How can the design of the Sensory Room and Withdrawal Room in educational and public environments in Ireland help children with the Autism Spectrum Disorder, and should there be standardised global guidelines for both environments?
This thesis will outline the differences between the design of an Autism Spectrum Disorder (hereafter referred to as A.S.D.) designed space in the educational setting and publicly designed A.S.D. spaces. It will also focus on examining the issues that have arisen from not having international A.S.D. design regulations and will set out reasons why for this legal imperative. It will go on to explore the differences between an autism unit designed in 2007 and compare it to the new autism unit designed early in 2019 in a rural school in County Laois. It will compare the designs to ascertain if the designed spaces have incorporated the key design rules according to the N.D.A. (National Disability Authority). The N.D.A. is an Irish independent statutory body that provides information and advice to the Irish Government. The study conducts research, as a case study, with teachers and pupils in a small national school, in the Irish midlands. It contrasts the opinions of students with A.S.D. and without. It concludes that more building regulations and uniformity are necessary for best design for A.S.D. space in the primary education setting as well as public spaces. It also identifies areas where further research and staff development would be beneficial.
Table of Contents
Chapter One: Introduction…..………………………………………………………………………………….2
1.1 Background of Autism Spectrum Disorder (A.S.D.) ………………………….………………….....……2
1.2 Background History of Design for A.S.D...………………………………………………………….........3
1.3 Designing for A.S.D. in Ireland. …………………………………………………………………….….…..6
List of Illustrations
Figure1: Shannon Airport's Sensory Room, Designed by Adam & Friends. Shannon Airport is the First European Airport Sensory Room Developed for Children with Neurodevelopmental Challenges, Including Autism. https://www.irishtimes.com/business/transport-and-tourism/shannon-airport-opens-sensoryroom-for-passengers-with-autism-1.3029221 Last accessed November 9th, 2019……………………………..13
Figure 2: Sensory Room in Sligo Clayton Hotel. (The First Hotel in Ireland to Have a Sensory Room). https://asiam.ie/autism-sensory-room-sligo-clayton-hotel/ Last accessed November 9th, 2019……………………...13
Figure 3: The First Leisure Park in Ireland to Have a Sensory Room. http://www.droghedaleisure.ie/sensoryroom/ Last accessed October 29th, 2019.……………………...14
Figure 4: Design by Student Saoirse (age 11), of a Sensory Room for Her School. https://www.irishexaminer.com/breakingnews/ireland/student-saoirse-11-designs-sensoryroom-for-her-school-865756.htmlLast accessed October 29th, 2019.……...14
Figure 5: An Image of a Standard Withdrawal Room, Also Known as an 'Isolation room', 'Calm Down Space', 'Safe Space' and 'Black-Out Area'. https://abcnews.go.com/Blotter/lawtargets-padded-rooms-autistic-kids/story?id=18892197Last accessed November 9th, 2019.…………………...15
The primary objective of this study is to investigate the existent design principles for A.S.D. in Ireland, and to identify the necessary procedures that can be taken to improve such facilities, particularly in the education system. This is achieved by conducting a case study on children with autism, taking note of the impact that their interior environment has on them. The same case study will be conducted on children without autism, to compare the results. Considering children with autism, the question is; Are the A.S.D. designed educational facilities also beneficial to a child without autism and have enough alterations been made to suit the needs of children of all levels of A.S.D.?
Chapter one describes the nature and characteristic features of Autism Spectrum Disorders. It will also examine the background history of design for A.S.D. It will consider the guidelines that the National Disability Authority (N.D.A.) has set for A.S.D. design in Ireland and it will focus on several examples of designs for A.S.D., not only in the education sector but also in other public places. It will also explore the design and use of Withdrawal Rooms and compare how it is perceived in Ireland and other countries.
Chapter two will elaborate on different designer's views on designing for A.S.D. globally. It will also explore examples of poor sensory room design, poor withdrawal room design and good sensory room design.
