Applied Behaviour Analysis (ABA)

About ABA

Applied Behaviour Analysis (ABA) is a therapy that focuses on changing behaviour using learning and reinforcement techniques. Supporters claim it helps individuals, especially autistic people, improve communication, social, and daily living skills (Autism Speaks, 2021).

However, concerns from neurodivergent communities highlight that ABA often prioritises changing behaviours to match neurotypical standards. This raises questions about whether ABA aligns with neurodivergent-affirming practices, which respect differences instead of enforcing conformity.

the history of aba

ABA was developed in the 1960s by psychologist Ivar Lovaas, who initially used strict behavioural interventions, including punishments, to enforce “acceptable” behaviours in autistic children (Lovaas & Simmons, 1969).

Why This is Controversial:

Early ABA focused on compliance and punishment.
Some ABA methods remain controversial today despite evolving over time.
Critics argue that modern ABA still prioritises “normalisation” over acceptance.

Research suggests that these deficit-based approaches can marginalise autistic individuals instead of supporting them (Roberts, 2021).

Recognising these issues is important for promoting affirming, inclusive alternatives.

🤔 Has ABA Evolved?

Although ABA has changed, many autistic individuals still speak about the harm they have experienced from these interventions.

🚨 Ongoing Concerns with ABA-Based Therapies:

Many programs still focus on compliance over consent.
Some interventions push for “normalisation” rather than accommodation.
Research shows that these practices can lead to long-term mental health issues like stress, anxiety, and masking.

Understanding these concerns helps explain why ABA remains a controversial topic among neurodivergent people and professionals.

Exploring Common ABA Approaches

Below are several ABA-based interventions commonly used in different settings. Understanding their goals and concerns can help determine whether they align with neurodivergent-affirming practices.

👉 Click on each section below to learn more.

🕒 Early Intensive Behavioural Intervention

Early Intensive Behavioural Intervention (EIBI)

🕢 Requires 20-40 hours of therapy per week (Reichow et al., 2012).
🆔 Prioritises changing or “normalising” behaviours rather than supporting the child’s identity.
🔥 Intensive programs may lead to burnout and stress, rather than offering flexible, child-led support.

🧠 Early Start Denver Model

Early Start Denver Model (ESDM)

🎯 Aims to target “core traits of autism” by changing brain structure and function (Havlik, 2016).
⚙️ Suggests that autism needs to be “fixed”, promoting ableist beliefs.
🚷 Risks reinforcing stigma and exclusion, rather than valuing autistic strengths.

👀 Pivotal Response Treatment

Pivotal Response Treatment (PRT)

👁 Uses ABA principles to promote eye contact (Carbone et al., 2013).
😖 Research shows that many autistic people find eye contact painful or distressing (Trevisan et al., 2017).
🌈 Enforcing eye contact as a social requirement ignores neurodivergent preferences.

🗣 Functional Communication Training

Functional Communication Training (FCT)

✖️ Teaches specific communication methods to replace “undesirable” behaviours (Applied Behaviour Analysis Edu, 2019).
🔕 If a child does not use the taught method, other communication attempts may be ignored.
📛 This can invalidate a child’s natural ways of expressing themselves, reinforcing the idea that they must comply to be understood.

Why I Won’t Use ABA-Based Therapies

I do not use ABA-based methods in my practice. Instead, I prioritise connection, autonomy, and well-being.

💬 Prioritising Connection Over Compliance

I do not use tactics like stonewalling (Scott, 2019), which push a child toward compliance rather than understanding.
Therapy should be mutual, collaborative, and consent-based.
Shifting away from compliance-based tactics shows individuals that they are valued just as they are.

🎠 Balancing Therapy and Childhood Joy

Children deserve play, rest, and relaxation, not therapy that overwhelms them.
Therapy should add to a child’s well-being, not take away from it.
Even adults struggle with long therapy hours, highlighting the need for balance.

🤝 Moving Beyond Compliance: Promoting Understanding and Consent

Compliance is not the same as consent.
Therapy should focus on understanding and collaboration.
A consent-based approach helps individuals feel safe, supported, and respected.

