Theme ‘time-out spaces’
‘Time-out spaces’ is a theme under the chapter ‘architectural spaces’. (See The recommendations.) ‘Time-out spaces’ is a collective term encompassing all spaces or places in which a person on the spectrum retreats in order to change the level of stimuli, including the lessening of social interaction.
Changing the stimuli level usually means decreasing it, but in some cases it may be an increase or a certain selection of stimuli such as one’s favorite music. For example, the latter may be the case in one’s own room or in ‘a sensory suite’; here one can both increase and decrease the stimuli levels. Here, we are reminded that, contrary to the usual emphasis on low thresholds and the danger of sensory overload, problems resulting from high thresholds can be just as considerable. (See ‘Over- and under-responsivity’.) A case in point are the so called ‘snoozling’ spaces, if only because there all the senses can be addressed. (See recommendation 56 in the parental home.)
‘Time-out spaces’ cover a whole range of possibilities, including independent living; think of a room of one’s own, a hiding place in the attic, in the garden or elsewhere. ‘Lee-places’ – in which one is partly secluded and partly involved in the surrounding social life – represent one extreme and separation rooms the other.
“All of us need a private place. Autistic children need their secret places too, in which they can hide and retreat to their own world. After all, autism is a ‘within-ness’ disability and autistic children need the security of their own hideaways. I had mine and it was a place for me to think and recharge myself.”
In what we have dubbed ‘the core literature’ almost every author mentions his or her own variant of the time-out space. E.g. Humphreys, proposes a ‘withdrawal space’ at the edge of the classroom, in addition to a ‘secret space’ elsewhere outside or inside a building. Whitehursts ‘sensory suite’ may – as mentioned above – be used to tune stimuli levels both up and down. Khare & Mullick mention ‘withdrawal spaces’, which are “helpful for children to avoid unnecessary stress and anxiety in socially demanding spaces…” and a “withdrawal area […] used as a place for students to get away from distractions and stimulations….”
In connection with her ‘spatial sequencing’ experiment in a classroom, Mostafa says:
“An additional, very essential station should also be included, namely an ‘escape space’. This should be located in the lowest stimulus area of the classroom. Essentially, it is a small partitioned area where a child may seek refuge whenever over-stimulated or overwhelmed. This space needs to be intimate and partially enclosed to limit the sensory environment the child needs to deal with. This should be designed as a sensory neutral space with various items close at hand (…), so that the child can have the space customized according to his or her sensory needs.”
From their own research on younger autistic children in special education, McAllister & Maguire arrive at a recommendation very similar to Mostafa’s. They advocate a ‘quiet room’ in the classroom which allows a child time to ‘recharge their batteries’ if getting tired or, alternatively, calm down if distressed. They propose that the space can take many forms; a small stage or reading area are among the possibilities.
In the most stringent of time-out spaces residents of treatment and long-stay homes are separated in increasing degrees of pressure. The Dr. Leo Kannerhuis distinguishes:
A low-stimulus room (also ‘relax room’ or ‘calm-down-room’) which has cushioned walls and no sharp objects or anything else which might hurt the person inside. Soft objects such as cushions are present. There is a small adjoining space which provides the possibility to keep visual and verbal contact without bothering others. Besides, light-, image-, and sound-installations can be placed there. In principle the room stays unlocked. If locked, this happens for a minimum period of time and there is staff present just outside (or in the adjoining space) to keep an eye on the person inside and who will communicate with him or her at all times. These are mostly present in treatment homes.
A time-out room is much like a low stimulus room, but lacks soft objects and a front space. This room is preferably unlocked as well and if not the same rules of constant supervision and contact possibilities apply. These are mostly present in long-stay facilities.
A separation room (sometimes/formerly ‘isolation room’) is like a time-out room but locked in principle. Here too a staff member is continuously present within view and within earshot. This facility is and can only be used in cases of involuntary admission, which (at least in The Netherlands and outside forensic psychiatry) is extremely rare for people on the spectrum.