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Architecture for autism: Built environment performance in

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Article  in  Design Principles and Practices · July 2015

DOI: 10.18848/1833-1874/CGP/v08/38300

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 VOLUME 8

Design Principles
and Practices
An International Journal—Annual Review

__________________________________________________________________________

Architecture for Autism:

Built Environment Performance in Accordance to the
Autism ASPECTSS™ Design Index
MAGDA MOSTAFA

DESIGNPRINCIPLESANDPRACTICES.COM
DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW
www.designprinciplesandpractices.com

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 Architecture for Autism: Built Environment
Performance in Accordance to the Autism
ASPECTSS™ Design Index
Magda Mostafa, The American University in Cairo, Egypt

Abstract: It is estimated that 1 in every 100 (Bancroft, K., Batten, A., Lambert, S., Madders, T. 2012) to 1 in every 68
individuals (Centers for Disease Control and Prevention, 2014) 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, as compared with the visually impaired, physically impaired, hearing impaired (LeRoy, B., Evans, P., and
Deluca, M. 2000) and those diagnosed with Down’s Syndrome (Shin, M., Besser, L. M., Kucik, J. E., Lu, C., Siffel, C.,
Correa, A., et al. 2009). Despite these startling numbers, autism remains under-represented in built environment
research and inclusion literature and minimally discussed in accessibility codes and design guidelines (Mostafa, M.
2008). The Autism ASPECTSS™ Design Index was developed specifically to address this gap. The index is based on the
Sensory Design Theory, which hypothesizes that by altering the sensory environment using specific design interventions,
as manifested through input from the built environment, autistic behavior can be altered positively (Mostafa, M. 2008).
The index summarizes the seven design criteria conclusively recommended to facilitate and improve the user-built
environment relationship for autistic individuals. These criteria are acoustics, spatial sequencing, escape space,
compartmentalization, transition spaces, sensory zoning and safety. The applications of the index include; assessment of
built environments, identification of autism inclusion performance issues and consequent proposal of retrofit design
solutions, as well as the development of new customized inclusive environments for autism. The objective of this paper is
to demonstrate the use of the index as an assessment tool for existing built environments, and to explore its correlation
with design performance, as perceived by the designers, users and critics of the building. Using 5 purpose built autism
schools as case studies, the alignment of perceived excellence in autism design and the respective Autism ASPECTSS™
Index score is assessed.

Keywords: Design, Disabilities, Universal Design, School Design

Introduction

A
utism is increasingly becoming one of the more prevalent challenges facing school-
children, with estimates that anywhere from 1 in every 100 (Bancroft, K., Batten, A.,
Lambert, S., Madders, T. 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 US categorized as
visually impaired, 1 in every 769 as physically impaired, 1 in every 714 as hearing impaired
(LeRoy, B., Evans, P., and Deluca, M. 2000) and 1 in every 970 diagnosed with Down’s
Syndrome (Shin, M., Besser, L. M., Kucik, J. E., Lu, C., Siffel, C., Correa, A., et al. 2009). These
estimates place Autism Spectrum Disorder at three times as prevalent as hearing impairment,
visual impairment and physical impairment 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

Design Principles and Practices: An International Journal — Annual Review

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DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW

building or accessibility code that incorporates requirements specifically to address children with
autism” (Mostafa, M. 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, C. 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, S.
2008). Following more closely the available literature at the time Iain Scott presents an
interpretation of various guidelines as applied to specific projects (Scott, I. 2009). In this review
Scott discusses the development of guidelines for autism in the UK’s Architects and Building
Branch’s Building Bulletins- BB 77, 91 and 94 (Architects and Building Branch,1999, 2001,
2005) respectively. These Building Bulletins present guidelines for schools and designers to
better incorporate special needs requirements. Although providing general guidelines for
designing for autism- such as creating low-stimulus environments, clear layouts, well
proportioned space with minimum detailing and indirect lighting [as cited in Scott, I., 2009]-
little 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, S., and Heylighen, A. 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 interviews with
parents, teachers, therapists and students with autism (Vogel, C.L. 2008). She summarizes these
findings by stating that built environments for autism should be: flexible and adoptable; non-
threatening; non-distracting; predictable; controllable; sensory-motor attuned; safe; and non-
institutional.
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 learnt from the new
environment and strategies to improve existing built environments (Whitehurst, T. 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; 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, M. 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 & 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

