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DOI: 10.1590/0004-282X-ANP-2020-0537
Family quality of life among families who have children with mild intellectual disability associated with mild autism spectrum disorder
Qualidade de vida familiar entre famílias que têm filhos com deficiência intelectual leve associada ao transtorno do espectro do autismo leve Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, Grant 18/19875-0), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Grant 88887.136366/2017-00) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Grant 465549/2014-4).![](https://www.thieme-connect.de/media/10.1055-s-00054595/202204/lookinside/thumbnails/10-1590-0004-282x-anp-2020-0537_20200537-1.jpg)
ABSTRACT
Background: Intellectual disability (ID) and autism spectrum disorder (ASD) are often concomitant childhood developmental disorders. These disorders can alter family quality of life (FQoL). Objective: To investigate FQoL among families who have children with mild ID, associated with mild ASD. Methods: Cross-sectional descriptive study with 69 families who have children with mild ID and ASD, ranging from six to 16 years old, and who were provided with disability-related services in Brazil. Data were collected using a family sociodemographic questionnaire, an ID and ASD personal profile form, the Barthel index for activities of daily living and the Beach Center FQoL scale. Results: People with ID and ASD had an average score of 88.2±11.5 in the Barthel index, thus indicating moderate dependency in basic activities of daily living. The average total FQoL score (3.56±0.34) was lower than the scores for the “family interaction” (3.91±0.42; p<0.001), “parenting” (3.79±0.35; p<0.001) and “disability-related support” (3.98±0.16; p<0.001) domains; and higher than the scores for the “physical/material well-being” (3.19±0.64; p<0.001) and “emotional wellbeing” (2.75±0.62; p<0.001) domains. Parents’ marital condition, monthly family income, family religious practice and effective communication skills among the people with ID and ASD were predictors for FQoL (R2=0.407; p<0.001). Conclusions: FQoL was sustained through factors such as family interaction and parents’ care for their children. Improving families’ emotional wellbeing and physical and material conditions is likely to positively affect the FQoL of these families.
RESUMO
Antecedentes: Deficiência intelectual (DI) e transtorno do espectro do autismo (TEA) são distúrbios do desenvolvimento infantil frequentemente concomitantes que podem impactar na qualidade de vida familiar (QVF). Objetivo: Esta pesquisa avaliou a QVF entre famílias que têm filhos com DI leve associada a TEA leve. Métodos: Pesquisa transversal e descritiva, que investigou 69 famílias com filhos com DI e TEA leves, com idades entre seis e 16 anos, que recebiam serviços relacionados à deficiência no Brasil. Os dados foram coletados por meio de formulário sociodemográfico, formulário de perfil da pessoa com DI e TEA, o índice de funcionalidade de Barthel e a Escala de QVF do Beach Center. Resultados: Os indivíduos com DI e TEA obtiveram pontuação média de 88,2±11,5 no índice de Barthel, o que indicou dependência moderada nas atividades básicas de vida diária. O escore médio da QVF total (3,56±0,34) foi menor que os escores dos domínios “interação familiar” (3,91±0,42; p<0,001), “cuidados dos pais com os filhos” (3,79±0,35; p<0,001) e “apoio ao deficiente” (3,98±0,16; p<0,001), e maior que os escores dos domínios “bem-estar físico-material” (3,19±0,64; p<0,001) e “bem-estar emocional” (2,75±0,62; p<0,001). Condição marital dos pais, renda mensal, prática religiosa e comunicação adequada dos indivíduos com DI e TEA foram preditores da QVF (R2=0,407; p<0,001). Conclusões: A QVF foi sustentada por aspectos como a interação familiar e o cuidado dos pais com os filhos. Melhorar o bem-estar emocional e as condições físicas e materiais familiares provavelmente afetará positivamente a qualidade de vida dessas famílias.
Keywords:
Intellectual Disability - Autism Spectrum Disorder - Quality of Life - Family - Family Relations - BrazilPalavras-chave:
Deficiência Intelectual - Transtorno do Espectro Autista - Qualidade de Vida - Família - Relações Familiares - BrasilAuthors’ contributions:
MCB: participated in the conception and design of the research project, data collection, analysis and interpretation, and writing, review and approval of the final version; CMRG: participated in the conception and design of the research project, data analysis and interpretation, and critical review and approval of the final version; LRSA, RFP: participated in the conception and design of the research project, data interpretation, and critical review and approval of the final version; DGM: participated in the conception, design and supervision of the research project, data analysis and interpretation, and writing, review and approval of the final version.
Support
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, Grant 18/19875-0), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Grant 88887.136366/2017-00) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Grant 465549/2014-4).
