Bodies exist. Brains exist. Nervous systems exist. These are concrete, biological realities. And like any biological reality—height, digestion, eyesight—they exist on spectrums. One person’s nervous system might be wired to find certain sensory inputs overwhelming. Another person’s executive function might have a particular relationship with time, task initiation, and reward.

So what, then, is ASD? What is ADHD? They are not objects we can put under a microscope and point to. They are diagnostic categories. They are clusters of neurological traits—things like attention regulation, social communication styles, sensory processing, hyper-focus, rejection sensitivity, and stimming—that have been bundled together by a medical and psychiatric system. And that system does not exist in a vacuum. It exists within a specific historical and economic context.

We have to ask a pointed question: why were these particular bundles of traits ever deemed a “disorder” in the first place? The word “disorder” is not a neutral, purely scientific term. It implies a deviation from some norm, and we have to ask whose norm, and why. The answer, on closer inspection, is that the norm being enforced is essentially the ideal worker and consumer.

Think about what society actually requires from people. It requires standardised schedules: the nine‑to‑five workday, the school bell, the rigid timetable. When someone’s neurology means they experience time differently, or their natural body clock simply does not conform to a factory‑friendly rhythm, that difference does not just become inconvenient—it gets reframed as a pathology, because it conflicts with the needs of the production line and the office.

Society also requires a very specific kind of sustained, uniform attention—the ability to sit still, perform repetitive tasks, and concentrate on whatever our employer assigns us for eight hours straight. A brain that craves novelty to function, or that hyper-focuses passionately on a subject of personal interest rather than the assigned spreadsheet, becomes a liability in that context. And so we name it a “deficit” and treat it as something to be corrected.

Beyond schedules and attention, society also demands a particular style of social compliance—the ability to navigate unspoken corporate rules, perform deference to authority figures, and engage in the small, often dishonest rituals of professional life. A person whose neurology leads them toward direct communication, who finds arbitrary eye contact uncomfortable, or who has a deep sense of justice that resists pointless authority, gets labelled as socially “disordered.”

The crucial insight here is that the “disorder” is not the trait itself. The disorder lies in the mismatch between the trait and the demands of a mode of production that prioritises profit, uniformity, and control over genuine human well‑being. The environment is doing most of the disabling work, but we keep pointing the finger at the individual.

When someone is described as “having” ASD or ADHD, the dominant way of thinking turns a dynamic, relational experience into a fixed, internal essence. It says, in effect, “this person is broken in this specific, named way,” as if the diagnosis were some object they are permanently carrying around inside them. Philosophers have a word for this kind of move: reification, which simply means taking a process—something fluid and relational—and treating it as if it were an essential component.

A materialist perspective does the opposite. It says that we are not our diagnosis. We are people with particular sets of neurological traits—a unique sensory profile, a specific way of processing information, a particular relationship to social reciprocity. The society we inhabit interprets that unique configuration of traits as a deficit. It groups our traits with those of others who face similar mismatches with the dominant system, applies a clinical label, and then uses that label to gatekeep resources, justify normalisation efforts, and explain away our marginalisation.

What we call “accommodations” today are really retrofits: small, grudging adjustments made after a design has already excluded most people. Inclusive, human‑centred design says: don’t build the exclusion in the first place. When we design a workplace, we shouldn’t assume one kind of focus, one schedule, one communication style. We should design for variability, because variability is the reality of human biology. It is simply good design that recognises who actually exists.

None of this means the traits themselves are not real. But we have to ask the right question about them. Why is a person with a particular sensory profile experiencing overload? Is it simply an inherent, tragic feature of their neurology? Or is it because they are forced to exist in environments—open‑plan offices, fluorescent‑lit stores, overcrowded and under-funded schools—that were designed for maximum efficiency and minimum cost, with zero consideration for the full range of human neurological difference? The problem is in the world built around us.

This is where the concept of human‑centred design becomes important. Design—whether of workplaces, schools, public spaces, or social norms—is never neutral. Today, most environments are designed around efficiency, standardisation, and the lowest common denominator of cost. Human‑centred design flips the priority: it starts with the actual diversity of human bodies, brains, and nervous systems, and asks how the environment can flex to accommodate that diversity, rather than demanding that people conform to the environment. It is the difference between designing a classroom with fluorescent lights that can’t be dimmed because it’s cheaper, and designing one with adjustable lighting, quiet zones, and flexible seating as the baseline, not as a special accommodation.

Under a genuinely different material reality—one not organised around profit, scarcity, and rigid hierarchy—the very concept of a neurological “disorder” would begin to dissolve. This is not a vague utopian wish; it is what happens when we apply inclusive, human‑centred design at every level. In a society organised around human need rather than profit, a person with heightened sensory sensitivity would not face a world of hostile, overstimulating environments and then be told the problem is theirs to fix. Instead, environments would be flexible and accommodating as a default, not as a special favour someone has to fight tooth and nail to receive. People with different work rhythms could function according to their own natural focus cycles rather than an industrial clock. People with direct, literal communication styles would not be penalised socially, because directness and honesty would be understood as valid and valuable ways of engaging with the world, not as signs of a social deficit.

With all of this in mind, to say “I have ASD” is, in a sense, to accept a label produced by the very system that is disabling us. It is a clinical, administrative term, invented within a particular economic and historical moment. To instead say “I am a person with these specific traits—sensory sensitivity, pattern recognition, deep focus, a non‑normative social style—and the society I live in pathologises and clusters those traits into a category called autism” is to reclaim our material reality from that system. It is to insist that the core of who we are is not a diagnostic label, but a unique, complex, and ever‑changing constellation of our actual being, in constant interaction with the material world around us.

The way forward is building a world where the full range of human neurology is not merely tolerated on paper, but actively accommodated and genuinely valued. We do not need to medicate people into fitting the machine. We need to build a world that was made for all bodies and all minds. That is what inclusive, human‑centred design means: not retrofitting exceptions, but building from the start for the full range of human neurology.