Introduction to autism-friendly design

After previously being a psychiatric nursing student and sociology graduate, I have been working as a researcher and book author on mental health issues ever since. This has included writing a book on designing buildings and homes for people with autism, published in 2013. Subsequently I started this website, ‘Architecture for Autism’, which teaches me something new every day: the more I learn, the more fascinating the subject becomes.

Autism is largely an inherited condition brought about by brain-impairments that influence all aspects of life. Today scientists are steadily pushing the frontier of what we know about autism in a quest to better understand the as-of-yet unknown and unidentified. New knowledge is also being added by people who themselves have autism. This is especially the case in the U.S. and the U.K. where a process of emancipation is under way, led by communicative people with autism who do not consider their condition a disorder. Instead they describe themselves as being neurologically different (neurodiverse) and certainly not inferior to people without autism, whom they may call ‘neurotypicals.’ In the last three to four decades, better knowledge and understanding of all forms of autism, has contributed to an increase in the prevalence of autism, so that presently about 1 in 68 of the population is now recognized as being on the spectrum, compared to just 1 in 2500 in the past.

Autism, partly due to an increased exposure in popular culture, has in recent years, acquired a growing public interest and a subsequent change in its image. Think of the movie “Rain Man” (1988) in which Dustin Hoffman plays a totally maladjusted numbers wizard. Then compare that with the TV-sitcom “Big Bang Theory” in which hyper-intelligent, sympathetic people comically act out socially awkward scenarios. For the vast majority of those with autism, the reality lies somewhere between these two extremes of the autistic spectrum.

It is often said that all people on the autism spectrum are different. This is because there are so many autistic traits, that one person with autism can have completely different characteristics compared to somebody else on the spectrum. Moreover, it is becoming more and more apparent that girls and women with autism generally behave differently than boys and men. They are more sociable and are better at Pretending to be Normal (a book title by the way). That is one reason why the incidence of autism among women has been systematically underestimated.
Shared traits that all people on the spectrum tend to have in common, however, are impairments in social interaction and/or communication, alongside ‘restricted stereotypical and repetitive behaviors, interests and activities’. At the severe end of the spectrum, those with autism often cannot or will not speak and do not seem to care about others. They can also appear to live in their own world in which they might occupy themselves for hours by repetitive behavior such as simply spinning an object or making flapping movements with their arms. Conversely at the other end of the spectrum are the precocious and extremely talented similar to the people we see portrayed in “Big Bang Theory.”  They are often comfortable and very gifted with subjects such as mathematics, computers, astronomy, engineering and music. If there is a system or pattern to a subject, the more that many people with autism will like it.
Despite these skills, those with autism tend be socially inept, finding other people unpredictable and incomprehensible. This is because they lack an antenna for social behavior including being unable to ‘read’ other peoples’ facial expressions or body language.

Almost everyone on the autism spectrum also has sensory problems. Sound can be perceived as being extremely ‘loud’ or ‘soft.’ Many people with autism can be extremely unsettled by bright light, smells, some colors, or cannot respond appropriately to heat or cold. The latter is part of the sense of touch in which difficulties may occur including sensing that clothes hurt the skin or make the touch of someone else unbearable.

Whilst there is no cure for autism, one can be taught social skills including how to have a conversation, how to listen to others, take turns, have eye contact and not go on endlessly about one’s favorite and all-consuming hobby. (The latter being a trait of having the aforementioned stereotypical interests.) Autism however remains a condition which permeates all spheres of life and something that can make it very hard for those on the spectrum to have romantic relationships, to complete their formal education or to get and keep a paid job. A minority do succeed in these things, often helped by obtaining a diagnosis and treatment at a very young age.

Autism-friendly design: the senses
People with autism do have to live somewhere, go to school and go to work, be it paid or otherwise. Some will have to live in a treatment or long-stay facility. The way these buildings are built and furnished can make a great deal of difference to their well-being. Only think of the noise, present in all schools. For someone with auditory sensitivity, who might experience this as two, three or even ten times as loud in volume compared to others, this can be excruciatingly painful. Soundproofing homes from neighbors, limiting acoustics, utilizing silent ventilation systems and locating motors of extraction systems away from occupied areas of the home are just some of the counter-measures that can help make autistic life more bearable with regard to sound.

Large windows which let in too much sunlight should also be avoided, not only due to a common oversensitivity to light, but also because of possible unwanted external distractions. For instance, someone with autism can be so obsessively absorbed in observing traffic, that it will distract them from doing anything else at all during the day. Internally, sunlight can also cause overheating due to the greenhouse effect. However, to those on the spectrum it often does not occur to take (semi-) conscious measures such as taking off one’s sweater, opening a window, or slowing down their activity to help counteract an increase in room temperature. So overheating (or under cooling in the opposite case) for those people may happen. Hence, maintaining good room temperature control is important in any indoor environment.

Orientation, interaction, communication
Whilst architectural measures to counter sensory abnormalities are easy to envisage, there are other less evident autism characteristics, that also demand autism-friendly actions. These include problems of orientation such as not knowing where one is, in addition to the aforementioned core-problems of social interaction and communication.
Difficulty in orientation may be a result of something called ‘Weak Central Coherence’. People without autism may observe a few details of, for instance, a wall, a room or a hallway and automatically and effortlessly produce an overall picture that helps locate themselves in that setting. By contrast those on the spectrum very often are unable to do this. Instead they see details which they cannot, or only with great effort, combine to see ‘the bigger picture’. It is therefore no wonder that they often do not know exactly where they are.

Another autism characteristic is trouble in being able to adapt flexibly to a new situation, sometimes termed “switching”. This has much to do with Leo Kanner, who is said to have first ‘discovered’ autism in 1943. Kanner considered this a core-feature of autism terming the characteristic as ‘an anxious and obsessive desire for sameness.’ People with severe autism can often become upset when something in their environment changes. This then demands an environment that is as clear and legible for the person with autism as is possible. Hence the fact that there are many treatment centers built around a central circulation space from which one can observe and locate almost all other spaces in the building.

Another measure to employ when designing an environment for autism is that of zoning. This is where the number of functions of a space is purposely limited, preferably to one, so that it is identifiable to the person with autism. For instance it is in the play room that play would take place. Employing the concept of zoning also means that spaces are arranged by the intensity of their functions: high-activity (and noisy) spaces (e.g. for sports and music) can be clustered together and separated from low-activity spaces (e.g. reading, homework) in order to minimize disruption when wanting a quiet environment.

One of the most important examples of a social problem that can be reduced through appropriate design measures is that of bullying. Children with autism are bullied much more often than other children. This can cause serious distress both to the child and their family. A school should therefore be built in a way that there are always sightlines available to teachers for supervision. This should include not only the internal school environment but also the exterior and the playgrounds. Carefully designed openings and partitions can allow low-key observation to take place, meaning that the children will be safe, without the feeling of being continuously watched.

An example of a simple but effective measure which can help with interaction, communication and shifting in a domestic situation is one that can be employed to help cope with unscheduled visitors. People who ring the doorbell of the home of someone with autism may not be expected or may not be immediately recognized. This can be frightening for the person with autism. However, installing a camera and a speaker at the door can help provide time and reassurance for the person with autism. This will give shifting-time to remember who might be calling and to decide whether or not one is up to this visit. If not, the visitor can be asked to wait, or to come back again later at a more convenient time.

These are just some examples of autism-friendly design. Hundreds of other examples can be given. Many problems for those with autism can be considerably reduced through autism-friendly design. This is a new and exciting field in which much will be discovered in the near future.

More about all of this can easily be found by simply typing a search term at the bottom of this page. Questions can be asked too.