Parent Perspectives on Dietary and Nutraceutical Therapies in Autism Spectrum Disorder: A Qualitative Thematic Analysis Using a Large Language Model.

OBJECTIVE: To explore how parents of children with autism spectrum disorder (ASD) implement dietary and nutraceutical therapies at home, and to understand the challenges, facilitators, and perceived outcomes that shape their use in real-world settings. DESIGN: A qualitative study using abductive thematic analysis to explore parent-reported experiences with implementing dietary and nutraceutical strategies for their children with ASD. SETTING: Remote interviews conducted with parents residing in Canada and the United States. PARTICIPANTS: A total of 10 semi-structured interviews were completed with 12 parents of children aged <18 years with ASD. Participants represented diverse regions, educational backgrounds, household structures, and linguistic environments. OUTCOME MEASURES: Parent perspectives on feasibility, decision-making processes, child responses, and perceived barriers or supports associated with dietary and nutraceutical strategies. RESULTS: Six themes were identified from parent interviews describing challenges in implementing dietary and nutraceutical interventions for children with ASD. These included parents as architects of care, in which caregivers assumed responsibility for researching, coordinating, and evaluating interventions; food as medicine and messenger, wherein behavioral and gastrointestinal responses served as real-time indicators of effectiveness; emotional weight and resilience, reflecting the psychological and practical burden experienced by caregivers; when systems fail, describing fragmented or insufficient medical guidance; compliance and the complexity of control, shaped by sensory sensitivities, rigid food preferences, family dynamics, and child autonomy; and rejection of one-size-fits-all solutions, emphasizing individualized, iterative approaches over standardized protocols. CONCLUSIONS: Parents face numerous sensory, emotional, and systemic challenges when attempting dietary and nutraceutical therapies for children with ASD. Greater clinical support and more individualized, evidence-informed guidance are needed to help families apply these strategies sustainably and determine which children are most likely to benefit.