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HIV is neurotrophic and has been shown to invade the developing central nervous system and cause encephalopathy in young children. Infants infected with HIV in South Africa were assessed using the Bayley Scales of Infant Development ll. The children were severely delayed in both motor and cognitive development at baseline and caregivers recorded very high parenting stress levels. The children were randomised into two groups, an experimental and a control group. The children who received a basic home stimulation programme showed statistically significant improvements in motor and cognitive scores over a one year period. Despite these improvements the children remained delayed at the end of the study period. Children infected with HIV need long term management which includes physiotherapy.