Background This study investigated the psychocultural perspectives concerning family quality of life among Brazilian families with children who have severe or profound intellectual disability. Methods Individual in‐depth semi‐structured interviews conducted with 15 mothers, selected by convenience, were analysed using a categorical thematic analysis technique. The themes were examined to allow for an interpretative approach of the results. Results Mothers revealed that their children with disabilities had insufficient access to services and support related to health care, transportation and recreation. Family quality of life was negatively affected by financial restrictions and social interaction difficulties. Caring for a child with disabilities seemed to be centred on the mother and religious coping appeared as a common psychological adjustment strategy. Conclusions Improving emotional and psychological cares, as well as social and practical measures comprising income support and access to appropriate health care, were inferred to be the mothers’ priorities to improve their families’ quality of life.
Objetivos: Examinar estudos sobre diagnóstico etiológico nas situações de deficiência intelectual ou atraso global do desenvolvimento, racionalizando o processo de investigação causal em um fluxograma aplicável na prática clínica. Método: Revisão não sistemática da literatura nas bases de dados PubMed e SciELO, sem restrições de tempo ou idioma, com seleção de artigos relevantes, análise crítica e síntese dos resultados. Resultados: Causas ambientais de deficiência devem ser consideradas na história clínica, identificando-se fatores de risco pré, peri e pós-natais. A história familiar e os exames físico, dismorfológico e neurológico podem sugerir a etiologia e orientar a investigação. Para investigar causas genéticas, a análise cromossômica por microarray é indicada como teste de primeira linha, associada à pesquisa de erros inatos do metabolismo e à testagem para síndrome do X-frágil. Exames de neuroimagem são importantes em pacientes selecionados, assim como a investigação de outros genes localizados no cromossomo X. Há uma discussão emergente sobre o papel do sequenciamento completo do exoma nessa investigação. Conclusões: A frequência de definição etiológica tem aumentado com a incorporação de novas tecnologias genéticas na investigação da deficiência intelectual. Afora a investigação etiológica, a abordagem clínica deve considerar diferentes demandas e permitir a construção de um plano terapêutico individualizado.
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