Why Buildings for Autistic People Are

Better for Everyone

Stuart Shell, AIA, WELL AP, LEED BD+C

If people who own, operate and design ASD as a part of natural variation in human
buildings are not thinking about people with biology, not requiring a ‘cure’ (Kapp et al.,
autism, they will be soon. Individuals diagnosed 2013). The DSM-5 lists the primary criteria as
with autism spectrum disorder, or ASD have the deficits in social interactions and restricted,
same rights to functional, accessible spaces that repetitive behaviors and interests. Sensory
the non-ASD world enjoys. Also, with 1 in 68 integration deficits are a second-tier criterion.
children diagnosed with autism in 2012 – up Nonetheless, most individuals with ASD do
from 1 in 150 in 2000 (Christensen et al., 2016; experience sensory hypersensitivity or
See Figure 1) – it is time for the United States to hyposensitivity, especially in hearing and touch
expand its idea of accessibility. (Fernández-Andrés et al, 2015). Alarmingly, the
prevalence of ASD is around 1 percent of the
Unfortunately, creating responsive buildings for
population, with more males affected than
people with ASD is difficult. Most architects, females. (Mostafa, 2008; Sanchez et al, 2011).
engineers, and building owners have limited
knowledge of ASD. Its broad range in sensitivity Figure 1: Prevalence of Autism per 1,000*
also means that each individual needs different
qualities in their surroundings. Even with the
“perfect” building design, inhabitants must be
empowered to interact with and modify spaces
to meet their immediate needs.