Chapter three will examine a case study, in a rural school i.e. Rath National School, Co. Laois. It will explore the differences between design for the A.S.D. facility (2007), when Rath National School's first Autism Resource Centre (A.R.C.) opened and compare it to the new Autism Resource Centre which was built in early of 2019. This research sets out to explore if there are still design issues that could be further developed.
Background of A.S.D and the History of Designing for an A.S.D Unit.
"Every child has the right to an education" - The Education Act 1998.
The chapter will outline the characteristics of Autism Spectrum Disorder (A.S.D.). It will also include the history of designing for A.S.D. from when it was first documented until the present. It will outline the key elements of designing for A.S.D. as stated by the National Disability Authority (N.D.A). Furthermore, it will give detailed examples of designing for A.S.D. in Ireland in the educational and public sector and it will set out to compare and contrast both types of unit to establish if there are notable differences. These steps will be taken to explore if the design of sensory rooms are being procured in different ways. One of the most important questions to be answered in the course of this study, is "Has there been enough research been conducted on A.S.D. design for both children and adult units?". This chapter will examine what has been done and is being done currently to ensure that designing for A.S.D. is meeting the needs of both children and adults. It will give a brief account on what A.S.D. is, as well as elaborating on the history of designing for A.S.D. It will then go through the different approaches of design that designers from around the world with different educational backgrounds are using set out the main chosen techniques of design and outline where they differ.
1.1 Background of Autism Spectrum Disorder (A.S.D.)
Autism is a disability that affects the normal development of the brain in areas of social interaction and communication skills. The first signs of autism usually appear as delay in development before the age of three. Autism is described as a 'spectrum' disorder. This means that the symptoms and characteristics of autism can present themselves in a wide variety of combinations and can range from mild to severe. Autism has no outward physical signs. The cause of autism is currently unknown. It is generally accepted that autism is caused by abnormalities in brain development. Autism runs in families so there is a genetic component to this condition. Autism is also thought to be related to brain development throughout pregnancy and after birth.
Early characteristics and signs of A.S.D. are usually noticed by the parents within the first year or two of the child's life. Signs could vary from the inability to smile or wave hands by six months, not make general baby sounds and lack of speech. Poor social skills and little or no speech by sixteen months can also signal A.S.D. Once any of these signs present, the family G.P. or Public Health Nurses can then refer the child to a paediatrician who can assess the child's developmental delay.
1.2 Background History of Design for A.S.D.
Prior to the 1970's, when a child was born with a disability, it was common for many children to be left in the care of the state in an institution facility. The first facility for people with learning disabilities was located in Great Warford, Cheshire, England, which was set up in 1902. It was named 'The Sandlebridge Colony' (also known as the 'Mary Dendy Hospital') and it was closed in 1986. This institution was considered progressive. In many communities, people with disabilities were considered to be 'rejects'. People with disabilities were seen as less than human that they were also one of the first populations that the Nazi's sought to exterminate in death camps. In 1939, for example, a Nazi programme (T4) and a large number of people with autism were killed. As they were seen as subhuman by the Nazi regime, it was acceptable in this context to test new ideas on them, for example, new drugs and experimental surgeries.
They were also sterilised as it was seen as wrong for a subhuman to be allowed create life.
The first signs of change occurred in 1946 when parents came together to form the 'National Associations of Parents of Backward Children', also known as Mencap which was located in
Co. Armagh, Northern Ireland. In the 1960's, buildings were designed to house adults with learning disabilities. These buildings set out to be sterile medical environments with easy to clean surfaces and bathrooms without toilet stalls for constant monitoring. This setup still pertains to this day. "There is no dividing line separating us from the past; we are a movement from it". The institutions of the past are the backdrop against which Multi-Sensory Rooms first emerged. The lives of people with disabilities have been massively shaped by the institutions social attitudes of the day.
During the 1970's, the 1970 (U.K.) Education Act was passed, which acknowledged that people with learning disabilities should be educated. The 1981 Education Act (U.K.), referred to people with learning disabilities as having "special needs", a term considered more positive than other terms used before.
