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When It Comes to Design for the Disabled, Let the Science Lead the Process

My firm, Orfield Laboratories (OL), has spent 50 years in architectural design, research, and testing, dedicated to the premise that what matters in design is the end user, because design in the absence of user comfort, preference, and satisfaction is a failure. In this process, we’ve developed building performance standards for most commercial building types, and we have now added to those standards the requirements for half of the world: people who are perceptually and cognitively disabled (PCD). The expense in doing this has been significant, but it has been one of the most important quests in my life.

Five years ago, Common Edge executive director Martin C. Pedersen interviewed me about why architecture is afraid of science. We discussed the problems of architectural education, the comparison of building design to product design, and the beliefs of many architectural deans that their students hate science and just want to do “art.” At the time, OL was 15 years into the study of PCD and had self-financed the development of multisensory design standards for aging, dementia, and autism at the cost of about $2 million. And we had completed an exemplary project for each: The Cottages, for Western Home Communities, a dementia campus in Cedar Falls, Iowa; and an autism clinic in Woodbury, Minnesota, for Fraser.

Our hypothesis in working with dementia was that reducing all perceptual noise could allow elders to revert by about 10 years to their earlier perceptual sensitivity. When residents were moved into this housing from institutional housing on the same campus, the care teams working in The Cottages began to report that residents who hardly ever talked were starting conversations, those who ate poorly were often now eating well, those who were less active became more active, and most became more social. We’re in the process of aggregating those data on that large change in behavior for a new publication, but it was proof that the sensory deprivation of aging could be significantly reduced, an amazing confirmation for us.



European architects are more often trained in design research science at a graduate level. U.S. graduate-level architectural students are generally trained in architectural history and theory, rather than in any specific area of science. And if there is a graduate level architectural program in science, such as the Building Performance Program at Carnegie, it is full of foreign students, even though the undergraduate program is full of U.S. students. My employee and friend Dr. Zhonghu Li was a brilliant scientist with a prior full professor position at Tsinghua University in Beijing, but there were no Americans in his class. Li turned down a professorship position at Carnegie to join our firm, as we had a fully equipped testing and research lab, while Carnegie was teaching theoretically, with no applications research and measurement program.

We have much evidence-based design research going on in the U.S., but it is being completed by academics with no specific subject expertise. This became overwhelmingly clear to me when I reviewed papers for the Center for Health Design. The Ph.D.-level researcher/writer would simply do a literature search of the subject under study, read some of those resources, and write a paper that made no sense to a subject expert in the field of the paper. And graduate-level researchers in the U.S. hardly ever use research-based design, where instead of reading studies, they actually develop studies, instrumentation, modeling, and subjective research as part of their project. The European design community, with good reason, doesn’t consider U.S. architects as equal players at the same depth in the research field, especially with regard to science and disabilities.



After our initial focus, we moved on to the study of mental illness, ADHD, PTSD, sensory processing disorder, blindness, and deafness. During this time, we established that most commercial buildings have at least 40%–50% of their populations in the PCD category, and many buildings, like hospitals and nursing homes, have a much higher percentage of disabled residents. Why does architecture not already know this information? Because each disability group tracks its own population, but they do not add other disability groups to their statistics. They don’t realize the power of a larger category of PCD disabilities.

Western Homes, The Cottages, in Cedar Rapids. The interior of the cottages, designed by Align Architects, in consultation with Orfield Laboratories, was created based on how sensory and low complexity criteria. Photo by Howard Doughty.


In considering this new inclusive design approach, there are a few well-accepted myths in architecture that we need to dispense with. First, excellent buildings do not have to cost any more than average buildings, they just need scientifically trained design and research teams. Second, designing for disabilities is not designing against “neurotypicals” (nondisabled folks), as both the diagnosed disabled and the nondisabled share many of the same emotional feelings and perceptual and cognitive responses. Most designers don’t realize that having PCD does not preclude the fact of normalcy in many domains of life. 



We’ve been studying the area of perceptual and cognitive disabilities in architecture for more than 20 years. Our interest has been in the different disability classifications and their needs. We’re less interested in their diagnosis as in their quality of life. Many PCDs have multiple disabilities, such as autism combined with depression and anxiety disorder. And many PCDs with different diagnoses share certain common disabilities—anxiety, depression, and bipolar disorder—with their other sensory and cognitive losses. So the design research on this broader category is quite complex.



Years of research on perceptual and cognitive disabilities has shown us that while each disability has its own symptoms and diagnosis, most PCDs find three design solutions to be overwhelmingly helpful.


Sensory Noise 

The first is to design the building to be perceptually quiet. This means quiet in all sensory domains, as each one can produce its own kinds of noise:

  • Hearing: acoustic noise and frequency response
  • Vision: too much brightness or darkness, too little contrast
  • Thermal: too-high or too-low velocity of air movement, uncomfortable temperature
  • Olfactory: undesirable smells
  • Gustatory: undesirable tastes
  • Tactile: uncomfortable surfaces


Design Complexity

The second design solution is reduction in design complexity. This design attribute focuses on simplicity in design and wayfinding. Design complexity—in terms of complex finishes, large numbers of different finishes, dark finishes, high contrasts between finishes, and so on—causes confusion and creates a cognitive load for interpretation of the space. Complex spatial layouts provide the same kind of cognitive load. And when the mind is processing complex spaces, other thinking is often masked by the complex thinking, which can cause anxiety, accidents, and other failures.


