Chapter 23

Architecture for autism: built

environment performance in
accordance to the autism
ASPECTSS design index
Magda Mostafa
The American University in Cairo, Egypt

Introduction
Autism is increasingly becoming one of the more prevalent challenges
facing school children, with estimates that anywhere from 1 in every 100
(Bancroft, Batten, Lambert, & Madders, 2012) to 1 in every 68 individuals
(Centers for Disease Control and Prevention) fall within the spectrum of
autism disorder in the United Kingdom and the United States, respectively.
This places autism among the most prevalent of special needs in school
children, compared to an estimated 1 in every 2000 children in the United
States categorized as visually impaired, 1 in every 769 as physically
impaired, 1 in every 714 as hearing impaired (LeRoy, Evans, & Deluca,
2000), and 1 in every 970 diagnosed with Down’s syndrome (Shin et al.,
2009). These estimates place autism spectrum disorder at three times as
prevalent as hearing impairment, visual impairment, and physical impair-
ment combined.
In 2002, when the underlying research for the Autism ASPECTSS Design
Index began, very little literature was available to guide the process of
designing for autism. In response to this scholarly gap, a preliminary study was
designed to generate guidelines, when no guidelines were found, to help
design the Advance Special Education Center in Maadi, Cairo.
At the time when the first Advance Center was being designed, and in
response to a request for autism design guidelines, the International Code
Council stated that “(we) know of no building or accessibility code that

Autism 3608. https://doi.org/10.1016/B978-0-12-818466-0.00023-X

Copyright © 2020 Elsevier Inc. All rights reserved. 479
480 SECTION | V Autism Spectrum Disorder

incorporates requirements specifically to address children with autism”

(Mostafa, 2008).1
Since that time there has been some development in the area of built
environment research for autistic users. In 2006, Christopher Beaver presented
a practice-driven view on the reiterative process of developing autistic-friendly
environments through communication with clients and trial and error and
feedback studies (Beaver, 2006). In this review, he recommends the use of
durable finishes, natural materials, natural ventilation, and an attention to
acoustics. Further practice-centered literature followed with the work of Simon
Humphreys who presented his vision for “calm, order, and simplicity” with
“minimal detail and materials” (Humphreys, 2008). Following more closely
the available literature at the time, Iain Scott presents an interpretation of
various guidelines as applied to specific projects (Scott, 2009). In this review,
Scott discusses the development of guidelines for autism in the UK’s Archi-
tects and Building Branch’s Building BulletinsdBB 77, 91, and 94 (Architects
and Building Branch, 1999, 2001, 2005), respectively. These Building Bul-
letins present guidelines for schools and designers to better incorporate special
needs requirements. Although providing general guidelines for designing for
autismdsuch as creating low-stimulus environments, clear layouts, well-
proportioned space with minimum detailing and indirect lighting [as cited in
Scott, 2009]dlittle evidence is presented to support the effectiveness of these
criteria.
Other researchers have strived to provide this underpinning of evidence
with qualitative research methods and user-centric approaches. Baumers and
Heylighen take an intriguing view into the built environment from an autistic
users perspective through the interpretation of “auti-biographies” or autistic
autobiographies (Baumers & Heylighen, 2010). They present the relationship
between the user with autism and the built environment, not as an issue of
malfunction, but one of “otherness,” focusing on the possible potential of
seeing the world through their eyes. This otherness may include an alternative
mode of perception, a perception of the world through its structure, a need for
cognitive preparedness, and a realization that the difference is not the way
sensory input is assimilated, but what is done with that assimilation.
Claire Vogel presents design strategies developed through a series of in-
terviews with parents, teachers, therapists, and students with autism
(Vogel, 2008). She summarizes these findings by stating that built environ-
ments for autism should be: flexible and adoptable; nonthreatening; non-
distracting; predictable; controllable; sensoryemotor attuned; safe; and
noninstitutional.

