern California School of Medicine, Division of Hematology-Oncology, Childrens Hospital of Los Angeles, and Laboratory of Developmental Psychology, National Institute of Mental Health Search for other works by this author on: Oxford Academic PubMed Google Scholar Stuart E. Siegel Stuart E. Siegel Department of PediatricsUniversity of Southern California School of Medicine, Division of Hematology-Oncology, Childrens Hospital of Los Angeles, and Laboratory of Developmental Psychology, National Institute of Mental Health Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Pediatric Psychology, Volume 7, Issue 3, September 1982, Pages 263–266, https://doi.org/10.1093/jpepsy/7.3.263 Published: 01 September 1982