To address the issue of where the education of people with learning disabilities would be sited as part of a wider facility, they were placed in a facility with a Sensory Room. This is where the Sensory Room was introduced as a concept. The starting point of Multi-Sensory Rooms is recognised as being the practice of Jan Hulsegge and Ad Verheul, who worked in a large institution in the Netherlands in the 1970's and 1980's. They first created a tent on the grounds of the institution and later created a room within a room. This was the beginning of what we know today as Sensory Rooms being created. The idea of the tent was inspired by their experience and love of nature, creating a tent so that people with disabilities could experience "pleasurable sensations" that they had experienced.
Jan Hulsegge and Ad Verheul saw experience of the natural environment as a means of relaxation and assumed that this is what people with disabilities would also enjoy too, bringing nature inside to those who cannot handle being outside or cannot go outside due to immobility reasons. These researchers also decided to have an annual summer fair to invite the public and families, to send a message that the people in the tent in the institution should not be forgotten but instead they should be remembered and celebrated.
Multi-Sensory Rooms were originally called "Snoezelen" which was trademarked by Hulsegge and Verheul. While there was a sudden interest in the creation such a room and a desire by others to recreate it elsewhere, people began to use the term 'Multi-Sensory Rooms' as a general title. "We speak of multi-Sensory Rooms and the term refers to many different types of rooms: light rooms, dark rooms, rooms with fiberoptics and bubble tubes, rooms with 4D immersive projection, soft play rooms and many more". Equipment is designed for different types of disabilities. A dark room is too drastic for children with A.S.D. Even though
Hulsegge and Verheul's approach was inspired and suited the needs of the time, being the first of its kind, it doesn't mean that their approach was beyond improvement. This is why people chose to develop and improve on it, including Hulsegge and Verheul.
With the onset of the 1980's, more has been asked from the Multi-Sensory Rooms than just being a relaxing place. After the design of the tent, Hulsegge and Verheul later created a room within a room in the institution. This is quite similar to what is being designed today in many places. In chapter three, the author describes a sensory room designed in Rath National School in co. Laois, Ireland. Here a new Sensory Room was created in May 2019. Prior to this, the school had a Sensory Room, which was like Hulsegge and Verheul's second design, i.e., a room within a room. The Sensory Room was built in the corner of the class room with plasterboard walls and a separate ceiling which was lower than the original one. This demonstrates that even after fifty years after the work of Hulsegge and Verheul's, the design concept had not changed significantly. Multi-Sensory Rooms in general were being designed without implementing the key autism design rules according to the N.D.A., whereas the designing of Sensory Rooms in schools were being designed by implementing the N.D.A. guidelines. The N.D.A. guidelines including the contents and the surroundings has been designed to specifically suit the needs of children with A.S.D. in preference to facilitating those with other disabilities. General Sensory Rooms which are titled 'Multi-Sensory Rooms' in hotels etc. pose their own challenges.
Sensory Rooms are to be found in schools, hospitals, clinics and community centres. They are also now being added into churches, airports, sporting venues and hotels. With more expectations of general Multi-Sensory Rooms and working on sparse research, consumers were being led by advertisements, not knowing what they were buying and whether the equipment and surrounds were best suited to the children for whom it was intended. At the beginning of the 1980's, only a few Sensory Rooms were being created in locations such as Britain, America and the Netherlands, but now they have become common place being located around the world in a variety of settings. Even though they are being created, the design influences are questionable. With the paucity of research in this area and the need for sensory rooms, organisations used guidelines from the government, which were specifically intended for people with dementia. The question which arises is how can designers think that it is acceptable to use dementia guidelines for people with A.S.D.? Neither groups of people with disabilities are served by doubling up on the use of designs. While there was a lack of regulation in Sensory Room design within the education sector, there is now a greater move towards an evidence-based practice.
