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AN ARCHITECTURE FOR AUTISM:

CONCEPTS OF DESIGN INTERVENTION FOR THE AUTISTIC USER

Magda Mostafa

Archnet-IJ AR, International J ournal of A rchitectural Research

Copyright 2007 Archnet-IJAR, Volume 2 - Issue 1 - March 2008 - (189-211)

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AbstractOne in every 150 children is estimated to fall withinthe autistic spectrum, regardless of socio-culturaland economic aspects, with a 4:1 prevalence ofmales over females (ADDM, 2007). Architecture, asa profession, is responsible for creating environmentsthat accommodate the needs of all types of users.Special needs individuals should not be exempt fromsuch accommodation. Despite this high incidence of

autism, there are yet to be developed architecturaldesign guidelines catering specifically to the scopeof autistic needs.

The primary goal of this research is to correct thisexclusion by developing a preliminary frameworkof architectural design guidelines for autism. Thiswill be done through a two phase study. The firstphase will determine, through a questionnaireof first hand caregivers of autistic children, the

impact of architectural design elements on autisticbehaviour, to determine the most influential. Thesecond phase, based on the findings of the first,will test the conc lusive highest ranking architecturalelements in an intervention study on autistic childrenin their school environment. Specific behaviouralindicators, namely attention span, response timeand behavioural temperament, will be trackedto determine each childs progress pre and postintervention, for a control and study group.

This study concludes in outlining the findings of bothphases of the study, the first being the determinationof the most influential architectural design elementson autistic behaviour, according to the samplesurveyed. The second group of findings outlinesdesign strategies for autism in three points. The first isthe presentation of a sensory design matrix whichmatches architectural elements with autistic sensory

issues and is used to generate suggested designguidelines. The second is the presentation of thesehypothetical guidelines, two of which are tested inthe presented study. These guidelines are presentedas possible interventions for further testing. The third is agroup of spec ific design guidelines resultant from theintervention study. It is hoped that these will providea basis for the further development of autistic specificdesign standards, and take us one step furthertowards more conducive environments for autistic

individuals.

KeywordsAutism; design; architecture; special needs; sensory

environment.

Introduction

The person-environment relationship has long

been an integral part of architectural research.

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The careful examination of the dynamicbetween the built environment- with its attributes

of acoustics, visual character, spatial quality,color, texture, geometry etc- and humanbehavior can lead to the development of morespecific and sensitive design guidelines. Withthese more attuned guidelines, designs becomemore conducive of productivity, efficiency andcomfort for all users. Special needs individualshave been given particularly close attention inthis type design guideline development. Autism, adevelopmental disorder which is characterizedby delayed communication skills, challengedsocial interaction, and repetitive behavior, haslong been excluded from various architecturalguidelines and codes of practice for specialneeds.

It is the primary objective of this study toremedy this exclusion and take the first steptowards developing autistic specific design

guidelines. Using an intervention study of agroup of autistic students, the impact of thearchitectural environment on their behaviorand development is analyzed. The conclusiveanalysis of the data collected from this casestudy provides the catalyst for the developmentof a framework, or sensory design matrix,which organizes the complex and dynamicrelationship between sensory characteristics of

the built environment and the variant spectrumof sensory issues found in autistic users. Theconclusive guidelines include specific designcriteria which may be used to customize a spacefor an individual user or a group of autistic userswith similar sensory profiles. Less case specific,broader guidelines are also outlined andinclude concepts such as sensory zoning, useof transition spaces between zones, adoption

of escape spaces and the use of visual cues to

enhance way-finding. Such guidelines, beingbased on the sensory design concept put

forth in this paper, and after further research,may be universally applied to any building typefor autistic users, from educationa l to residentialto medical and recreational.

Architecture and Autism

Recent research has indicated that autism isgrowing at almost epidemic proportions (Hill& Frith, 2003) and (Fombonne, 2005). Despiteits overwhelming incidence, autism is by andlarge ignored by the architectural community,excluded from building codes and guidelines,even those developed specifically for specialneeds individuals. In reference to this exclusionBrown of the International Code Councilstated

I know of no building or accessibility code that

incorporates requirements specifically to addresschildren with autism. However, accessibility in

general is addressed in the codes developed by theInternational Code Council. Brown, L.,(2003), CBO

Codes & Standards Development, Technical Staff1

The United Nations mandate on the GlobalProgram on Disability also fails to outlinespecific building standards for autism. Althoughnot legally binding, the Standard Rules on

the Equalization of Opportunities for Personswith Disabilities, resolution 48/96 annex of 20/12/1993, presents governments with a moralcommitment to provide equal opportunitiesfor persons with disabilities. This covers manyissues, including employment, recreation,religion, education and accessibility to publicservices. The issue of accessibility is of primaryconcern to architects. No specific references

are made in the mandate regarding individuals

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with developmental disorders or even autism,but the term consideration is applied with

regards to other communication disorders(UN Global Program on Disability, 1993). This hassince been reviewed and it has been pointedout that individuals with developmental andpsycho-soc ial disorders, of which autism is one,have been overlooked (Al Thani, 2004). Variousbuilding codes of practice have also excludedspecific requirements for designing for autism.Among these are three documents published bythe Department of Education and Employmentin the UK (Architects and Building Branch,Department of Education and Employment(1), (2), (3)). The first two documents Accessfor Disabled People to School Buildings andDesigning for Pupils with Special EducationalNeeds- Special Schools, make no referenceto specific guidelines when designing forautistic users, while Inclusive School Design-Accommodating Pupils with Special Educational

Needs and Disabilities in Mainstream Schoolsmentions autism in a very limited sense withgeneric reference to acoustics for specialneeds. These documents do, however, providecomprehensive guidelines for dealing with otherspecial needs and learning difficulties.

This general exclusion may be a result, in part, ofthe non-standardized nature of challenges and,

respec tively, needs along the autistic spectrum.It is the contention of this paper however, thata design strategy to deal with these varyingchallenges may be put in place allowing aform of customization for groups of users. Thisstrategy will also facilitate the generation ofbroad design guidelines and policies.

In order to have a better understanding ofthis disorder, many definitions and theories

have been set forth in the past regarding themechanisms of autism. This paper bases its

hypothesis on the sensory definition of autism,put forth by researchers such as Rimland

(1964), Delacato (1974) and Anderson (1998).In such theories, autistic behavior is credited toa form of sensory malfunction when assimilatingstimulatory information from the surroundingphysical environment. It is the conceptual pivotof this research that the architect, throughdesign of this physical sensory environment, hascontrol over the nature of this critical sensoryinput. By understanding the mechanisms ofthis disorder and consequent needs of theautistic user, this environment may be designedfavorably to alter the sensory input, and perhapsmodify the autistic behavior, or at least createan environment conducive of skill developmentand learning.

