Recently, there have been numerous occasions where these topics have come up with PBSUK. This is perhaps unsurprising given the field in which we work! Several of us attended Dr Damian Milton’s talk regarding these topics before Christmas (hosted by the Tizard Centre, you can find the talk on their YouTube channel). We also met with Armando Bernal to discuss running a neurodiversity-affirming business (amongst other things). As an autistic Behaviour Analyst, Armando always has an interesting perspective (Armando has been providing supervision sessions to PBSUK for several years now, and we really value his expertise). Many of us at PBSUK have also been contributing (in various forms) to the PBS Special Edition of the Tizard Learning Disability Review. Of course, neurodiversity has arisen frequently in this respect as well (including in an article regarding implementing Skills-Based Treatment; Price, Newcombe & Lyon, 2026. Link in reference list!).
One of the questions that Dr Milton was asked at the end of his talk, was what the PBS field can do to acknowledge and take responsibility for the distress autistic people have experienced from poor or harmful implementations of PBS. In many respects this question led me to think of the experiences described by Quinn (2025), which I found both moving, and harrowing. Quinn (2025) hints at invalidating responses, dismissing what she experienced as “not PBS”, and requests curiosity and openness from those reading the article. I resonated with this request when I originally read this article (and still do), as in many respects this attitude cuts through the binary for / against discourse so frequently encountered regarding PBS and ABA. However, returning to the question that was put to Dr Milton, I don’t think it should be considered invalidating to also apply the same ‘curiosity’ to the question of why PBS has been poorly, or even harmfully, implemented. Neurodiversity and neurodiversi…
With respect to Quinn’s personal experiences, I can’t comment on why their experience was so awful (I wasn’t there, I didn’t experience these things, and I don’t know the thoughts or intentions of the professionals who were involved). However, considering the reasons for poor or harmful implementations of PBS more broadly, this article made me think of several other issues. Firstly, Quinn (2025) referenced Price et al., (2024) multiple times. It struck me that there are many similarities between the experiences described by Quinn (2025), and those described by people in receipt of mental health services, captured within this researcher’s catalogue of work. Despite their research not relating to PBS (or even support delivered to autistic people), similar mechanistic, dehumanising approaches are described. Neurodiversity and neurodiversi…
The experiences described by Quinn (2025) are deeply concerning. As are other autistic people’s accounts of harm arising from behavioural intervention (e.g., Anderson, 2022). It’s also important to note that expertise regarding behavioural science alone is not sufficient. For practitioners working with autistic people (with or without co-occurring learning disabilities), they must also have extensive knowledge of the population they are supporting (as outlined in the UK-SBA code of ethical and professional conduct), as well as a humble and reflective outlook on their work. This should absolutely include knowledge of the criticisms and concerns raised by autistic people (we cannot be neurodiversity-affirming, without listening to the criticisms raised by neurodivergent people, whether we agree or not…). Neurodiversity and neurodiversi…
When asked if his views on ABA and PBS had changed following hosting ABA–PBS–Behaviourism: The Big Autism Conversation, Jules Barton from Autistic Radio (quoted in Bowring, 2025, p. 47) stated:
“I saw a wild west frontier science that has a long way to progress before reaching a mature orthodoxy, and I still see that. The hopeful change I see is a tiny group of behaviourist-informed professionals willing to use autistic people as a source of inspiration, as partners, rather than subjects.” Neurodiversity and neurodiversi…
This is pretty well aligned with my own concerns regarding our field. My perspective is that there must be accountability and transparency regarding the qualifications and experience of those delivering PBS services. In the UK therefore, being registered with the UK-SBA should be a necessity, not a choice. Whilst the situation where any professional, service, or organisation can “say” they are delivering PBS without having to demonstrate that they have the necessary qualifications and experience, it seems inevitable that accounts of poor practice and / or harm will arise. That is not to invalidate the experience of those who report such accounts – as a field, we must take ownership of these issues. “That’s not PBS” isn’t a reasonable defence, if we are not actively trying to prevent such situations arising (i.e., if we act as passive bystanders to poor practice being delivered under the banner of ‘PBS’). Neurodiversity and neurodiversi…
Finally, returning to the conversation with Armando… We discussed the same question that was put to Dr Milton. Armando highlighted that our approach to human behaviour and experience can only be considered a “science” if it is continually evolving and improving. The moment it becomes static, it is no longer a science of behaviour. As such, the curiosity regarding criticisms of our field advocated by Quinn (2025), isn’t a choice, it’s a necessity. Neurodiversity and neurodiversi…
Huw Price
PBSuk Associate Director
Jan 2026 Neurodiversity and neurodiversi…
References
Anderson, L. K. (2022). Autistic experiences of applied behavior analysis. Autism, 27(3), 1–14. Neurodiversity and neurodiversi…
Bowring, D. (2025). Autistic Radio’s ‘ABA–PBS–Behaviourism: The Big Autism Conversation’ – an interview. International Journal of Positive Behavioural Support, 15(1), 45–51. Neurodiversity and neurodiversi…
Care Quality Commission. (2020). Out of sight – who cares?: Restraint, segregation and seclusion review. Neurodiversity and neurodiversi…
Friman, P. C. (2021). There is no such thing as a bad boy: The circumstances view of problem behavior. Journal of Applied Behavior Analysis, 54(2), 636–653. Neurodiversity and neurodiversi…
McGill, P., Bradshaw, J., Smyth, G., Hurman, M., & Roy, A. (2020). Capable environments. Tizard Learning Disability Review, 24(3), 109–116. Neurodiversity and neurodiversi…
Milton, D. E. M. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887. Neurodiversity and neurodiversi…
Price, H., Newcombe, H., & Lyon, K. (2026). Implementing skills-based treatment in naturalistic contexts. Tizard Learning Disability Review, 1–11. Neurodiversity and neurodiversi…
Quinn, A. (2025). Relationships of concern: The perils of the progress paradox in Positive Behavioural Support. International Journal of Positive Behavioural Support, 15(1), 35–44. Neurodiversity and neurodiversi…
