Journal of Nursing, Social Studies, Public Health and Rehabilitation X:X | DOI: 10.32725/jnss.2026.017

Adaptation of autistic clients to weekly residential care

Blanka Ježková¹, Alena Hricová ORCID...^{1, 2, *}

¹ Prague College of Psychosocial Studies, Prague 4, Czech Republic

² University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, Institute of Social and Special-paedagogical Sciences, České Budějovice, Czech Republic

Objective: To explore how adaptation to weekly residential care unfolds for autistic clients and to identify practices that support clients, family caregivers, and direct-care staff during the transition.

Methods: A qualitative multiple-case study was conducted in a weekly residential social service in the Czech Republic. Two clients - one adolescent and one young adult - were followed during staged adaptation. Data comprised more than 330 structured staff records, four interviews with family caregivers and key workers, routine service documentation, and reflexive records. Analysis combined chronological case reconstruction with reflexive thematic analysis: data-near codes were clustered into candidate themes and iteratively checked across sources and cases. Rating scales were used only to orient the chronology and prompt closer reading of accompanying narrative records.

Results: Four themes were identified: a prepared and adjustable pathway; individualised communication and sensory support; family participation bridging home and service; and staff adaptation supported by psychological safety. One trajectory was smooth, whereas the other included a temporary setback requiring slower pacing and reduced stimulation. Repeated review of information from several actors enabled timely adjustments. Staff uncertainty varied more by role and responsibility than by client.

Conclusion: In these two cases, adaptation appeared to be shaped by a relational and organisational process rather than by client factors alone. Social assessment, gradual exposure, flexible pacing, individualised communication, active family partnership, and accessible support for key workers operated as mutually reinforcing components that merit examination in larger and more diverse samples.

Keywords: Autism; Family caregiver; Residential social service; Social work; Staff support; Transition

Conflicts of interest:

Blanka Ježková was employed as the manager and social worker of the study service during data collection. This dual role is disclosed as a potential non-financial competing interest. Alena Hricová declares no competing interests. Neither author declares a financial conflict of interest.

Received: July 26, 2026; Revised: September 25, 2026; Accepted: October 19, 2026; Prepublished online: October 19, 2026