The key to such modification is the process of

perception. If we look at typical perception asthe understanding of, and relevant responseto, the sensory input from the surroundingenvironment, i.e. the architectural design, wecan better understand the role of architecturein autistic behavior. Most interventions forautistic individua ls, predominantly medical,therapeutic and educational, deal with thesensory malfunction itself and the development

of strategies and skills for the autistic individualto use when coping with these malfunctions. Itis the contention of this research that autisticbehavior can be influenced favorably byaltering the sensory environment, i.e. thestimulatory input, resulting from the physicalarchitec tural surroundings (color, texture,ventilation, sense of closure, orientation,acoustics etc.) before, rather than after

the sensory malfunction occurs. Perhaps by

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altering this sensory input in a manner designedto accommodate specific autistic needs,

behavior may be improved, or at least a moreconducive environment created, for moreefficient skill development.

Previous architec tural research has supportedtheories regarding the influence of thearchitectural environment upon user behaviorin typical non-autistic users. Deasy and Laswelldiscuss architects use of common patternsof cognition to guide and manipulate user

behaviour in a space (Deasey & Laswell,1990). If we look at meaning, or the cognitivevalue given to an experience, we canunderstand how a user typically interprets hisarchitectural environment. Lang discussesvarious mechanisms through which meaningis obtained from the architectural environment(Lang, 1987). Architec ts utilize this concept indesigning space, by giving certain meanings

through form, to influence user behaviour.Mostafa discusses the means by which cognitiveissues generate architec tural patterns in variouscultures (Mostafa, 1998). J ust as architecturalpractices adjust themselves to accommodatesocio-cultural cognitive patterns this paperproposes similar sensitivity to the very differentcognitive patterns of autistic individua ls. Thesepatterns are formed through multi-sensory

perception and hence deviate from the typicalin autism. It is the objective of this paper tounderstand these patterns through the eyesof autism and develop them into designguidelines, approaches and concepts.

Methodology

Study Design- Phase 1To reach this goal of developing a frameworkfor architec tural guidelines for autism, a twophase study was carried out. The first phase ofthis was a cross-sectional descriptive study ofthe primary caregivers and teachers of autisticchildren. The objective of this first phase was torank the impact of specific architectural factorsor spatial characteristics - acoustics, visual(colors and patterns), visual (lighting), texture,olfactory and spatial sequencing of functions.

The results from this ranking would indicatethe most influential architectural factors onautistic behavior, which would become theintervention variables to be studied in Phase 2.

Study Tools- Phase 1The primary tool used for this phase of thestudy was an online questionnaire posted

on the Families for Early Autism Treatment,FEAT, a website dedicated to families andeducators of children with autism. This samequestionnaire was also distributed to thecaregivers and teachers of the AdvanceSoc iety for Developing Skills of Spec ial NeedsChildren, Cairo1. Participants were asked torank 5 architectural factors - acoustics, visual(colors & patterns), visual (lighting), texture,

olfactory and spatial sequencing of functions,from the most influential to the least.

Study Sample- Phase 1A purposeful sample of a total of 83 individuals,with a distribution of 25 teachers and 58 primarycaregivers, responded to this questionnaire.

Their participation was voluntary. Therespondents were both local (Egyptian) andwestern (Americans). All participants were

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from the middle to upper strata of the socio-economic middle class.

Study Design- Phase 2This second phase is comprised of twointerventions, both implemented at theAdvance Society for Developing Skills ofSpecial Needs Children in Cairo. Each of theseinterventions studies an architectural variable,chosen based on the results of the phase1 survey. These variables are acoustics andspatial sequenc ing. Both interventions compare

the performance of a control and study group.

The first test analyzes the impact of acousticson autistic behavior in speech and languageacquisition. This intervention involved theacoustical modification of a speech andlanguage therapy room through soundproofingof floor, wall and ceiling surfaces with theobjective of reducing both echo and external

noise penetration. The detailing used for thissoundproofing used inexpensive materialsrequiring minimal installation in order to becost-effective and reduce the disturbance tothe schools operation during such installation.

The average background noise level wasreduced from 65.5 decibels to 52.5 decibels.

The echo ratio was reduced from 96% to 57%.These readings were taken using a standard

sound level meter and a 90 decibel soundsource. Noise levels were recorded on a gridthroughout the room and a numeric averagewas taken. Echoes were measured against allfour walls and again a numeric average ratiowas taken (Kuttriff, H., 1991).

The second intervention dealt with spatialsequencing. This involved reorganizing thespatial layout of one of the schools classrooms,

in such a way that promoted routine. This wasachieved through the organization of the

functiona l spaces of the classroom, within whicha single activity is carried out, into stations orseparate defined zones, including an escapespace which acted as a haven for times ofsensory imbalance in the children (fig. 1). Thisscenario was based on the long-standinghypothesis that autistic children adhere toroutine (Kanner, L. 1943), (Medical WorldNews, 1966), a compulsion which is an integraldiagnostic indicator of autism (Schopler et al,1988). This resistance to c hange is commonlyviewed as a problem in autism, but it is hopedthat by capitalizing on this otherwise negativecharac teristic, positive changes can be made.By creating a predictable environment in thelearning space and catering to the childs needfor routine, he or she may be more open tolearning essential skills that can be generalizedoutside this controlled space, making him or her

ultimately less dependant on the routine.

This design approach of compartmentalizationalso confines the limits of the sensoryenvironment with which the child interactsduring any given activity or station. Thephysical compartmentalization of activities alsohelps decrease visual distractions, and limitsfields of peripheral vision. These issues normally

add to the distractibility of the child and limithis attention span. It is theorized that by limitingthese visual and other sensory issues, the childwill learn to focus on the educational task athand. Ultimately the visual and auditory cues ofthe activity will condition the child and help himgeneralize his responses outside the controlledenvironment.

Some may argue that the real world is not setup

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in clearly defined stations and very frequentlyroutine is disrupted. This is a very realistic

and relevant observation, but it is hoped that

such a configuration within the classroom willhelp develop skills to deal with such chaos,

disorganization and unpredictability.

Study Tools- Phase 2The study technique used for both interventions,acoustical modification and spatial sequencecompartmentalization, was the progressobservation of specific behavioral indicators.