Taken all together, it is not a surprise that the

design world has more progress to make
regarding inclusive buildings. But there is also *Data depicts 8-year-olds at 11 ADDM sites in
an up-side to the challenge; everyone benefits the United States (Christensen et al., 2016) . The
range in prevalence rates between the sites is
from the features that make a facility autism- shaded.
friendly. This article highlights why a focus on
occupants with ASD is a powerful approach to Architecture can address the needs of
creating great architecture. occupants with ASD. That is because buildings
accommodate the needs of their occupants
Autism and Buildings through spatial configuration, acoustics,
Autism means not feeling relaxed. It appears to lighting, temperature, air quality, furnishings
be caused by complicated genetic and and finishes. A common hypothesis in the
environmental interactions, and there is no literature is that modulating these features of
cure. The evidence of effective interventions is the physical environment can help all occupants
limited (Rodger et al, 2010). In fact, many view relax and focus.
However, interventions that only address environmental conditions. Some examples of
design will be of limited value because the these stimuli are temperature, light contrast, air
physical environment is intertwined with the quality, echo, and air speed. Occupants
social environment (Sanchez et al, 2011). For experience pleasure as a result of changes that
example, a study by Fernández-Andrés et al. align with their internal states. Therefore, the
(2015) found that children diagnosed with ASD phenomena is highly individual, and manifests
experienced greater sensitivity to touch when in differently as a result of cultural norms.
classroom environments than when at home.
The authors proposed that the combination of The pleasure associated with alliesthesia may
social and environmental context of classrooms be related to the voluntary behavior of an
individual seeking homeostasis, as opposed to
make physical contact more intrusive.
involuntary responses such as sweating and
Occupants not only sense the quality of their pupil dilation. By recognizing that different
surroundings – they take part in it. In this way, individuals can have very different needs from
achieving indoor environmental quality requires their surroundings at different times, engineers
that occupants interact with their physical and architects can create high-performance
space. Often that also entails adapting social spaces for all occupants.
norms for behavior, like closing blinds or
wearing short sleeves. Individual factors are This is relevant for building design because
humans like to interact with their surroundings
fundamental to understanding the drivers of
this social behavior. Two of the most important – both to remove uncomfortable stimuli and to
personal factors for comfortable spaces are create sensory pleasure. For people with ASD
this is relevant because hypo- and
alliesthesia and executive functions.
hypersensitivity is common, and can be
Alliesthesia ameliorated through the sensory environment.
This may partially explain the popularity of
Alliesthesia describes how an individual’s
intensive sensory therapies, which stimulate the
internal state and subjective conditions can
body in an effort to modify behavior. Sensory
make a certain stimulus pleasing or displeasing.
rooms are also popular in autism-friendly
It is a physiological phenomenon present in all
spaces because they provide a controllable
the senses that helps individuals attain what
environment as a retreat from overwhelming
they need. For example, a glass of water is
stimuli.
satisfying to someone who is thirsty, and a cold
breeze can feel good to someone who is
running (de Dear, 2011). The glass of water and
Executive Functions
cold breeze can cause displeasure to the same While alliesthesia helps explain the motivation
person if his or her internal state has changed. for an individual’s interaction with the
surroundings, there’s another process involved
Underscoring alliesthesia is that fact that when it comes to achieving comfort. Executive
humans are very sensitive to changes in the functions refer to a set of cognitive skills that
environment – much more so than absolute individuals leverage to achieve their goals over
states. By attending to these subtle changes, the course of a lifetime. According to Mischel &
the organism can discern the most beneficial Ayduk (2002), emotional regulation and
cognitive control are two foundational Design for Options
capacities of executive functions. In their Occupants vote with their feet. By
model, executive functioning involves the perambulating to spaces of preference,
interplay of emotional-based impulses from the individuals select environments that support
amygdala and cognitive processing of those their intended occupation while also providing
impulses from the hippocampus. comfort. However, occupants cannot always
choose between multiple spaces, and
A room that offers inhabitants control of their
sometimes, one aspect of a room is annoying
surroundings creates opportunities to exercise
while everything else is fine. This is where
executive function. That’s especially relevant
designers can help by providing spaces with
because most individuals diagnosed with ASD
locally controlled, culturally relevant options.
exhibit deficits in executive function skills
(Ozonoff et al., 1991). In fact, executive Affordance is one way to think about the
functioning is a second-order criterion that diversity of possibilities a space offers to
helps with diagnosing ASD. While executive inhabitants (Kinnaer et al., 2016). This varies
function skills may or may not be involved in dramatically due to the breadth of the autism
the manifestation of ASD symptoms (Sanchez et spectrum and the purpose of the space. Which
al., 2011), they are nonetheless core features of is why specific guidelines for autism-friendly
many established therapies for ASD (National spaces offers limited value, and the best advice
Autism Center, 2015). tends to be quite general.
Some popular treatments for individuals with For example, Mostafa (2014) recommends that
ASD seek to transform how the body interprets school design for students with ASD incorporate
sensory information. Sensory Integration seven principles: acoustics; spatial sequencing;
Therapy and deep pressure therapy are escape; compartmentalization; transition
examples of this approach. While these spaces; sensory zoning; and safety. Each of
intensive sensory therapies may have short- these principles provides general information to
term benefits, there is little evidence of their designers for consideration without listing
long-term impact on behavior (Rodger et al., prescriptive criteria. Sanchez et al. (2011) also
2010). provides a broad overview of findings regarding
the physical environment and ASD behavior.
Nonetheless, sensory stimulation can prove to
be effective in developing cognitive regulation In the spirit of general guidelines, some
skills. Through spaces that afford control of suggestions are included Table 1. Perhaps a
stimuli, inhabitants can learn to manage meta-principle for autism-friendly design is to
sensory overload – a skill that has long-term focus on flexibility over ‘getting it right.’ The
benefits (Rodger et al., 2010). Individuals also following section details how buildings that
feel a greater sense of agency when they accommodate the needs of autistic people are
perceive control over the physical environment better for non-autistic people.
(Toftum, 2010).
Findings The human preference for contrast in scale is
exemplified by the evolved human-habitat
Spatial Configuration
relationship described by Jay Appleton in 1975.
The need for personal space varies in different
His concept of prospect and refuge has today
cultures, and between individuals. Those with
become a design pattern for indoor spaces that
ASD may also have different needs for personal
combine safe shelter with expansive views
space – or proxemics (Sanchez et al., 2011). For
(Kellert et al., 2011). This provision is especially
architecture, the provision of space is a first
relevant for autism-friendly spaces that provide
principle that shapes floors, walls and ceilings.
for a broad range of spatial needs.
The resulting feeling of enclosure is
fundamental to perception of safety and The frame of perception is a driving factor in
control. Together with the number of people in creating spaces of preference, especially in the
a space, enclosure sets limits for inhabitants’ context of social interaction. A room that feels
personal space. Therefore, larger spaces offer too small could also feel too large depending on
meaningful options for people with ASD in the individual or individuals in question, and
achieving comfort. what they are trying to accomplish. For
example, several small groups working
In fundamental ways, perception of space for
simultaneously in a classroom may introduce
people with and without ASD is similar. A study
too much motion and background noise for
by Cooper et al. (2015) compared adults with
someone with ASD to participate. Similarly,
and without ASD in their ability to notice
