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Design Approach for Autism Treatment Centers
Conference Paper · November 2014
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Design Approach for Autism Treatment Centers
Pomana A.1
1
Dipl.Architect, 2014 Graduated, Faculty of Architecture, “Ion Mincu” University of Architecture and
Urbanism (Romania)
[email protected]
Abstract
As autism is becoming a more severe issue for society since its discovery in the mid
1
‘40s , the scientific community is on an endless quest for answers. Although sensory
sensitiveness for people with autism is still a debate among specialists, more and more studies
show the link between the major autistic disabilities and perception.2 As the theory begins to
gain ground, it also begins to receive interest from the architecture community. Since
architects are held responsible for creating environments, a few theories have emerged
regarding architecture for people with autism. In accordance with treatment plans, two major
design approaches have been created, both based on the perception issues of people with
autism, and also possessing features almost opposite to one another. While Sensory Design
Approach focuses on creating a controlled sensory environment that make autistic people feel
comfortable, therefore facilitating skill acquirement, the Neuro-Typical Approach is centered
on direct integration to different typical urban and public situations.
The paper concentrates on the analysis of both design methods and examines which of
the two would give the best results in the long term. This means that the main purpose should
be integration into society and the ability of people with autism to lead an independent life.
Also, the study represents a research for an architectural, urban, social and educational
program that preceded an experimental architectural model that best suites the conditions and
needs of people with autism.
Keywords: sensory design, neurotypical, autism, autism design, autism center, autism
architecture
1 NECESSITY FOR DISTINCT DESIGN APPROACHES
Although the differences in therapy methodology vary just slightly, the ways in which
architecture has developed to accommodate this shift in focus have resulted in design
approaches that are almost in opposition with each other. This situation is created in spite of
both methods focusing on the same sensory issues that autistic people have. For treatment
methods that concentrate more on autistic people’s ability to adapt to different day to day
scenarios, the necessary architecture approach is Neuro-Typical Design3. In contrast, for
treatment methods that are centered on autistic people’s acquisition of certain useful abilities,
the necessary architecture approach is the Sensory Design.4
Due to autistic people’s inability to adapt to certain environmental conditions, the
design of the treatment center can become as important as the therapy itself. Circumstances
that are considered normal by most of us, for autistic may become toxic environments,
because of their sensibility to auditive, visual and tactile stimulus.
Although there aren’t many regulations concerning architecture for autism treatment
centers, being the older one, the sensory method has established as the default design theory
1
and used all over the world, whereas the Neuro-Typical approach is accepted only by a few
organizations, mainly in the United States.
2 SENSORY DESIGN THEORY – RESEARCH AND APPLICATIONS
The prevalence of sensory difficulties for people with autism is still under debate
while “a question mark hangs over the sensory phenomena, which are often reported but not
currently required for diagnosis.”5 Regardless, architecture solutions that take into
consideration the sensory development of patients have been proven successful. Similar to the
concept of “sensory diet” (Willbarger & Willbarger, 1991 and Anderson, 1998), Sensory
Design Theory explores the manipulation of environment to the benefit of autistic people.
Developed by arch. Magda Mostafa, the aim of this method is to create an appropriate basis
for autistic therapy. By altering the space in such a manner that patients feel secure and
comfortable in their surroundings, the levels of focus and concentration rise, making therapy
sessions more efficient. Furthermore, behavior modification and the acquisition of new skills
benefits from this type of controlled environment.
Applying this theory to a treatment facility for people with autism means to rigorously
separate the space into two distinct areas: a high stimulus area which functions as developed
public interface with training and conference rooms and a low stimulus area which is destined
for treatment activities. Since the two spaces differentiate with one another both by function
and by building environment character, usually they require two separate volumes. Therefore,
the treatment facility needs to be integrated into an introverted type of layer that
communicates only with its inside spaces and proper controlled outside environments, while
the public interface becomes an extroverted spaces which needs to communicate and
interrelate with the public environment surrounding the institution.