These indicators were attention span, responsetime and behavioral temperament. The

rationale behind the choice of these indicatorsis their inherent role in skill development for allindividua ls, but particularly autism, where theyplay a fundamental role in skill acquisition anddevelopment. Since it is the ultimate goal ofthis research to outline strategies to createenvironments more conducive of learning,

Figure 1: Plan of compartmentalized study c lassroom showing simultaneous use of various stations. (Source: Author).

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these behavioral indicators must be addressed.It is hoped that by creating an environment

where the autistic child is more focused and lessprone to behavioral outbursts, an educationalwindow of opportunity will be generated,and more efficient skill development will beachieved in a shorter period of time. This sortof approach is fundamental in outweighing thedevelopmental delay of the autistic child.

Direct observations, by the researcher andteachers, as well as video, were the tools

used to measure and record the indicators.In the case of attention span, defined as theamount of time in seconds the child remainson task without distraction, a longer attentionspan indicates a positive result. With regards toresponse time, defined as the amount of timein seconds it takes for the child to respond toa command or question, a shorter responsetime indicates a positive result. Behavioral

temperament was indicated by measuringthe occurrence of self-stimulatory behavior.

This behavior is a habitual, compulsive ac tionexhibited by the autistic child, indicative ofdiscomfort and sensory imbalance. Unique toeach child, this may range from head bangingto hand-biting to rocking etc. It has been shownthat such behavior, when decreased, indicates asuccessful outcome of the intervention (Kaplan

et al, 2006).

The total time period of these tests was oneacademic year, the first semester being usedfor baseline documentation to benchmarkeach individual childs progress, as well as toallow the children to familiarize themselves withthe presence of the researcher on the premisesduring observations. The second semesterwas used to document the impact of the test

scenarios on the study group and control group.For each of these indicators, during this second

semester, readings were taken at specificmilestones during a total span of 12 weeks, from

February to J une 2003, at week 0, week 4, week8 and week12. Each reading was taken duringone 45 minute class period. In the case ofattention span and response time, an averagetime was calculated for the week. In the caseof behavioral temperament an averageoccurrence rate of self-stimulatory behaviorduring one class period was calculated foreach week.

Behavioral mapping was also used as anadditional qualitative tool, to internally validatethe findings. This tool outlined behavioralpatterns and their relationship to use ofspace (Sanoff, H., 1991). Such patterns weredocumented at milestones parallel to the otherreadings: week 0, week 4, week 8 and week12.

The observational data collected from this toolhelped translate the abstract data recordedinto workable architec tural guidelines. Toproduce the behavioral map, each child wasobserved for a five minute interval, or vignette,in the altered space. His responses, movementsand activities were documented as anannotated diagram on the layout as well as ina time-line chart (fig. 2). This technique was only

used for the spatial reorganization test scenarioas the acoustical modification scenario did nothave a spatial sequence element.

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Study Sample- Phase 2

Both interventions use a comparative studygroup vs. control group format. Special needsclasses, particularly those for autistic childrenare small, with a teacher to child ratio reaching1:1 in some cases. One study class and onecontrol class, out of a total of 8 classes in thecenter, participated in the study, with 6 studentsin each class, making a total sample size of 12students, representing 25% of the student body.

The classes chosen for intervention were fromthe primary level classes, given that their earlyage makes them most impressionable andindicative of intervention impact. These classesare grouped based mainly on skill and abilityrather than age alone. The ages of the studentsparticipating in the study therefore ranged from6-10 years, with a mean age of 8.33 years andstandard deviation of 1.63 and median of 8.5 in

Figure 2: Behavioral map of study classroom showing annotated diagramming and time chart. (Source: Author)

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the study group, and a mean age of 7.5 yearswith a standard deviation of 1.643 and medianof 7 in the control group. Given the naturaltendency of higher occurrence of autism inboys over girls the ratio of males to females inthe study was 9:3.

Due to the heterogeneity of the sample andthe fact that skills vary from child to child, resultswere analyzed relatively, with regards to eachchilds respective performance, rather thanabsolutely, across the entire sample. Friedman

testing was used for the multiple progressreadings of attention span and response timewhile Wilcoxon Signed Rank Testing was usedfor the pre and post progress readings of

behavioral temperament.

Ethical Considerations

Given the sensitive nature of this study, and

the confidentiality issues involved, particularlywith respect to the young age of the childrenand the adopted tools of video, consent fromthe primary caregivers of the children wasessential. A written consent form, outlining thegoal, structure and projected outcomes of thestudy, was distributed to all the parents andlegal guardians of the children participating inthe study, requesting their permission for three

aspec ts. The first aspect was the inclusion of thechild in the study, the second was access to thechilds clinical and academic file, and the thirdwas permission to record the childs progressthroughout the study. Separate consent wasrequested for videotaping and photography.

The wishes of all parents regarding the degreeand type of involvement of their children wereunequivocally respected.

Results and Discussion

The overall results of this study show promising

indications of the possible improvement ofautistic behaviour, as indicated by increasedattention span, reduced response timeand improved behavioural temperament,using an altered architectural environment.

These indicators, when combined, createa behavioural environment more conduciveof learning and may increase the autisticchilds opportunity for skill acquisition

and development. This also indicates thepreliminary success of acoustical control andspatial sequencing as architectural guidelinesconducive of positive autistic behaviour.

Despite the heterogeneity of the samplepopulation, as well as the small sample size,statistica lly significant results, as calculatedusing the Mann-Whitney test, support these

preliminaryfindings in most cases, as indicatedby a significance lower than 0.05.

This study should hence be considered a firststage exploratory study, intended to judgepreliminary influence of the test variables onautistic behaviour as measured by the testindicators. It is therefore recommended thatfurther studies, using randomized testing witha larger sample size and standardized possible

confounder factors, be conducted to verify itspreliminary findings.

Phase 1- Architectural Influence onAutistic Behavior

The results of this phase show that, accordingto the sample surveyed, acoustics are themost influential architectural factor on autistic

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behavior, followed by spatial sequencing.According to the results of the questionnaire 64%of teachers and 79.3% of parents rank acoustics,and 20% of teachers and 13.79% of parentsrank spatial sequencing as the most influentialarchitectural factor on autistic behavior. Otherfactors such as visual (lighting), visual (colorsand patterns), texture and olfac tory issues weregiven less influential importance by the samplesurveyed. Percentage of teachers rankingthese factors as highest were 8%, 4%, 4% and0% respectively, while percentage of parents

were 3.45%, 0%, 1.72% and 0% respectively.These results formed the basis for choicevariables for the experimental testing of Phase2, conc luding acoustics and spatial sequencingas appropriate interventions for experimentaltesting.

