Our principles

The National Autistic Society wants to bring joy, independence and the best quality of life to the autistic children and adults we support – we want each person to be themselves, be safe and fulfil their potential. These values underpin the decisions we make about the support we provide, the advice we give and the changes we campaign for. We fundamentally believe support should: 

• always be person-centred and promote autistic people’s dignity
• keep people safe, healthy and happy
• enable autistic people to do the things they love
• never try and make someone ‘less autistic’, which is impossible anyway
• never use punishment. 

Support should always be guided by and built around each individual and their strengths, challenges and interests, combining elements of different approaches and frameworks as appropriate. This should always be based on the best available evidence, including NICE guidelines, and delivered by someone who understands autism. We will not use, condone, or promote anything that goes against these principles. 
 

What we think about PBS

We use a range of support in our schools and adult services. One of these is Positive Behaviour Support (PBS). PBS is a widely used and person-centred approach to identifying and meeting a person’s support needs, in particular if someone is distressed and at risk of harming themselves or others. PBS is most commonly used to support people with learning disabilities, some of whom may also be autistic. Practitioners should follow the PBS Framework, which sets out how to deliver good quality support.
  
It is based on working with the individual and their support network to understand why someone is distressed, the impact their environment has on them and the best ways to keep them safe and happy. For instance, if someone becomes distressed during unstructured times, the professional would work with them to develop a personalised schedule of activities, helping them to choose how to spend their time. This would reduce anxiety created by unstructured time.

PBS is just one approach the National Autistic Society uses to support some people in our schools and services. This is alongside other support strategies and interventions, as advised by speech and language therapists, occupational therapists and psychologists, in consultation with the individual and their support networks. There isn’t a single form of support that works for autistic children and adults, because people have different and varying needs. In deciding what types of support to offer, we always follow the best available evidence, as well as latest guidance and advice from governments and regulators, and continually evaluate what we do.
 

What we think about ABA

We are sometimes asked about PBS and how it relates to another kind of intervention called Applied Behaviour Analysis (ABA). 

ABA is a term for interventions that are based on observing and understanding people’s behaviour. Every ABA-based intervention is based on identifying why people act in certain ways and how the environment around them could affect their actions. Because it is a broad approach which first emerged in the mid-twentieth century, ABA interventions have changed over time and have ranged from: 

• using encouragement and rewards
• making small changes to the environment (for example, reducing bright lights or loud noises)

to:

• early intensive behavioural interventions
• trying to ‘treat’ autism
• cruel methods that use punishment.

Some early forms of ABA were barbaric, including even the use of electric shocks. We would never, ever allow anything like this to be used in the UK today. People are rightly concerned and angry that such interventions were ever used: we are too, and we call them out if we see them. 

ABA is now one of the most researched of all autism approaches, but there are significant limitations and gaps in the research, particularly about long-term effects.

People’s views about ABA are strongly polarised. Some point out that ABA has developed considerably, can help people develop vital life skills and help them stay safe. Others fundamentally opposed and report being traumatised by its use. It is also clear that there is significant variation in the quality of training, practice and formal guidance. As with any support, these things are vital.  

We do not support any intervention that follows one-size-fits-all approaches, or that goes against the principles we outlined at the top of this page, and we believe that some ABA interventions used today are not sufficiently person-centred and are too intensive. 

Some types of other support have evolved from early practices of ABA. While they still rely on observing the way people act in certain situations, they focus on being person-centred and positive in their approach. This includes PBS, which first emerged in the 1980s in response to rising concern over the use of punishment and restrictive strategies in intensive ABA practices.

As set out in our principles at the top of this page, we also do not support interventions of any kind that use punishment or try to make people ‘less autistic'. That is wrong and it is impossible to make someone less autistic. 
 

Research into PBS

When PBS is used in line with the PBS Framework, by well-trained staff in a person-centred way, it can – alongside other support – help some people we support to feel less anxious or distressed in certain situations. 

We also believe that there needs to be more research into PBS. Most research is based on the experiences of people with a learning disability, and in our services PBS is mainly used to support autistic people with a learning disability. We are always reviewing what we do. We plan to partner with independent academic researchers and autistic people so we can help contribute to the research base and continue to improve our services and the support we offer.