architecture - Chalmers...Brain related situations requires more attention, therefore design is...
Transcript of architecture - Chalmers...Brain related situations requires more attention, therefore design is...
Master thesis by Cagil Kayan Examiner: Peter Fröst , Chalmers Architecture, MPARCPresented at May 24th, 2011
Neu
ro- ar
chit
ectu
reEnriching healthcare environments for children
I.research
part
Master thesis project of Cagil KayanChalmers .VT2011
Neuro-architecture: Enriching healthcare environments for ChildrenExaminer: Peter Fröst
I would like to thank to :
My family for always believing and supporting me making me feel
near
Anders for all his endless professional and emotional support and
especially for his patience during my stressed study periods
Peter Fröst, for suggesting me this topic, directing my during my
thesis and helping me with connections
Cecilia Bjursell and Gunnar Bjursell (Center for Culture and
Health), Michael Nilsson and Lennart Ring (Sahlgrenska), Sofia
Månsson (Play therapy), Kate Himmelmann (Children rehabilitation
in Bräcke),Paul Uvebrant (Drottning Silvia’s) for answering my
questions and helping my research
Stefan Lundin, for his interest in my thesis, and introducing me to
White architects and all colleagues from White helped me through my
thesis, Krister, Niclas and Elin
and all my friends for all the warm and fun times before and during
(and probably after) the thesis..
and thank you for reading these lines and being interested in my
work!
.Glossary
PART I. (Research)1. Introduction ......................................
1.1 Abstract..........................................1.2 Thesis formulation.................................
2. Neuroscience and Architecture......................
2.1 Emerging Field .................................... 2.1.1 Developments.............................. 2.1.2 Application areas.........................
2.2 Learning with neuroscience ........................ 2.2.1 Neuroscience & perception ................ 2.2.2 Environment and memory ..................
2.3 Environment , brain and stimuli.................... 2.3.1 Environment/ Behavior+Neuroscience. 2.3.2 Enriched environments .................... 2.2.3 Alternative methods for stimuli: Kultur och Hälsa ...................................2.4 Research methods connected to neuroscience 2.4.1 Evidence based design........................
3. Healthcare environments for children .............
3.1 Designing for children............................. 3.1.1 Planning, circulation ................... 3.1.2 Children’s perception ....................
3.2 Children’s healthcare ........................... 3.2.1 Neurologic needs in children’s healthcare...
3.3 New approaches in children’s healthcare 3.3.1 Klimmendaal Rehabilitation.................. 3.3.2 Bloorview Kids Rehabilitation..............
.Index
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4. Interventions for children’s healthcare .......
4.1 Determining design parameters for architecture .................................. 4.1.1 Way finding & Navigation.................... 4.1.1.1 Landmarks 4.1.1.2 Clear planning and Circulation 4.1.1.3 Color references
4.1.2 Social interaction ......................... 4.1.3. Enriching Environments ..................... 4.1.3.1 . Natural impact ..................... 4.1.3.2 .Volumes, shapes ................. 4.1.3.3. Colors ..............................
4.1.4. Variables 4.1.4.1 Light ............................... 4.1.4.2 Sound .................................
. References ..........................................
[5. Design applications with neuroscience & architecture]
Index for 5. chapter follows in the “thesis part ıı.”
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Glossary
6www.neuroticarkitekten.blogspot.com
Study of how information concerning faculties such as perception, language, reasoning and emotion is presented and transformed in a nervous system
Acquisition of knowledge and skill by mental or cognitive processes. Simply product of our perception by listening, watching, touching or experiencing.
Studies relationship between environments and human behavior exploring such dissimilar issues as common property resource management, wayfinding in complex settings. the effect of environmental stress on human performance
If an ability, approach, or type of activity is hard-wired into the brain, it is a basic one and cannot be changed. Neurologically based factor, the neural connectors primarily formed during gestation, similar to the hard wiring of a computer
associated with long term memory- where memory is designed- it doesn’t store the memory, but builds it up. declarative memory. memory problems are related with this part
studies the nervous system includes brain, spinal cord, sensory nerve cells, advancing the understanding of human thought, emotion, and behaviors.
The post occupant research is based on interviews or reports after the building is used to serve its duty. Evidence based design usually studies the post occupancy tests, comparing the numbers and reports of previous condition and the improved one.
Brain damage, rapidly developing loss of brain functions due to the disturbance in the blood supply.Affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see side of the visual field.
Cognitive science:
Cognitive learning:
Environmental psychology:
Hard wired:
Hippocampus:
Neuroscience:
Post occupancy:
Stroke:
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1.