Phase 2- Acoustical Modification Test

Attention Span:The results of this intervention indicate positiveimprovement in attention span of the studygroup students. The children were better ableto identify, recognize, imitate and verbalize inthe soundproofed speech room. On averagethe study group exhibited an increase of morethan 3 times their original attention spans. Theyexhibited a gradual increase in their attention

span median from 44 to 58 to 72 to 142.50seconds over the 12 week period. The mean ofthe group progressed gradually from 45 to 130.5seconds with standard deviations of 27.07 and34.61 respectively.

The control group did not exhibit similar gradualprogress. There was no distinct pattern ofimprovement in their attention spans whosemedian progressed from 38 to28 to 22 to 27

seconds over the 12 week period. The mean ofthe group moved from 38.67 to 27.33 to 27.83to 27.33 with standard deviations of 17.69, 17.1,22.09 and 8.26 respectively.

The statistical significance of these resultswere verified using the Mann-Whitney test andranged in exact significance from 0.818, 0.026,0.009 and 0.002 respectively over the 12 weekperiod.

The Friedman rank testing results of this data

also shows significant relative progress of eachindividual student over time in the study group,

with a gradual increase in mean ranking from1.33 to 2.17 to 2.50 to 4.0 through weeks 0-12, with an asymptotic significance of 0.004.Friedman rank testing of the control group showslittle relative improvement of each individualstudent with mean ranks of 3, 2.17, 2.33 and2.5 through weeks 0-12, with an asymptoticsignificance of 0.7060.

Response Time:With regards to response time, promisingindications were also observed. The studentsof the study group were seen to respond fasterand were able to sustain that quick responsemore frequently and for longer periods of time.During the span of the trial, students from thestudy group illustrated a gradual decrease in

their response times, indicating a positive result.Their median response times decreased from25.50 to 16 to 10.50 to 7.00 sec onds throughweeks 0, 4, 8 and 12 respectively. Their meanresponses decreased gradually from 24.83 to6.83 seconds with standard deviations of 12.92and 5.08 over the same period of time.

Again the control group did not exhibit suchuniform progress. Their median response time

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progressed from 9 to 8 to 9.5 to 12 secondsthrough weeks 0-12, showing no distinct patternof improvement, but rather general consistency.

Their mean response times were 10.3, 7.17, 9.67and 11.66 seconds with standard deviations of3.14, 3.54, 3.83 and 4.23 respectively throughweeks 0-12.

The Mann-Whitney exac t significance scores ofthese results were 0.065, 0.132, 0.818 and 0.093respec tively over the 12 week period.

Regarding individual relative progress of casesFriedman rank testing of response time progressfor the study group is also promising, showinga gradual decrease in mean rank from 3.83 to2.5 to 1.92 to 1.75 during the study period, withan asymptotic significance of 0.02. Again thecontrol group did not display similar regularityin progress. The control groups response timemean ranks were 3.08, 1.25, 2.25 and 3.42 withan asymptotic significance of 0.009.

Behavioural Temperament:The behavioural temperament of the studygroup students was also seen to improve, withthe median occurrence of self-stimulatorybehaviour in the study group decreasing from 2.5to 1 occurrence, compared to a stable medianof 2 occurrences in the control group, pre andpost intervention at weeks 0 and 12. The mean

occurrence in the study group was decreasedfrom 3.33 to 1.17 with a standard deviation of 2.66and 1.17 respectively, pre and post intervention.

The control group showed little change with amean of 2.17 and 2.5 occurrences, pre and postintervention, with standard deviations of 1.17and 2.17 respectively.

Given the pre and post reading format ofbehavioural temperament the Wilcoxon signed

rank test was used to determine individua l caseperformance over time. 5 out of 6 of the studystudents showed negative ranks, indicating apost-intervention occurrence of self-stimulatorybehaviour less than the pre-interventionoccurrence, i.e. an improvement in behaviouraltemperament. One tie rank was also observed.

These results had an asymptotic significance of0.041. With regards to the control group, only 2out of the 6 displayed a decrease in occurrenceor negative ranking, with 3 exhibiting positiveranking, or increase in occurrence of self-

stimulatory behaviour, and 1 tie. The asymptoticsignificance of this reading was 0.480.

Phase 2- Spatial Sequence Intervention

Similarly promising results were observed inthe second intervention which involved thestudy of the impact of spatial sequencing, orcompartmentalization, on the test indicators.

Attention Span:In tracking the progress of attention span in thestudy group after implementation of the spatialsequence intervention, a general patternof improvement was observed. The medianattention span dipped at first and then graduallyincreased from 13.5 to 12.5 to 22 to 30 secondsfrom week 0 through12. The mean attentionspan was 18, 17.83, 34 and 44 sec onds with

standard deviations of 12.7, 13.11, 26.01 and28.85 over the same period. A similar patternof gradual improvement was not observed inthe control group. Median attention span inthe control group went from 39.5 to 25 to 28 to25.5 seconds from week 0-12. These results hadan exact significance of 0.093, 0.132, 0.818 and0.485 through week 0-12.


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In tracking individual case relative progress,this interventions Friedman rank testing resultsshowed a preliminary plateau, then gradualincrease throughout the study period, in meanranking of the study group from 1.5, to 1.5 to3.33 to 3.67 with an asymptotic significance of0.002. A similar pattern was not found in thecontrol group which had a mean ranking of 3.5to 2.33 to 1.83 to 2.33 from week 0-12, with anasymptotic significance of 0.145.

Response Time:

Response time was also seen to be improvedas a result of the compartmentalization andspatial sequencing of the classroom. The studygroup exhibited a decrease, i.e. improvement,in median response time from 11 to 8.5 to 6.5to 3.5 seconds during week 0, 4, 8 and 12respec tively. Their mean response times overthe same period were 18.33, 8.67, 8.5 and 4.17seconds with standard deviations of 21.21, 4.32,

6.92 and 3.19.The control group again showed no regularpattern of increase of decrease. Their medianresponse times were 11, 7.5, 17 and 12.5seconds from weeks 0-12. Their mean responsetime was 12.33, 8.5, 23 and 12.17 seconds with astandard deviation of 8.59, 3.39, 20.02 and 4.02,over the same period of time. The asymptoticsignificance of these results was 0.937, 0.937,

0.093 and 0.009 from weeks 0-12 respectively.

The individual relative progress of studentsin the study group exhibit similar patterns ofimprovement. The Friedman rank testing resultsof the study group show a gradual decreasein mean rank from 3.67 to 2.58 to 2.67 to 1.08with an asymptotic significance of 0.006. Again,although the individual performance reflects

the group pattern, or lack thereof, there seemsto be no distinct pattern of improvement orregression in the control group. Their meanrank progresses from 2.33 to 1.5 to 3.42 to2.75 through weeks 0-12 with and asymptoticsignificance of 0.07.