1. This information was obtained through correspondence with the International Codes Council by
the researcher dated 4/3/2003 and published in Mostafa, M., 2008, An Architecture for Autism:
Concepts of Design Intervention for the Autistic User, The International Journal or Architectural
Research, 2(1); (189e211).
 Architecture for autism Chapter | 23 481

Similarly Teresa Whitehurst uses user feedback to present a comparative

look at students’ experiences with their built environment from their old and
new premises. Written from a research and development perspective, this work
strives to isolate lessons learned from the new environment and strategies to
improve existing built environments (Whitehurst, 2006). She concludes that
the positive features of the purpose built environment were: autonomy in
space, choice, and privacy; orientation through curved and guided circulation
elements; and clear views and a general calmness in design.
Although most research focuses on learning environments, residential
design has also been the subject of previous research. Taking the Sensory
Design Theory to housing design, Mostafa presents a case study of the Charis
Workhome in the Netherlands, describing the development of design criteria
for a customized retrofit housing project for adults with autism spectrum
disorder in Rotterdam (Mostafa, 2010). These criteria translated the sensory
design principles under five key areas: spatial quality, spatial organization,
spatial orientation, spatial integration, and safety. Expanding on this single
case format, Ahrentzen and Steele present a comprehensive review of housing
features for autistic users in the United States, concluding a roster of design
goals followed most commonly throughout the examples reviewed. These
design goals include the necessity to ensure safety and security; maximize
familiarity, stability, and clarity; minimize sensory overload; allow opportu-
nities for controlling social interactions and privacy; provide adequate choice
and independence; foster health and wellness; enhance one’s dignity; ensure
durability; achieve affordability; ensure accessibility; and support in the sur-
rounding neighborhood (Ahrentzen & Steele, 2010).
From the educational perspective, McAllister andand Maguire present a
studio exercise aimed at creating a “tool-kit” for autism-friendly classroom
design. Again using an iterative, user-centered approach, this time with
physical models, various strategies for appropriate classroom design were
developed, based on the work of Humphreys (Humphreys, 2008) and Vogel
(Vogel, 2008), presenting an interesting model for professional practice
(McAllister & Maguire, 2012).
Taking a more diagnostic look at autism, Sanchez et al. present the in-
tersections between the various manifestations of the disorder-limited capacity
for imagination; communication challenges; difficulties with social interaction
and sensory challenges; and the built environment, generating a dialogue of
resultant criteria (Sanchez, Vázquez, & Serrano, 2010).
Although much of this literature focuses its attention on the sensory issues
and challenges of autism and advocates sensory-centric approaches to design,
others maintain that such an approach may create isolated success within the
customized environment, a success that will not be generalized and maintained
in a typical situation. Presented in the work of Marion, this so-called Neuro-
Typical approach calls for the adaptation of autistic users to typical sensory
environments and calls on the school environment to present that opportunity
482 SECTION | V Autism Spectrum Disorder

(Marion, 2006). A comparative look at the Neuro-Typical approach versus the

Sensory Design approach outlined in this research, and which forms the basis
of the Autism ASPECTSS Design Index, can be found in the work of Chris-
topher Henry (Henry, 2011). Henry poses that, of the challenges faced by
individuals with autism, generalization of skill may be more pressing than
sensory difficulties and consequently supports the possible advantage of a
neurotypical environment.
Presenting the sensory-driven approach in “An Architecture for Autism:
Concepts of Design Intervention for the Autistic User,” Mostafa outlines the
Sensory Design Theory and its consequent Sensory Design Matrix (Mostafa,
2008). Building on the hypothesis that by constructively altering the built
environment with autistic sensory needs in mind, one can alter autistic chil-
dren’s behavior positively; this research is one of the few evidence-based
experimental research projects in the field of designing built environments
for autism. It also addresses the common critique of sensory-specific design,
proposing a graduated and flexible use of its conclusive criteria to avoid any
“green-house” effects, a phenomenon where behavior is only improved within
the customized environment. Even one of Mostafa’s Sensory Design critics has
called it “a paradigm shift in how architects have been studying autism design”
and “leagues above what most other architects have been doing” (Henry,
2012).

The autism ASPECTSS design index

Providing the evidence underpinning the Autism ASPECTSS Design Index,
the 2008 research based its experimental testing on the most pressing built
environment issues for autistic users. These issues were determined through a
survey of teachers, parents, and primary caregivers of children with autism.
Working on the premise that it is sometimes at the problem definition stage
that exclusion occurs in inclusive design (Clarkson, Cardoso, & Hosking,
2007, P. 182), the study looked at what these stakeholders prioritizedd
acoustics, spatial sequencing, and the sensory qualities of classroom envi-
ronments in a special needs school. This study used attention span, response
time, and behavioral temperamentdas represented by self-stimulatory
behaviordas indicators. It compared a control group and study group in
two design intervention classroomsdan acoustically altered speech therapy
class and compartmentalized general classroom space (Mostafa, 2008).
In summary, this study proposed that to design a built environment for
autism one must calm it down, break it down into manageable experiences in
discrete spaces, organize those spaces in a sensory and temporally logical flow,
and accommodate for sensory overload escape.
This approach can be summarized into three general design strategies that
were found to have a positive effect on autistic behaviordthe general
reduction of sensory input through manipulation of the built environment, the
 Architecture for autism Chapter | 23 483