Maybe the only design method that has empirically proven its efficiency, the Sensory
Design Theory is meant to provide the best situations for all the varieties of autistic spectrum
disorders. Because it has the ability to adapt the space to the patients’ needs, it can provide
autistic people safety and comfort, but it can also become an environment that forces them to
adapt to certain situations. By altering space characteristics such as color, texture, perspective,
sound, orientation, lighting etc., to accommodate each individuals’ requirements, therapy has
proven to be more effective, especially when dealing with acoustics.
The Sensory Design Theory also implies a deeper analysis into context and
community, navigation and spatial sequencing, classroom spaces, therapy spaces and outdoor
learning areas. All these aspect come to support the different therapeutic sessions for skill
acquirement, context and community being the only part that focuses directly on capacities of
people with autism to adapt and integrate in society.6
3 NEURO-TYPICAL APPROACH – RESEARCH AND APPLICATIONS
As a design philosophy, the Neuro-Typical Approach is almost in opposition to the
sensory design theory. Although both target the development of skills necessary for the
integration of people with autism spectrum disorders, the Neuro-Typical method focuses on a
more direct approach to integration in basic day-to-day circumstances. Because it
concentrates more on the ability to generalize context rather than the capacity of people with
autism to acquire skills and knowledge, the method is centered around the creation of physical
environment that patients would come across in their everyday use of space. Therefore, in
relation with the therapy, patients are emerged into a highly stimulating environment that
should force them to develop a sense of familiarity with the different circumstances that they
might observe in normal public spaces.
2
The Neuro-Typical Design Theory focuses on improving autistic people’s skills to
generalize space and its function. By creating environments that have the same function but
have different sensory characteristics, patients should develop the capacity to adapt to
variations of the same kind of space. Also, because the environment is similar to usual urban
and public places, autistic people are bound to adapt over time to this kind of highly
stimulating context. As a result, treatment institutions have areas designed in such a manner
that they mimic usual outside spaces: transit areas look like streets and alleys, therapy rooms
look like classrooms or libraries, the cafeteria looks like a restaurant and so on.
In contrast with the sensory design theory, the Neuro-Typical Approach doesn’t have
any empirical evidence of its effectiveness. Although this is definitely in favor of the first
design method, the results have still to be discovered in regard to Neuro-Typical treatment
facilities. Because it is not directly involved in the process of therapy sessions, this design
method does not have an impact on the learning process, but rather on the overall
development of skills.
4 COMPARISON BETWEEN THE TWO DESIGN APPROACHES
Both design methods have well established arguments for their principles. The fact
that the results have different consequences and are delivered on a different timetable makes
the comparison between them even harder. In general, because in present the focus falls down
to the therapy process, the sensory design theory is more accepted by the scientific
community. The general results of each approach are yet unknown.
The main criticism for the Neuro-Typical method is its inability to accommodate
people with severe autism or with very high sensory disabilities. Also, the time it takes for
less severe autistic people to adapt to the surroundings, may be considered wasted. For the
present time, the main concern of therapy for children with autism is to prepare them in order
to have an easy task in integrating into the public school system at a proper age. As many
therapists agree, if this task is accomplished, the chances they have to adapt to a normal
lifestyle are very high and the necessity for future intensive therapy, very slim. Thus, the time
it takes for autistic children to adapt to a Neuro-Typical treatment environment may easily
balance the scale in favor of the sensory design theory even if the first approach may have
long term benefits. In addition, in order to be able to generalize different circumstances,
people with autism first need to acquire the knowledge and skills to be able to successfully
understand and use the environment.7
Another argument against the Neuro-Typical Approach is more of a criticism against
society’s responsibility towards autistic people. Why should the focus come on the
requirement of autistic people to adapt to present environment circumstances? Such as urban
or public spaces have been manipulated in order to accommodate the needs of people with
motor or visual disabilities, so should be the case for individuals with autistic spectrum
disorders.8 Moreover, the benefits of lower stimulus public environments should also be
beneficial to everyone else.