✅ Validating Emotions for Genuine Support

Ignoring emotions in favour of compliance-based goals can lead to long-term harm (Schreiber & Veilleux, 2022).
Therapy should prioritise emotional validation and understanding, not just behaviour modification.

🌝 Prioritising Emotional Safety in Therapy

Therapy should not cause trauma or emotional distress.
Many ABA-based methods are linked to PTSD (Kupferstein, 2018).
Building trust and safety is key to effective, affirming therapy.

🔬 What About the Evidence Base?

📊 Reliability of ABA’s Evidence Base

While ABA claims to be evidence-based, newer studies raise concerns about its validity.
This highlights the need for further critical review.

⚠️ Weak Evidence in ABA’s Effectiveness

Reichow et al. (2018) found that EIBI may help some autistic children.
However, they also noted that the evidence is weak and unreliable due to small, poorly designed studies.

💰 Conflicts of Interest in ABA Research

Researchers who train others in ABA often fail to disclose conflicts of interest (Bottema-Beutel & Crowley, 2021).
This raises concerns about the accuracy of ABA’s reported effectiveness.

⚕️ Biases Rooted in the Medical Model

ABA research is heavily influenced by the medical model, which focuses on reducing perceived “disability”.
This bias skews research outcomes toward compliance-based goals rather than individual well-being (Autistic Self Advocacy Network, 2021).

🚨 Long-Term Risks of ABA Exposure

Studies, such as Kupferstein (2018), show that adults who experienced ABA have a higher risk of PTSD.
These findings highlight how compliance-based interventions can cause long-term harm.

From Behaviour Control to Self-Understanding: Evolving Approaches in Therapy

Applied Behaviour Analysis (ABA) is considered a first-wave behavioural approach, rooted in behaviourism and focused on observable actions and reinforcement principles (Baum, 2017). While ABA has contributed to understanding learning and behaviour, it has been widely criticised within the neurodivergent community for promoting compliance-based goals and ignoring internal experiences. In contrast, third-wave approaches such as Acceptance and Commitment Therapy (ACT) integrate mindfulness, values, and self-acceptance, aiming to support autonomy and psychological flexibility rather than behaviour control (Hayes et al., 2011). These newer models are far more aligned with neurodiversity-affirming practice, prioritising wellbeing, agency, and authentic self-expression.

Picture Exchange Communication System (PECS)

What is PECS?

The Picture Exchange Communication System (PECS) is a tool designed to help individuals with communication challenges express their needs and wants using pictures. Based on Applied Behaviour Analysis (ABA) principles, PECS encourages individuals to exchange visual cues with a communication partner.

However, PECS has been criticised for its links to ABA techniques and the potential negative effects it may have on neurodivergent individuals (Roberts, 2020). These concerns focus on whether PECS prioritises compliance over authentic communication.

Visual Examples of PECS Cards

PECS uses visual symbols to represent everyday items, actions, and emotions. These cards are intended to support communication by encouraging structured exchanges with a communication partner.

However, critics argue that:

PECS limits communication to requesting items, rather than encouraging expressive language.
The structured exchange format may discourage spontaneous communication.
It prioritises task completion over self-expression.

operant conditioning

The Role of Operant Conditioning in PECS

PECS is closely linked to operant conditioning, a key principle of Applied Behaviour Analysis (ABA). This method, based on B.F. Skinner’s behaviourism theory, focuses on reinforcement to shape behaviour (McLeod, 2024).

example:

When a child uses a picture to request an item, receiving that item acts as a reward, reinforcing the behaviour.
Over time, this is meant to increase communication attempts through PECS.

The Problem:

However, this reward-based approach has raised concerns:

It may prioritise compliance over self-directed communication.
It could limit broader language development, focusing on task completion rather than genuine expression.
It might discourage natural curiosity and self-motivation.

The Impact of PECS on Child Development and Language Learning

Prioritising Compliance Over Autonomy

Operant conditioning rewards certain behaviours while ignoring others, placing a strong focus on conformity. This can:

Reduce a child’s ability to express themselves naturally.
Limit independent decision-making, which is important for healthy development.
Push children to seek external approval rather than recognising their own needs.