attempting individual work in a gymnasium may
changes to a virtual room. Results showed that
present too much visual distraction. Layers of
those with ASD generally had more difficulty
spaces can offer a sense of comfort, such as a
noticing changes, but were similarly attuned to
tent within a room. Importantly, when
the ways the rooms had changed. This suggests
occupants have control over the organization of
a similar mental processing of space.
space, they also experience greater comfort
Spaces with certain features can be easier to (Sanchez et al., 2011).
adapt to, and therefore less overwhelming for
There is good evidence that flexible spaces are
occupants with ASD. Rooms that display order
helpful for those with ASD. In a study by
and definition are more legible to autistic
Hirasawa, Fujiwara & Yamane (2009), an
individuals (Kinnaer et al., 2016; Gaines et al.,
individual with ASD exhibited fewer repetitive
2014). The best spaces also feature areas and
behaviors when classrooms and care settings
pathways that are reconfigurable for different
were reorganized. The researchers adjusted
occupants. One-way, sequential circulation
furniture and materials to provide intentional
patterns reinforce routine and improve focus.
interactions with staff and improve the
Subdividing rooms so that spaces that contain a
comprehensibility of task sequence. The clear
single activity also increases learning (Mostafa,
organization of rooms into activity areas based
2008). Providing storage spaces for non-
on intended functions is similarly a best practice
relevant materials helps to further encourage
for classrooms in general (Tomlinson & Imbeau,
focus (Gaines et al., 2014).
2010).
In wayfinding, symbols and coordinated colors (Clausen & Wyon, 2008). In a study of time on-
or distinctive landmarks can improve task in a speech therapy rooms, autistic children
navigation. This improves navigability, maintained focus longer when the rooms were
especially when the signals are culturally better insulated from external noise and
relevant and related to the intended use of the reverberation time was decreased (Mostafa,
space (Mostafa, 2008; Sanchez et al., 2011). 2008).
One possible explanation for this is that
individuals with ASD are better at navigating Lighting
spaces when there is a clear objective. A study In addition to rendering the world in radiant
by Fornasari et al. (2012) found that children colors and shadows, light interacts with human
with ASD explored virtual environments physiology. In the ubiquitous indoor habitat,
similarly to a control group when searching for exposure to light is much lower than that
objects in the game. However, they explored outdoors. The retina is partly responsible for
less area when instructed to explore the melatonin levels in the body, which impact
environment without such an objective goal. mood and circadian sleep cycles. Through this
mechanism, exposure to light is related to
Acoustics mood disorders such as depression (Srinivasan,
Sound perception occurs in numerous ways. For 2006), and even the incidence of breast and
indoor environments, considerations include prostate cancer (Stevens, 2007). Melatonin
background noise (e.g. mechanical equipment) treatments can improve sleep for individuals
and distracting sounds (e.g. a ringing phone). with ASD (Reiter et al., 2009). It may also be
Reverberation time also relates to the that artificial lighting disrupts the light-dark
perception of how ‘live’ or ‘dead’ a room feels. environment, thereby contributing to melatonin
suppression and poor sleep for individuals with
Rooms may be too loud or too quiet. The ability ASD (Leu et al., 2011).
to adjust the equivalent sound pressure level of
background noise is likely an important feature Light also has a psychological dimension. For
of spaces for all occupants. For example, adding example, colors impact mood and behavior.
background noise with biophilic elements, such Occupants exhibit greater creativity in the
as birdsong or water sounds, can improve presence of green and blue, and red may
occupants’ perception of acoustics (Mackrill et undermine cognitive performance (Eliot &
al., 2014). Adding pink noise is another common Maier, 2014; Gaines et al., 2014). Autism-
strategy for creating sound privacy in spaces friendly designs generally incorporate
with diverse activities. unsaturated, light earth tones with only small,
contained areas of bright color (Mostafa, 2014).
Sound carries messages; most notably, speech.
Electro-acoustic paging systems and alarms are Sunlight exposure is also associated with
also examples of meaningful sounds. These Vitamin D, which functions to help repair DNA
encoded signals are almost always distracting damage (Kinney et al., 2010). Therefore,
and can be minimized to create the best parents who are Vitamin-D deficient experience
possible space. Furthermore, there is greater likelihood of having children with ASD.
considerable individual variance regarding the For community health, facilities should provide
impact of background noise containing speech access to sunlight – both through quality
daylight design indoors and by making outdoor Furnishings, carpet and wall finishes also
spaces available to inhabitants. introduce chemicals into spaces that may
jeopardize the health of future parents. For
Thermal Comfort example, the flame retardants used in most
Heat transfer between humans and the furniture and electronics increase the risk of
surrounding environment entails the most having children with ASD (Messer, 2010).
intimate measure of quality in the physical Larsson et al. (2009) also found that type of
environment. This is because heat has an flooring in parents’ bedroom was associated
important psychological dimension that forms with the incidence of ASD in their children.
in the first hours of life and continues to impact Children with parents who experience elevated
perceptions and interactions. For example, exposure to common mutagens such as
Bargh & Shalev (2012) found that experiences mercury, cadmium, and vinyl chloride have
of physical warmth increased feelings of social greater risk of ASD (Kinney et al., 2010).
warmth in college students, suggesting that
individuals seek physical warmth in ways similar Air Quality
to their desire for experiences of social warmth. Scientific knowledge on the impact of air
pollution on health is far from complete. The
Thermal comfort depends in part on air evidence that does exist is vital for the
temperature and air velocity. Building designer
operation of buildings, which can clean the
and operators can provide opportunities for outdoor air for occupants. However, even this
alliesthesia to occupants by modulating these measure does not obviate the need for
variables. Because there is no evidence relating awareness of air pollution in urban
thermal comfort to ASD, generalizations are
environments, especially for expecting mothers.
necessary. Strategies for improving comfort
include varying temperature set points for The risk of having a child with autism is greater
different spaces, providing ceiling fans, for mothers who live near traffic sources of
providing operable windows, and giving pollutions. A study of children diagnosed with
occupants control of these amenities. ASD in Los Angeles between 1998 and 2009
showed that their mothers experienced
Materials elevated levels of ozone, respirable particulate
Finishes and furniture represent a small portion matter, and nitric oxide (Becerra et al., 2013).
of most construction budgets, but have an Parents who live near power plants with
enormous impact on indoor environmental mercury emissions are more likely to have
quality. Bookshelves, workstations and seating autistic children, as are those in urban
are examples of furnishings that define the size environments in general (Kinney et al., 2010).
and privacy of spaces. Because of the
importance of these dimensions for people with Reinforcing these findings, a recent nation-wide
ASD, movable furniture is better than built-in study of mothers (n=1,767) found that exposure
furniture. This is especially true when it can to respirable particulate matter (PM2.5) during
reinforce the social use of space by groups or pregnancy increased the odds of having a child
individuals (Gaines et al., 2014; Sanchez et al., with ASD by 57 percent (Raz et al., 2015). It
2011). appears that exposure to this common product
of motor vehicles may be most detrimental
during the third trimester of pregnancy. Specifically, CO2, volatile organic compounds
Regarding the general risk of living in the city, a and ventilation rate explained over 80% of the
study of children in Denmark (Laurtisen et al., observed increase in human performance (Allen
2014) shows that the prevalence of ASD et at., 2016).
increases with population density. Data from
this article is depicted in Figure 2. Following the protocol of the Allen et al. study,
a best practice for autism-friendly architecture
Figure 2: Autism Incidence Rate and is to providing 40 cubic feet per minute of fresh
Urbanicity air per person. Another best practice is to
provide ultraviolet lamps (ultraviolet germicidal
irradiation) in air handlers to reducing the
spread of illness within buildings.

