At 8.40 am on a Monday, two professionals look at the same list. There is a report due by noon, a reply owed on an email sent on Friday evening, a dentist’s appointment to book and a parent-teacher meeting to fit in later in the week.
The first gets through it quickly. Within 20 minutes she has answered Friday’s email with a timeline, booked the dentist by text and started notes for her report. The second is neurodivergent. She looks at the same list and cannot tell where to begin, because every item feels equally urgent.
She talks the list through with an AI planner. It sorts the tasks into colour-coded blocks on a short timeline, suggests which one to start with and sets a focus timer so she can see how much time has passed. When the brief for the report becomes hard to read on screen, she switches to speech-to-text and dictates her first section. At 11am, a support app asks how she is doing. By noon, both women have made progress on the report. Only one of them needed tools designed for the way she thinks.
Many of these tools are now sold as inclusive. Whether the second professional ever uses one depends on two things. She has to know she is neurodivergent, and someone has to pay. A subscription works for people who have a diagnosis and can afford it. Everyone else relies on an insurer, an employer or a government, and each country pays for different things. Any company that calls its product inclusive should be asked who pays for it, and what that money is meant to achieve.
Diagnosis is the first hurdle. In April 2025, the US Centers for Disease Control and Prevention reported that one in 31 eight-year-olds had an autism diagnosis in 2022, up from one in 36 two years earlier. Experts at the agency put most of the rise down to better understanding of autism and how to identify it.
Four months later, a review from King’s College London looked at older people. It estimated that 89% to 97% of autistic adults aged 40 and over in the UK are undiagnosed, and 96% of those over 60. Only 0.4% of autism research since 1980 has focused on people in midlife or older age, the review found.
A thesis that became a company
Tiimo, one of the best-known planners for neurodivergent people, began in 2015 as a master’s thesis at the IT University of Copenhagen. Helene Lassen Nørlem and Melissa Würtz Azari, students of digital design and communication, studied families of children with ADHD and autism. Denmark was then moving students with support needs into mainstream classrooms. The two interviewed neurodivergent teenagers about how technology could help them at school, and saw how often assignments were missed and mornings went wrong. One parent asked them: “Why isn’t there a tool that actually works for the way my kid thinks?” They kept working on the idea after graduating and founded the company.
Azari was diagnosed with ADHD and dyslexia as an adult, after work on the planner had started. Tiimo says she had spent years using tools that were not designed for her, and her company biography describes her as “a dyslexic ADHDer and service designer”. Tiimo now has more than a million users and is available in 22 languages. In December 2025, Apple named it iPhone App of the Year, and Apple’s editors credited Azari’s own experience for the app’s recognition in inclusive design.
“Most planning tools weren’t made for neurodivergent people,” said Nørlem, now co-chief executive, in a case study published by the European Investment Fund in February 2026. “Our tools are adaptive by design; visual, flexible, and grounded in how neurodivergent people really plan, think, and follow through.”
“The question is where neurodivergent users sit when the decisions are made. Adding accessibility treats them as an edge case after launch. Building from the outset makes them the core user, so information load, pacing, notifications and sensory design are planned around them from the start,” said Reenita Das, founder and managing director of Nxt Horizon, who analyses healthcare and longevity markets. Das cites Tiimo as an example. In August 2024, more than three in four of its 50,000-plus paying subscribers identified as neurodivergent, and the company says many of its staff are neurodivergent too. Its premium tier costs about $10 a month, and users pay for it themselves.
Language matters as much as design. In Qatar, researchers found that people who communicate using symbols were relying on systems designed elsewhere, which did not reflect Qatari culture. The Arabic symbol set they created, Tawasol, is now maintained by the Mada Assistive Technology Center. “Tawasol in Qatar found that translating English tools wasn’t enough, so it built an Arabic symbol set from scratch,” said Das.
Investors have backed few specialists
“I don’t put a single number on it, and I’d be cautious of anyone who does. There is no clean category. The spending sits inside assistive technology, digital health, education, workplace tools and mainstream consumer software,” said Das.