Behavioral Temperament:Again, behavioral temperament of the studygroup was seen to improve, although not assignificantly as the other indicators. The medianoccurrence of self-stimulatory behavior in

the study group decreased from 1.5 to 0.5occurrences, with a mean of 2.83 and 1.33with corresponding standard deviations of3.54 and 1.75, all pre and post intervention atweek 0 and week 12. The control group didntshow similar significant improvement, with amedian oc currence of 1 and 1.5, pre and postintervention, and mean occurrence of 0.83 and1.50 with corresponding standard deviations of

0.76 and 1.05. The exact significance of theseresults was 0.485 and 0.699 at week 0 and week

12 respectively.

Individua l progress of cases parallels the resultsof the groups. Again using Wilcoxon signedrank testing 4 out of 6 students from the studygroup showed negative ranks, or a decreasein self-stimulatory behavior, with 0 positive ranksand 2 ties. The control group did not exhibit

similar progress with only 1 student out of 6showing negative ranking, or a decrease in self-stimulatory behavior, and 3 students showingpositive ranking, or an increase, with 2 ties. Theasymptotic significance of this is 0.194.

Observational Results of Behavioral Mapping:Many interesting observations were recordedregarding the behavioural use of space


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throughout the duration of the spatial sequencetest. One of the very first observations madeearly on in the test was the effect of the

escape space upon the behaviour of thechildren, particularly the hyperactive andseverely autistic ones. Prior to the modifications,one such child with complex auditory, tactileand proprioceptive issues, was constantlyremoving herself from the group to sit on thefloor against a wall with legs stretched in front,banging her head against them. This wouldusually last for about 10 minutes, after which she

would sit quietly alone for a few minutes andthen rejoin the group. The c hild was apparentlyescaping the maladjusted sensory stimulationof the session at hand and re-calibrating herinner sensory mechanism. She first removedherself from the situation and then providedherself with the sensory input required: auditoryreduction by distancing herself, tactile byinflicting pain, and proprioceptive through the

rhythmic movement and physical boundary ofthe wall.

Once an escape space was made available,where no other activity was conducted, bothteachers and the researcher expected thischild to spend the majority of her time withinit. At the very beginning, that was the case,but eventually the child used the space lessand less. It was observed, however that she

constantly looked over her shoulder, checkingto make sure it was still available. She becameslightly more focused, if anything only becauseof the diminished number of escapes. It wasalmost as if the mere presence of the option toescape was sufficient, and her need to escapedecreased, now that she was comfortablewith the fact that there was constancy in thatescape opportunity.

In the control class, with the absence of aformal and partitioned escape space, similareffects were not observed. Those children

who did need time-out used a cushion in thecorner but were constantly either disturbed bytheir curious peers, or joined by them. Eitherway, both the individual childs escape time,as well as the session, was disrupted. Althoughthere was a partitioned area in the class, itwas arranged for one to one instruction, withdistractions and sensory stimulus incongruentwith a true escape.

Another apparent positive influence observedwas the effect of the compartmentalizationupon the visual distractionof the children. Manyof the hyper-visual and even hyper-auditorychildren would look up, becoming distractedfrom their work, if anyone moved around orentered the room. Since regaining the attentionof an autistic child, once distracted, can bedifficult, this was a major problem. The designmodification, however, with its physical andvisual compartments, influenced this positively.In the new layout, the children were alwayssituated so that visual accessibility would beminimized, particularly during their one to onesessions where focus was a priority, and, unlikegroup sessions, outside interac tion was to beminimized (fig. 1).When the child heard a soundor saw something move in his peripheral vision,

he would look up, as before, but in this case beunable to see above and around the partitions.Eventually the child became conditioned notto look up. He became more attentive andfocused with this decrease in distraction. Withthe repetition of this exercise he may learn totransfer the sense of focus and associate it withthe activity at hand. Hopefully such a skill caneventually be generalized to other spaces,

An Architecture for Autism: Conc epts of Design Intervention for the Autistic User 202

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where such visual accessibility is not controlled.Again the control group, with the absence ofthe physical and visual boundaries, did notdevelop this conditioning.

Spatial efficiency was a further positiveobservation made in the study class. Due tothe segmented and compartmentalized natureof the new classroom layout, the availablespace was used much more efficiently. Thelevel of activity achieved in the new layoutwas not possible prior to the modifications.

Previously, the teachers found it far toodistracting for the children to conduct merelythree one to one sessions concurrently. Afterthe spatial reorganization, three one to ones,a group table session, a floor play session anda napping student in the escape space wereall comfortably and attentively using the spaceat once.

During such a session it was noted that thegeneral attentiveness of the children, as wellas their temperament, was above average,despite the fact that each child was involved ina different activity. Apparently the physical andvisual boundaries of the various compartmentshelp provide limits, and with these a certainlevel of control. In an autistic child the smallestof environments may seem vast as his senses,with their various sensitivities, are being

constantly over or under-stimulated. It wasobserved that by limiting the extents of thisenvironment, both physically and visually, andadjusting its sensory components, for a certainperiod of time, it allowed the child to remainfocused on the activity at hand. This createdthe ever-important window of opportunity forskill development.

This observation was, perhaps, the most clearlyabsent in the control group. Despite havinga small number of children, it was observedthat on many occasions it became impossibleto work as a group with even a single one toone session in parallel. The one to one childrenwere constantly being removed from the classto use another empty class or even office fortheir sessions.

The concept of generalizing behaviour learntin the c lassroom is an important one in autistic

education. The altered spatial organization ofthe test classroom was observed to facilitatethe first stage of this process. As the child entersthe partitioned area, the equipment, furnitureand teacher are always arranged in a certainfashion for each ac tivity, triggering a sort ofpredictability. Prior to the test modifications,similar arrangements were used. The new spatialorganization, however, seems to have amplified

the predictability factor. When a child seesthe arrangement, coupled with the physicaland visual boundaries of the compartment,he can predict what activity will take place. Itis such predictability that autistic children seekthrough their adherence to routines. When thechild is able to expect what will come from hisotherwise highly unpredictable environment,he settles. Capitalizing on this is a helpful tool tohelp calm them and allow them to focus. Thisnew arrangement apparently created just thisopportunity.

In the case of the control group there was nospatial compartmentalization to amplify thispredictability, even with the use of familiararrangements. Children were observed to take afew minutes from the beginning of each sessionto orient themselves to the arrangement and


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task at hand. This wasted prec ious time that wasavailable to those children of the study groupwho had this spatial facilitation.

