🧬 Session 16: Medical Model vs. Neurodiversity vs. Cognitive Ecology
🌿 Transformative Education for Neurodivergent Liberation

📌 If you’re just joining us, I recommend reading [Session 1 – Why I’m Leading This Workshop (My Positionality)] for shared agreements and to understand how this space is held.
🧭 I Entered Through the Side Door
I earned my psychology degree in 2021—and yet, I don’t remember ever truly learning about autism. We skimmed neurodevelopmental disorders. We memorized diagnostic criteria. But we never explored autism as identity, as a lived reality, or as a meaningful way of being in the world. And the word neurodivergence? Not once.
My program focused on addiction. Which, in hindsight, makes sense—many neurodivergent people navigate substance use as a survival strategy in a world that misunderstands them. I now realize I was studying the downstream consequences of a system that never recognized the upstream cause: cognitive difference met with systemic misattunement.
I shared classes with students in an Applied Behavior Analysis (ABA) track. At the time, I didn’t know what ABA really was. But I remember how tense our shared discussion posts became. They spoke in clinical terms—compliance, maladaptive behavior, extinction. I didn’t have the language yet, but I had the instinct: Something about this is off.
I didn’t discover the word neurodivergence in a textbook. I found it in trauma-informed workshops. In community spaces. In conversations that felt like truth. And slowly, I noticed a pattern: the people I trusted and felt at home with—mentors, friends, colleagues—were all Autistic, ADHD, gifted, or some alchemy of all three.
I’d been identified as gifted as a kid, but nothing ever came of it. That’s what happens when you’re lower-income and white. No resources. No support. Just a label with nowhere to land.
So I started reading about adult giftedness. And it felt like coming home.
Eventually, I enrolled in a psychoeducational workshop on gifted trauma—and it cracked something open. For the first time, my brain wasn’t a problem to be managed. It was a system to be understood.
That doorway led me to autism.
An autistic friend mirrored me back to myself so clearly that I couldn’t unsee it. I pursued a diagnosis—not for permission, but for language. And I got it. But that also meant being ushered into the clinical realm of the medical model… at the same time I was encountering the liberatory language of neurodiversity.
Both offered value.
But neither was enough.
The medical model gave me access—but through a lens of deficiency.
The neurodiversity movement gave me community—but sometimes flattened complexity into celebration.
I needed something more.
A model that could hold both the pain and the pattern.
The trauma and the brilliance.
The truth of difference—and the reality of systems.
That’s what led me to develop the Cognitive Ecology Model.
Not as a rejection. But as an expansion.
🧠 Autism Wasn’t Discovered. It Was Constructed.
The word autism might sound like a stable category—but it isn’t. It never has been.
What we now call autism has been shaped over decades—through science, culture, politics, and power. It’s been defined and redefined by whoever held the mic at the time: psychiatrists, researchers, institutions, parents—and more recently, autistic people ourselves.
Critical Discourse Analysis reminds us:
Autism isn’t just described. It’s narrated.
It’s narrated by institutions trying to contain difference.
By researchers attempting to quantify it.
By systems built to categorize, treat, and manage what doesn’t conform.
For most of the last century, the dominant narrative was deficit.
In the DSM, autism is defined by what we lack:
“Persistent deficits in social communication...”In behaviorism, we were subjects to be corrected.
In education, we were framed as burdens or puzzles.
Even the neurodiversity movement—which was a profound turning point—has limits. Its language has been co-opted. Its visibility diluted into slogans. Its liberatory roots often clipped by institutions eager to brand themselves “inclusive” without shifting any actual power.
That’s where the Cognitive Ecology Model steps in.
Not to reject these histories. But to recontextualize them.
To ask a deeper question:
Not just “What is autism?”
But “Who got to decide?”
And what becomes possible when we begin to decide for ourselves?
🧭 From Static Identity to Dynamic Relationality
The Medical Model asks:
How do we fix this person so they can function “normally”?
The Neurodiversity Paradigm asks:
How do we affirm this identity and challenge the systems that marginalize it?
The Cognitive Ecology Model asks:
How is this person’s way of being shaped by their environment, their history, their culture, and their relationships?
And what do they need to feel safe enough to be their whole self?
Where the medical model relies on pathology
and the neurodiversity paradigm centers affirmation—
the Cognitive Ecology Model seeks integration.
It doesn't treat the self as separate from the system.
It holds the inner world and the outer world in relationship.
It sees needs as relational, not fixed.
It recognizes that "functioning" is often just a measure of environmental fit.
CEM doesn’t throw out what came before.
It builds on it.
It weaves it.
It asks:
What’s the truest thing now?