organization of space to allow for predictability, and the provision of space to

mitigate sensory overload. These strategies and their consequent design index
aim at one simple objectivedto alleviate the autistic users sensory overload
and provide him or her means to manage it when it occurs, in order to open a
window of opportunity for learning, social interaction, and general skill
development. These strategies are represented in the seven design criteria that
compose the Autism ASPECTSS Design Indexdacoustics, spatial
sequencing, escape space, compartmentalization, transition spaces, sensory
zoning, and safety as follows:
Acoustics: The most highly prioritized design feature in the 2008 pre-
liminary survey, acoustics, and its management, is the first criterion in the
index. This criterion calls for the reduction of internal and external noise
sources through various means such as cavity walls, soundproofing and
sound absorbent materials, spatial configuration to reduce echoes and
isolation of sound-emitting building systems, and avoidance of sound-
emitting fixtures such as fluorescent lighting. This criterion however,
does not call for the complete soundproofing of spaces. Rather, it suggests
the provision of spaces with reduced noise, at various levels, to allow
students to accommodate themselves to different background noise levels
and to mitigate their reliance on this accommodation. Consequently this
would allow for the generalization of skill in nonacoustically-managed
spaces in the real world.
Spatial sequencing: This criterion calls for the alignment of the sequential
organization of space and the daily routine of the users. This should be in a
series of smooth transitions from one space to another, in a manner that
follows the typical daily schedule of users, and allows for as seamless and
sensory nondisruptive flow as possible.
Escape space: This criterion calls for the provision of small, defined, and
discrete sensory neutral environments throughout the building that are
easily accessible to autistic users. These spaces should be intimate in scale
and can range from the completely physically and visually enclosed to the
subtly defined. Their objective is to provide a sensory haven for autistic
users to escape sensory overload resulting from the physical and social
environment. Sensory kits can be made available to help recalibrate the
sensory balance of the user, similar to that advocated by Anderson’s sen-
sory diet (Anderson, 1998).
Compartmentalization: This criterion outlines the organization of spaces in
a series of monofunctional compartments, allowing for single activities and
smaller numbers of users. An architectural opposite of the universal open-
plan space, this approach tries to reduce the sensory and social input an
autistic user has to deal with to the minimum required to carry out their
activity. These compartments can be defined and delineated from one
another using various meansdfrom complete enclosure using walls and
484 SECTION | V Autism Spectrum Disorder

partitions to moderate enclosure using carefully placed furniture and var-

iances in levels to a minimalistic definition using perhaps color, pattern,
and finishing material to define each space.
Transition spaces: Working hand in hand with Spatial Sequencing and
Sensory Zoning, this criterion allows for the sensory shift from one activity
to another, or one sensory level to another, and helps avoid abrupt changes
in function and stimulation. It helps ensure the seamlessness required when
circulating from one zone to the next.
Sensory zoning: Typically the built environment is organized according to
functional requirement, grouping activities, and their consequent spaces
of similar need and utility, together. When designing for autism, a slightly
different approach is called for, requiring the organization of spaces in
accordance to their sensory levels and qualities. Sensory zoning calls for
the grouping of spaces with similar sensory stimulation levels together,
into high-, moderate-, and low-stimulation zones. Transition spaces
should be used between these zones, and circulation should be planned
following the daily routine as called for by the spatial sequencing
criterion.
Safety: Children with autism commonly have an altered sense of spatial
orientation, depth perception, and general proprioception, making them
prone to injury. The may also seek sensory stimulation in ways that can be
dangerous such as self-injury, harmful tactile stimulation, swinging,
rocking, water play, and mass water consumption among many others.
Safety considerations must be taken with all building systems, material
choices, surfaces, protective barriers, furniture, fixtures, etc. It is best that
all spaces also be visually accessible to allow safe monitoring of children at
all times.