Safety
Because behavior for individuals with ASD can
be unpredictable, a robust physical
environment is desirable. Appropriate levels of
risk can be incorporated into spaces while
eliminating likely hazards. For example,
This data depicts the incidence rate ratios for regulating water temperatures is an important
children in Denmark with an ASD diagnosis.
Children born in a metro area (5520 people/km2)
precaution for occupants who register
are diagnosed with ASD at three times the rate temperature slowly (Sanchez et al., 2011).
of rural children (55 people/km2). The shaded Anchoring larger, unstable furnishings and
area is the 95% confidence interval. Data is from
Lauritsen et al. (2014). providing resilient surfaces can reduce risk.
Designers who avoid features with sharp
Thankfully, buildings are able to remove corners will eliminate the need for corner
particulate matter and ozone using specialized protection, thereby reducing visual clutter.
MERV 13 and activated carbon filters. However,
buildings also have the challenge of managing Role of the Design Team
contaminants that are released from within the Understanding how groups interact is key to
space. Common indoor contaminants are designing comfortable spaces. Individuals share
cleaners, food, plants, electronic equipment goals, values and experiences together that
and people. Using either dilution, displacement, create norms of interaction. They also
or a combination of both, building designers participate in a larger community context to
attempt to deliver ‘fresh’ air to the breathing produce cultural capital. For these reasons, an
zone. This practice is called ventilation. ethnographer can help interpret and define the
architectural requirements to help align the
There is not yet evidence on ventilation for building with its purpose. This approach uses
individuals with ASD. Air quality research may observations, in-context interviews, and surveys
be generalizable to individuals with ASD. A to better understand social interactions.
study with 24 subjects correlated cognitive
functioning with increased air quality.
Making great spaces for all inhabitants may not comfortable spaces is a challenge we must face
be easy, but it doesn’t have to cost a fortune. together.
Many of the design interventions described
Forte Building Science, a division of M.E. GROUP,
here represent a small premium on initial
provides Building Physics, Commissioning,
construction cost, and may be easily retrofitted
Occupant Experience, and Certification services.
for existing buildings. A universal design Their building science team include registered
approach requires planning for increased floor architects, professional engineers, social scientists,
area and additional consultation with experts. TAB professionals, and sustainability consultants.
Importantly, explicit input from building users
may be the design team’s best strategy for a References
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Table 1: Design Recommendations
Dimension Recommendation
General Use multiple methods to understand group needs (ethnography).
Involve occupants in initial design discussions.
Focus on flexibility over ‘getting it right.’
Provide ornamentation in select locations.