On the other hand, the sensory design theory does not lack criticism. The fact that
skills and knowledge can be acquired in this type of space does not necessarily mean that they
can be used in any other environment. If the learning can only be done in a sensory controlled
place, so may the application of these abilities be bound to a certain site. Because of this, the
task of integration and the gain of generalization skills falls into the hands of the therapists. If
the therapy schedule does not take into consideration the adaptation to new circumstances or
higher stimulus spaces, autistic individuals may form a stronger bond to sensory controlled
environments, making it harder and harder for them to conduct activities in places such as
public schools and classrooms. Also, autistic people that have less severe disabilities may
3
easily be kept from accommodating to normal high stimulus environments. As a result, for
treatment facilities designed on sensory design theory principles, the requirement for
experienced, well trained therapeutic staff is essential for the success of autistic people’s
integration.
In most cases, the therapy done inside a sensory environment is not enough to assure
integration for autistic people. More than learning the necessary skills, people with autism
need to explore and understand spaces outside the treatment facility.
5 CONCLUSION
Although both design approaches have their shortcomings, architecture for people
with autism has made an enormous progress in the past 10 years. On an overview, the Sensory
Design Theory comes as a better solution on the short term, but in some cases, the Neuro-
Typical approach can come as a better method if we think of the long term results. Both
design approaches have the advantage of flexibility. This means that they do not limit the
possibilities for present or future therapy models, which can only encourage more research in
architectural design.
The two design methods possess features that do not exclude one another. Since the
sensory approach is clearly addressed to people with severe autistic spectrum disorders and
high sensory sensibility while the Neuro-Typical Method is focused on resolving the poor
generalization skills and integration disabilities, a combination between the two may result in
a complex integrated facility that will solve most of the problems.
What architects can do to help people with autism does not restrict only to establishing
the correct design approach for the treatment center. Facilitating integration should also be an
important study subject where architects and psychiatrists need to work together and find the
best solutions concerning integration to classroom circumstances9 , urban and public spaces.
The placement of the treatment facility inside the city should focus on establishing
communication with places and public institutions that encourage peer to peer learning.
REFERENCES
[1] Frith, Uta (2003) - Autism: Explaining the Enigma 2nd edition, Oxford, (Blackwell).
[2] Russo N, Foxe JJ, Brandwein AB, Altschuler T, Gomes H, Molholm S. (2010 Oct) - Multisensory
processing in children with autism: high-density electrical mapping of auditory-somatosensory
integration, Autism research
[3] Henry, Christopher N. (2011 Nov) "Designing for Autism: The ‘Neuro-Typical’ Approach",
ArchDaily
[4] Mostafa, M. (2008). An Architecture for Autism: Concepts of Design Intervention for the Autistic
User, Archnet-IJAR: International Journal of Architectural Research
[5] Frith, Uta (2003) Autism: Explaining the Enigma 2nd edition, Oxford, (Blackwell) p. 10
[6] Mostafa, M (2014) - ARCHITECTURE FOR AUTISM: Autism ASPECTS în School Design,
International Journal of Architectural Research, Volume 8
[7] Mostafa, M. (2008). An Architecture for Autism: Concepts of Design Intervention for the Autistic
User, Archnet-IJAR: International Journal of Architectural Research
[8] Henry, Christopher N. (2011 Nov) - "Designing for Autism: The ‘Neuro-Typical’ Approach",
ArchDaily
[9] Owen-DeSchryver. J, Carr. E, Cale. S, Blakeley-Smith. A (2008 March) - Promoting Social
Interactions Between Students With Autism Spectrum Disorders and Their Peers in Inclusive
School Settings, Focus on Autism and Other Developmental Disabilities, 23: 15-28
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