🧶 Real-World Scenario: Disclosing Autism at Work
Let’s say an autistic adult decides to disclose their diagnosis after experiencing sensory overwhelm and communication breakdowns in meetings. How their truth is received—and what happens next—depends entirely on the model shaping the response.
🧪 Medical Model Response
“Thanks for telling us. Please provide documentation so we can determine what accommodations you qualify for. We can offer noise-canceling headphones or a quiet room, but you’ll still need to meet standard performance expectations.”
Framing:
You’re broken. We’ll make a few exceptions so you can perform as if you’re not.
Message received:
Your needs are only valid if they’re documented, measurable, and convenient for the system.
🧠 Neurodiversity Paradigm Response
“We value neurodivergent perspectives. Let us know how we can support and affirm your identity here.”
Framing:
Your brain works differently—and that’s okay. We accept that.
Message received:
We celebrate you, but it’s still on you to do the explaining. To show your value. To make the bridge.
🌿 Cognitive Ecology Model Response
“Let’s have a conversation about what helps you thrive. What relationships, rhythms, communication styles, or environmental shifts support your clarity and ease? We’re not here to fix you—we’re here to co-create something that works for all of us.”
Framing:
Your way of being is shaped by an ecosystem—and we are part of that system. Belonging is a shared responsibility.
Message received:
You don’t have to minimize your needs to fit in. We’re willing to change, too.
🔄 Why It Matters
Each model doesn’t just describe autism—it shapes how people are treated, understood, and supported.
🧩 The Medical Model adapts the individual to fit the system.
🌈 The Neurodiversity Paradigm affirms identity but often leaves the system intact.
🌐 The Cognitive Ecology Model seeks to co-regulate, co-design, and reimagine systems—because support isn’t a checklist. It’s a relationship.
When we ask what’s wrong with a person, we pathologize.
When we ask what do they need to feel safe, seen, and sustained—we begin to build something liberatory.
🌐 Where the Cognitive Ecology Model (CEM) Diverges
CEM doesn’t offer a new label. It offers a new lens.
It doesn’t ask, What are you?
It asks, What shaped you? What holds you? What makes sense in context?
It’s built not on categories—but on connection.
Not on traits—but on patterns.
Not on diagnosis—but on relational fit.
CEM is rooted in:
Lived experience as epistemic ground—not anecdotal aside
Adaptive intelligence—how we respond to harm in brilliant, protective ways
Relational coherence—the alignment (or fracture) between our inner and outer worlds
Non-diagnostic affirmation—you don’t need a label to be valid
Anti-supremacy practice—in systems, in story, in science
🌀 “Cognitive Ecology is not about replacing one label with another.
It’s about changing the lens.
From pathology to pattern.
From cure to context.
From disorder to adaptation.”
📓 Reflection Invitation: Pattern Over Parts
Take a moment. Breathe into your body. Ask gently:
When have you felt flattened by a model that claimed to define you?
Where did it fail to see your complexity, your context, your becoming?
What would it mean to be understood not in fragments—but in pattern?
Let your answers arrive slowly. Scribbled, spoken, felt.
There is no rush. There is only remembering.
🪞 Closing Thought
We don’t need better labels.
We need better language.
Not to describe what we are—
But to remember who we’ve always been.
💫 New Sessions Every Monday & Wednesday
This 12-week journey unfolds twice a week—every Monday and Wednesday—with each session building on the last. Each offering is part of a living inquiry: not just learning, but unlearning, remembering, and reimagining.
You can view the full session lineup here, and here’s what’s coming next:
✨ Session 17 – Intersectionality in Practice: Race, Gender, Class, and More
We’ll explore how neurodivergence doesn’t exist in a vacuum. How race, gender, class, language, and culture shape both how we’re seen—and how we see ourselves. This session will name what many of us already know: that identity is not additive, it’s relational. And that true support must be rooted in intersectional reality—not institutional checkbox.
💬 Share Your Reflections
This space is co-created. Your questions, stories, insights, and embodied responses are part of the collective learning. Share them in the comments, or privately if that feels safer. All of it matters.
💖 A Note on Support
This series is freely shared and will never live behind a paywall.
But it is labor—emotional, intellectual, and relational.
If you’re able to support this work through a paid subscription, it helps keep this space open to everyone, sustains the writing, and supports the work of The Compassion Collective—a community rooted in mutual care, justice, and transformative systems change.
Every share, every moment of resonance, every contribution is part of the ecosystem.
Thank you for walking this with me.
🌿
With care,
Shamani of The Compassion Collective
this is the most valuable thing Ive read thank you
Your posts feel like coming home to me. I've always looked for the upstream causes instead of just treating (ongoingly) the downstream symptoms. "When we ask what do they need to feel safe, seen, and sustained—we begin to build something liberatory" The Cognitive Ecology Model recognizes where the agency belongs and where the power and freedom come from.