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Arnold School of Public Health


Li awarded $400K from NIH to explore neurodevelopmental outcomes based on care settings of AIDS-orphaned children

March 14, 2016 | Erin Bluvas, bluvase@sc.edu 

Since 2005, Health Promotion, Education, and Behavior Professor Xiaoming Li and his U.S.- and China-based collaborators* have been funded by R01 grants from the National Institutes of Health (NIH) to study the psychosocial needs of children affected by HIV and to develop interventions that promote psychosocial well-being among children. The team will now take their research a step further with a two-year, $400K R21 grant from NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development to explore the relationship between care settings (i.e., community-based group homes, orphanages, kinship care) and neurodevelopmental outcomes in children who have been orphaned by AIDS.

“Previous studies have investigated the effects of early social deprivation with institutional rearing, such as orphanages, and they revealed an increased incidence of cognitive impairment and specific behavioral problems, such as inattention and overactivity,” says Li, who is the S.C. SmartState Chair for Clinical Translational Research, Director of the SmartState Center for Healthcare Quality, and principal investigator on the grant. “Now there is emerging evidence that such deficits and behavioral patterns are associated with altered neural function and structure—which has raised concerns about the use of these institutional settings in the care of orphaned children as well as prompted the study of programs, such as foster care and community group homes.”

However, scientists’ understanding of these effects remains incomplete as there has been limited empirical investigation of neural correlates across care settings or on the timing parameters (e.g., age of onset of adversity, time in care) and features of care settings. The researchers’ new study will dig deeper into these connections to better classify care settings associated with healthy and unhealthy neural outcomes as well as reveal some of the timing parameters for children who experience early adversity.

In doing so, they will apply cognitive and behavioral assessments, as well as advanced brain imaging techniques, to identify neurodevelopmental alterations that are associated with a history of adversity and subsequent exposure to different care settings among 90 children who have been orphaned by AIDS in China. Given the number of orphaned children worldwide and the devastating effects of parental HIV/AIDS on children, the findings from this study will further the development of interventions that are critically-needed to promote psychosocial well-being of children worldwide who experience early adversity.

“Collecting this data will allow us to determine which care settings—and some of the timing parameters—that are associated with healthy vs unhealthy neurodevelopmental outcomes,” says Li, who is also the Chief Analytics Officer of Health Sciences South Carolina. “These findings could guide policy decisions in determining how growing numbers of children, worldwide, can be best cared for following HIV/AIDS and other adversity as well as indicate differential and more targeted intervention protocols for children manifesting unhealthy outcomes associated with chronic stress and subsequent care.”

*Primary collaborators include Michael Behen (Wayne State School of Medicine/Children’s Hospital of Michigan), Bonita Stanton (Seton Hall University and Hackensack UHN School of Medicine), and researchers at China’s Henan University and its affiliated hospital.