Instead of promoting self-directed communication, this structured approach can hinder emotional and social growth.

Limited Generalisation

Behaviours learned through structured, reward-based approaches do not always transfer well across different environments (Jurgens et al., 2009).

For example:

A child may use PECS successfully in therapy sessions.
However, in real-world settings, where reinforcement is inconsistent or missing, they may struggle to communicate.

This lack of generalisation can slow development and reduce long-term success in natural conversations.

Lack of Intrinsic Motivation

When children rely too much on external rewards, they may:

Struggle to develop their own curiosity and desire to communicate.
Engage only for rewards, rather than showing genuine interest in learning.
Find long-term engagement difficult, as rewards become less meaningful over time.

By focusing on internal motivation, therapy can encourage children to enjoy communication naturally.

Emotional and Psychological Impact

Constant reinforcement or punishment in structured therapy can negatively impact emotional well-being.

For example:

Children may feel anxious, stressed, or hesitant if they receive little positive feedback.
They might become fearful of making mistakes or exploring new ways of communicating.

By using a more flexible, responsive approach, children can gain confidence in their communication skills (Miu et al., 2017).

Reduction of Complex Behaviours

Breaking communication down into small, measurable parts (as done in PECS) can oversimplify language learning.

Language is more than just words. It involves:

Understanding context, emotions, and social cues (Chomsky, 1967).
Developing spontaneous, natural interactions.

When therapy prioritises structure over depth, it can limit a child’s ability to engage in meaningful conversations.

Concerns About PECS

While PECS is promoted as a helpful communication tool, several concerns have been raised about its design and impact on neurodivergent individuals.

Disregards the Person’s Autonomy

Many children using PECS rely on physical prompts to exchange their cards initially.

While PECS aims to reduce prompting over time (Besaw, 2023), this raises concerns:

Does the child truly have control over their communication?
Is their autonomy being fully respected?

Professional guidelines from the Health and Care Professions Council (HCPC, 2023) stress that:

“Speech and Language Therapists respect and uphold the rights, dignity, values, and autonomy of service users, including their role in the assessment, diagnostic, treatment, and/or therapeutic process.”

Can Frustrate and Upset the Service User

PECS requires children to exchange specific cards before receiving a response.

This rigid structure can:
☹️ Cause frustration, as children may not be allowed to communicate in ways that feel natural to them.
👎🏽 Strain the therapist-child relationship, making therapy feel restrictive rather than supportive.

A more flexible approach values all forms of communication and ensures children feel heard and respected.

Offers Only a Narrow Range of Communication

While PECS teaches basic requests, it may not support the spontaneous, complex communication needed for everyday life (Roberts, 2020).

Communication involves:

💭 Expressing thoughts, emotions, and personal experiences.
💬 Engaging in fluid, back-and-forth conversations.

PECS focuses primarily on requesting items, meaning:

It may not allow individuals to express their full range of emotions and ideas.
The structured format might limit natural, free-flowing conversations.

The HCPC guidelines state:

“Speech and Language Therapists must modify their own means of communication to address the individual communication needs of service users and remove any barriers to communication where possible.”

This raises ethical concerns about whether PECS fully supports a child’s right to natural self-expression.

Moving Towards More Affirming Approaches

Instead of focusing on structured compliance, alternative approaches should:

💞 Support communication diversity by allowing for flexible expression.
✨ Respect the individual’s autonomy, ensuring therapy does not prioritise compliance over comfort.
🙌🏽 Prioritise meaningful engagement, helping children develop confidence and self-advocacy.

Final Thoughts

While PECS may help some individuals develop basic communication skills, concerns remain about its reliance on ABA principles, its focus on compliance, and its limited flexibility.

By exploring affirming alternatives, we can create more inclusive, respectful communication strategies that:

Encourage spontaneous expression.
Prioritise self-advocacy and autonomy.
Allow all communication methods to be valued.