Publication History
Received: 14 November 2020
Accepted: 15 June 2021
Article published online:
31 January 2023
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References
- 1 American Psychiatric Association. Manual Diagnóstico e Estatístico de Transtornos Mentais - DSM-5. Porto Alegre: Artmed; 2014: 33-59
- 2 Moeschler JB, Shevell M. Committee on Genetics. Comprehensive evaluation of the child with intellectual disability or global developmental delays. Pediatrics 2014; Sep; 134 (03) e903-e918 https://doi.org/10.1542/peds.2014-1839
- 3 Brasil. Instituto Brasileiro de Geografia e Estatística. [accessed on Sept 11, 2020] Available at: https://biblioteca.ibge.gov.br/visualizacao/periodicos/94/cd_2010_religiao_deficiencia.pdf
- 4 Mefford HC, Batshaw ML, Hoffman EP. Genomics, intellectual disability, and autism. N Engl J Med 2012; Feb; 366 (08) 733-743 https://doi.org/10.1056/NEJMra1114194
- 5 Mpaka DM, Okitundu DL, Ndjukendi AO, N'situ AM, Kinsala SY, Mukau JE. et al. Prevalence and comorbidities of autism among children referred to the outpatient clinics for neurodevelopmental disorders. Pan Afr Med J 2016; Oct; 25: 82-82 https://doi.org/10.11604/pamj.2016.25.82.4151
- 6 Srivastava AK, Schwartz CE. Intellectual disability and autism spectrum disorders: causal genes and molecular mechanisms. Neurosci Biobehav Rev 2014; Oct; 46 Pt 2: 161-174 https://doi.org/10.1016/j.neubiorev.2014.02.015
- 7 Meral BF, Cavkaytar A, Turnbull AP, Wang M. Family Quality of Life of Turkish families who have children with intellectual disabilities and autism. Res Pract Persons Severe Disabl 2013; Dec; 38 (04) 233-246 https://doi.org/10.1177/154079691303800403
- 8 Xue J, Ooh J, Magiati I. Family functioning in Asian families raising children with autism spectrum disorders: the role of capabilities and positive meanings. J Intellect Disabil Res 2014; May; 58 (05) 406-420 https://doi.org/10.1111/jir.12034
- 9 Gardiner E, Iarocci G. Family quality of life and ASD: the role of child adaptive functioning and behavior problems. Autism Res 2015; Apr; 8 (02) 199-213 https://doi.org/10.1002/aur.1442
- 10 Wang M, Summers JA, Little T, Turnbull A, Poston D, Mannan H. Perspectives of fathers and mothers of children in early intervention programmes in assessing family quality of life. J Intellect Disabil Res 2006; Dec; 50 (Pt 12) 977-988 https://doi.org/10.1111/j.1365-2788.2006.00932.x
- 11 Schlebusch L, Dada S, Samuels AE. Family quality of life of South African families raising children with autism spectrum disorder. J Autism Dev Disord 2017; Jul; 47 (07) 1966-1977 https://doi.org/10.1007/s10803-017-3102-8
- 12 Samuel PS, Rillotta F, Brown I. Review: the development of family quality of life concepts and measures. J Intellect Disabil Res 2012; 56 (01) 1-16 https://doi.org/10.1111/j.1365-2788.2011.01486.x
- 13 Wang M, Kober R. Embracing an era of rising family quality of life research. J Intellect Disabil Res 2011; Dec; 55 (12) 1093-1097 https://doi.org/10.1111/j.1365-2788.2011.01509.x
- 14 Summers JA, Poston DJ, Turnbull AP, Marquis J, Hoffman L, Mannan H, Wang M. Conceptualizing and measuring family quality of life. J Intellect Disabil Res 2005; Oct; 49(Pt 10) 777-783 https://doi.org/10.1111/j.1365-2788.2005.00751.x
- 15 Schlebusch L, Samuels AE, Dada S. South African families raising children with autism spectrum disorders: relationship between family routines, cognitive appraisal and family quality of life. J Intellect Disabil Res 2016; May; 60 (05) 412-423 https://doi.org/10.1111/jir.12292
- 16 Chiu SJ, Chen PT, Chou YT, Chien LY. The Mandarin Chinese version of the Beach Centre Family Quality of Life Scale: development and psychometric properties in Taiwanese families of children with developmental delay. J Intellect Disabil Res 2017; Apr; 61 (04) 373-384 https://doi.org/10.1111/jir.12356
- 17 Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health 2015; Sep; 42 (05) 533-544 https://doi.org/10.1007/s10488-013-0528-y
- 18 Vidal FAZ, Figueiredo VLM, Nascimento E. A quarta edição do WISC americano. Aval Psicol 2011; Aug; 10 (02) 205-207
- 19 Schopler E, Reichler RJ, DeVellis RF, Daly K. Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS). J Autism Dev Disord 1980; Mar; 10 (01) 91-103 https://doi.org/10.1007/BF02408436.
