How can we make our autism clinic more sensory friendly?

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Hello,

I am a medical student working in an Autism clinic. The doctors and I are trying to make the clinic more sensory friendly for our patients. Do you have suggestions of things we can improve?

Thanks!

Do not use fluorescent lighting. Use soft desktop lamps and lamps that can be dimmed.

Do not play music in the clinic. Have charging stations so that people can make sure their mp3 players and phones can stay charged so that they can listen to their own music through headsets.

Have lots of stim toys available and many different kinds for children as well as for adults. Make sure they are sanitized regularly.

Speak softly and concisely and be very patient when we try to answer you

Have different types of seating, hard chairs, soft chairs, bean bags, chaises where people can stretch out etc. Even have cots available if someone needs to lie down while waiting in the waiting room.

If you can afford an aquarium, get one. Have a sensory room with textures that people can touch and where people can destress while waiting. If you can have an office cat, that would be great as well.

Make sure the color that the walls are painted absorb light rather than reflecting it. The walls should be soothing and relaxing, calming colors.

Have swings, tubes and weighted blankets and vests for people who need stimulation or deep pressure

Have a respite area where high functioning people can spend a night or two or even up to a week or two and be in a sensory safe and nurturing environment.

Provide coloring pages and crayons and colored pencils and books.

Provide stuffed animals

Make sure that Autistic adults are told that they are allowed to play with any of the toys in the office. Some of us are extremely young emotionally and it really helps us relax and feel less anxious if we are allowed to play with the children's toys. In many doctor's offices, we want to play with the toys but we are not socially allowed so it makes it difficult. But in an Autism clinic, that sort of thing should not be looked down on but allowed and encouraged.

Soft low level lighting. No ceiling florescents. If it were me I wouldn't have any music playing at all since our tastes are so diverse and any music we don't like is bound to be irritating. Besides the younger ones of us will most likely have something jammed into our ears anyway. Also, since you did ask here you should know you're very likely to get a lot of widely diverse (and conflicting) advice because, as I'm sure you already know, we are all as individual as NT's and what makes some of us calm cool and collected is likely to irritate the bejeezums out of others.

Welcome to the world of auties!

Thank you for your replies. Yes, it is possible that if we have good ideas we can get a large amount of funding for this project so any and all ideas are helpful!

I agree on the no florescent and no bright lighting.

Sit and listen as if you were a patient. Do you hear any loud background noises? Aquariums are nice, but some pumps can be loud and buzz a lot. That's not good.

Are the office phone ring tones low volume and soothing or are they loud and brash? Ring tones can be changed on office phones as can their volume.

I agree on not having music. I can get songs or parts of songs looping in my head even for days.

NO strong smells! Either from artificial air fresheners or perfumes or colognes from staff.

I agree employees and practitioners should talk to patients softly.

Do not put waiting room chairs too close together. Having a stranger sit right next to you is uncomfortable.

Don't have busy "loud" patterns on the flooring, walls, etc.

If you have a TV in the waiting room, don't have the volume on high. I find TV's very distracting in waiting rooms because they command my attention especially if the volume is on.

One item most people over look is carpeting the floor for sound absorption. Cloth covered furniture and cloth curtains also help. I personally won't stay long in a room with what I call hard acoustics where all of the sounds carry and bounce forever.

^^ about the television thing - if you have one, please keep the sound low - and the volume control locked down. (I'd actually recommend not showing regular programs, but rather the kind of thing you can find in Japan - beautiful videos of nature. Mountains, waterfalls, undersea vids of reef fish, *happy* videos of animals - if you have a TV on. These can be shown with or without their musical soundtracks - nature sounds are quite popular in these videos, too; water, birdsong.)

And I can't recommend this enough: a TV-free zone. An area where the TV isn't in anyone's sight line, where the sound doesn't disturb them.

I was a guerilla TV-turner-offer in my younger years, when TV was just beginning to invade public spaces. I was never offensive or aggressive about it, but I would plead migraine in order to get it turned off, and I avoided venues where the TV was an obligatory part of the ambience (sports bars etc). I cannot imagine going to a clinic for help and support directly related to my AS, and being forced to hatewatch random television broadcasts in order to get to see someone. Because that is what it feels like, if you're wired like I am. Being forced to pay a sensory harassment toll in order to "earn" time with the pro.

(I will quite happily watch TV with people, if the TV watching is the point of the interaction. But having it intrude on my waiting, dining and/or conversation, and forcing me to deal with that sensory intrusion when I am sick, frightened, in pain or in need of comfort? Lowest circle of Hell.)

(Edit in: these days, TV is so ubiquitous in restaurants and waiting rooms that I carry earplugs, and if I am having a really bad sensory overload day, I will put them in and turn my chair to face *away* from the screen.)

Agree with the posts above. Key issues for me are smell, hearing and sight. So noises of electrical things (you may need someone with very sensitive hearing to test this for you!). No flowers. No bright lights. Plenty of chairs with their backs to the wall, and gaps/tables in between.

Use soft lighting and keep it quiet.Keep the batteries in the smoke detectors fresh so they don’t start that hideous beeping.
Happened to me in an office and I wanted to swat the darn thing off the wall.
Don’t have noisy appliances.The wall heater was making a god awful sound when was in counseling and I told my therapist it was so annoying I wanted to kick it.He said “Why don’t you?”So I did,good thing that I did because the cover popped off and the filter was covered in inches of mold.I knew it smelled bad in there, found out why.So also no strong smells like air freshener or strong cologne.

