In this edition of pantheon// we are tackling numerous out-of-order subjects, whether in architecture, art, education or society. One of the most confronting topics came up in a conversation I had with Berit Ann Roos. She is the director of the Academy of Architecture at the Hanzehogeschool in Groningen, has an extensive background in architecture and is currently working on her PhD research. In her research she explores the contribution of architecture to the quality of life of intellectually impaired individuals showing challenging behaviour and possibly autism.

She built several buildings for these individuals. Amongst them an extensive area of day-care/work units in the dunes of Noordwijk and a very intensive care facility for a health care institution on a health park in Ermelo. The latter being one of the case studies of her research with the aim of creating a living environment that was as comfortable and safe as possible for both the residents and the employees of the institution. 

About the exploratory talks with residents and experts

A successful project is usually preceded by extensive preparation involving discussions with stakeholders. Although that always takes up a lot of time and energy, it was certainly a major challenge in this particular case. The immediate residents and users of the new design are intellectually impaired individuals showing challenging behaviour and autism and many have a mental age of 2 to 4 years. Communicating their wishes and translating those wishes into concrete design concepts can prove to be quite a task. By talking extensively not only to the residents, but also to parents, staff, care providers and experts in the field of autism, Berit Ann was able to draw up an extensive program of values to include in the design. In addition, she visited similar very intensive care units and lived with them several times in order to experience individuals showing challenging behaviour, their needs and wishes first hand.

One of the striking things Berit Ann told me was the conversation she had in the University of Leiden with a professor on autism. She explained to her that autistic people generally show difficulties coping with unpredictability and the unknown. When they do not know what is around the corner they can experience stress. With that in mind, one can only imagine how scary doors and corridors can feel to these people. In addition, Berit Ann was able to tell me that autistic people experience their surroundings in a totally different way than we do. They often see all the details and take in every aspect of the room, but because of this fragmented impression of spaces the overall picture gets lost and an overdose of stimuli might occur.

To the experts, these were perfectly logical characteristics for autistic people, but they were not reflected in the architecture for these individuals. The available literature on the influence of architecture on autism was lacking at that time. General practical knowledge was certainly available, but the bridge between research and architecture on this topic still needs improving. And perhaps not only here. There is a lack of good communication between the various sciences and disciplines. It is this part that is really out of order.

About the design brief and its concepts

The design brief given to Berit Ann for the day-care/work units by the care institution in 2009 was for a building containing all the different functions for the residents and carers. There had to be room for a greenery, an animal farm, a horse farm including stables, a dog shelter, office space, dining rooms and so on. In addition, the complex had to invite contact with outsiders and passers-by since the institution should not be a closed facility hiding somewhere in the dunes.

In the conversation I had with Berit Ann, she told me that there was a major contradiction in the task itself: the client tried to place all the functions under one roof, but at the same time wanted to encourage interaction with passers-by. For her, this did not go together, so instead of one building, she decided to give the various functions their own building and arranged them along a bicycle path around small courts. This way, users and passers-by move along the paths between the buildings, which provides a natural interaction between users. In addition, this clear distinction of functions is of course much easier to grasp for the autistic residents and users. They especially benefit from structure and logic. Each building is different and distinguishes itself from the other buildings and is therefore recognizable for the autistic users. 

About the design for Brandon’s accommodation

Berit Ann told me the story of Brandon, one of the residents of the care facility in Ermelo. Brandon suffered from a severe form of challenging behaviour in which certain triggers can make him very aggressive. His living conditions were very extreme at that point because of his aggressive behaviour, which left the healthcare institution helpless since they were focussed on containing the risks of his aggression towards himself, others and his surroundings. Also the risk of him breaking out and by that possibly hurting people had to be minimalized. He had absolutely no choice concerning his living environments: he was not able to open his windows, flush his toilets or use proper cutlery. His bed was fixed to the floor, the toilet bowl was made of stainless steel, and the wallpaper (which he would tear off in an aggressive fit) had been replaced with featureless linoleum that he would not be able to get off the wall by force. Also, he was chained to the wall while other individuals were present in his room. His living conditions resembled a prison instead of a home. 

Although the care institution only tried to protect the caregiver and Brandon from himself with these interventions, this is dehumanizing. Especially for those individuals who cannot express themselves or have a choice concerning their living environment, it must be ensured that their living environment feels comfortable and attractive.

In the end, Berit Ann submitted a design for Brandon's new home (and the other residents). This resulted in a design which was based on a new treatment method that supports the residents in their development. The safety consists of the connection between the care providers and the residents and therefore has an open floorplan. It is a homey, light place with, among other things, as few doors as possible. Because, every threshold, whether physical or programmatic, poses a challenge to the residents. For example, it can be difficult for a resident to make the transition from lying in bed to getting dressed, or to switch to brushing their teeth after breakfast. So, it is beneficial to lower the physical thresholds and leaving out unnecessary doors, maybe even place the sink in the bedroom instead of the bathroom.  

In addition, the corridors throughout the complex are spacious, wide and light. By making the spaces open and airy, the residents and the care providers feel more comfortable and, above all, safer. (For the caregivers too, it is simply a scare when one of the residents acts aggressively towards you). By avoiding blind corners and dark rooms as much as possible, you immediately create a much nicer environment for everyone.

All these aspects make the residents' lives a lot more pleasant and safe. And all that without an extra security camera, locks and loot-proof materials. So you could say that good architecture is a powerful tool, while moderate to bad architecture only reinforces the negative impulses of the residents.

About her PhD research

Meanwhile, Berit Ann Roos is working on her PhD research. She is doing research on the contribution of architecture on the quality of life of intellectually impaired individuals showing challenging behaviour and possibly autism. There is still a lot to discover in this field and she does this by means of her own designs. During her design assignment for 's Heeren Loo, Berit Ann found out the hard way how little information and knowledge is available or shared in order for an architect to make a contribution to the living conditions of individuals showing challenging behaviour and possibly autism. With her research she hopes to expand this knowledge and of course make it available to future designers for this target group.

But the knowledge she gains is not only useful for people showing challenging behaviour or autism, care providers, their family, and architects building for them. This knowledge can also be of great value to every architect, Berit Ann tells me. Individuals showing challenging behaviour or autism are much more sensitive to the things around them than we are. You could say that their senses are much more finely tuned than ours, so they can experience things much more intensely. Since they appear to be finely tuned instruments, much can be learned from their experience of space. Some research even shows that spaces, specifically designed for autistic individuals, are even more beneficial for neurotypical individuals. 

By using these experiences and the research on this topic the basis can be laid for defining the aspects and characteristics of spaces that create a pleasant and agreeable atmosphere for everyone. In this way, it is possible for us as future architects to design more pleasant living environments not only for ourselves, but also for those who perhaps need it most.

To conclude

To conclude, I would like to thank Berit Ann Roos for her cooperation on this article and the inspiring conversation I had the opportunity to have with her. I would also recommend everyone to keep an eye on the results of her research. This can be done via the following website: https://www.linkedin.com/in/berit-ann-roos-3278b56/