How homes and health care spaces are becoming autism-friendly
Bright lights, loud noises and other stimuli can be overwhelming to a child with an autism spectrum disorder (ASD). Even a short visit to a doctor’s office, with humming florescent lights and ringing phones, can create sensory overload.
Through its autism-friendly initiative, Nemours Children’s Health System is designing health care spaces throughout their hospitals and care sites to ensure that children with autism are as comfortable as possible. Nemours also works with families to help them make their homes autism-friendly.
“We want to be mindful about space in general,” said Emily Bernabe, clinical director of psychology at the Swank Autism Center at Nemours. “Often having wide, open spaces can be intimidating to individuals with unique sensory needs.”
For instance, Nemours offers separate quiet areas for patients with ASD where families can be by themselves. The quiet rooms have fully dimmable lighting controls, mats for safe play and backlit marble sensory units. In the larger waiting rooms, there are also separate sensory areas and cocoon-like chairs where kids can feel safe.
Families can implement these design principles and use the same approach at home, similar to what Nemours did by breaking up open spaces. That’s particularly important as many newer homes are constructed with open floor plans and high ceilings.
Children with ASD need structure and like to know what is about to happen. By breaking up larger rooms, as well as having designated spaces, children are less likely to feel overwhelmed.
“For newer homes especially, there should be specific parts of the house designed for homework time and calm-down time,” Bernabe said. “You can use furniture to set up natural barriers in the home, such as using big, bulky bookshelves or screens. And if you have a long hallway, look for ways to break that up.”
Large areas also can be segregated by floor colors. A space with a rug could serve as a homework area, for example.
Sound issues are another aspect that should be addressed at home. Nemours eliminated any buzzing or humming from overhead lights, carefully insulated walls and ceilings and used acoustic tiles to absorb sound.
“Excess noise can cause sensory overload,” Bernabe said. “Think about your environment at home. Is there noise from ventilation or traffic, or any rattling sounds? Those sounds should be addressed.”
Likewise, lighting should be taken into account. At home, avoid having extremely bright lights and use indirect lighting when possible. Dimmers are a great option, and if windows are present, be sure to use blinds or shades to block out sunlight, which can be disruptive to children with sensory concerns.
Decorating schemes should also be subtle and muted. “Nemours took into account the decor when designing our spaces, and the same can be done at home,” Bernabe said. “You want to use low-arousal decorative schemes — not bright, overstimulating colors.”
Children with ASD often experience communication challenges and pictures help them understand what is about to happen next. Nemours explains routines and procedures in the medical offices through labeling and visual clues — something that can be adopted at home.
For instance, at Nemours, the sequence of events are explained by a visual schedule — images that include getting out of the car, walking to the clinic, entering the clinic, and so forth depict the process of a visit and every step the child will encounter.
That same approach can be used in the home. The steps involved in washing hands can be illustrated and spelled out visually — turn on the water, rinse your hands, put soap on your hands, rinse and dry.
“With our autism initiative, the premise was that we would never exclude individuals with any other disabilities, and we shouldn’t be excluding anyone with autism,” said Bernabe, who co-chairs the Autism-Friendly Hospital Committee. “The goal is to create low-stress spaces for children with autism and their families. The same approach can be made at home by being mindful of sounds, lights, colors and everyday routines. These design changes make a big difference.”
Find more resources from Nemours about autism in children at www.nemours.org/services/autism.html.
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