Methodology
The methodology of this research began with the development of a survey. The
survey was comprised of 12 questions, 1 for each of the seven criteria at the
whole-school level, and 1 at the classroom level where applicable, in addition
to an overall summative scoring of the building’s performance. It measured
performance using a ranked score, with 5 points awarded for optimal provision
for the criteria and 1 for absence of such provision. All criteria were weighted
equally. The survey also included basic demographic data of student body size,
teacher-to-student ratio and provided the opportunity for narrative description
of design issues in the school.2

2. The online survey can be found at http://www.surveymonkey.com/s/Autism-ASPECTSS-Built-

Environment-Assessment accessed June 2013.
 Architecture for autism Chapter | 23 485

The survey was sent to five architectural practices specializing in autism

design,3 as well as to the administrations of six of the schools they designed,
all of which were purpose built for autism. Selection of practices and schools
was based on professional merit, as represented through recognition by the
National Autistic Society in the United Kingdom4 as well as award entries for
the World Architecture Education Awards and the Council of Education Fa-
cility Planners International (CEFPI).5 Responses were received for five
schools, four of which were special schools and one that was an inclusive
mainstream school. Of these schools, three were in operation while two were
under construction at the time of the research. Designer responses were
received for four out of five of the schools, and user feedback was received for
two out of five of the schools.
These schools were the Acland Burghley School’s Autism Resource Center
in the United Kingdom by Christopher Beaver; GA Architects; the Northern
School for Autism in Australia by Hede Architects; the Western School for
Autism in Australia by Hede Architects; the Advance Center for Special Needs
in Cairo by Progressive Architects, which at the time of this research was in
the last stages of construction; and the Centre for Autism in Abu Dhabi by
Simon Humphreys Architects, which was under construction at the time of the
research. These cases provided an international balance with samples from
Australia, the United Kingdom and the Middle East and presented an oppor-
tunity to apply the index in different cultures, climates, and contexts.
The first objective of this survey was to assess the alignment of the index
with quality design practice. Moderate alignment would be indicated by a
score of 3 or above for each of the 12 criteria questions, which would be
represented by a minimum total score of 36 out of a possible total 60 points,
while high alignment would be indicated by an average score of 4 in each
question, and a total score of 48 or more. An adjusted score was also calcu-
lated to factor in any unanswered criteria questions.
In addition, this alignment would be assessed by the relationship between
the index score and the preliminary assessment of the respondentdwhether
designer or userdas to the autism-friendliness of the school, as indicated by

3. These architectural practices included Progressive Architects where the author is an associate.
4. See National Autistic Society’s page on designing physical environments for individuals
with autism http://www.autism.org.uk/working-with/leisure-and-environments/architects.aspx
accessed June 2013.
5. World Architecture Education Award entries, The Northern School for Autism, Australia http://
backstage.worldarchitecturenews.com/wanawards/project/the-northern-school-for-autism-2013/
?source¼search&keyword¼autism&selection¼all the Advance Center for Special Needs http://
www.worldarchitecturenews.com/index.php?fuseaction¼wanappln.projectview&upload_id¼
13547&q¼autism and the Council of Educational Facility Planners International (CEFPI)
http://cefpi.org.au/awards/awards-2013/2013-category-1-new-construction/northern-school-for-
autism all accessed June 2013.
486 SECTION | V Autism Spectrum Disorder

question 6 of the survey. This was represented by a perceived performance:

actual index score ratio, with a maximum of 1 indicating complete alignment.
Narrative data provided in responses to the open-ended questions of the
survey were also analyzed to give qualitative support and elaboration to these
findings. This was done using computer-generated word clouding, a tool which
creates an infographic representation of the most statistically common design
issues noted in the narrative section of the survey. This analysis used multi-
word strings of up to three words.
In the cases where both designer and user feedback were available, an
additional objective was added to assess the alignment of designer intent with
user perception. This was indicated by the point spread between designer
survey scores and those of the user, in each of their overall autism-friendliness
scores, index scores, and individual criterion score.

Results and discussion

The Acland Burghley School’s Autism Resource Center serves a school of
1265 mainstream students in London, UK. 20 of these students are diagnosed
with autism spectrum disorder and are served by the resource base (Fig. 23.1).
The teacher-to-student ratio is 1:4. The conducive characteristics of the center,
as stated by designer, are the use of subdued colors, indirect lighting, opti-
mized acoustics, curved walls, and natural materials (Figs. 23.2e23.4).
The Northern School for Autism is located in Australia and is one of two
campuses. There are a total of 144 students attending the school, all of who are
diagnosed within the spectrum. The teacher-to-student ratio is 1:3. The
conducive characteristics, as presented by the designer, are secure outdoor
play areas, calming spaces, strong curved main circulation designed to be
noninteractive to reduce distractions, natural lighting, and controlled small

FIGURE 23.1 The Acland Burghley autism resource centre floor plan. Source: GA Architects.
 Architecture for autism Chapter | 23 487

FIGURE 23.2 Indirect lighting and seating arrangementsdAcland Burghley. Source: GA

Architects.