Introduction
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...For my thesis project, I wanted to research deeply on a subject that has an interdisciplinary connection to architecture, using the chance of sparing extended time on research while I am still studying, and getting specialized information that can be
beneficial for architectural knowledge.
I was interested on how architecture affects on us, and Peter Fröst, my examiner, suggested me about the new emerging field in architecture, called ”Neuroarchitecture”. It is rather a new subject, which means that I will be researching and also connecting relevant information from neuroscience to apply on architecture and filter then for healthcare environments for
children.
During my research I thought the thesis can be more interesting, -concrete- if I can show some applications. After I met Stefan Lundin, and he offered me to study on new children’s hospital,
being designed by White architects. Being part of a real project, gave a more realistic approach to my thesis. I learnt a lot
during the process, and I tried to sum up what I gained in this thesis report.
1.Introduction
.Perceiving image
.Recalling memory
.Behavior
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1.1 Abstract
111. Introduction
We live with perception: Perceiving our surroundings with our senses we learn the environment. Not only we form an image, we form memories with them, we sense dimensions with echoes, we feel the dampness with smell, we see light/shadow... In other words, we learn with memories, we recall them, we behave with them.
What we come across in our environments eventually affect our behaviors. Perception stimulates the brain with every image stored in our memories. Architects are aware of, how the built environments affect our behaviors and senses and they take this cause-effect relationship into consideration when they are designing. However the question “how?” is something which architects need other professions help to answer.
Architecture and neuroscience were two disparate disciplines until it was found that brain was continuously remodeled by the environments we are living in. The collaboration finds a platform on health care, study and work environments. Focusing on healing environments, a well designed built environment with principles of neuroscience, reduces patient stay, and even plays a part in treatment such as retrieving old memory or brain stimuli. These principles gets specialized when the target group is children. Children differ from adults in many ways, for memories, dimensions, concentration, learning abilities... Brain related situations requires more attention, therefore design is modelled considering desired or undesired behaviors.
Neuroscientist studies behaviors and brain, and architects should use the inputs in design. Learning how our brain works with perception will lead to new developments on behalf of users in design. New treatments combined with architectural approaches gives children a pleasant stay, shortens the healing process, and even can be involved with environmental treatment.
keywords: neuroscience, children, brain, healthcare, environmental treatment, enrichment, perception
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.Phase 1
.Based on literature search
.Searching and reviewing books and internet sites about neuroscience and brain stimuli to find relevant parts concerning perception and impact of environments.Interviewing with experts on field of brain stimuli, visiting Culture and Health
.Phase 2
.Studies on mental states and environments.
.Reviewing data about which qualities of environments affect our behaviors in which ways. Study visit to Östra Psychiatry, information on spaces.Relation with perception and behavior.Tables to visualize research
Kultur och Hälsa
Environmental treatments Brain &
environment architecturechildren in healthcare
Neuroscience and Brain
Sahlgrenska
childrens brain
Plasticity
Neuroscience
Perception
Brain stimulihealing spaces
evidence based design
therapies
Ag
en
1.2 Thesis Formulation
131. Introduction
.Phase 3
.Connecting to architectural solutions
.Environment and mental state, how should it be designed to achieve desired behavior, or to avoid undesired mental state. Formulating design parameters for enriched environments. Architectural methods to improve treatments in healthcare.
.Phase 4
.Architectural applications
.Interviewing therapist from Östra .observing children’s behaviors in healthcare environments and therapies. .Applying the design parameters to new children’s hospital, proposals on common spaces, therapy rooms, and connections.
designparameters
natural input
Age vs Abilities
variables
navigation
sense of space
enrichment
enriched environments
proposals on spaces in new Children’s Hospital
architectural conclusions
White Arkitekter
D.Silvia Children’s Hospital Playtherapy
1.2 Thesis Formulation
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Kultur och Hälsa
Environmental treatments
Brain & environment architecture
children in healthcare
Neuroscience and Brain
Sahlgrenska
childrens brain
Plasticity
Neuroscience
Perception
Brain stimulihealing spaces
evidence based design
therapies
1.2.1 Loops
1. Introduction
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designparameters
natural input
Age vs Abilities
variables
navigation
sense of space
enrichment
enriched environments
proposals on spaces in new Children’s Hospital
architectural conclusions
White Arkitekter
D.Silvia Children’s Hospital Playtherapy
As always, research and application in design cannot have a successive order. Putting the research into application made me go back and forth to my previous researches, go deeper more, or change, or add to the information to be used in the design phase. Meeting the client (hospital) and working with architects (real project) brought other aspects, such as regulations, medical situation of patients or demands from staff. It was a challenge to adapt the research into program, to show how information from neuroscience can be applied to architecture in practice.