- 20 Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 1989; 42 (08) 703-709 https://doi.org/10.1016/0895-4356(89)90065-6
- 21 Hoffman L, Marquis JG, Poston DJ, Summers JA, Turnbull A. Assessing family outcomes: psychometric evaluation of the beach center family quality of life scale. J Marriage Fam 2006; 68 (04) 1069-1083 https://doi.org/10.1111/j.1741-3737.2006.00314.x
- 22 Jorge BM, Levy CC, Granato L. Cultural adaptation quality of family life scale for the Brazilian Portuguese. Codas 2015; Nov-Dec 27 (06) 534-540 https://doi.org/10.1590/2317-1782/20152014142.
- 23 Summers JA, Marquis J, Mannan H, Turnbull AP, Fleming K, Poston DJ. et al. Relationship of perceived adequacy of services, family professional partnerships, and family quality of life in early childhood service programmes. Intl J Disabil Dev Educ 2007; Aug; 54 (03) 319-338 https://doi.org/10.1080/10349120701488848
- 24 Rivard M, Mercier C, Mestari Z, Terroux A, Mello C, Bégin J. Psychometric properties of the beach center family quality of life in French-speaking families with a preschool-aged child diagnosed with autism spectrum disorder. Am J Intellect Dev Disabil 2017; Sep; 122 (05) 439-452 https://doi.org/10.1352/1944-7558-122.5.439
- 25 Millau M, Rivard M, Mello C. Quality of Life in immigrant parents of children with autism spectrum disorder: a comparison with parents from the host culture. J Child Fam Stud 2019; Jun; 28 (06) 1512-1523 https://doi.org/10.1007/s10826-019-01395-8
- 26 Valenzuela A, Dornbusch SM. Familism and social capital in the academic achievement of Mexican origin and Anglo adolescents. Soc Sci Q 1994; Mar; 75 (01) 18-36
- 27 Campos B, Ullman JB, Aguilera A, Dunkel Schetter C. Familism and psychological health: the intervening role of closeness and social support. Cultur Divers Ethnic Minor Psychol 2014; Apr; 20 (02) 191-201 https://doi.org/10.1037/a0034094
- 28 Hernández MM, Bámaca-Colbert MY. A behavioral process model of familism. J Fam Theory Rev 2016; Dec; 8 (04) 463-483 https://doi.org/10.1111/jftr.12166
- 29 Cronemberger IHG, Teixeira SM. Familismo na política social brasileira e as mulheres. Rev FSA 2012; Aug-Dec 9 (02) 205-221
- 30 Santos WR. O circuito familista na Política de Assistência Social. Textos Contextos (Porto Alegre) 2017; Dec; 16 (02) 388-402 https://doi.org/10.15448/1677-9509.2017.2.24250
- 31 Karst JS, Van Hecke AV. Parent and family impact of autism spectrum disorders: a review and proposed model for intervention evaluation. Clin Child Fam Psychol Rev 2012; Sep; 15 (03) 247-277 https://doi.org/10.1007/s10567-012-0119-6
- 32 Eskow K, Pineles L, Summers JA. Exploring the effect of autism waiver services on family outcomes. J Policy Pract Intellect Disabil 2011; Mar; 8 (01) 28-35 https://doi.org/10.1111/j.1741-1130.2011.00284.x
- 33 Dzamonja T, Milanovic M, Zegarac N. How services for children with disabilities in Serbia affect the quality of life of their families. Res Dev Disabil 2017; Sep; 68: 1-8 https://doi.org/10.1016/j.ridd.2017.06.009
- 34 McFelea JT, Raver S. Quality of life of families with children who have severe developmental disabilities: a comparison based on child residence. Phys Disabil 2012; Aug; 31 (02) 3-17
- 35 Oliveira EBC, Pereira RCM, Apis A, Germano CM, Pilotto RF, Melo DG. Quality of life in families with children with moderate intellectual disability. J Bras Psiquiatr 2019; 68 (02) 101-109 https://doi.org/10.1590/0047-208520200537233
- 36 Tait K, Fung F, Hu A, Sweller N, Wang W. Understanding Hong Kong Chinese families’ experiences of an autism/ASD diagnosis. J Autism Dev Disord 2016; Apr; 46 (04) 1164-1183 https://doi.org/10.1007/s10803-015-2650-z
- 37 Canda ER. Transcending through disability and death: Transpersonal themes in living with cystic fibrosis. Soc Thought 2001; 20 1-2 109-134 https://doi.org/10.1080/15426432.2001.9960284
- 38 Poston DJ, Turnbull AP. Role of spirituality and religion in family quality of life for families of children with disabilities. Educ Train Autism Dev Disabil 2004; 39 (02) 95-108
- 39 Fitzgerald M, Birkbeck G, Matthers P. Maternal burden in families with children with autistic spectrum disorder. Ir J Psychol Med 2002; 23 1-2 2-17
- 40 Foley KR, Girdler S, Downs J, Jacoby P, Bourke J, Lennox N. et al. Relationship between family quality of life and day occupations of young people with Down syndrome. Soc Psychiatry Psychiatr Epidemiol 2014; Sep; 49 (09) 1455-1465 https://doi.org/10.1007/s00127-013-0812-x