FIGURE 23.3 Lighting schemes in day (above) and night (below). Source: GA Architects.

learning spaces. The user perspective reiterates these features as conducive and
adds the ability of students to work in like-ability groups, the availability of a
discrete outdoor learning space for each classroom, and purpose-built play-
ground equipment, the use of subdued colors and generous storage
(Figs. 23.5e23.9).
488 SECTION | V Autism Spectrum Disorder

FIGURE 23.4 Curved circulation and indirect lighting. Source: GA Architects.

FIGURE 23.5 Layout of the northern school for autism. Source: Hede Architects.
 Architecture for autism Chapter | 23 489

FIGURE 23.6 Elevations of the northern school for autism. Source: Hede Architects.

FIGURE 23.7 An aerial view of the northern school for autism. Source: Hede Architects.
490 SECTION | V Autism Spectrum Disorder

FIGURE 23.8 Showing the Intermediate Play area. Source: Hede Architects.

FIGURE 23.9 The Early Play area with its curved wall. Source: Hede Architects.

The Western School for Autism is located in Laverton, Australia, and is a

special school with a student body of 311 students. The teacher-to-student
ratio is 1 to 3.5. The most conducive features, as indicated by the adminis-
trator’s survey, were the arrangements of the school’s learning spaces into
clearly defined teaching pods, customized teaching spaces, and the fact that
the designers worked closely with staff to develop the scheme. As noted in
their 2013 entry to the World Architecture Education Awards, Hede
Architects add that “student learning is achieved in small, calm and directly
accessible areas of changing shape (that) assists (the students’) sense of order
which assists their learning” (World Architecture News, 2013)
(Figs. 23.10e23.12).
 Architecture for autism Chapter | 23 491

FIGURE 23.10 Showing an aerial view of the Western School for Autism. Source: Hede
Architects.

FIGURE 23.11 Showing the ground floor plan of the Western School for Autism. Source: Hede
Architects.

The Advance Centre for Special Needs is located in Qattameya Cairo, and
as of the date of this research, was nearing completion. The Advance Society,
which has a campus in Maadi, Cairo, planned to relocate to these new pre-
mises in September 2013. The school is designed to house 100 students, all of
whom are within the autism spectrum. The planned teacher-to-student ratio is
492 SECTION | V Autism Spectrum Disorder

FIGURE 23.12 The color-coded entrance of one of the individual learning pods. Source: Hede
Architects.

1:3. The conducive features, as indicated by the designer’s survey, are clear
circulation; acoustical control through double-screen walls on main street
facades; the use of a sensory garden in the heart of the school to allow sensory
transition while moving from one sensory zone to the other as well as voca-
tional gardening opportunities for the children; easy access to outdoor learning
spaces; circulation nodes as transitions in corridors; provision of small sensory
neutral spaces throughout the school; and integration of natural ventilation,
lighting, and materials (Figs. 23.13 and 23.14).

FIGURE 23.13 Showing the entry level plan of the advance centre for special needs. Source:
Progressive Architects.
 Architecture for autism Chapter | 23 493

FIGURE 23.14 Showing the Central Sensory Garden with its Curved Wall and Double-Screen
Facades. Source: Progressive Architects.

FIGURE 23.15 Showing an exterior view of the Abu dhabi autism centre Source: Simon
Humphrey’s Architects.

The Abu Dhabi Centre for Autism is located in the United Arab Emirates
and as of the date of this research was under construction. It is a special school
with a planned population of 120 students. The teacher-to-student ratio
is variable. The conducive design features, as indicated by the designer’s
survey response, are the use of restrained materials, nonreflective finishes,
indirect lighting, and appropriate orientation for climatic purposes (Figs. 23.15
and 23.16).6
An analysis of the survey responses presents the following results
(Table 23.1).

6. The school data outlined in this paper was as of May 2013.

494 SECTION | V Autism Spectrum Disorder

FIGURE 23.16 Showing ground floor plan of Abu dhabi autism centre Source: Simon Hum-
phrey’s Architects.