Das estimates there are between 1.2 and 1.6 billion neurodivergent people worldwide, based on the commonly used figure of 15% to 20% of the population. The most reliable global count covers only autism. The Global Burden of Disease Study 2021, published in The Lancet Psychiatry in 2025, estimated that 61.8 million people were on the autism spectrum, one in every 127. Das pointed to a global study that found around 366 million adults with ADHD symptoms, and compared it with an assistive technology market she put at $23 billion to $27 billion. “Products built specifically for neurodivergent people are a small, fragmented part of that. Demand is enormous and supply is underbuilt,” she said.
The companies building for this group have raised relatively little. Tiimo has raised $4.8 million in total. Kantoko, an Australian ADHD care platform, raised a $3.5 million seed round led by Side Stage Venture and Tenmile. Ben Grabiner, a founding partner at Side Stage, called scaling high-quality care for this group “one of the biggest unsolved problems in health.” Neurode, backed by Khosla Ventures and SOSV, has raised $10 million.
Evidence is still rare
“Think of it as a ladder: tester, adviser, employee, then founder or decision-maker. Most companies stop at the first two rungs. Real influence starts when neurodivergent people decide which problem gets solved,” said Das.
She also looks for evidence. “Can the company show outcomes, or only features? Credible evidence shows improvements in daily life, such as independence, anxiety, employment and time to complete tasks. It covers different ages and profiles. It names neurodivergent people in senior roles. And it’s validated independently, by a regulator, a health system or published research. Engagement numbers and awards are not outcomes,” she said.
Brain in Hand, a company that combines an app with round-the-clock human support for autistic adults, is one of the few with published clinical data. In a 12-week study run with seven NHS autism services, 66 of 99 participants completed the programme. Researchers found a significant drop in anxiety, though not in depression. Company staff were among the study’s authors. “Autistic people are poorly served by our society,” said Dr Louise Morpeth, its chief executive.
Big technology companies reach far more people. Apple says it designed its Assistive Access mode with feedback from people with cognitive disabilities and those who support them. Das pointed to Microsoft’s Immersive Reader, which started as a tool for people with dyslexia and is now part of mainstream Microsoft products. Companies rarely pay for clinical studies unless an insurer or health system will pay for the results.
Insurers decide which apps survive
“Akili won FDA clearance for the first prescription video game for ADHD, but insurers largely didn’t pay for it. In 2023 it lost $59.5 million on $1.7 million in revenue, and it was sold in 2024 for about $34 million. Approval without reimbursement doesn’t create a market,” said Das.
Where insurers would not cover its EndeavorRx game, Akili asked patients to pay cash, according to its filings. A later over-the-counter version for adults put the cost on the patient. Cognoa, whose Canvas Dx is the first FDA-authorised device to help diagnose autism in young children, has had more success. Highmark became its first commercial insurer in January 2024, and Wyoming became the first state Medicaid programme to cover it. Founder Dennis Wall called the Highmark contract “model medical policy.” Not every insurer agrees: BlueCross BlueShield of Tennessee still listed such tools as investigational when it reviewed its policy in September 2025.
“Germany works better because insurers pay for prescribed digital health apps that prove their value, which links evidence to revenue,” said Das. Since 6 August 2025, all German statutory health insurers have covered attexis, an app that its distributor MEDICE says is the first permanently listed digital health application for adults with ADHD. It costs €599.40. Karl Broich, president of the German regulator BfArM, told a regulatory congress in May 2025 that companies must show in a superiority study that their app works better than usual care without it. By April 2025, 22% of the 227 applications received had gained permanent listing.
The German system has critics. A report by the insurer Barmer counted 74 reimbursed apps and 1.9 million prescriptions or approvals by the end of 2025, and said the costs were out of proportion to the benefits. Statutory insurers put the average price charged by manufacturers in 2025 at €544, and said the freedom to set prices in the first year of listing was a major reason for the cost.
“Europe’s Accessibility Act, in force since June 2025, sets a minimum standard of compliance but doesn’t create demand,” said Das.