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“As neuroscientists, we believe that the brain is the organ that controls behavior, that genes control the blueprint, but the environment can modulate the function of the genes, and
ultimately the structure of our brain, but the environment can modulate the function of the genes, and ultimately the structure of our brain. Changes in the environment change the brain and
therefore they change our behavior.
Architectural design changes our brain and our behavior.”
Fred ‘Rusty’ Cage, neuroscientist, Salk Institute. AIA Convention 2003.
2.
Neuroscience and
Architecture
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During 1990s with his interest on steam cells, he teamed up with Fred Cage in University of California to study with enriched environments and steam cells. In 1998 he established his breakthrough discovery showing that the human brain contains stem cells that can form new neurons. (which brings us to the topic of connection between enrichment environment and brain stimuli)
“We continue to identify stem cells and their genetic machinery of the human brain to understand better the mechanisms governing the recovery of stroke, Parkinson’s disease, depression and multiple sclerosis, “said Peter Eriksson.
The study forced a paradigm shift in beliefs about how the brain functions. His data removed many barriers in neuroscience research, creating, virtually overnight, the possibility of brain repair. Gage is currently working to understand how new brain cells can be induced to become mature functioning nerve cells in the adult brain and spinal cord. He has shown that environmental enrichment and physical exercise can enhance the growth of these cells.He is a fellow of the National Academy of Sciences, American Association for the Advancement of Science, American Academy of Arts and Sciences and the Institute of Medicine and has been president of the Society for Neuroscience.
Fred H. Gage, Ph.D. is a professor in the Laboratory of Genetics at the Salk Institute in La Jolla, CA. Gage studies degeneration and regeneration in the central nervous system, with an eye on possible future treatments for devastating neurological damages resulting from disease or injury. He achieved national renown in 1998 for his groundbreaking experiments demonstrating that neurons are constantly being born in the adult brain, a process called neurogenesis.
Fred Cage
2. Neuroscience and Architecture
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Peter Eriksson (1959-2007)
He was born in Gothenburg, and got his degree in medicine from University of Gothenburg with his parallel studies and researches on brain cells and nervous system. He got his specialization degree in Sahlgrenska university hospital on neurology in 1999 and became a professor of neurobiology and specialized in steam cells in 2001.
1. http://rsrt.org
2. http://www.sahlgrenska.gu.se
3. http://www.petererikssonstiftelsen.se/peter.html
.1 Seeking common ground, Esther M. Sternberg, Mathew A.Wilson, Cell 127
.2 Brain Landscape, J.Eberhard,
.3 Introduction to Neuroscience, J.F. Stein with C.J. Stoodley, Wiley,
Neuro.architecture
Earlier it was believed that our brain stops developing new neurons when we are early in our twenties. In 1998, Fred H. Gage (Salk Institute for Biological Studies) and Peter Eriksson (Sahlgrenska University Hospital) discovered and announced that the human brain produces new nerve cells in adulthood. Our brain is formed in the 3rd month of pregnancy, and after that grows remodeled by environments we are surrounded with.
Neuroscience explains the connection between environment and behaviors; from perception to impulse transportation and how neurons built up and store information in our brains.1 When we learn all we ‘think’ and ‘feel’ are formed by our brain and nervous system, we realize the importance of our unique perception and impact of environments.
In order to understand the relation between neuroscience and architecture, we can start with our basic activities that we use our five senses to perceive the environments. Perception also involves with our navigation in space, and neuroscience explains on how physical environment affects our cognition, problem solving ability and moods. Understanding these principles can guide architects to design built environment serving better spatial orientation, reinforcing cognitive abilities and minimizing negative effect in emotions and motivation.
Neuro.architecture can be defined as built environment designed with principles of neuroscience, which establishes spaces that encourage memory, improve cognitive abilities, avoid stress and/or stimulate brain.
2. Neuroscience and Architecture
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1. Academy of Neuroscience for architecture www.anfarch.org
A section from the interview from Society for Neuroscience1, 2003Fall, issue:
Why are architects and neuroscientists beginning to work together?
Eberhard: Architecture has the most impact when the ideas used in building design reflect our understanding of how the brain reacts in different environments. Neuroscientists can help architects understand scientifically what have historically been intuitive observations.
