April 2, 2015
Lisa Marchi

Healthcare facilities have the potential to enhance the quality of life through the built environment and the comprehensive services they provide. This is something we hear over and over again. We at HKS promise our clients that we are dedicated to: “Creating environments that enhance the human experience”. But how can we enhance the human experience of those who experience the world from an entirely different perspective from our neuro-typical* viewpoint?

*Neuro-typical: refers to an individual who is not neurologically categorized as having a behavioral, mental, cognitive, or social disorder. A person who is considered to possess typical “neuro” processes and responses consistent with those perceived to be normal (definition from the UK National Autism Society).

Unfortunately, there are few facilities in the United States that have been designed to enable the growth and happiness of individuals who are challenged socially, psychologically, and emotionally. In particular, assisted-living facilities, group-housing for those with long term disabilities, and mental health facilities have the potential to extend beyond their current focus on physical disabilities or safety. If we, as designers and healthcare planners, are going to enhance the human experience, it is imperative that we understand how we can enhance the quality of life of those who are most affected by the environment itself.  We are charged with the responsibility to create spaces that service the body, the mind, and the soul (Pallasmaa 71).


How can a healthcare facility address the issues of individuals with social, behavioral, mental, or cognitive disorders? Thankfully, experts around the world are leading the charge to develop theories using environmental psychology and Biophilia to guide the analysis of existing facilities.

There is one particular user group that I have spent time researching who would benefit from improved environments; these individuals are found on the Autism Spectrum. Individuals with Autism Spectrum Disorders (ASDs) include children and adults with five disorders: Autism, Rett’s Disorder, Childhood Disintegrative Disorder (CDD), Asperger’s Syndrome, and Pervasive Developmental Disorder (PDD-NOS). Since the impairments and challenges faced by individuals with ASDs is complex, this chart explains the spectrum of general characteristics associated with the five disorders.


Individuals may face any of the following challenges: motor and neuro-muscular challenges; cognitive, sensory, and communication issues; visual and auditory impairments; epilepsy; language delays; social and communication challenges; unusual behaviors and interests; intellectual disabilities, difficulties with human interaction and emotional contact; difficulties in perception and interpretation of the world; and extreme sensory sensitivities. The built environment needs to respond to the variety of issues and anxieties that are associated with these challenges. Since ASDs create a range of challenges, it is important that design focuses on common fundamental issues, found in individuals along the entire spectrum. By addressing these issues, we can begin to design facilities that are both therapeutic and enabling.


The following are common impairments and how the built environment can respond:

  • The first commonly shared issue is in the executive function system of the brain, which is found in the prefrontal cortex. This impairment limits the ability to carry out tasks such as eating, walking, focusing, discerning stimuli, creating perception hierarchies, and concentrating (Ozonoff 1082; Sanchez 368). The built environment has the potential to aid those with Executive Functioning deficits by reducing distractions, simplifying way-finding, increasing consistency, and easing transitions where spaces change drastically with light, color, or sound.


  • The second most common impairment is with Sensory Integration dysfunction (SID) that causes either hypo- or hyper- sensitivity to sensory stimuli (Vincenta 2). The built environment can respond to both hyposensitive and hypersensitive individuals by providing a variety of spaces with different sizes, shapes, colors, lights, sounds, materiality, and functions. To help alleviate anxiety of those found in the space over stimulating, small escape spaces and alcoves can act as womb-like retreats, void of all stimuli.
  • The third most common impairment amongst individuals along the autism spectrum is cognitive mapping, which is the technique the brain uses to navigate the physical environment, linking our senses to memories (Zeisel 148). Cognitive mapping deficits, also linked to fragmented perception, require that a building should be designed in such a way that the environment is simple and easily navigated with obvious architectural way-finding systems and good signage with symbols.


Below are a few strategies designers should consider when shaping the environment for individuals along the autism spectrum:


In summary, we have the responsibility to design buildings that enhance the human experience for individuals on and off the autism spectrum. Current design strategies have been developed by architects and landscape architects that directly and indirectly help to alleviate some of the challenges faced by individuals on the autism spectrum. Such individuals include Professor Shari Ahrentzen at Arizona State University, Christopher Beaver at GA Architects in London, Denise Resnik at SARRC, Teresa Whitehurst at the Sunfield Research Institute, and Naomi Sachs at Texas A & M. 

If you’d like to learn more about facilities that exist today to enable individuals with ASDs or the research associated with designing for ASDs, please visit the websites below:








Works Cited:

Pallasmaa, Juhani. (1996). The eyes of the Skin: Architecture and the Senses. John Wiley & Sons Ltd. West Sussex.

Ozonoff, Sally. (1991). Executive Function Deficits in High-Functioning Autistic Individuals: Relationship to Theory of Mind. J. Child Psychology Psychiatrist. Vol 32 (7). 1081-1105

Sanchez, P.A. (2011). Chapter 19: Autism and the Built Environment. In T. Williams (Ed.), Autism Spectrum Disorders – From Genes to Environment. Croatia: InTech. 363-380

Vincenta, T. and Sachs, N. (2011). Outdoor Environments for children with Autism and Special Needs. Implications, 9 (1).

Zeisel, John. (2006). Inquiry by Design: Environment/Behavior/Neuroscience in Architecture, Interiors, Landscape, and Planning. W.W. Norton & Company, Inc.

Posted in Health, Interiors