Recommendations and Conclusions

As outlined in the above discussion,both interventions seem to have positiveimplications on the test indicators measuredin this study. These preliminary findings cannow be translated into architectural toolsand guidelines. Much testing is still required

before the interventions tested here may begeneralized to all environments designed forautism. This study, however, will present a tool toorganize the generation of guidelines for furthertesting, as well as present a group of suggestedguidelines, resultant from the study.

The conclusions of this research are outlined ina series offindings and recommendations. The

first finding is the result of the preliminary cross-sectional descriptive study which determinesthe highest ranking of architectural factorsinfluencing autistic behaviour as acoustics andspatial sequence, according to the samplesurveyed.

The second group involves the outline for adesign tool and its resultant guidelines. This tool,a sensory design matrix, helps organize the

dynamic relationship between the architecturalenvironment and the complex range of autisticsensory issues. (see appendix A).

Since autism presents a large scope ofsymptoms, each autistic individual has theirown group of needs. According to Delecatos(1974) original theories, these needs arederived from each different sensory issue, from

the hyper, hypo to white noise interferencemanifestations. Although impossible tocustomize a public environment, like a school,to each user, grouping of students with similarneeds is possible. An organizational toolmatching the various autistic sensory needsrepresented in the horizontal axis of the matrix,with their appropriate architectural treatmentrepresented by the vertical axis of the matrix,has been developed by the researcher for thispurpose. In this sensory design matrix, eacharchitectural attribute, such as proportion,

scale, symmetry, color, lighting and texture,is analyzed with respect to its capacity torespond to the various autistic sensory needs.

This generates a number of architecturaltreatments or guidelines, like the acoustica lmodification and spatial sequencing testedhere, which are shaded in the matrix. This matrixalso generates a further group of treatments tobe considered for use in autistic design, and

which can be the basis for further research andintervention tests similar to the ones presented inthis paper, in the future.

This design tool acts as an architectural guidelinegenerator, where the users needs are input asa sensory profile and a group of architecturalguidelines are matched for each individual userin customized environments such as homes, orgroups of users in public buildings such as schoolsand academic centers. (see appendix B).

Additionally, design recommendations generatedfrom the results and observations of this researchmay be summarized as follows. These arerecommended guidelines to be used by architectsdesigning environments for autistic users.

The application of noise and echo treatment


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in areas such as speech rooms, although itsapplication may be beneficial in almost allspaces used for autistic instruction and particularlyin those where long attention spans, quickresponses and high levels of focus are required.Such spaces could include computer rooms, oneto one instruction rooms, sensory integration andneurological organization rooms.

The creation of a graduated series ofacoustically modified rooms for speech therapyas well as other activities requiring similar

acoustical environments. This is to avoid thegreenhouse effect, where a child becomesdependant upon the optimum acousticalquality of the room and is unable to functionand generalize his skills outside of it. Thisgraduated series would allow the child to usethe fully soundproofed room during the criticalstage of his autism, when such an interventionmay be the only way to initiate communication.

Having mastered a fundamental group ofcommunications skills the child should then bemoved to a moderately sound-proofed roomwhere he will begin to develop backgroundnoise filtration skills. This should continue throughthe series of available rooms with the ultimateobjective of functioning in as acousticallynormal an environment as possible.

The c reation of an escape space in learning

spaces. The sensory make-up of the spaceshould also be well designed. In general itseems best to design a baseline neutral sensoryenvironment, as if designing for the hyper-sensitive across the entire spectrum. Elementsof sensory stimulus can then be added tocompensate for those hypo-sensitive individuals,by being made available to those who needthem. This concept is based on the idea that

it is easier to add stimulation from an externaltemporary source, like a piece of sandpaperfor the hypo-tac tile, or a moving mobile for thehypo-visual, or music for the hypo-auditory, thanto remove stimulation from the environment,like soundproofing for the hyper-auditory, orchanging textures for the hyper-tac tile.

J ust as escape spaces need to be conduciveof the activity of escape all other areas inthe classroom should be designed with eachactivity to be conducted in them in mind.

A group of facilitative furniture arrangementsfor various educational activities wasdeveloped during the course of this research.As observed previously, the consistency ofthese arrangements also provides visual cues tocondition the child to expect and settle easily tothe task at hand.

Such conducive arrangements, and the creationof visual cues, could have particular impactwhen coupled with compartmentalization.Such compartmentalization capitalizes uponthe autistic adherence to, and preference of,routine. This routine theory was shown to besuccessful in the a place for everything andeverything in its plac e concept applied throughthe compartmentalization of the study groupclassroom. As seen such compartmentalizationlimits the sensory environment which the child

has to assimilate. It has been shown to promotefocus and concentration.

This theory may be extended to encompassthe sequencing of activities and functionsfrom inside the classroom to the building as awhole. This would involve developing designsemphasizing order, sequence and routine.Activities could be arranged to follow a sort of


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one-way c irculation arrangement, accordingto the daily schedule. Different ac tivities couldbe clearly visually and spatially defined. Universal

or multifunctional spaces, such as open-planclassrooms, should be avoided to reducesensory confusion. This sensory coherence couldhelp student temperament, improving overallperformance and economizing on precioustime while getting to and from classes, as well asreducing the need to allow calming down timeand effort at the beginning of each session.

This discussion brings us to conclude thatthe autistic user identifies the architecturalenvironment around him or her in accordanceto sensory zoning rather than conventionalfunctional zoning. Spatial groupings couldfollow autistic logic and involve sensorialcompatible functions. These groupings canbe accessed through a one-way circulationsystem, emphasizing, as well as capitalizing on,

routine, as discussed previously. For examplehigh-stimulus functions like music, art, crafts andpsychomotor therapy, requiring a high levelof alertness can be grouped together, whilelow-stimulus functions like speech therapy,one to one instruction and general classrooms,requiring a high level of focus, can be groupedtogether. Services, which are usually high-stimulus, including bathrooms, kitchens, staff-rooms and administration, should be separated.Only those requiring student ac cesses should begrouped near the high-stimulus zones and as faras possible from the low-stimulus zones.

The application of the concept of sensory zoningcould also reduce the problems of distractionand diversion. Keeping the sensory atmosphereof each area as coherent as possible, couldallow a more continuous circulation from one

space to another. Through the preliminarystructured interviews conducted during thisresearch, it seemed that when the autistic

child veers off course when moving from onespace to another it is not a question of gettinglost but rather a question of being distractedalong the way. Some parents and teacherseven found the visual recollection skills of theirchildren to provide them with an excellentbasis for navigation. It was their distractibilityby the surrounding sensory environment thatprevented them from reaching their destination.