The first Sensory Room designed fifty years ago was intended to be a Multi-Sensory Room. It was designed so that children with disabilities that could not go outside for various reasons, now had the opportunity to experience the outdoor environment by bringing nature indoors and creating a 'tent' to simulate a camping experience. However, the sensations received from nature could over stimulate a child with A.S.D. and create problems for them.
The research that has been done to date for sensory rooms is far from conclusive. According to Joanna Grace, the author of Multiple Multi-sensory Rooms, "Suffice to say there is very little research out there, which considering we are now fifty years into the use of Multi-Sensory Rooms is a very poor showing indeed". From research, it is evident that the people using the room, the third party, should be questioned and studied for future development. Teachers in Sensory Rooms in schools have a first-hand knowledge of what the needs are for the children and what suits them best. Consultation with these teachers and indeed with parents could provide a useful primary source for research purposes, leading to more informed designs in the future.
1.3 Designing for A.S.D. in Ireland
In Ireland, a school can apply for a grant, e.g. a "Special class start-up grant". Primary schools can receive a grant of €6,500 which is used for to cover the cost of general equipment and furniture. There are several other grants available, e.g. the "enhanced capitation grant" which is one of the basic grants, or the "once off grant" which is a sum of €7,000 that is used for equipment and furniture for a Multi-sensory Room and is included in the overall schedule of accommodation.
One-fifth of the education budget is currently spent on S.E.N. (Special Educational Needs). It is an apparent strategic use of funds, properly allocating buildings, staff development, classroom resources and flexible use of funds for trips etc. would be advantageous to the experience of pupils with A.S.D. and others with other special educational needs. There is a need for more funds to be allocated to the re-designing of autism facilities already present, as well as the build of new autism unit facilities where there is a lack of in a school as all children have the right to an education.
The National Disability Authority (N.D.A.) is an Irish independent statutory body that provides information and advice to the Irish Government. They have set guidelines for A.S.D. design which are usually applied to a schools. The first aspects to be considered were surfaces and finishes. The building's floor finishes are required to help individuals to navigate their way around the building safely, identifying features throughout the building. Also, the floor finishes throughout the building needs to be slip resistant, durable and have acoustic performance. Matt or a satin finish flooring with complimentary colours and small patterns are considered preferable to date. Another consideration is the walls and ceiling finishes, which should be considered to maximise the aesthetic, acoustic and visual qualities of the environment. The suggestion is that the ceilings should be bright in colour and background walls should be nondistracting, plain and have even surfaces. It is best to avoid bold patterns on walls and ceilings and flooring. It is advisable to use different colours on the wall finishes to help differentiate between different floor levels in a building. Also, features such as doors should have a different surface. It is helpful to use coloured strips along a wall to assist with navigation around the building.
Any glass screens need to be marked using contrasting materials and it is important that the places marked on the glass would be applied at two eye levels of 850mm to 1000mm and 1400mm to 1600mm above floor level. The presence of glass must be clearly highlighted to prevent it being a hazard risk to all people occupying the building. The guidelines recommended that spatial sequencing is important as people with autism who respond well to surroundings that are associated with everyday living which offers a sense of familiarity, a sense of specific order and security. Also, it is vital for people with autism to feel they can 'escape'. The designer needs to create a safe space for when those with autism are feeling overwhelmed and overloaded to give them a place to retreat, readjust and remerge.
Another consideration is compartmentalisation, which should be taken into consideration. Spaces should be broken into small manageable areas providing minimal materials that the individual needs to complete a specific task within those areas. The guidelines also recommend that it is important to ensure that there is a smooth transition space provided throughout the building for the individual so that they can adjust. Furthermore, sensory zoning is a key factor when designing. It is vital to design the building around the senses because that is what people with autism understand. Best practice dictates; high stimulation spaces next to high stimulation spaces and low stimulation spaces next to low stimulation spaces with a smooth transition between both. Once these design conventions are applied, the building will be ready for people with autism to enter and to leave safely and securely.