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); (189-211)

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 MOSTAFA: ARCHITECTURE FOR AUTISM

the necessity to: ensure safety and security; maximize familiarity, stability and clarity; minimize
sensory overload; allow opportunities 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 surrounding
neighborhood (Ahrentzen, S., & Steele, K. 2010).
From the educational perspective, McAllister & 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, S. 2008) and Vogel (Vogel, C.L.
2008), presenting an interesting model for professional practice (McAllister, K., and Maguire, B.
2012).
Taking a more diagnostic look at autism, Sanchez et al present the intersections 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, P., Vázquez, F. S., and Serrano, L.A. 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 (Marion, M.
2006). A comparative look at the Neuro-Typical approach vs. 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 Christopher Henry (Henry, C. 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 neuro-typical
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 children’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, C. 2012).

The Autism ASPECTSSTM 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 prioritized- acoustics, spatial sequencing and the sensory
qualities of classroom environments in a special needs school. This study used attention span,
response time and behavioural temperament- as represented by self-stimulatory behavior- as
indicators. It compared a control group and study group in two design intervention classrooms-

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DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW

an acoustically altered speech therapy class, and compartmentalized general classroom space
(Mostafa, M. 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 behaviour- the general reduction of sensory input through
manipulation of the built environment, the 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 objective- to 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 Index- acoustics, spatial
sequencing, escape space, compartmentalization, transition spaces, sensory zoning and safety as
follows:
Acoustics: The most highly prioritized design feature in the 2008 preliminary 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,
sound proofing 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
non-acoustically 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 non-disruptive 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 sensory diet (Anderson, J.M. 1998).
Compartmentalization: This criterion outlines the organization of spaces in a series of mono-
functional 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
means- from complete enclosure using walls and partitions, to moderate enclosure using
carefully placed furniture and variances in levels, to a minimalistic definition using perhaps
colour, 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

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 MOSTAFA: ARCHITECTURE FOR AUTISM

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 7 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
The survey was sent to 5 architectural practices specializing in autism design 3, as well as to
the administrations of 6 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 UK 4 as well as award entries for the World
Architecture Education Awards and the Council of Education Facility Planners International
(CEFPI)5. Responses were received for 5 schools, 4 of which were special schools, and one that
was an inclusive mainstream school. Of these schools, 3 were in operation while 2 were under
construction at the time of the research. Designer responses were received for 4 out of 5 of the
schools, and user feedback was received for 2 out of 5 of the schools.
These schools were: the Acland Burghley School’s Autism Resource Center in the UK 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 UK and the Middle East and presented an
opportunity 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

2
The online survey can be found at http://www.surveymonkey.com/s/Autism-ASPECTSS-Built-Environment-
Assessment accessed June 2013.
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/?source=search&keyword=autism&selection=all the Advance Center for Special Needs
http://www.worldarchitecturenews.com/index.php?fuseaction=wanappln.projectview&upload_id=13547&q=autism 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

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DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW

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 calculated 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 respondent- whether designer or user- as to the autism-
friendliness of the school, as indicated by 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, was also
analyzed to give qualitative support and elaboration to these findings. This was done using
computer generated word clouding, a tool which creates an info-graphic 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 3 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. 1). The teacher to student ratio is 1:4. The conducive
characteristics of the center, as stated by designer, are the use of subdued colours, indirect
lighting, optimized acoustics, curved walls and natural materials (fig. 2-4).
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
non-interactive to reduce distractions, natural lighting, and controlled small 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,
purpose built playground equipment, the use of subdued colours and generous storage (figs. 5-9).
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 administrator’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) (fig. 10-12).
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 premises 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 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 vocational gardening opportunities for the children; easy access to outdoor
learning spaces; circulation nodes as transitions in corridors; provision of small sensory neutral