For more affirming approaches, explore AAC systems that support flexibility and genuine self-expression.

social skills training

what is social skills training?

Social skills training includes various interventions designed to help people improve social skills. These programs are often used with neurodivergent individuals, including autistic people and ADHDers. They typically focus on skills such as making eye contact, taking turns in conversations, and practicing active listening (Brighten Learning, 2024).

Professionals such as teachers, allied health specialists, and ABA therapists often deliver this training, using methods based on Applied Behaviour Analysis (ABA) and Cognitive Behavioural Therapy (CBT) (Brown, 2022). The goal of these programs is to help neurodivergent individuals navigate social situations more effectively by focusing on key social behaviours.

The Problems with Teaching Social Skills

It Reinforces Neurotypical Expectations

Many social skills training programs prioritise neurotypical social norms rather than embracing diverse communication styles. These programs often:

Emphasise making eye contact.
Focus on following strict conversation rules (e.g., waiting for turns).
Encourage staying on “appropriate” or expected topics.

While these expectations may be standard for neurotypicals, they can marginalise neurodivergent individuals, whose natural ways of communicating differ but are equally valid (Choi and Lee, 2013).

It Can Lead to Masking

Social skills training can unintentionally pressure neurodivergent individuals to hide their natural ways of interacting to fit neurotypical norms. Over time, constant masking can cause:

Increased stress and anxiety.
Emotional exhaustion.
Burnout (Chapman et al., 2022).

When social training prioritises compliance over individuality, it may cause harm instead of fostering confidence in authentic self-expression.

It Follows a Medical Model Approach

The medical model of disability focuses on “fixing” differences rather than understanding them. Many social skills interventions:

Suggest that natural neurodivergent traits are unwanted.
Encourage people to change their behaviour instead of fostering self-acceptance.

This approach lowers self-esteem and reinforces the idea that neurodivergent communication is “wrong,” when in reality, it is simply different.

It Creates Stigma

Highlighting the need to “fix” social behaviours suggests that neurodivergent ways of interacting are a problem. This stigma can:

Make individuals feel inadequate.
Damage self-esteem and well-being.
Increase social anxiety (Ali et al., 2012).

Instead of focusing on “correcting” communication, therapy should support neurodivergent self-expression and help create environments that value all forms of interaction.

Why We Shouldn’t Teach "Correct" Social Skills

Bridging Communication Gaps: Understanding the Double Empathy Problem

Traditional social skills training assumes neurodivergent people need to adapt to neurotypical norms. However, the Double Empathy Problem (Milton, 2012) highlights that miscommunication happens on both sides—not just with neurodivergent individuals.

This means:
Neurotypical people also struggle to understand neurodivergent communication styles.
Social struggles are not one-sided—they are the result of mutual misunderstanding.

What is the double empathy problem?

Dr. Damian Milton (2012) introduced the Double Empathy Problem to show that communication issues are not the sole responsibility of neurodivergent people. Instead, both neurodivergent and neurotypical individuals can struggle to understand each other.

By recognising this, we can shift away from expecting neurodivergent people to “fix” their social skills and instead foster mutual understanding and respect. Milton’s (2012) findings are below:

Mutual Misunderstandings:

Neurotypical individuals may struggle just as much as neurodivergent people when it comes to understanding different communication styles.

Communication barriers:

Neurodivergent individuals may process conversations differently, leading to misinterpretations.

barriers to communication:

Social difficulties are not a one-way issue—both neurodivergent and neurotypical individuals must adjust for better interactions.

Reframing Social Expectations

Instead of forcing neurodivergent people to conform, we should:

Recognise the validity of neurodivergent communication.
Shift the focus from conformity to collaboration.
Promote mutual learning and understanding.

What About the Evidence?

Is Social Skills Training Effective?

The evidence for social skills training is limited. A Cochrane review—known for its thorough evaluation of interventions—found that:

No harm was reported in social skills training.
The effectiveness was inconclusive, particularly for teenagers (Storebø et al., 2019).

This suggests that social skills training does not provide strong, consistent benefits, reinforcing the need for alternative approaches.

