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Design for Neuro-Diversity (1): Understanding ND Clients' Sensory Worlds

Whether it is a house or a daycare center, if a project is serving neuro-divergent (ND) clients—those who have autistic spectrum disorder —, lowering their sensory stress and the work stress of their caregivers would be the primary design objective. The first step would be to gather knowledge of the ND clients' sensory profiles, sensory worlds, the logic of coping behaviors, and social communication intervention by caregivers. This would be accomplished through meetings with the ND clients and their caregivers as well as on-site observations of the ND clients when possible.

An exterior view of a daycare center for persons with autistic spectrum disorder and intellectual disabilities

Understanding ND Clients

While every ND person's sensory profile is unique, due to the neurological conditions they generally are challenged by various forms of deficient sensory input processing, deficient attention modulation, deficient emotion modulation, and hyper or hypo-sensitivities to some of the sensory stimuli such as bright light, fluorescent light, certain colors, strong visual patterns, sound, touch, smell, taste, body balance, and various body part sensations. ND persons are prone to sensory overload which can be experienced as extreme physical pain or discomfort in their nervous system, in addition to acute emotional stresses caused by the chaotic perceptions of life and the world. Hypersensitivities can occur not only in terms of intensity but also of duration, which means that for ND persons sensations can remain much longer - a number of hours, even days after the physical sensory stimuli has been removed.

People with autistic spectrum disorder and intellectual disability at a daycare facility

Some ND persons' vision may lack depth, be fragmented, be distorted, and generally be so chaotic beyond intelligibility as perceived objects never settle down, continue to slither, change in shape and size, or even disappear especially when they try to concentrate on looking.


The majority of ND persons' visual hypersensitivity and distorted vision can be alleviated by wearing colored lenses ("Irlen Lenses") that filters out the wavelengths of light to which they are hypersensitive.

people with autistic spectrum disorder at a daycare facility

ND persons' seemingly bizarre repetitive self-stimulating behaviors, rigid thinking, along with the hyper/hypo sensitivities are coping strategies or symptoms of sensory or emotional stress being experienced.


When designing a comfortable physical environment for ND persons, it is crucial to understand what stimuli they are hypersensitive to, what their sensory worlds are like, how sensory overload occurs, and the above-mentioned logic of their behaviors. Hypersensitivities can get worsen during puberty and may change over the course of the ND person's life. Autistic sensory profile can fluctuate quite a bit depending on the person's ever-changing stress level and other life environment / circumstances.


That said, it seems social communication intervention from early childhood could make a difference in the quality of the ND person's later life, if implemented continuously and consistently by all caregivers involved. Learning and implementing protocols that keep the ND person's autistic behaviors and sensory issues from escalating into habitual severe behavior disorders seems crucial. The design of physical environment should facilitate such intervention as well.


On the other hand, generally many ND persons are hypo-sensitive to internal bodily feeling such as thirst, hunger, digestion, pain, heart rate, muscle tensions, and sensations in bowel, bladder, etc, which can lead to constipation and incontinence. Impaired sense of balance and body movement awareness are not uncommon, either. Since emotions are closely related one's bodily sensations, it is also harder for ND persons to recognize their own emotions, which affects their self-control skills. Poor interoceptive awareness combined with the chaotic external sensory world perception may hinder the development of sense of self, which can lead to low self-esteem..

people with autistic spectrum disorder at a daycare facility

Basic Design Recommendations

While design recommendations would vary from one project to another, below two could be commonly prioritized.

  • Bathroom & laundry room optimized for toilet assistance or training, incontinence cleanup, and bathing

  • Spaces ND persons use should be made tranquil & safe according to their sensory profiles, durable enough to withstand the coping behaviors, and easy to clean.

By reducing physical environmental sensory stressors, architectural design can free ND clients from having to compensate for sensory overloads which in turn improves processing of overall senses including interoception.


Note

In this post the word ND refers to the neuro-developmental conditions known as autistic spectrum disorder with or without intellectual disability.


References

The sources YA learned about ND persons sensory issues from include the following books & websites.

  • 高橋 みかわ Takahashi, M. (2011) 重い自閉症のサポートブック[Support Book for Those with Severe Autistic Spectrum Disorder]. Tokyo: Budosha

  • Caldwell, P. (2006) Finding You Finding Me. London: Jessica Kingsley Publishers

  • Bogdashina, O. (2016) Sensory Perceptual Issues in Autism and Asperger Syndrome . London: Jessica Kingsley Publishers

  • On the topic of interoception related issues: https://autismawarenesscentre.com,

  • On the topic of visual sensitivity: www.integratedtreatmentservices.co.uk

  • Dr. Bogdashina's website: https://www.olgabogdashina.com


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