Intervenção mediada por cuidadores na seletividade alimentar e estresse familiar em crianças com Transtorno do Espectro Autista

Abstract

Introduction: Autism Spectrum Disorder (ASD) often presents sensory processing alterations that intensify food selectivity, acting as a disruptive factor in the family system and generating a burden on caregivers' mental health. Given the complexity of feeding management, it is essential to investigate how parental empowerment can convert emotional reactivity into strategic mediation, reducing collective stress. Objective: To evaluate the impact of an intervention based on caregiver training on the feeding behavior of children with ASD and on the perception of parental self-efficacy and family stress. Method: A longitudinal, prospective, and qualitative-descriptive study was conducted with a sample of 15 Brazilian caregivers residing in Toronto, Canada, whose children with ASD were aged between 2.5 and 10 years. The six-week intervention included weekly consultations and food-monitoring diaries. Article 1 used the Brief Autism Mealtime Behavior Inventory (BAMBI) scale at two time points (T0 and T1), and statistical analysis used the Wilcoxon Test. Article 2 gathered caregivers' experiences through open-ended questionnaires and analyzed them using Bardin's content analysis framework. Results: In Article 1, a significant reduction in food selectivity and active food refusal was observed after six weeks, indicating that parental mediation stabilizes mealtime behavior even before the expansion of the nutritional repertoire. In Article 2, initial findings (T0) revealed a daily routine marked by guilt and exhaustion; however, after technical support (T1), reports indicated a recovery of parental self-efficacy and a reorganization of domestic rituals. The caregivers' posture evolved from "anxious vigilance" to an analytical and welcoming approach. Conclusion: Both studies show that caregivermediated intervention in real-world settings effectively promotes family balance. While quantitative data confirm improvements in the child’s behavior, qualitative data corroborate that technical empowerment can reduce accumulated parental strain, converting feeding stress into strategic management and collective wellbeing.