Visual motor integration delay in preschool children infected with HIV

Abstract

Introduction: It is estimated that more than 200 000 children under the age of 14 years are living with human immunodeficiency
virus (HIV) in South Africa. These children - including those on antiretroviral therapy - may present with neurocognitive delay and may
find it difficult to participate in educational activities. This study aimed to determine the extent of the delay of visual motor integration
(VMI) which correlates significantly with academic achievement in pre-school children with vertically transmitted HIV.
Method: This was a descriptive quantitative study in which 71 children infected with HIV aged between 5 - 6 years, attending a
HIV clinic in South Africa, were assessed using the Beery Developmental Test of Visual Motor Integration (DTVMI). The results were
compared to the normative DTVMI scores, and correlated with health factors related to HIV such as CD4 count and socioeconomic
factors such as attendance at crèche or preschool.
Results: Results confirm that a delay exists in VMI and visual perception (VP) in the at risk category. Mean scores on the motor
coordination (MC) fell in the average range. Visual perception was the most affected in this sample with an average delay of between
11 and 17 months found. Visual perception also showed a moderate positive correlation with CD4 count, while VMI had a moderate
relationship to attendance at crèche or preschool and mother's level of education.
Conclusion: This study confirms children with HIV are at risk for neurodevelopmental delay related to visual motor integration and
visual perception, particularly in children with a low CD4 count. These aspects need to be assessed as part of routine neurodevelopmental
monitoring.

Key words: Neurodevelopmental delay, HIV, preschool children, visual motor integration delay, visual perception delay, motor coordination