Design for People on the Autism Spectrum

John Van der Have is the principal of Bio-Building Design Pty Ltd - Architects and Access Consultants, based in the City of Blue Mountains, NSW. He is an accredited member of ACAA, and also a member of the Australian Institute of Architects. He has designed several medical centres, including a dedicated Autism Centre.

Autism Spectrum Disorder (ASD) is a developmental disability that affects an individual's social interactions, behaviour and overall ability to interface with his or her environment. Autism is characterised by difficulty in social communication, difficulty in social interaction, repetitive behaviours and restricted interests. There is no cure.

In 2018 there were more than 205,000 people in Australia with ASD, a 25% increase since the previous survey undertaken just three years earlier in 2015 (1). The increase in the prevalence of autism measured between 2015 and 2018 is noteworthy, and parallels corresponding increases in other parts of the world.

A report by Monash University commissioned by the NSW Department of Education estimated that the number of children diagnosed with ASD had grown from 1.1 percent of students in 2013 to 1.9 per cent in 2018 (2). When adjusted for the increase in total enrolments, that was an average increase of 12.2 per cent a year. The prevalence of ASD in schools is expected to increase from 2.0 percent in 2019 to 3.5 percent by 2028, the report says. These NSW statistics reflect similar trends in other states and territories.

Design For The Neurodivergent Community

A common experience for people on the autism spectrum is sensory overload. They can feel overwhelmed by too many sounds, sights, smells or tactile experiences. This can lead to stress on the mind, nervous system and body. As a result they feel under stress, with many of their senses in heightened states of activation.

Occupational therapists employing techniques of sensory regulation can give children some relief from feeling hammered and disorganised. Sensory integration therapy provides a systematic approach to help the nervous system process sensory input in a more organised way. Sensory integration may involve playful bouncing, brushing, swinging, or pressure applied to the body and joints, and other techniques. Most children enjoy this kind of therapy. It is a break from other therapies that they may find more wearying.

In a therapeutic or educational setting a sensory room may be provided to enable sensory regulation therapy. For example, in a recent design for an Autism Centre, BioBuilding Design Architects included two sensory rooms.

Additionally we included a music therapy room. Music therapy can give a beneficial sense of rhythm and co-ordination. Various forms of music can benefit people with ASD, ranging from classical music to drumming. Rooms for music therapy need to be acoustically well insulated.

Design for people on the spectrum needs to consider the impacts on the human senses of all choices of building services and systems (for example mechanical ventilation and airconditioning, selection of fixtures and fittings, choice of colours and patterns, etc). Everything that may impact on the senses needs to be given careful consideration.

There is a large body of work internationally that suggests biophilic principles are beneficial to human health. For people with ASD, general health and wellbeing can be enhanced through biophilic elements such as natural lighting and views of nature (3). Natural ventilation (as opposed to air conditioning) is also desirable. Signage needs to be carefully considered, as people with ASD can be very literal in interpreting signs and social cues (4).

It is widely agreed that acoustics is a vital criterion in design for neurodivergent people. But how much acoustic insulation is enough, and how much is too much? Questions such as these have implications for construction costs.

Fittings and fixtures within a building for neurodivergent people need to be robust. Surfaces need to be able to take impact, yet also be resilient. A variety of materials can meet these specifications.

International Examples

Magda Mostafa, an Egyptian architect and researcher, has developed a design theory of inclusivity encompassing the needs of the neurodivergent community. She has developed an Autism Friendly Design Guide - a framework of design for both the neurodiverse and the neurotypical communities (5). One of the principles she has identified is the need for ‘escape spaces’ - the creation of spatial infrastructure that allows for respectful sensory retreat when needed.

Around the world over recent decades other researchers and activists have also been designing and building facilities for the neurodivergent community. Building types include residential and transitional living environments, schools and universities. Different techniques and strategies have been employed by different design practitioners. There is still a lot of experimentation in this field, with no overarching global organisation coordinating research. While valuable lessons have been learned by individual designers, there is no international body that collates results as to what works and what doesn’t work.

Design Of Educational Settings

Children on the autism spectrum can struggle within primary and secondary schools. Children with ASD may find difficulty interacting with their peers at school - an important social environment for all children. There have been calls for more resources within schools to enable staff to deal with complex student needs. Additionally, calls have been made for every school to have a staffed ‘time-out room’, where disruptive students can still learn, and at the same time receive counselling and various specific therapies to ensure that they will be safe in a classroom setting. Some NSW public schools have already provided such ‘time-out rooms’, along with dedicated staff.

In classroom settings for children on the spectrum it is important to facilitate natural lighting, at the same time minimising distractions from external activities. Highlight windows, or skylights, to provide natural daylight while blocking out distractions beyond the classroom, can achieve this. Within the tertiary education sector similar principles apply.

Design Of Domestic Settings

Similar techniques to those mentioned above for schools can be employed in domestic settings. For example, a calming space could be designed within a home. A ‘sensory diet’ prescribed by an occupational therapist could enable calming activities to be included into a child’s daily domestic routine. In this respect, a space that gives a child the ability to control levels of privacy and social interaction is important. Some parents have squeezed trampolines into their backyards, or hung swings from doorways or trees. Parents need to choose activities that are appropriate and fun for their individual child.

Individual spaces for people on the spectrum should be fitted out and furnished to suit the particular individual’s preferences. Personal choice should be allowed, enabling decisions as to how a personal space is finally fitted out, to be by the occupant.

Increasingly, there will be demand for design of residential settings to cater to the needs of both those with physical disabilities and also those with other disabilities including ASD. Home therapy programs for the neurodiverse may, in some cases, require the need for carers to enter the home each day, for possibly many hours each week. In such cases, space will need to be allocated to these carers, and for implementation of the care program that they oversee. Circulation space for carers should be designed so as to not impact the privacy and connectedness of the rest of the family (6).

Autism Spectrum Disorder And The Building Regulations

Given the increasing prevalence of Autism Spectrum Disorder within Australia (and other countries) over recent years, it is only a matter of time before moves are made to include requirements governing design for the neurodivergent community into the building regulations regime.

This has already commenced in a limited way, relating specifically to group homes. The Specialist Disability Accommodation Design Standard (7) outlines requirements for ‘robust construction’ - requirements in the design of group homes that are in addition to requirements in the Building Code of Australia and in the Access-to-Premises Standards.

For group homes, the Specialist Disability Accomodation Design Standard makes reference to a ‘breakout room’, ‘intended to be dedicated and used to enhance learning, exploration or to positively impact mood. This room would … be expected to make use of activities, equipment, sound and lighting in ways that are appropriate to the current residents.’ (Clause 18 - Breakout room). This design standard may be the forerunner to more detailed guidelines for design for people with ASD.

At present we have no agreed guidance on design for people with ASD in environments other than group homes. There is a whole world beyond group homes, with buildings of all types within which neurodivergent people need to to interact, and for which appropriate designs need to be prepared.

References

1. ABS: Disability, Ageing and Carers Australia: Summary of Findings, 2018

2. May, T. & Williams, K. - Understanding increased enrolments of autism and mental health needs in NSW government schools, Monash University, 2019

3. Dival, Michelle, Different Buildings for Different Minds - Winston Churchill Memorial Trust of Australia, 2018, p 20

4. ibid., p 35

5. Mostafa, M: Autism Friendly Design Guide - <www.autism.archi/> - [accessed 22.05.22]

6. Clarke, A - Residential design through a lens of care - Architecture Australia, MarApr 2022

7. National Disability Insurance AgencyNDIS Specialist Disability Accomodation Design Standard, Edition 1.1, 2019