Sensory atmospheric coherence through designmay help to reduce this distraction.

When moving to or from an area of high sensorystimulus, the use of sensory transition zones,in the form of gardens or sensory curriculumareas, may help to prepare the child for such amove with minimal distraction. It is hoped thatsuch an arrangement would allow the child

a form of sensory calibration, in order to makethe transition from these varying sensory zonesmore fluid hence allowing improvement ofnavigational skills.

These concepts of zoning and circulationmay be enforced and enhanced using visualcues. As Peeters (1997, p. 63) has shown,such cues have a powerful associative andcommunicative effect on autistic perception.

Even from a first-hand perspective, Grandin(1996) based her explanation of autism on theconcept of thinking in pictures. Patterns, colorsor abstractions may be used to communicateto the children the character of various zonesand spaces. Visually distinctive landmarks maybe used at the hub of each zone, indicative ofits character. A similar visual concept may beused for signage throughout any autistic facility.


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This would serve two purposes, first, comfort tothe child allowing him a commonly lackingsense of orientation, and second ultimately

allowing him ability to navigate these spacesindependently.

In closing it is this idea of independence thatis the pivotal concept of facilitating andimproving quality of life for all special needsindividua ls, but for autism particularly. As thefirst step towards inclusion and acceptance,independence represents an important goal

in all autistic interventions. With further researchand testing of the guidelines outlined in this studyit is hoped that this paper will take us one morestep towards achieving that goal. Environmentsbased on careful scientific analysis will benefitnot only those with special needs, but all usertypes, making our architecture more genuinelyresponsive to all our range of needs.

AcknowledgementsAc knowledgement should go to Dr. Zakia Shafie andDr. Hammam Serag El Din, both of Cairo UniversitysDepartment of Architectural Engineering, for theirsupervision of the original thesis upon which this paperis based. Mrs. Maha El Helali and all of the ADVANC Eschool administration and staff provided the generouscooperation required to make testing of this study inan autistic environment possible. This study would nothave been possible without the consent and support

of all the parents of the children involved in the study.This work was primarily developed to help people withautism. The children of this study have been patient,cooperative and at many times an inspiration.

References

Al-Thani, H. (2004). Updating the Standard Rules,International Federation of Hard of Hearing People,7th World Congress, Helsinki, Finland.

Anderson, J .M. (1998). Sensory Motor Issues in Autism,Therapy Skill Builders, The Psychological CorporationTexas, USA.

Architects and Building Branch, Department ofEducation and Employment (1) (1999). Access forDisabled People to School Buildings, Building Bulletin77, United Kingdom.

Architects and Building Branch, Department ofEducation and Employment (2) (1999). InclusiveSchool Design- Accommodating Pupils with SpecialEducational Needs and Disab ilities in MainstreamSchools, Building Bulletin 94, United Kingdom.

Architects and Building Branch, Department ofEducation and Employment (2) (1997). Designingfor Pupils with Special Educational Needs, SpecialSchools Building Bulletin 77, United Kingdom.

Autism and Development Disabilities MonitoringNetwork (ADDM) (2007). Prevalence of the AutismSpectrum Disorders in Multiple Areas of the UnitedStates, Surveillance Years 2000 and 2002, NationalCentre on Birth Defects and Developmental

Disabilities, Online http:// www.cdc .gov/ncbddd/dd/addmprevalence.htm, Accessed on June 16, 2007.

Deasy, C.M., and Laswell, T. (1990). Designing Placesfor People- A Handbook on Human Behaviour forArchitects, Designers and Facility Managers, WatsonGuptill Publications, New York, USA.

Delacato, C .H. (1974). The Ultimate Stranger- TheAutistic Child, Academic Therapy Publications,Novato, California, USA.

Fombonne, E. et al (2005). The Epidemiology ofAutism Spectrum Disorders, In proceedings of:AWARES Autism 2005, Online www.awares.org/conferences .

Grandin, T. (1996). Thinking in Pictures; and OtherReports from my Life with Autism, Random House,USA.

Hill, E., and Frith, U. (2003). Understanding Autism:Insights from Mind and Brain, Philosophical


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Transac tions: Biologica l Sciences, Vol. 358 (1430), pp.281 289.

Kanner, L (1943). Autistic Disturbances of AffectiveContact, Nervous Child, Vol. 2, pp. 217 250.

Kaplan, H. et al (2006) Snoezelen Multi-SensoryEnvironments, Task Engagements and Generalization,Research in Developmental Disabilities, Vol. 27, pp.443 455.

Kuttruff, H. (1991). Room Acoustics, Elsevier AppliedScience, New York, USA.

Lang, J . (1987). Creating Architectural Theory; TheRole of Behavioural Sciences in EnvironmentalDesign, Van Nostrand Reinhold C ompany, New York,USA.

Medica l World News (1966). Breaking through to theAutistic Child, Vol. October, p. 62.

Mostafa, M. (1998). Culturally ResponsiveArchitecture: Its Existence, Objec tivity AndMechanisms, M.Sc. dissertation, Department ofArchitecture, Cairo University, Ca iro, Egypt.

Peeters, T. (1997). Autism: From TheoreticalUnderstanding to Educational Intervention, WhurrPublishing, London, United Kingdom.

Rimland, B. (1964). Infantile Autism, Appleton C enturyCrofts, New York, USA.

Sanoff, H. (1991). Visual Research Methods in Design,Van Nostrand Reinhold, New York, USA.

Schopler, E., et a l (1988). The C hildhood AutismRating Scale, Western Psychological Services WPS,USA.

UN Global Program on Disab ility (1993). Mandatesof the UN Global Program on Disab ility: StandardRules on the Equalization of Opportunities for Personswith Disabilities, Target Areas for Equal Participation:Ac cessibility, United Na tions General Assemblyresolution 48/96, annex, 20/12/1993.

