Nonverbal cognitive assessment of children in Tanzania with and without HIV

Jonathan Lichtenstein*, Caitlin Bowers, Jennifer Amato, Christopher Niemczak, Abigail Fellows, Albert Magohe, Hannah Haile, Travis White-Schwoch, Nina Kraus, Enica Massawe, Ndeserua Moshi, Jay Buckey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Children living with HIV can experience cognitive difficulties. Most neuropsychological tests have been constructed in Western languages, meaning they may not be appropriate for use in non-Western settings. To address this, we used an entirely nonverbal measure of cognitive ability in a sub-Saharan African sample. For this cross-sectional analysis, 316 children (162 HIV+ and 154 HIV-, ages 3–9) completed the Leiter-3 as part of a larger study in Dar es Salaam, Tanzania. Statistical tests included analysis of covariance and multiple linear regression to account for environmental variables. HIV+ children performed worse than HIV–controls on two composite scores: Nonverbal IQ (p < .001) and Processing Speed (p < 0.001). Similar trends were observed on core subtests. Multiple linear regression models revealed that age, socioeconomic status, and school attendance predicted all Leiter-3 test composites. Critically, the addition of HIV status to the models improved prediction of Nonverbal IQ (∆R2 = 0.03, p = .001) and Processing Speed (∆R2 = 0.06, p < .001). Children living with HIV performed worse than HIV- controls on most Leiter-3 measures. While age, SES, and school attendance predicted Leiter-3 performance, HIV status improved prediction capabilities when added to the model. The Leiter-3 may offer a viable measure of cognitive ability in non-Western settings that can be used in its original form without translation.

Original languageEnglish (US)
Pages (from-to)107-119
Number of pages13
JournalChild Neuropsychology
Issue number1
StatePublished - 2022


  • Africa
  • HIV
  • Nonverbal assessment
  • cognitive development
  • socioeconomic status

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Developmental and Educational Psychology
  • Pediatrics, Perinatology, and Child Health


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