The award-winning Caudwell International Children’s Centre (CICC) in Newcastle-under-Lyme was the UK’s first purpose-built diagnostic and therapy centre for autistic children and other neurodivergent conditions.
James Pass, who took over as lead architect on the exemplar project while working for multi-disciplinary consultant C4 Projects, recalls a journey working closely alongside the charity. This even included investigating the usage of light, texture, colours and acoustics to present children with physical and sensory reassurance consistently.
With all this in mind, what principles did James and his colleagues use to design this landmark building?
It’s also important to note that RIBA uses identity-first descriptions of autism (example: autistic person) in this article, as recommended by the National Autistic Society. RIBA does, however, acknowledge that some readers may disagree with this approach. We encourage feedback and are committed to developing our approach in this area over time.
What was the brief for the Caudwell International Children’s Centre?
The headlining elements of the brief for CICC called for a building that would reduce distraction and avoid over-stimulation, stress and anxiety for the children that used it.
“One of the key issues for autistic children can be short attention span, so if you can increase attention span it can help with diagnosis and intervention,” James explains. “So, as a design team, we are always looking to remove sources of distraction, confusion and anxiety, which led us to also look at things like visual connectivity and visual reassurance.”
Subsequently, James and his team introduced a curvilinear navigational strategy so that there are no blind corners at CICC. People can see where they are going, where circulation routes are leading, and what lies ahead in the next space. Knowing what (and who) is ahead can give autistic people a sense of safety. Instead of relying on signage to navigate tight corridors, designing an open layout with visual connectivity and reassurance is key.
The floor plan of the building is a figure-of-eight loop, like an infinity sign, so those using the building can go in whatever direction they choose and cannot get lost, instead eventually finding their way back to where they started. Circulation routes are wider than recommended by NHS Estates to avoid congestion and to help reduce another potential source of anxiety. There are also numerous breakout areas, some of which are secluded.
“The different areas give users the opportunity to take action if they think they’re becoming over-stimulated,” James continues. “They can go and sit down with their backs against a wall if they need time to readjust to their surroundings away from sources of noise and confusion or they can choose to withdraw to a more secluded space should they need to do so.”
Ceiling heights are one of the ways used at CICC to signal that users are transitioning between different zones of the building. From a three-storey entrance hall, they will step down through varying ceiling heights, corridors and breakout spaces, and then step down further to 2.4m for assessment suites which are designed to be reassuringly home-like and comforting.
Read more about how architecture can design for neurological conditions like epilepsy.
What other recommendations are there for architects designing for neurodivergences?
Before the now-established PAS 6463:2022, guidance on how to design for neurodivergences would focus on lighting and particularly acoustics (for instance the avoidance of long reverberation times). But from research carried out by Caudwell Children, it was clear there was a whole gamut of sensory reactions to consider and mitigate, including:
- colour
- lighting
- shading
- patternation
- texture
- smells
- noise
To these, James recommends adding predictability and environments that are readily understood. “For instance, if something looks like wood, it should be wood,” he says. “If it’s material printed to look like wood, it could be disconcerting for some when interacting with an unexpected surface or texture.”
It was colour that presented some of the greatest challenges in the design phases, James continues, not least because the same colour might have positive or negative connotations to different users – one child’s favourite colour could be enough to induce panic in another.
James recalls how different-coloured stair handrails were considered for wayfinding purposes before research suggested there would be some children who would find a red handrail distressing because they associated it with being too hot. Additionally, a blue handrail might be avoided for being too cold. Early-stage research found that some children would be happy to pass through their favourite-coloured door but dreaded entering through their trigger-colour door.
Find out more and download RIBA’s Inclusive Design Overlay to the Plan of Work.
How designing for neurodivergence has progressed
Another consideration was that while 70% of autistic people tend to be hypersensitive to visual stimulation, the other 30% tend toward hyposensitivity and will react positively to strong colour stimuli.
Task lighting in the centre is large and flat, helping to reduce the number of point sources to reduce dazzle and over-stimulation.
Additionally, the solution adopted for diagnostic and therapy rooms at CICC leaves nothing to chance. Indirect perimeter lighting can be changed to whatever colour you want. A child can walk into a room bathed in their favourite colour and feel comfortable and happy. Clinicians can also change the colour, brightness and intensity according to a child’s sensitivity and preference.
Even a few years ago, there was a general lack of understanding about which design aspects or features could be triggering to an autistic person. The CICC was opened in 2019 and PAS 6463 appeared three years later, while RIBA’s own Inclusive Design Overlay to the Plan of Work was launched in 2023. James says general awareness and understanding are thankfully increasing all the time.
Thanks to James Pass, Lead Architect & Divisional Director, E3 Cube.
Text by Neal Morris. This is a Professional Feature edited by the RIBA Practice team. Send us your feedback and ideas.
RIBA Core Curriculum topic: Inclusive environments.
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