Social Challenges Extend Beyond Medical Treatments

While medication can help manage certain ADHD traits, it does not address broader social challenges (Storebø et al., 2019). This highlights that:

Social skills cannot be “fixed” with medical treatments.
Support should focus on natural communication rather than forcing compliance.

Tailored Interventions are Necessary

A meta-analysis found that school-based interventions for autistic children had minimal effectiveness (Bellini et al., 2007).
Research shows that traditional social skills programs often fail to support autistic and ADHD individuals (Antshel et al., 2011).

This suggests that tailored, neurodivergent-affirming approaches are more effective than rigid training.

Why Neurotypical Communication Isn’t the Standard

The Unique Dynamics of AuDHD

ADHD and autism frequently co-occur, leading to unique social communication patterns (Craddock, 2024). Recognising these differences can help create better support strategies.

The Intersection of ADHD, Autism, and Epilepsy

ADHD, autism, and epilepsy often overlap (Besag, 2017; Dunn et al., 2016).
Communication challenges in these groups may be influenced by processing speed, cognitive load, or sensory factors (Johnson et al., 2022).

Recognising these multiple neurotypes allows for more inclusive and effective support strategies.

Challenging the Concept of "Normal"

Instead of assuming that neurotypical communication is the default, we should:

Acknowledge that different communication styles are equally valid.
Shift focus from teaching conformity to promoting authentic expression.

Final Thoughts: Embracing Neurodivergent Communication

By moving away from ableist approaches and validating diverse communication styles, we can:

Reduce pressure to mask.
Encourage authentic self-expression.
Create more inclusive social spaces.

For further resources, check out:
My Resources Page
Neurodiversity Hub
Neurodivergent-Affirming Approaches

positive behaviour support (Pbs)

One approach that has gained huge traction in UK schools over recent years is Positive Behaviour Support (PBS). It’s often marketed as a progressive, “evidence-based” method for managing so-called ‘challenging behaviour’, particularly in autistic and ADHD children. Because it sounds positive, many settings adopt it without scrutiny. Most important of all…

The evidence base for PBS is weak!

PBS evidence-base is weak. A systematic literature review by Allen et al. (2022) found that the evidence base for Positive Behaviour Support is notably weak, with many studies lacking methodological rigour, sufficient replication, or robust outcome measures. This raises serious questions about the reliability of PBS as an evidence-based intervention.

What is PBS?

PBS is rooted in the same behavioural principles as Applied Behaviour Analysis (ABA) a method heavily criticised by the neurodivergent community. While PBS is often framed as gentler or more collaborative, it still fundamentally focuses on compliance, external rewards, and the modification of behaviour deemed undesirable by adults (Therapist Neurodiversity Collective, 2024).

Children are often praised for “quiet hands,” “eyes forward,” “being good”, none of which reflect internal wellbeing, safety, or authentic self-regulation.

Why is PBS so widely used?

PBS has grown rapidly across UK education settings. Local authorities often cite it as “evidence-based,” and it is increasingly replacing the involvement of Speech and Language Therapists, Occupational Therapists, and mental health professionals.

Why? Possibly because PBS can be delivered by teaching assistants or school staff without the need to commission clinical services. That makes it attractive from a funding and logistics perspective but it’s not in the best interests of the child.

But what’s the problem with PBS?

PBS might appear neutral or even helpful but in practice, it is:

Compliance-based, not needs-led – focusing on labelling, punishments and surveillancing (Kim and Venet, 2023).
Often focused on making a child look okay, rather than feel okay.
Known to encourage masking, rewarding behaviour like sitting still, suppressing stimming, or making eye contact, regardless of distress.
Delivered in ways that lack meaningful individualisation or understanding of neurodivergent communication and regulation.
We again are not listening to the voices of neurodivergent people who do not recommend the use of PBS (AT Autism, 2024).

We’ve already discussed how many “social skills training” programmes are built on the same idea that neurodivergent communication is wrong and must be corrected. PBS sits in the same category.