The results of the survey show a high alignment between the Autism
ASPECTSS Design Index and quality design practice, with an average score of
52.32 in the samples surveyed represented by a range from 46.4 to 57 points
out of a possible total of 60. On a criterion-by-criterion analysis, only 2% of
the total responses scored any criteria below 3 and a remaining 8% of re-
sponses awarded a score of 3. The remaining scores were above 3.
The relationship between the index score and perceived performance score
was also calculated. All respondents awarded the maximum overall perceived
performance score of 5 points that is factored as 60/60. The average ratio
between index score and perceived score was found to be 0.87, with a range
from 0.77 to 0.95, and an average point spread of 7.68 out of 60 points.
With regards to the case where both designer and user feedback were
available, in the Northern School for Autism, designer intent and user
perception were found to be fully aligned, with both design team respondents
and user awarding a maximum score of 5 for overall autism-friendliness.
Regarding the ASPECTSS Index score, a spread of 2.64 points was observed,
representing a 4.4% difference, with the user awarding a higher index score
than the average score awarded by the responding design team. Finally, on a
criterion-by-criterion basis, the average point spread between user scoring and
designer scoring was 0.34, with the user awarding an equal or higher score in
TABLE 23.1 A summary of the survey results and ASPECTSS scores.
Acland Northern Northern The
Burghley school school for Northern Western advance
schoold for autismd autismd School for School for centerd Abu Dhabi autism
designer designer designer autismd autismduser designer centreddesigner
Performance response response response user response response response response Average

1265 total
No. of students 20 ASD 144 144 144 311 100 120

Teacher: students 1 to 4 Unknown 1 to 6 1 to 3 1 to 3.5 1 to 3 Variable 3.9

Overall school
performance
(perceived score) 5 5 5 5 5 5 5 5

Overall school
performance
(perceived
Criteria score)/60 60 60 60 60 60 60 60 60

A Acoustics School 5 4 3 2 3 4 4 3.57143

Class 5 4 3 3 4 4 5 4

SP Spatial sequencing School 5 4 5 5 5 5 5 4.85714

Class 4 4 5 5 5 5 5 4.71429

E Escape spaces School 5 5 5 5 4 4 5 4.71429

Class 1 5 5 5 4 5 5 4.28571

C Compartmentalization School 4 4 5 5 5 5 5 4.71429

Class 4 4 5 5 4 5 4 4.42857

T Transition School 4 4 5 5 No response 4 5 4.5

Class n/a n/a n/a n/a n/a n/a n/a n/a

Continued
TABLE 23.1 A summary of the survey results and ASPECTSS scores.dcont’d
Acland Northern Northern The
Burghley school school for Northern Western advance
schoold for autismd autismd School for School for centerd Abu Dhabi autism
designer designer designer autismd autismduser designer centreddesigner
Performance response response response user response response response response Average

1265 total
No. of students 20 ASD 144 144 144 311 100 120

Teacher: students 1 to 4 Unknown 1 to 6 1 to 3 1 to 3.5 1 to 3 Variable 3.9

Overall school
performance
(perceived score) 5 5 5 5 5 5 5 5
Overall school
performance
(perceived
Criteria score)/60 60 60 60 60 60 60 60 60

S Sensory zoning School 5 3 4 5 No response 5 5 4.5

Class 5 No response No 4 No response 5 5 4.75

response

S Safety School 5 1.5 3 3 No response 4.5 4 5

Class

ASPECTSS index 52.0 42.5 48.0 52.0 34.0 55.5 57.0

score

Adjusted ASPECTSS 52 46.4 52.4 52 51 55.5 57 52.3182

index score

Index and 8.00 13.64 7.64 8.00 9.00 4.50 3.00 7.68
perceived score
spread

Index: perceived 0.87 0.77 0.87 0.87 0.85 0.93 0.95 0.87
score
 Architecture for autism Chapter | 23 497

FIGURE 23.17 Word cloud indicating facilitative design issues for students with autism spec-
trum disorder as indicated by prevalence throughout narrative survey question text. Source: Author.

10 out of the 12 criteria. Only acoustics was seen by the user to perform lower
than that intended by the designer.
In analyzing the narrative data provided through the open-ended survey
questions, it was found that a number of design issues were commonly
attributed to successful design performance of the school. These issues were
concluded as a result of their statistical prevalence throughout the text.
Fig. 23.17 illustrates these design issues, with statistical prevalence indicated
by font size.7
As indicated by this narrative analysis, students are the most common
concern, indicating the importance of attention to student-centered design. The
following most common design issues noted by respondents to be facilitative
in designing for users with autism were the use of transitions; the use of
subdued colors; partitioning of space; the reduction of distractions; the use of
natural lighting, ventilation, and materials; access to outdoor play spaces;
controlled acoustics; adjustability; organization; and independence.
The collective results of this analysis seems to indicate the appropriateness
of the Autism ASPECTSS Design Index as a tool for assessing built envi-
ronments, given the relatively high alignment of the index criteria with the
design issues perceived important by both the designers and users. In addition,
the narrative analysis confirmed the importance of the criteria presented by the
index. Furthermore, it highlighted four issues of importance in addition to
those assessed by the index, namely: student-centered design; use of subdued
color; use of natural lighting, ventilation, and materials; and access to outdoor
play space.