In an Irish context, designing for autism can be considered behind other countries. A good example of a sensory room being designed and placed in a location in Ireland would be the sensory room at Shannon Airport which is the first Sensory Room developed for children with neurodevelopmental challenges including autism (fig.1) in Europe. It was designed by the Education and Therapy company 'Adam and Friends'. "Niall Maloney, director of operations at Shannon airport urged other Irish and International airports to standardise this service."23
Since establishing the sensory room, Shannon Airport authorities have received over thirty enquiries from government agencies, airports and sporting venues around the world seeking advice on how best to establish an airport sensory room. Even though Shannon is a positive example of a sensory space and the rest of Ireland is placing more Sensory Rooms in public places, the negative aspect is to be found in the fact that key autism design guidelines according to the N.D.A., were not adhered in the Shannon model. This may result in issues of concern arising in the future.
Besides Shannon Airport having the first Sensory Room in an airport in the E.U., a second good example of a Sensory Room designed and placed in a building in Ireland is to be found in 'Sligo Clayton Hotel'. This is the first hotel in Ireland to have such a space, since August 2017. (fig.2) From research, the room seems to fit the basic needs for children with A.S.D., however, the room is to small and confide with too many patterns on the floor and signs on the walls. The ceiling is black and the colour black has a negative effect on a child with A.S.D. There is also a lack of windows which does not allow the option of natural lighting within the room. Simple changes could be made to these autism facilities to meet the needs of children with A.S.D.
There is also a sensory space to be found in a Leisure Park in Drogheda; a Multi-Sensory Room which is slightly different as it covers more than just children with autism. This was also another first for Ireland, but in all three, the key autism design N.D.A. guidelines where not implemented throughout the designing of these facilities. (fig.3)
Ireland is beginning to make changes to take into account children and adults with A.S.D. in not just the education sector but in other public places. Besides the sensory aspect of the design, the social aspect deserves consideration also. The 'Movie House' is a cinema that has four locations, catering to the needs of those with A.S.D. "During these screenings, lights are kept on, audiences are free to move around freely, volume is turned down and no advertisements or trailers are played.
Shops are now considering design and protocols for those with A.S.D. e.g. Lidl, a German global discount supermarket chain, based in Neckarsulm, Germany, that operates over 10,000 stores across Europe and the United States, has also made adaptations to suit the needs of people with A.S.D. in Ireland. They have become an Autism Awareness Store and offer an autism aware quiet evening every week. The exact location and other information is to be found on their website e.g. it will give the specific day and time for quiet time in the store. They facilitate this time by making changes, such as reduced lighting, having no music or announcements played, having lower till scan sounds and having priority queuing. Assistance dogs are also made welcome inside.
The lack of regulations within designing for Sensory Rooms comes to light when an elevenyear-old girl from Cork, Saoirse Hayes, designed a Multi-Sensory Room for her school 'Scoil Naomh Eltin. This was highlighted when 'Adam and Friends' supplied the equipment.27 (fig.4) From this example, it is evident that there are no strict guidelines when designing Sensory Rooms as a child was allowed to do so. Or does it show that it is important to see through a child's eyes and perspective. This is similar to Kijeong Jeon's approach, a designer from America, who based his design theory from an empathetic approach "by putting himself in autistics' situation to know which things effect their senses and what makes them distracted"?
Currently, the Irish government is delaying the passing of the Autism Bill. According to Kathleen Funchion, the Autism Support Services member, "Ireland still awaits an Autism Bill and an Autism Strategy despite an initial Autism Bill being introduced to Dáil Éireann in 2012, and lapsing in 2014. "Also a subsequent attempt at an Autism Bill is awaiting the second stage in the Dáil since July 2017".  Lack of legislation on building guidelines and regulations presents a real problem, when designing for A.S.D. This can be seen when referring to a 'Withdrawal Room' (fig.5), that has been designed and placed in primary schools for children with A.S.D. Withdrawal Rooms, better known as 'Isolation Rooms' are designed to provide a safe place for children with A.S.D. when they are overstimulated and having a tantrum or are perceived to be a threat to themselves, other students or teachers. The space acts as a temporary soothing shelter. The Sensory Room gives protection to the child as well as protection to other students and school staff by taking the child out of the classroom. Its original name is an 'Isolation Room', but the word 'isolation' has a natural negative ring to it and this has led to the renaming of the room to a 'Withdrawal' room, which is now more commonly used. Using the room is seen as a last resort, but still seen as a positive intervention, when required.