The law applies to smartphone apps, smart home and health devices and kiosks, and it covers people with cognitive impairments. Each of the 27 member states has written it into national law in its own way, leaving questions about scope and enforcement. Law firm Taylor Wessing reported in March 2026 that regulators had so far focused on raising awareness and had issued few fines. In May 2026, Italy’s digital authority began giving companies deadlines to fix problems before it moves to formal sanctions.
Awareness campaigns have grown faster than funding. In 2025, Dubai became the first Certified Autism Destination in the Eastern Hemisphere, after more than 70,000 people completed autism and sensory awareness training. “Governments here are the largest buyers of health, education and employment services. If they link procurement and insurance coverage to proven outcomes, and to neurodivergent people being involved in design, this region could lead globally. What’s missing is a clear route to payment,” said Das.
Help at work needs funding
UK government figures put the employment rate for people with a neurodiversity condition at 31%, compared with 54.7% for disabled people overall. Those who do have jobs are often “overqualified and very often underpaid,” Sir Robert Buckland told a House of Lords committee in 2025.
Ian Mitchell, an operational research manager, was diagnosed as autistic at 49. “A change in management can turn dream jobs into nightmares for me,” he said in a case study published by Brain in Hand. His employer lets him work from home three days a week. After an assessment, he was given a workplace supporter, and when his coping strategies stop working, an alert button in the app sends her a message. “Brain in Hand helps a lot. It helps keep me on track and at work,” he said.
The UK government’s Expert Academic Panel on Neurodiversity, chaired by Professor Amanda Kirby, published its final report on 2 October 2026. It found that neurodivergent people can do well at work when support is based on their needs, whatever their diagnosis. The panel said the government’s Access to Work scheme, which can pay for support in the workplace, “has ‘levelled the playing field’” for employers worried about cost. It recommended more funding to clear the scheme’s backlog, removing the cap on awards, and requiring employers to respond to requests for adjustments within two weeks. It also found that “assistive technology is less effective if implemented without training and mentoring on adoption.”
Adults are largely left out
“Most of the market stops at 18. Investment goes to children, because that’s where parents pay and health systems reimburse. Adults need help with work, money and independent living, often after a late diagnosis and with little support around them,” said Das.
Children’s tools are where most of the activity is. Jade Autism, founded in Brazil and now based in Abu Dhabi, says its game-based tools reach nearly 200,000 children in more than 170 countries, and it works with public schools and governments so the tools stay free. In January 2026 it won the $1 million Zayed Sustainability Prize in the health category. Even public support for children is being cut back in places. In 2024-25, 38% of people on Australia’s National Disability Insurance Scheme listed autism as their main disability, and half of new entrants were children under nine. From July 2026, children with mild to moderate autism or developmental delay are moving to a separate $2 billion programme called Thriving Kids. These children “should not, in my view, be on a scheme set up for permanent disability,” said disability minister Mark Butler. The Australian Autism Alliance said the change raised serious questions.
At the other end of life, the King’s College review found that autistic adults were four times as likely as non-autistic adults to be diagnosed with early-onset dementia. Its figures suggest that “many autistic adults will have never been recognised as being autistic,” said Dr Gavin Stewart, the review’s lead author. “We’re building a healthy-ageing economy that hasn’t accounted for neurodivergent people growing older. They face normal cognitive and sensory ageing on top of lifelong differences, and there’s a real risk of misreading one as the other,” said Das.
The second professional got through her Monday morning with a planner, speech-to-text and a check-in app. Tiimo shows how tools like these are built, and its users have kept the company going by paying for it themselves. That works for someone who knows her diagnosis and can afford a monthly subscription. It does little for a 60-year-old who has never been diagnosed, a family that cannot pay, or an employee who needs support from a health system or an employer.
For them, an inclusive product only helps if an insurer, employer or government will pay for it and check that it works. German insurers do this for apps that pass a trial, and the UK government can pay through the workplace. In most other places, there is still no clear route. So when a company calls its product inclusive, it is fair to ask who pays for it, and what they expect it to achieve.
“Sustained investment follows reimbursement,” said Das.