Spatial Configuration Provide more floor area than typical.

Do not create large spaces for small group or individual work.
Anticipate layout of furnishings to reinforce the intended occupation.
Create a strategy for wayfinding that uses landmarks.

Acoustics Identify and validate best practices for background noise level and
reverberation time.
Limit sound transmission from outdoors and adjacent spaces.
Provide biophilic soundscapes in selected spaces.
Identify and remove noise sources, especially those with tonal dominance or
intermittent occurrence.

Lighting Provide sufficient daylight and artificial light for health benefits.
Provide lighting controls.
Use natural, low-saturation colors and avoid large areas of intense color.
Green and blue and good choices.
Adjust lighting at night to minimize interference with circadian rhythm.
Provide dimmers for each lighting area, based on task.
Conceal lamps from direct view and set limits for luminance contrast.

Thermal Comfort Provide ceiling fans and operable windows.

Vary temperature set points for transient and collaborative spaces.
Limit expansive areas of glass.
Provide thermostats for occupant control.

Materials Identify materials to be avoided in the space, such as heavy metals and
halogenated flame retardants.
Avoid PVC, especially in flooring materials.

Air Quality Provide 40 cubic feet per minute of ventilation air to each occupant.
Monitor outdoor ozone and PM2.5, especially in urban settings.
Provide UVGI and activated carbon filters. Use MERV-13 filters.
Isolate contaminant sources, such as copy machines.
Avoid air fresheners, toxic cleaners, and fragrant hygiene products.
Provide separated spaces for food preparation and consumption.

Safety Design appropriate risk and eliminate hazards.

Anchor large, unstable items and avoid sharp corners.
Limit hot water temperatures.