# A Computerized Neurocognitive Battery for Use in Youth Affected by HIV in Resource-limited Settings

> **NIH NIH R01** · CHILDREN'S HOSP OF PHILADELPHIA · 2020 · $418,595

## Abstract

Abstract
 The introduction of combined antiretroviral therapies has reduced the incidence and severity of HIV-related
encephalopathy in youth living with HIV. However, neurodevelopmental delays and cognitive impairment are
nonetheless still common in this population. Unfortunately, in resource-limited settings (RLS), where HIV
infection impacts millions of children, cognitive and neurodevelopmental disorders commonly go undetected
because of a lack of appropriate assessment instruments and local expertise. In this project, we build on the
synergistic work of two research groups to: (1) culturally adapt and validate the Penn Computerized
Neurocognitive Battery (CNB) and examine its validity for detecting both advanced and subtle
neurodevelopmental problems among school-aged HIV-infected and HIV-exposed children in RLS; and (2)
simultaneously fine-tune a brief screening instrument (The Pediatric Symptom Checklist, PSC) to prioritize
children most likely to benefit from further cognitive assessments. The CNB is a well-validated battery of
neurocognitive tests that assesses all major domains of cognitive functioning in adults and children as young
as 5 years of age. It has shown sensitivity to mild cognitive deficits, and has been applied in large-scale studies
and in multiple cultural contexts. We aim to validate the CNB in youth in Botswana, a RLS with high rates of
perinatal exposure to HIV and limited neurocognitive assessment tools and expertise, by culturally adapting
and then administering the adapted version of the CNB to 200 HIV-infected, 200 HIV-exposed uninfected, and
240 HIV-unexposed uninfected children. A series of analyses will be conducted to examine the reliability and
construct validity of the CNB in these populations. Since a one hour comprehensive cognitive assessment may
not be feasible to implement among all children in many busy clinics in resource-limited settings, we will also
adapt a rapid psychosocial screening tool, the Pediatric Symptom Checklist to make it suitable for identifying
children who are most likely to benefit from further neurocognitive assessment. To accomplish these aims, we
have assembled a unique, multi-disciplinary expert team with long-term experience developing and validating
novel and highly adaptable neurocognitive assessments, and conducting Africa-based collaborative HIV
research. This project will apply procedures for effective translation and cultural adaptation that have been
developed through extensive collaborations of our group with international researchers from both Western and
non-Western cultures (e.g., in South Africa in an adult Xhosa-speaking population). If successful, the proposed
tools would provide practical screening and streamlined, comprehensive assessments that could be widely
used in RLS to identify children with cognitive deficits within programs focused on the care and treatment of
children living with or affected by HIV. The utility of such assessments could extend well beyo...

## Key facts

- **NIH application ID:** 9933079
- **Project number:** 5R01HD095278-03
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Elizabeth Dawn Lowenthal
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $418,595
- **Award type:** 5
- **Project period:** 2018-09-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9933079

## Citation

> US National Institutes of Health, RePORTER application 9933079, A Computerized Neurocognitive Battery for Use in Youth Affected by HIV in Resource-limited Settings (5R01HD095278-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9933079. Licensed CC0.

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