------------------------------

Magda MostafaMagda Mostafa is an Assistant Professor at the

Department of Architectural Engineering, CairoUniversity where she has taught various designcourses since 1996. She is also an adjunct AssistantProfessor at the Performing and Visual Arts, as wellas the C onstruction and Architectural Engineering,Departments at the American University in Ca iro.She was born and raised in Canada , and later cameto Egypt to reside where she received her B.Sc inarchitecture from Cairo University. She recentlyreceived her Ph.D. from Cairo University, where her

doctoral dissertation studied architectural design forchildren with special needs and sensory dysfunctions,with a focus on autism. She is currently working as aspecial needs design consultant for government andprivate sector projects in Egypt, the G ulf and Europe,as an associate at the Cairo based architecturalfirm Progressive Architects. She recently completeddesigning the Advance school for children withautism in Qattemeya, Cairo, which was presentedat the World Congress on Autism in 2006, and is thefirst building to be designed based on her sensorydesign theory. She was recently nominated for the2005 UNESCO Prize for research and training in specialneeds education for children. She can be contactedat [email protected]


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Appendix A: Sensory Design Ma trix

Sensory Issues

Auditory Visual Tactile Olfactory Proprioceptive

a b c a b c a b c a b c a b c

A 1 2 1 2 1 2 1 1 2 2 1 1

B 3 4 3 3 4 4 3

C 5 6 5 5 6 5 6 5 6 5 5

D 7 7 7

E 8 8 8 8

F 9 10 9 10 9 9 10 9G 11 11 11

H 12 13 13 12 13 13

I 14 15 14 14 14

J 17 16 18

K 19 19 20

L 21 21 21

M 22 22 23

N 24 25 24

O 26 26 26 26 26 26

P 27 27 27 27

Q 28 28 28 28 28

C

I

C

I

Q

t

Sensory Issuea. Hyper b. Hypo c. Inter erence

Arch tectural Attr uteA. C osure J . Co orB. Proportion K. LightingC. Sca le L. AcoustcsD. Orentaton M. TextureE. Focus N. VentilationF. Symmetry O. SequenceG. Rhythm P. Proxm tyH. Harmony Q. RoutineI. Ba ance


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1. High enclosure and

containment

1) to reduce external visual and acoustical distrac tion for the hyper-

auditory and hyper-visual2) to provide tactile stimulation via tight spaces and c ontainment forthe hypo-tactile3) to c reate visual focus in cases of visual interference4) to reduce olfac tory intrusion via ventilation for the hyper-olfac tory

2. Low enclosure and openess 1) to increase opportunities for acoustical stimulation for the hypo-auditory2) to provide visual stimulation for the hypo-visual3) to reduce sense of containment for the hyper-tactile

3. Low ceilings and moderateproportions

1) to reduce echoes for the hyper-auditory2) to reduce visual distortion and illusions of space for the hyper-visual3) to promote balance for the hypo and interference-proprioceptive4) to create a more acoustically controllable environment for theinterference

4. High ceilings andexaggerated proportions

1) to increase ec hoes and auditory stimulation for the hypo-auditory2) to c reate visual illusionary stimulation for the hypo-visual3) to stimulate the proprioceptive sense of space for the hyper-proprioceptive auditory

5. Use of intimate scale 1) to reduce echoes for the hyper-auditory2) to c reate a controllable auditory environment for the interferenceauditory3) to c reate a controllable and manageable space for the hyperand interference visual4) to increase tactile stimulation from boundary proximity for thehypo-tactile5) to increase proprioceptive stimulation from boundary proximity forthe hypo-proprioceptive6) to c reate a controllable environment for the interference auditoryand proprioceptive

6. Use of open scale 1) to create auditory stimulation through echoes for the hypo-auditory2) to create visual stimulation through spatial exapnse for the hypo-visual3) to relieve over stimulation from spatial boundaries for the hyper-tactile and hyper-proprioceptive

7. Orientation towards externalviews and elements ofinterest

1) to create focus and attraction for the hypo-visual2) to instill balance and direc tion for the hypo-proprioceptive

Appendix B: Architectural Design Guidelines generated by the Sensory Design Matrix


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organize space1) to increase attention span and reduce distrac tibility for the hyper-auditory and visual

2) to create a behavioural and geometric point of reference for thehypo and interference proprioceptive

9. Symmetrical organization 1) creates predictability for the hyper-visual2) creates acoustical balance for the hyper-auditory3) increases sense of centre and balance for the hypo andinterference proprioceptive4) creates a c ontrollable environment for the interference visual

10. Asymmetrical organization 1) creates auditory and visual stimulation for the hypo-auditory andvisual2) creates proprioceptive stimulation for the hypo-

proprioceptiveTables

11. Use of visual or spatialrhythm

1) to c reate visual stimulation and tracking opportunities for thehypo-visual2) to create predictability and coherence to the spatial environmentfor the hypo and interference

12. Visually harmonious spacewith no contrast or discord

1) to create a visually neutral space for the hyper-visual2) to create a neutral tactile space for the hyper-tactile

13. Visually unharmoniousspace using accents and

contrasts

1) to create visual stimulation for the hypo and interference visual2) to create proprioceptive stimulation for the interference and

hypo-proprioceptive

14. Use of dynamic andstatically balanced spaces

1) to create orientation and stability for the hyper-proprioceptiveand visual as well as the interference proprioceptive and visual

15. Use of unbalanced spaces 1) to create visual stimulation for the hypo-visual

16. Use of bright colours 1) to create visual stimulation for the hypo-visual

17. Use of nuetral colours 1) to create serenity for the hyper-visual

18. Use of warm colours 1) to create psychological warmth for the hypo-tactile

19.Indirect natural lighting

1) minimize glare and distracting views for the hyper-visual2) less distracting than buzzing artificial light for the hyper-auditory

20. Direct natural lighting andviews

1) creates visual stimulation for the hypo-visual

21. Noise and echo-proofing 1) creates a conducive environment for the hyper-auditory2) removes the distracting opportunity of self-stimulation throughechoes for the hypo-auditory3) creates a neutral auditory background for the interferenceauditory



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STAFA 22. Use of smooth textures 1) calms the hypo-tactile

2) creates echo and reverberation stimulation for the hypo-auditory

23. Use of rough textures 1) stimulates the hypo-tactile24. Cross-ventilation 1) redues smells and odours for the hyper-olfactory

25. Enclosed ventilation 1) may help contain scents during aromatherapy for the hypo-olfactory

26. Organizedcompartmentalization usingvisual cues

1) helps orient and adjust the hyper-visual2) helps stimulate to action the hypo-visual3) helps organize the interference visual4) creates necessary boundaries for the hypo-tactile5) helps orient the hypo and interference proprioceptive

27. Spatial organizationaccording to sensorycharacteristics

1) helps orient and adjust the hyper-visual2) helps organize the interference visual3) helps orient the hypo and interference proprioceptive

28. Use of one-way circulationpatterns to capitalize onroutine

1) helps orient and adjust the hyper-visual2) helps organize the interference visual3) helps orient the hypo and interference proprioceptive4) helps create predictability in general across the spectrum,particularly the hyper-auditory


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