Soft lighting, using dimmable LEDs (no fluorescents).
Sound-dampening carpets and wall coverings.
"Booth" seating, so as to not force eye-contact with strangers.
Staff does not wear cologne, perfume, scented soaps or scented deodorants.
No TV, radio, or "Muzak" system.

And when calling a client into the examining area (which should have the same motif as the reception area), have the receptionist come out and softly ask if the person is ready to come in. Do NOT shout the name or announce it over a P.A. system.

And cats ... lots of cats ... friendly cats that like being petted...

Choose the colors that you paint the walls and ceiling with . Better still , let some of your patients choose them . A peaceful and calm environment is extremely important to us . Sudden unexpected noises , humming sounds from florescent lights , traffic sounds etc. all can be very disturbing to us . Color combinations like the black on white of printed media is glaring to me so I changed the background color of my web browser , big improvement .

Have a separate tv corner where the tv is turned away from the main room so that not everyone has to see the visual and use the closed captions rather than the sound.

You can also have an alcove where it is dark if people want to sit in a dark room while they are waiting.

Choose furniture that is comfortable enough for people to really rest while they wait. A lot of us are extremely exhausted all the time and when I am waiting for an appointment, I like to be able to close my eyes and put my head back comfortably and rest.

When people register with your office, use a photo id system like at sports clubs. When you are ready to call the next "patient," you can pull the person's photo up on your computer so that you know what he or she looks like. Then you can walk up to them in the waiting room and call them quietly rather than yelling their names across the room. And when you speak to us do not assume that we are all deaf. Speak in soft tones of voice but do speak clearly.

Have non verbal sign cards in the waiting room. Many non verbal people will have their own means of communication with them but some of us, like myself, can be verbal sometimes and non verbal other times depending on the circumstances and what has been happening previously. It is always good for the office to have options for people to use to communicate nonverbally like picture boards and letter boards. And always have someone on staff at every shift who is capable of reading ASL. If no one knows ASL, hire someone who does or make it a staff project to have staff learn. Even just learning the alphabet can be very helpful. I finger spell in ASL a lot when I am nonverbal and low or nonfunctioning. It is shocking to me how in the hospitals I go to, no one is capable of even recognizing the alphabet. You can learn the ASL alphabet in under an hour. But at the very least, have letter boards and picture boards available.

Also have a stash of washable weighted blankets and vests in adult and pediatric weights.

Touched on above, but I would like to agree on having "booths" or "alcoves" or cubicles for people to be separated if they prefer. Heck, my auto dealership's waiting lounge even has this! A place to go online to check emails, a zone to read the newspaper or magazines, a zone for watching TV, and a zone with toys for the customer's kids to hang out - all separated by glass walls and fairly soundproof. (Plus dealership provides a range of snacks, fresh-baked cookies, and both hot and cold beverages!)

I was diagnosed in a clinic serving almost totally children. While I'm mature enough that I could deal with it, the way I was treated was pretty infantile. For instance, when mail came to my house, it was always addressed to "The Parent of (Bea Arthur)," which is suitable for a child, but ridiculous for an adult. My husband tried to tease me about it, until I told him to can it.

Make it as natural as possible. If you are building a building use lots of natural materials like beautiful woodwork. Natural things are very calming and soothing and give off good energy. Have plants as well and if you can make a garden with a beautiful water fountain or pond that would would be great. It does not not have to be big. I have even seen indoor tiny gardens with koi ponds which are amazingly soothing.

Also you should put in soundproof windows to keep outside traffic noises out. And heating and air conditioning systems should be as quiet as possible. Also your computer keyboards should be as quiet as possible.

Also be mindful of the clothing you wear. A lot of Autistic people have epilepsy and can be triggered by overwhelming patterns on clothing.

Do not chew gum in the office. Just don't do it. Some Autistics, like me, also have Misophonia and gum and mouth sucking and chewing noises can be massive triggers and cause us to have horrible meltdowns. Any noises like gum snapping, lip smacking, teeth sucking, pen clicking, these are noises that can make us go off the edge and the consequences can be really bad. So be very mindful of all of these little noises that can be avoided. Even Autisics who do not have Misophonia can be triggered by these little noises and the meltdowns can be pretty traumatic.

I am so grateful that you want all of our ideas. We have to deal with all of these triggers everywhere we go all the time. It would be so nice to have one place that we can go to and not have to worry about these kinds of things.

I have other ideas that I want to bring up as well that are really vital but before I do, please tell me what your clinic will be doing and focusing on as far as helping Autistic people.

BeaArthur brings up a great point about not being treated in infantile ways. But on the flip side, if an Autistic adult needs to play with the toys in the office and needs to be allowed to be very emotionally young, please respect that need as well. It can be a very difficult and delicate balance for those of us, like myself, who are very mature intellectually but who are extremely young and like little children emotionally. We need the balance of both and it is important that when we are young, people treat us at the age level that our brains are actually in, not at our chronological age levels. But on the same token, it is important to recognize that that same person who is emotionally very young is also an adult and in many ways will need to be treated and expect to be treated as an adult of his or her chronological age. So you will have to really pay close attention and ask questions if you need to understand the age level at which someone functioning at any given moment and understand that those functioning and age levels can change moment to moment without warning or notice. So you have to be prepared to just go with the flow and not criticize or challenge someone if her functioning levels change dramatically in very short periods of time. You will get to know your regular patients in time but if you really allow them to be who they are and work with them, they will trust you. Trust is super important and the more trustworthy and respectful you are, the better our interactions with you will be.