Zones of Regulation and alexithymia

A popular tool often used alongside PBS is the Zones of Regulation. While this can be helpful for some, it has significant limitations when used with neurodivergent children especially those with alexithymia, a common experience for autistic individuals and those with ADHD. There is also very little evidence to support its effectiveness (Mason, Leaf and Gerhardt, 2023).

Children with alexithymia often struggle to recognise, label, or describe their internal emotional states. Colour-coded systems that require them to decide what “zone” they are in may not reflect their lived experience. As Kinnaird et al. (2019) note, traditional emotional recognition strategies can be ineffective or even distressing for those with alexithymia.

Instead of colour-coding, more supportive approaches include:

Tapping into energy states (“I feel fast” / “I feel heavy”) (Autism Level Up has great resources for this!)
Sensory-based awareness work
Collaborative sessions with SLTs and OTs to build interoceptive understanding and co-regulation skills
Emphasis on supporting, not fixing or correcting, the child’s way of being

Is PBS really evidence-based?

PBS is often described as evidence-based, but the reality is more complex. Much of the research:

Focuses on short-term behavioural outcomes, not long-term wellbeing
Lacks diversity and lived experience input
Doesn’t explore impact on mental health, masking, or identity development

Put simply, we must question whether PBS is being used because it’s effective, or because it’s cost-effective.

Teachers are not therapists—and shouldn’t have to be

Let’s be clear: this is not a criticism of teachers. Teachers are working incredibly hard, under immense pressure, often without the training or support they need.

But increasingly, teachers are expected to deliver interventions that were previously the remit of SLTs, OTs, and therapists particularly for children with additional needs such as speech, language, communication differences, sensory regulation needs, or trauma histories.

This blurring of professional boundaries means:

Children aren’t getting the specialist support they need.
Teachers are being expected to act outside their remit.
As a Speech and Language Therapist, I would not walk into a classroom and try to teach a group of 30 children literacy or maths. That’s not my expertise. In the same way, teachers are not trained healthcare professionals, and they shouldn’t be expected to take on those roles just because services are being stripped back.

A better way forward

If we truly want to support neurodivergent children, we need to move away from compliance-based behaviour systems and towards connection, collaboration, and co-regulation.

That means:

Involving SLTs, OTs, and therapists who understand neurodivergent development
Listening to lived experience and self-advocacy voices
Prioritising wellbeing and autonomy, not just behaviour modification

PBS, no matter how it’s rebranded, is still rooted in ABA. It cannot be neurodiversity-affirming.

Our children deserve better. And so do the educators trying to support them.

Why This Matters, Compliance and Vulnerability

Moving away from compliance-based or behaviour-focused approaches isn’t only about supporting autonomy, it’s also about safeguarding.

Research indicates that neurodivergent individuals are often at increased risk of victimisation through emotional, relational or coercive harm (Brake et al., 2024). Masking or compliance-based behavioural expectations increase vulnerability by suppressing self-advocacy and boundary skills, heightening risk in interpersonal relationships (Zaks, 2025). Children and adults with neurodevelopmental differences also experience higher rates of complex trauma, especially when interventions focus on compliance rather than authentic self-expression (Kalisch et al., 2024).

These findings highlight why it’s so important to prioritise agency, consent and communication-based approaches within education and therapy. To explore how coercive dynamics can develop, and how language-focused, ACT-informed support can aid recovery — visit my Neurodivergence and Abuse page.

references by category

neurodivergence and autism

Milton, D. (2012). On the ontological status of autism: the ‘double empathy problem’. Disability & Society, 27(6), pp.883–887.
Anderson, L.K. (2022). Autistic experiences of applied behaviour analysis. Autism, 27(3), pp.737–750.
Roberts, J. (2021). Neurodiversity and Autism Intervention (ABA) can’t be reconciled. [Online] Therapist Neurodiversity Collective.
Trevisan, D.A., Roberts, N., Lin, C., & Birmingham, E. (2017). How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? PLOS ONE, 12(11).
Reichow, B., Barton, E.E., Boyd, B.A., & Hume, K. (2012). Early intensive behavioural intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews.
Kinnaird, E., Stewart, C. and Tchanturia, K. (2019). Investigating Alexithymia in autism: a Systematic Review and meta-analysis. European Psychiatry, 55(1), pp.80–89.

