The Effect of Oral Candidiasis on the Speech Production, Feeding Skills, and Self-Concept of Children and Adolescents With Symptomatic HIV Infection

Language impairments in children with symptomatic HIV infection are associated with the direct effects of HIV on the central nervous system (CNS). Furthermore, expressive language is more vulnerable to the effects of HIV compared to receptive language (Wolters, et al., 1995). Several factors, however, are likely to be involved in producing the expressive language impairments observed in the HIV-infected pediatric population. Oral candidiasis (thrush), a fungal infection in the oral cavity that frequently appears in HIV-infected children (Walsh, 1994), also may contribute to speech and language deficits depending on the severity of the thrush. Feeding skills and self-concept may be negatively affected by oral thrush as well. The effect of oral candidiasis on the speech production, feeding skills, and self-concept of children and adolescents with HIV infection will be examined in this pilot study. Several disciplines (Neuropsychology, Speech, Nursing, and Infectious Disease) will be involved to investigate the severity of oral candidiasis on various aspects of everyday behavior. Interdisciplinary assessment of the ramifications of oral thrush on speech production and feeding skills have not been conducted to date in children or adolescents infected with HIV. Most studies have assessed only single dimensions or functions such as language or they have yielded only descriptive data, for example, regarding the severity of oral thrush. This pilot study, however, will investigate the association between oral thrush and speech and feeding dysfunction using some newly-developed measures. The study will also examine whether oral candidiasis may influence the self-concept of children and adolescents with HIV infection.