When Eating Organizes the Day: Food Chronocare Among Socioeconomically Vulnerable Families of Children and Adolescents With Autism and Other Neurodevelopmental Conditions in Northeastern Brazil

Purpose To understand, within the analytical scope of this article, how parents and caregivers organize and interpret the eating rhythms of children and adolescents with autism spectrum disorder (ASD) and/or attention-deficit/hyperactivity disorder (ADHD) in relation to sleep, school, medication, behavior, sensory needs, and food selectivity. Methods An explanatory sequential mixed methods study was conducted in three municipalities in northeastern Brazil. The quantitative phase included 128 families of children and adolescents with ASD and/or ADHD, including co-occurring conditions. The qualitative phase included interviews with 35 parents or primary caregivers representing 37 children and adolescents, analyzed through an interpretive thematic approach. Findings were integrated to examine convergences, complementarities, and mixed-methods interpretations. Results Ninety-four participants (73.4%) presented four or more of eight caregiver-reported food selectivity manifestations. A higher manifestation burden was associated with the need for help or supervision during meals (adjusted prevalence ratio [aPR] = 1.43; 95% confidence interval [CI]: 1.10–1.87), sleep difficulties on ≥ 8 days (aPR = 1.45; 95% CI: 1.08–1.95), and hypersensitivity reactions on ≥ 8 days (aPR = 1.88; 95% CI: 1.28–2.75). Qualitative findings showed how feeding was coordinated with sensory predictability, medication, school routines, sleep, nighttime hunger, and caregiver rest. Integration indicated that eating times were interconnected with other temporal and relational demands of family care. Conclusion The integrated findings informed the development of food chronocare as a provisional interpretive concept that captures the family caregiving work through which eating rhythms are coordinated with sensory needs and the broader temporal demands of family life, schooling, medication use, and sleep among children and adolescents with autism and other neurodevelopmental conditions.