THE AMBIVALENT USE OF ULTRA-PROCESSED FOODS IN FEEDING NEURODIVERGENT CHILDREN AND ADOLESCENTS WITH FOOD SELECTIVITY IN SOCIOECONOMICALLY VULNERABLE SETTINGS: CAREGIVERS’ NARRATIVES FROM NORTHEAST BRAZIL

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Abstract
Food selectivity among neurodivergent children and adolescents is often discussed in terms of sensory sensitivity, restricted repertoires and nutritional risk, but less is known about how caregivers manage these difficulties in socioeconomically vulnerable settings. This qualitative study aimed to understand how caregivers of neurodivergent children and adolescents in small municipalities in Northeast Brazil narrate everyday feeding care in the face of food selectivity, material constraints and the ambivalent use of ultra-processed foods. Thirty-five parents and/or primary caregivers of 37 Autistic children and adolescents with or without attention-deficit/hyperactivity disorder and/or co-occurring neurodevelopmental conditions were interviewed in three municipalities in Ceará, Brazil. Data were generated through face-to-face semi-structured interviews, and contextual instruments on socioeconomic vulnerability and family food consumption. Interviews were transcribed, reviewed and analysed using an interpretative thematic approach. Six thematic categories were constructed: food as everyday care work; selectivity as a bodily and sensory experience; inventiveness and strain in managing feeding; material limits in feeding the child; ultra-processed foods as an ambivalent care resource; and the demand for specialised guidance. Caregivers described feeding as a relational, sensory and socially situated practice shaped by refusals, negotiations, economic constraints, school routines and limited access to professional support. Ultra-processed foods were recognised as nutritionally undesirable, but were also used pragmatically as predictable, accepted and practical resources in everyday care. The findings suggest that feeding interventions for neurodivergent children should move beyond individualised parental advice and address the material, sensory and institutional conditions that shape food choice and feeding care.