adhd and overlapping conditions

Antshel, K.M., Polacek, C., McMahon, M., et al. (2011). Comorbid ADHD and Anxiety Affect Social Skills Group Intervention. Journal of Developmental & Behavioral Pediatrics, 32(6).
Dunn, D., Williams, A., Giust, J., & Kronenberger, W. (2016). Epilepsy and attention-deficit hyperactivity disorder: links, risks, and challenges. Neuropsychiatric Disease and Treatment.
Ginapp, C.M., Greenberg, N.R., MacDonald-Gagnon, G., et al. (2023). The experiences of adults with ADHD. SSM – Qualitative Research in Health.
Besag, F. (2017). Epilepsy in patients with autism: Links, risks and treatment challenges. Neuropsychiatric Disease and Treatment.

communication and social skills

Lovaas, O.I., & Simmons, J.Q. (1969). Manipulation of self-destruction in three retarded children. Journal of Applied Behaviour Analysis.
Bottema-Beutel, K., & Crowley, S. (2021). Conflicts of Interest in ABA Autism Literature. Frontiers in Psychology.
Havlik, K. (2016). The Early Start Denver Model. [Online].
Hotchkiss, L. (2023). Myths & Misconceptions about PECS®. Pyramid Educational Consultants.
Roberts, J. (2020). The Problem with PECS®. Therapist Neurodiversity Collective.

ableist approaches

Many interventions for neurodivergent people aim to improve well-being and help them adjust to environments that often fail to meet their needs. However, when these interventions focus on “normalising” traits instead of offering meaningful support, they can cause harm.

For example, approaches that focus on holding back natural behaviours instead of understanding them can leave individuals feeling misunderstood and under significant stress.

Defining ableist approaches

An ableist approach occurs when interventions push neurodivergent people to fit neurotypical standards. Instead of promoting acceptance and inclusion, these methods often overlook or dismiss real neurodivergent expression.

What Are Ableist Approaches?

Ableist approaches appear in schools, workplaces, and therapy settings, where neurodivergent people are pressured to fit neurotypical standards.

🚫 Instead of promoting inclusion, these approaches:

👤 Focus on making behaviours appear “normal”
💪🏾 Ignore the person’s strengths and needs.
💔 Cause harm by dismissing neurodivergent differences.

the long term impact

Many neurodivergent adults report trauma from these interventions (Anderson, 2022).
These stories highlight the need to prioritise inclusive, supportive practices that respect neurodivergent identities.

Ableist Approaches and Deficit-Based Views

Many ableist interventions frame neurodivergent traits as problems that need “fixing” instead of natural differences.

🚨 The Deficit-Based Mindset

Encourages hiding or changing natural behaviours.
Creates pressure to avoid negative attention.
Ignores the person’s true expression

📌 Over time, these pressures can:

Masking as a Response to Ableism

📌 Over time, these pressures can:

Harm mental and emotional well-being
Lead to increased stress, anxiety, and burnout
Force individuals to conform rather than thrive

Instead of forcing neurodivergent people to meet external expectations, we should focus on valuing their differences and strengths.

Masking, the act of hiding neurodivergent traits to fit in, often happens due to teasing, rejection, or judgment. While masking can help people navigate certain situations, long-term masking has serious consequences.

The Hidden Costs of Masking:

Higher stress and anxiety
Loss of connection to one’s true self
Mental health struggles (Ginapp et al., 2023)

☀️ A Better Alternative:

Instead of encouraging masking, we should use supportive approaches that:
🎨 Allow for natural self-expression
🌈 Recognise and accommodate neurodivergent needs
💫 Help individuals build confidence in their authentic selves

📃 Research Highlights:

Supportive, affirming environments reduce stress and anxiety.
Approaches that value self-expression help build resilience and confidence (Miller, Rees & Pearson, 2021).