7. Word cloud generated by Jonathan Feinberg’s Wordle application.

498 SECTION | V Autism Spectrum Disorder

Recommendations and future visions

It is hoped that this study not only demonstrates the use of the index as a built
environment assessment tool, but that it takes the first step toward proposing
the Autism ASPECTSS Design Index as a standardized tool to assess and
measure autism inclusion performance of built environments. The diversity of
locations of the schools assessed here, and their relatively similar responses to
the index, seems to indicate a possible versatility of the index to be applied
regardless of culture, context, or climate. From this paper, and with the varying
student numbers, scales and types of schools assessed, the index seems to be
applicable with some degree of versatility.
It is proposed that future iterations of the index may present versions where
the criteria are weighted. This can be based on a survey of parents, teachers,
caregivers, therapists, and individuals with autism themselves to determine the
relative importance of each of the criteria with respect to the user with autism.
Future iterations of the index may also provide an expanded scope to include
the additional criterion presented here. Additional research may be required as
proof of concept of the validity of these additional criterion however.
From narrative analysis presented here, it seems that issues of passive and
sustainable designdnatural lighting, ventilation, and materialsdmay be a
venue for future research. This has been proposed in previous literature
(Wehe, S. 2009) and is supported here by the prevalence of these criteria in the
narrative of the survey responses.
The index was used in this research to assess existing or planned envi-
ronments. It is also proposed, however, that it may be used as part of the
planning process to develop and adjust designs at any stage, from concept to
design development to construction detailing. Further investigation is needed
to determine the applicability of this.
Although autism design code development is a relatively debatable goal,
given the vast scope and diversity of symptoms of individuals along the
spectrum, the Autism ASPECTSS Design Index may be a tool to provide some
best practice guidance. The Sensory Design Matrix, from which the index was
developed, proposes matching needs of autistic users with architectural design
elements, generating possible design guidelines at each intersection (Mostafa,
2008). This may be used as a form of catalyst to generate customized design
guidelines for individual users. Additionally, and more broadly, an autism
archetype persona, based on statistical prevalence of ethnographic profiling
(Clarkson, Cardoso, &Hosking, 2007) can act as an input to this matrix to
generate more widely applicable guidelines.
From this generation of guidelines, a sort of pattern language (Alexander,
Ishikawa, & Silverstein, 1977) can be developed for designing built environ-
ments specifically for autism. This is not the first time the pattern language
theory has been proposed as an appropriate premise for autism inclusive
design (Baumers, 2012, pp. 66e7; Froyen, 2012). It is the first proposal,
 Architecture for autism Chapter | 23 499

however, that ties it to a structured index of criteria to generate these patterns,

in a manner that they may form a vocabulary to speak an inclusive experience
as opposed to impose a predetermined code.
It is hoped that the cases demonstrated here may provide a first step to the
broader and more widespread use of the index, and its criteria, to assess,
develop, and promote autism-inclusive environments.

Acknowledgment
The author would like to thank: Christopher Beaver of GA Architects in the UK; Paul and
Maria Hede of Hede Architects, Australia; Ashraf Tawfik of Progressive Architects, Cairo;
Simon Humphreys, of Simon Humphrey’s Architects, UK; Anna Rigoni, Principal of the
Northern School for Autism, Australia and the Western School for Autism for their valuable
feedback. The author would also like to thank the Advance Center for Development of Skills
of Special Needs Children in Cairo for their courage to embark on a new design strategy for
their premises. Finally special thanks goes to Zeina and Jenna Tawfik for their support.

