# How sound processing in the ear and brain relates to educational outcomes, mental health, and quality of life in adolescents living with HIV

> **NIH NIH R01** · DARTMOUTH COLLEGE · 2024 · $834,593

## Abstract

Even with active antiretroviral therapy, some children living with HIV develop neurocognitive deficits and
show neurodevelopmental delays. This can affect their ability to read, form relationships, and find productive
employment. Detecting HIV-associated central nervous system (CNS) effects early, and following their
progress reliably, is critical for studying, assessing, and treating this disabling HIV co-morbidity—particularly in
the lower- and middle- income countries where most cases exist and resources are limited. We have been
tracking literacy development and cognitive performance longitudinally in a cohort of children living with and
without HIV (CLWH/CLWOH) in Dar es Salaam Tanzania. The focus is determining if tests of central auditory
function (i.e., tests of the brain’s ability to process complex sounds) are associated with, or predict, the
development of literacy, behavioral problems, and neurocognitive abilities. Results show that CLWH have
worse neurocognitive performance, poorer literacy skills, and more behavioral problems on average than their
non-infected age and socioeconomic status matched peers. Interestingly, central auditory test performance
correlates with literacy and neurocognitive outcomes. Children who consistently perform better than their peers
in detecting speech in background noise are more likely to read earlier than those who do not. Similarly,
children with poor central auditory performance also have worse performance on cognitive tests of memory,
attention, and processing speed. These results support our previous work showing that performance on tasks
assessing the central auditory system correlate with tests of neurocognitive abilities. These longitudinal results
suggest the tests might be predictive, where a central auditory test at a young age might help predict the
subsequent development of literacy and at a later age. Children entered the current study at ages 3-8, now
they will be entering adolescence. A key question is whether these tests might predict critical life outcomes
such as school performance, mental health, and quality of life. Very few studies exist that follow CLWH into
adolescence when CLWH take more responsibility for their care. This renewal will show how auditory tests
relate to educational outcomes, mental health, and quality of life in a well-studied cohort of CLWH/CLWOH as
they progress into adolescence. We have assembled an international team with experience in central auditory,
neurocognitive, and neuropsychological testing. Dr. Nina Kraus and her team at Northwestern are
internationally recognized experts in auditory electrophysiology. The Dar es Salaam team has extensive
experience in performing both central auditory and neurocognitive tests and managing large-scale studies. Dr.
Jonathan Lichtenstein is expert in assessing neurocognitive function and developmental delays in children.
Together this team will track educational, mental health, and quality of life outcomes in CLWH and...

## Key facts

- **NIH application ID:** 11009395
- **Project number:** 2R01HD095277-06
- **Recipient organization:** DARTMOUTH COLLEGE
- **Principal Investigator:** JAY C BUCKEY
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $834,593
- **Award type:** 2
- **Project period:** 2018-08-16 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11009395

## Citation

> US National Institutes of Health, RePORTER application 11009395, How sound processing in the ear and brain relates to educational outcomes, mental health, and quality of life in adolescents living with HIV (2R01HD095277-06). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11009395. Licensed CC0.

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