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 MOSTAFA: ARCHITECTURE FOR AUTISM

spaces throughout the school; and integration of natural ventilation, lighting and materials (figs.
13,14).
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, non-reflective finishes, indirect
lighting and appropriate orientation for climatic purposes (figs. 15,16). 6

Figure 1: The Acland Burghley Autism Resource Centre Floor Plan

Source: GA Architects

Figure 2: Indirect Lighting and Seating Arrangements- Acland Burghley

Source: GA Architects

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

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DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW

Figure 3: Lighting Schemes in Day (above) and Night (below)

Source: GA Architects

Figure 4: Curved Circulation and Indirect Lighting

Source: GA Architects

Figure 5: Layout of the Northern School for Autism

Source: Hede Architects

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 MOSTAFA: ARCHITECTURE FOR AUTISM

Figure 6: Elevations of the Northern School for Autism

Source: Hede Architects

Figure 7: An Aerial View of the Northern School for Autism

Source: Hede Architects

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DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW

Figure 7: An Aerial View of the Northern School for Autism

Source: Hede Architects

Figure 8: Showing the Intermediate Play area

Source: Hede Architects

Figure 9: The Early Play area with its curved wall

Source: Hede Architects

Figure 10: Showing an aerial view of the Western School for Autism
Source: Hede Architects

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 MOSTAFA: ARCHITECTURE FOR AUTISM

Figure 11: Showing the ground floor plan of the Western School for Autism
Source: Hede Architects

Figure 12: The colour-coded entrance of one of the individual learning pods
Source: Hede Architects

Figure 13: Showing the Entry Level Plan of the Advance Centre for Special Needs
Source: Progressive Architects

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DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW

Figure 14: Showing the Central Sensory Garden with its Curved Wall and Double Screen Facades
Source: Progressive Architects

Figure 15: Showing an Exterior View of the Abu Dhabi Autism Centre
Source: Simon Humphrey’s Architects

Figure 16: Showing Ground Floor Plan of Abu Dhabi Autism Centre
Source: Simon Humphrey’s Architects

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 MOSTAFA: ARCHITECTURE FOR AUTISM

An analysis of the survey responses presents the following results (Table 1).

Table 1: A Summary of the Survey Results and ASPECTSS Scores

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 responses 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 was 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 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. Figure (17) illustrates these design issues, with statistical prevalence indicated by font
size. 7

7
word cloud generated by Jonathan Feinberg’s Wordle application

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DESIGN PRINCIPLES AND PRACTICES: AN INTERNATIONAL JOURNAL — ANNUAL REVIEW

Figure 17: Word Cloud Indicating Facilitative Design Issues for Students with Autism Spectrum Disorder as Indicated by
Prevalence Throughout Narrative Survey Question Text
Source: Author

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 colours; 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 environments, 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 4 issues of importance in addition to those assessed by the
index, namely: student-centered design; use of subdued colour; use of natural lighting,
ventilation and materials; and access to outdoor play space.

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 towards 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
design- natural lighting, ventilation and materials- may be a venue for future research. This has

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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 environments. 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, M. 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, J., Cardoso, C., Hosking, I.
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, C., Ishikawa, S.,
& Silverstein, M. 1977) can be developed for designing built environments 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. 66-7; Froyen, 2012). It is the first
proposal 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.

Acknowledgement
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.

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ABOUT THE AUTHOR

Dr. Magda Mostafa: Associate Professor, Department of Construction and Architectural
Engineering, The American University in Cairo, Qattameya, New Cairo, Egypt

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Design Principles and Practices: An International
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