Healthcare architecture vis-a-vis handicapped children

Hussain Varawalla

Obsessed as I seem to be with both children’s hospitals and book reviews nowadays, I have a slightly refreshing change in store for you. This one is about a School for Remedial Learning (attached, I must confess, to a children’s hospital) which has been given the opportunity to design, discussed in the context of an interesting and relevant article in a magazine titled “Children’s Environments Quarterly”. The article is headlined “Designing Child Care For A Handicapped Community: The National Children’s Center” by Marcie Meditch Murphey, Cooper-Lecky Architects, PC, Washington, DC, USA.

The National Children’s Center has an inspiring history. In 1958, a group of parents with multi-handicapped children/ children with physical handicaps, mental retardation, emotional disturbances and sensory impairments joined hands to set up a school for their children. It was soon filled to the capacity and since 1986, it has had a waiting list that was undiminished for many years. As a result, in the late 80s, a decision was taken to construct a new building that would substantially increase the number of users.

What I am interested in, as a designer, is the mechanics of making a programme for this facility, the specific design objectives that evolved from this programme, and the design response that translated these objectives into built reality.

Unfortunately, the article does not throw much light on the methodology of constructing the programme. All it says is that the programme “was derived from observing the National Children’s Centre’s current facilities, interviewing staff, and capitalising on the architects 25-year history of designing environments for children, particularly those with learning disabilities.” I am awed and impressed that in the 80s an architectural firm could have had 25 years of experience in such a focused area. Talk about specialisation and commitment!

However, the article goes on to give a list of design objectives that were to become the impetus behind the ensuing design. I have quoted these objectives before in an article in this self-same fine publication titled “Healthcare Environment for Handicapped Children”. Talk about obsessions!

But for those of you who missed that issue, I give them again to you:

• Providing a circulation system that promotes easy orientation and administrative surveillance of the building and meets accessibility standards;
• Providing a non-institutional, non-threatening setting that simulates the home environment;
• Creating three distinct territories for the three programmes to be housed in this new building, (early intervention, preschool and adult programs) each having a distinct identity and sense of place;
• Developing an architecture that is compatible with the surrounding neighbourhood; The architects research included an analysis of Anna Freud’s research, whose finding showed that the emotional development of institutionalised children who are separated from their parents over a long period of time, is greatly enhanced by grouping them in “families” of five to six children who are responsible to and cared for by one, consistent adult (“mother”).

Her observations confirmed those of the architects and the centre’s staff, which led to a group of assumptions that were incorporated into the design of the project:

• That children thrive in a family scaled setting;
• That a simple, clear, orderly environment reduces anxiety and thereby promotes growth and learning;
• That children relate strongly and positively to an environment, which has a clear identity or “territory” that they can call their own;
• That an environment where colour, light, acoustics, tactile surfaces, and climate control have all been carefully thought out will also exhilarate the learning process.
  

Given here is an axonometric drawing of a typical classroom interior, for the preschool programme (age group 3.5 to 6.0 years). The children are encouraged to be active physically, and thus their environment facilitates this. Active areas include tables and chairs for group projects and a climbing loft to play “king of the mountain”. In contrast to these provisions, there are also provisions for quiet spaces within the same classroom. Provided is a pillow-filled “tent” that is for quiet activities such as reading, puzzles, or simply to be alone.

The thrust of the programme at the National Children’s Center is to foster independence, promote social skills, and provide effective emotional and physical outlets for these rapidly maturing children. The design response to these programme requirements has been expressed by clustering the preschool “neighborhood” around an indoor atrium play space.

This space is rich in colour and warm sunlight, carpeted in playful designs, and full of opportunities to play and interact with peers. A performance stage, scooters on ramps, climbing sculptures, and a ball pool (a waterless pool filled with foam balls to stimulate exercise of large motor muscles) are just a few of the activities that are offered in this space. Even the heating and cooling ducts are brightly coloured and plumbing pipes constructed of glass to stimulate the minds of these active and curious children.

In conclusion, the article says that the fine-tuning of details was addressed during the final stages of the project to ensure its success. These details include:

• The careful use of colour to provide an appropriate emotional climate;
• A studied selection of lighting to enhance a desired activity within a space;
• The selection of a variety of interior surfaces that allow numerous sensual experiences but still consider the problems of seizures, visual impairment and movement support;
• The attentive balance of loud and quiet in response to the acoustic needs of each child.

So our School for Remedial Learning in our very own Mumbai has a lot to learn from the lessons of the National Children’s Centre in Washington, DC, an institution half a planet away but kindred in spirit. Our children and theirs are enjoined souls, separated only in space.

The moral of the story then is to focus on the relationship to the environment of these children of a lesser god. Try, as a designer, to see through their eyes; feel, if you can, the pain and the joy…they go hand in hand.

Hold out yours to help them, and in return you will find grace.

The author is Director-Design Services, Hosmac India Private Limited.

E-mail: hussain.varawalla@hosmac.com