Involvement With Nature

The third design solution is a focus on nature. We’ve been studying the benefits of natural experience for many years, partially through our study of perception and partially focused on restorative natural settings and therapeutic garden and landscape design. Here is where the simplicity and complexity intermingle in a complex but interesting way. As I’ve explained to many of my friends in design, upon completing a walk in the woods, you never make the comment, “I could have designed it better.” Why is that? 

Fraser Woodbury Clinic. A natured-inspired seating area. Designed by Pope Architects, in consultation with Orfield Laboratories. Photo by Philip Prowse.


Our research suggests that what’s going on is so complex that it is simple. When we take that walk, there is no symmetry, and none is expected. We’re in the moment, and if we don’t know the trail, we make our directional decisions on the fly, based on various objectives. Although the woods are complex, we have little inclination to organize and understand our surroundings. We’re immersed in the moment and in the experience.

This is one place in our world where we accept the complexity implicitly without realizing it, as there is no reason to try to organize the experience. And this lets us off the hook in the same way as experiencing the aroma of a flower or looking at a piece of art. And even if we are familiar with the surroundings, there is still so much variability in nature that we move by landmarks, guideposts and distant views, rather than by the logic of interior organization. If there is a path, it may not be the same next year; if the path is smooth, this is often temporary; and if the path is blocked by a fallen tree, we continue around the tree as if the path was still there. While our indoor movements are highly and geometrically organized, our outdoor movements do not follow many rules, except to get to the destination or to find our way back to our starting point.

In disabled populations, there is a similar analog. Inside buildings, we try to find our point of origin, we try to find our destination, but these folks also understand that we’re not playing the same game in nature. In many ways, we have a freedom to choose, within our framework, that we would never have inside. And as we bring the anxious, the depressed, those with sensory losses or sensitivities, much of this population understands this transaction as one of play rather than navigation. What our modern analysts know as gamification, our normal population knows as freedom to experience. It’s a metaphor much like recess at school—not a task, but rather an experience of joy, wonder, or curiosity.



In our experience with architects of disability-based buildings, most of them tell us that they don’t want too much disability design in their buildings, as it would be unfair to the nondisabled. They don’t want, for example, five autism classrooms, they just want one, as that can handle the population. They believe there is a conflict between design for the disabled and for the nondisabled. This is simply not true. A great autism design is preferred by most everyone, as is a great dementia building, as they are both more peaceful and Zen, with fewer stimuli and less complexity.

At the outset of our studies, our hypothesis on design for disabilities was that each disability would require different design features, and in some cases this is true; interestingly, however, in many cases it is not. This may be due to the fact that most disabilities tend to bring with them anxiety, apprehension, some level of depression, some level of confusion. So part of our job in design is to clarify and simplify to reduce those pressures and anxieties.

We now know that a common set of desired features for most PCDs is low sensory stimulus levels, a design with very limited complexity and significant exposure to nature. In other words, most occupants, with or without disabilities, prefer perceptually quiet and cognitively simple buildings that provide nature as a principal amenity. The disabled may need these environments, but the nondisabled prefer them.



In my life as a sensory design research consultant, most complaints come from “normals.” If a restaurant is too noisy, most everyone hates it. When it is too bright out and one walks into a theater, the problem is not a lack of vision, but having no speed to adapt to changes in lighting. When one is sitting in church and cannot read the projected music and cannot hear the sermon, it is generally a person with reasonable vision and hearing in a church with terrible acoustics and lighting, and we have remediated hundreds of these churches. And when we are disturbed by aircraft noise above us, it is not our sensory system at fault, but rather an aircraft that is usually too loud and has often deviated from the flight path. So these problems experienced by the half of us who are disabled are also experienced by the half of us who are not. 

Exterior of Orfield Laboratories, in Minneapolis. The facility also includes a recording studio. Minnesota native son Bob Dylan recorded his seminal album, Blood on the Tracks, there. Photo by the author.


We need to revisit one of the most interesting parts of architectural philosophy: Can buildings be considered correct or incorrect? In other words, are some buildings examples of design mistakes? As an expert witness for many years in cases of building design litigation, it is clear that there are many cases of mistakes. It is equally true that so much about buildings is vendor-designed by salesmen for architectural product companies, that the design team is often not really the source of the design. But what this should imply in the architectural education field is that we must teach more about human perception, comfort, and preference. And this leads to our conclusion about current disability design. Most design for disabilities uses no standards other than physical disability standards, like ADA. As a result, most buildings we’ve measured are outside of the comfort range in daylighting, lighting, acoustics, thermal comfort, and indoor air quality. They aren’t comfortable for the nondisabled, and they are worse for the PCD population. We need far better building performance standards to improve this type of design failure. 

Second, and most important, all buildings should be designed for PCDs and use multisensory design standards that ensure perceptual comfort, and they should employ subjective testing to ensure perceptual preference. Currently, most of these buildings are done with no disability intent, and this is a major mistake. In the future, ADA should include these types of standards, but there is no excuse for not having specialized consulting on all buildings to ensure compatibility with PCD disabilities. The result will be far more peaceful and relaxing buildings for the 40%-50% who need them—and for the rest, who don’t need them but prefer them.

While studying autism years ago, with the help of Autism Speaks, I asked their executive spokesman, Peter Bell, which were the best autism schools in the country. He gave me a list of 10. I called all of them, as well as their architects, and we talked about design and approach. But the central question I asked them was, “Did you use any autism science in the design of your school?” All of them said no, and looking at the images of these new buildings, I clearly saw those failures. All the buildings were based on mistaken concepts in autism, as are most PCD buildings to this day.

Featured image: Orfield Laboratories’ Anechoic Chamber, “the quietest place on earth.” Photo by the author.



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