References
Ahrentzen, S., & Steele, K. (2010). Advancing full spectrum housing: Designing for adults with
autism spectrum disorders. Tempe: Arizona Board of Regents.
Alexander, C., Ishikawa, S., & Silverstein, M. (1977). A pattern language: Towns, buildings,
construction 2. USA: Oxford University Press.
Anderson, J. M. (1998). “Sensory motor issues in autism”, therapy skill builders. U.S.A: The
Psychological Corporation Texas.
Architects and Building Branch, & Department of Education and Employment. (1999). Access for
disabled people to school buildings. Building Bulletin 91, UK.
Architects and Building Branch, & Department of Education and Employment. (2001). Inclusive
school design- accommodating pupils with special educational needs and disabilities in
mainstream schools. Building Bulletin 94, UK.
Architects and Building Branch, & Department of Education and Employment (DfEE). (2005).
Designing for pupils with special educational needs- special schools. Building Bulletin 77,
U.K.
Bancroft, K., Batten, A., Lambert, S., & Madders, T. (2012). The way we are: Autism in 2012.
London, UK: The National Autistic Society.
Baumers, S. (2012). Beyond known worlds: A fragmentary exploration of encounters between
autism and designing space. Katholieke Universiteit Leuven.
Baumers, S., & Heylighen, A. (2010). Harnessing different dimensions of space: The built envi-
ronment in auti-biographies. In P. Langdon, P. J. Clarkson, & P. Robinson (Eds.), Designing
inclusive interactions: Inclusive interactions between people and products in their contexts of
use (pp. 13e23).
Beaver, C. (2006). Designing environments for children and adults with ASD. In 2nd world autism
conference, Cape Town, South Africa, 2006.
Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorders d
autism and developmental disabilities monitoring network, 11 sites, United States. 2010.
Morbidity and Mortality Weekly Report, 63(2), 1e21.
500 SECTION | V Autism Spectrum Disorder

Clarkson, J., Cardoso, C., & Hosking, I. (2007). Product evaluation: Practical approaches. In
R. Coleman, J. Clarkson, H. Dong, & J. Cassim (Eds.), Design for inclusivity: A practical
guide to accessible, innovative and user-centered design (pp. 181e196). Hampshire, England:
Gower Publishing.
Froyen, H. (2012). Universal design: A methodological approach. The Institute of Human Centred
Design.
Henry, C. (November 3, 2011). Designing for autism, the neuro-typical approach. ArchDaily.
http://www.archdaily.com/181402/designing-for-autism-the-neuro-typical-approach/#_edn3.
Henry, C. (January 5, 2012). Architecture for autism: Architects moving in the right direction.
Arch Daily. http://www.archdaily.com/197788/architecture-for-autism-architects-moving-in-
the-right-direction/.
Humphreys, S. (October 3, 2008). Architecture and autism. UDDA, Hasselt.
LeRoy, B., Evans, P., & Deluca, M. (2000). United States and european school-aged disability
prevalence: An investigative study to elaborate differences. USA: Office of Special Education
Programs, Department of Education.
Marion, M. (2006). Bringing the world to the classroom. The Exceptional Parent, 36(4), 32e35.
McAllister, K., & Maguire, B. (2012). “Design considerations for the autism spectrum disorder-
friendly key stage 1 classroom. Support for Learning, 27(3), 103e112.
Mostafa, M. (2008). An architecture for autism: Concepts of design intervention for the autistic
user. The International Journal or Architectural Research, 2(1), 189e211.
Mostafa, M. (2010). Housing adaptation for adults with autistic spectrum disorder. Open House
International, 35(1), 37e48.
Sanchez, P., Vázquez, F. S., & Serrano, L. A. (2010). Autism and the built environment. In
T. Williams (Ed.), Autism spectrum disorders- from genes to environment. InTech
Publications.
Scott, I. (2009). Designing learning spaces for children on the autism spectrum. Good Autism
Practice, 10(1), 36e51.
Shin, M., Besser, L. M., Kucik, J. E., Lu, C., Siffel, C., Correa, A., et al. (2009). Prevalence of
down Syndrome among children and adolescents in 10 regions of the United States. Pediat-
rics, 124(6), 1565e1571.
Vogel, C. L. (MayeJune 2008). Classroom design for living and learning with autism. Autism
Asperger’s Digest.
Wehe, S. (2009). Why green buildings work for autism. Environmental Design and Construction
(EDþC). retrieved from www.edcmag.com.
Whitehurst, T. (2006). The impact of building design on children with autistic spectrum disorders.
Good Autism Practice, 7(1), 31e42.
World Architecture News Education. (2013). Western school for autism. http://backstage.
worldarchitecturenews.com/wanawards/project/western-school-for-autism/?
source¼sector&selection¼all.

Further reading
Khare, R., & Mullick, A. (2009). Incorporating the behavioral dimension in designing inclusive
learning environment for autism. International Journal of Architectural Research, 3(3),
45e64.