Why PBS is harmful for Autistic and Neurodivergent young people (Part 1)
Today we’re joined by guest contributor, Helen Edgar, Founder of Autistic Realms, a platform for neurodiversity-affirming education, training, and community resources. In Part 1 of this blog for our ‘AGAINST PBS & ABA’ campaign, Helen explores the harmful impact PBS can have on Neurodivergent young people.
As an Autistic adult, parent to Neurodivergent children, and former Special Educational Needs and Disabilities (SEND) teacher, I’ve spent years navigating systems that claim to support inclusion while enforcing conformity. Among these, Positive Behaviour Support (PBS) is one of the most pervasive and harmful practices used with Autistic and Neurodivergent children in UK schools, care settings and recommended on parenting courses. Often viewed as a gentler alternative to Applied Behaviour Analysis (ABA), PBS retains the same harmful foundations: compliance, control, and behavioural modification.
Despite it’s ‘positive’ branding, PBS is not and cannot be neurodiversity-affirming. It is a behaviourist framework rooted in trying to make Neurodivergent children fit into neuronormative expectations and values through external rewards and sanctions. PBS teaches and reinforces that a young person’s natural ways of being are wrong. Rather than being supportive, PBS often leads to masking, burnout, and trauma.
The behaviourist roots of PBS
PBS emerged directly from ABA, a model built to change behaviour through external reinforcement, not to understand or affirm a person's internal state and authentic identity. Though some see PBS as a more compassionate alternative, the difference is one of aesthetics: pretty packaging, cute-looking children’s games, and social stories all with the aim that ‘challenging behaviour’ or different ways of being must be corrected. Observable compliance is still the ultimate goal.
As Gore et al. (2022) state, “PBS is not intended for persons identifying as neurodivergent”. Yet, these approaches are widely applied to Neurodivergent pupils without acknowledging the mismatch in values, experiences, and communication styles. PBS strategies such as token systems, reward charts, and certain social stories are often packaged in a sugar coating: teachers can be swept up into thinking that they are really helping young people. However, when you dig a bit deeper, the underlying message of PBS is that a child’s acceptance is dependent on behaving like a neurotypical person. PBS reinforces that Autistic people are not good enough as they are, and it can increase the feelings of shame that they experience.
Masking and burnout
One of the most harmful consequences of PBS is the encouragement of masking. Masking is the act of suppressing natural needs and sensory signals to meet external expectations. PBS reinforces masking behaviour. Children praised for ‘good sitting’ or ‘whole-body listening’ may, in fact, be frozen in anxiety, dissociating, or trying desperately to avoid punishment. When children perform compliance while suppressing their distress, the result is often long-term harm, and they will not be in any meaningful space to engage with learning.
PBS and educational practice
Reinforcing desirable behaviour and ways of communicating and socialising becomes especially dangerous when it ignores or overrides a child’s internal experience. Reflecting on my own past practice as a teacher, which was rooted in behaviourist approaches in my teacher training, I now recognise how common praise for quietness or eye contact may have reinforced survival strategies, rather than supported authentic engagement.
I used PBS strategies myself before I knew better. I have had to unlearn a lot of my teacher training and re-learn other ways of supporting Autistic people. PBS may appear to ‘work’ on the surface, and show results, but we need to consider the cost of this apparent progress. Too often, compliance masks shutdown and doesn’t allow space for real learning and growth. What looks like progress may be performance that comes at the cost of a child’s wellbeing. As teachers, parents and professionals, we can only do the best we can with the knowledge we have at the time, but when we know better and know about the harm of PBS, we need to start thinking of alternative ways and practices. We need to think of better ways of connecting with children, that honour their authentic ways of being and builds trusting relationships.
Despite its name, PBS is not trauma-informed and is not positive. Practices such as ‘planned ignoring’, holding back desired items until communication occurs in a prescribed manner and rewarding communication, sensory and social compliance to neuronormative standards and ideas fail to respect the reality of trauma and distress many Neurodivergent children experience.
Research has shown that behaviourist approaches are linked to long-term harm. Anderson (2023) and Kupferstein (2018) both document increased PTSD symptoms, anxiety, and suicidal ideation in Autistic individuals subjected to ABA-style interventions. What looks like gentle support may be really traumatising.
References
Anderson, L.K. (2023). Autistic experiences of applied behaviour analysis. Autism, 27(3), 737–750.
Gore, N. et al. (2022). Positive Behavioural Support in the UK: A State of the Nation Report. Int. J. of Positive Behavioural Support, 12(1), 3–16.
Kupferstein, H. (2018). Evidence of increased PTSD symptoms in autistic adults as a result of ABA. Advances in Autism, 4(1), 19–29.
