Abstract
Abstract Background Autism care in Kazakhstan continues to develop amid limited training, unclear referral systems, and uneven provider readiness. While gaps in formal infrastructure have been well documented, the informal adaptations used by families and Physicians have received less attention. Aim To explore how informal learning, peer knowledge, and role modelling shape autism diagnosis and care in Kazakhstan, by examining the everyday behaviours and improvised routines that form a hidden curriculum alongside formal systems. Methods This study uses secondary analysis of two datasets: semi-structured interviews with parents of autistic children (n = 10), and national survey data from parents (n = 190) and physicians (n = 110). A concept-driven thematic analysis was applied to both interview and survey responses to identify recurring informal behaviours and decision-making patterns. Descriptive survey statistics were used to contextualise these qualitative findings. Results Parents frequently reported being left without post-diagnostic guidance, prompting them to rely on social media, peer groups, and personal networks. Physicians, especially those early in their careers, described relying on observation or mimicking more experienced colleagues in the absence of formal training. These behaviours reflect a hidden curriculum, unofficial but influential practices that shape practices that lead to inconsistent post-diagnostic guidance. Conclusion In Kazakhstan, informal knowledge-sharing and improvisation often affect care consistency or outcomes. These practices help fill urgent gaps but also introduce inconsistencies and shift burdens onto families, especially mothers. Policy and training reforms must acknowledge and address these informal structures to improve equitable care.