Unfortunately, due to no specific design guidelines or regulations set by regulations, this room has had a down side to it, as many schools are misusing the room, for disciplinary reasons, which has led to negative backlash from concerned parents.31
The Department of Education have stated in an interview with 'The Journal' in September 2018, "the Department of Education holds that it is currently working on new guidelines to address dealing with crisis situations with pupils with behavioural difficulties".
Regarding Withdrawal Rooms in Ireland; "Small spaces may make them suffocate while huge spaces may confuse them". This presents us with a reason to look into the Withdrawal Room and ask the question, why create a small confined space for a child who is angry and having a tantrum if small spaces can have a negative impact on the child? We examine the question;
Is it better suited to have a calming space in learning classes so that the child isn't being excluded and put into a confined space or is the Withdrawal Room a necessity, best suited as a soothing shelter? "The Withdrawal Room should only be used during extreme situations"34, but what is classed as an "extreme" situation?
In America, thirty states have already banned the use of a withdrawal room as well as Columbia, who attempted a complete ban. A campaign group, 'Parents Against Isolation Rooms', are working towards the banning of these rooms in Ireland. Currently, schools are not required to record the use of these rooms or why they were used. Schools are not required to inform parents. "In order to avoid misuse of these rooms, it is essential that the process is transparent and can stand up to scrutiny".
Teachers in A.S.D. units in primary schools in Ireland are not always trained or have the relevant expertise to know how to support a child when they are suffering from anxiety, stress or are on the verge of a meltdown. Without this training and in absence of strict guidelines, Withdrawal Rooms are more likely to be overused by teachers with appropriate training and qualifications teachers may well be able to function without resorting to the use of such rooms. Teachers could contribute to the development of the design to better suit everyone's needs in crisis situations.
Guidelines for the use of a Withdrawal Room are set by the board of management of individual schools rather than at the national level. A room that is portrayed to be part of a positive intervention to help a child with A.S.D., defies research findings which point to negative outcomes for use of these rooms. This is an important example of why it is important to have specific design guidelines set in law for A.S.D. units and the use of withdrawal and other spaces.
This chapter has highlighted the characteristics of Autism and how designing for A.S.D. has developed from 1902 to the present day. It shows the importance of how the first institution in Northern Ireland was set up as well as Jan Hulsegge and Ad Verheul's introduction of their play on the tent for people with disabilities. This all provides a backdrop and starting point to develop what we know today as an autism facility. This chapter has also explored how designing for A.S.D. in Ireland in the education sector in contrast to designing for public spaces are quite different. There is a more definite structure used in schools, who apply the N.D.A. guidelines, whereas other public spaces have no specific clean adherence to the N.D.A. or other guidelines. The executive director of the Irish Society for Autism, Pat Matthews, urged the Department of Finance to make more money available for the Autism services, and stated "If this could be done without legislation, that would be fine." This shows a clear view of the lack of prioritising of Autism services, in decision-making departments. Ireland is still awaiting an 'Autism Bill' to be passed and such a law could well prevent the poor design of A.S.D. spaces.
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https://www.hse.ie/eng/services/list/4/childrenandfamilyservices/child-and-adolescent-health/autismservices.html?fbclid=IwAR1IcgknZRyTCrkgl9vyXPbdl3ZHecMFQyljgd1GDiDIeYVABacaGpQUFNc. Last updated 2018. Last accessed October 29th, 2019.
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