Gage: Neuroscience has reached a point in its understanding of the brain and how it is influenced by the environment that neuroscientists can work with architects in their designs for environments that enable people to function at their fullest within those environments.
2.1 Emerging Field, merging fields
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Engaging Architecture and Neuroscience
2.1.1 Developments
John Eberhard is the director of research planning at the American Institute of Architects, and Fred Cage is professor of neuroscience in Salk Institute; basing on impact of built environment they found a platform to discuss and invest in develop architecture further.
There are many examples that we no longer notice how innovations in other sciences have developed architecture. For example after steel was founded, we managed to build high rise buildings, design of theaters are getting more flexible with developments in acoustics. As for neuroscience, it is no longer a separate discipline for architecture after the discoveries of F.Cage and Peter Erikkson proving that our brain responds stimuli , therefore how built environment affects us.
2.2.1.1 ANFA
Academy of Neuroscience for Architecture was founded by San Diego chapter of American Institute of Architects in 2003, to establish the research to connect neuroscience and architecture.
The academy is supported by various architect unions, neuroscience laboratories and University of California. The academy runs education programs based on workshops for different environments, relating neuroscience and working on hypothesis. Education programs are engaged with researches on fundamental subjects in neuroscience such as way finding and enriched environments.
The academy runs education programs based on workshops for different environments, relating neuroscience and working on hypothesis. Education programs are engaged with researches on fundamental subjects in neuroscience such as way finding and enriched environments.
211. Society of Neuroscience ww.sfn.org
2. Neuroscience and Architecture
neıroscientists and ar-chitects unite for better environments
Academy of Neurosciencefor Architecture [ANFA]
1. Academy of Neuroscience for architecture www.anfarch.org
2. Inquiry by Design, J. Zeisel
2.1 Merging Field
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Learning and School Environments
The field of application fields of neuroscience to architecture is extensive, from education to work environments and healthcare spaces. The discussion upon distraction and concentration in schools is a topic involving neuroscience. The methods used in research are based on hypothesis, testing the parameters in different school, seeing the effects of changing parameters keeping the other values stable.
As earlier it was assumed that having large windows we distracting children’s attention, later after comparing the grades of students in schools with similar properties differing in window sizes, the perspective changed into as nature can stimulate learning abilities.1
Role of architecture in our daily life sometimes surprises with its impact. Not only in healthcare, neuro.architecture is involved to any built environment used by humans. Especially spaces where use of brain activity is important, architects gain more responsibility with awareness of neuroscience.
2.1.2 Application areas
Memory and Alzheimer, Elderly
Connection of architecture and stimulating memory brought new design approaches to environments of people with Alzheimer disease. The tendency of lose way with weak memory in the disease is caused by the damage in hippocampus (see: glossary).
Studying the common problems of the patients, architectural designs are suggested to form easily recognizable destinations. John Zeisel who is an architect studying sociology and researching on neuroscience-architecture, came up with another treatment approach of therapy gardens. Involving with plants aims to strengthen the memory of the patients making them suggest the time/seasons with environmental modifications. 1
Work environments and Salk Institute
When it comes to work environments, the scope of the work is important to determine the architectural approach, yet it might differ if it needs more concentration or more abstract thinking.
One of the early examples of involving neuroscience in work environments was Salk Institute designed by the architect Louis Kahn.2 Brainstorming together with Jonas Salk, they focused on how environmental design can lead to an effective research environment? Questions of aesthetics and functionality brought the solution of ultimate flexibility, where the scientists can decide upon how large space or teams they will work with, and which also encourages collaboration of employees in a unique open space.
232. Neuroscience and Architecture
1. Inquiry by Design, J. Zeisel
2. Academy of Neuroscience for architecture www.anfarch.org
.1 Kultur och Hälsa . University of Gothenburg
.2 Mapping the Mind, Rita Carter
.3 Inquiry by Design .John Zeisel
2.2 Learning with Neuroscience
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Although the very earliest and most basic development of the brain is genetically programmed, from about the third month of pregnancy and throughout the rest of life its structure is continuously remodeled by the environment.3
Brain plasticity:
Our age, spatial properties determines the level of interruption of environment, which is called brain plasticity. Earlier it was known that people were born with a number of brain cells, and the number was showing a decrease, or degrading throughout the life. Today, discovery of “brain plasticity” that brain responds stimulation.
Gunnar Bjursell from Culture and Health describes as: The more you focus, the more your brain produces stem cells that develop into neurons. Plasticity of brain is increased by training of the brain. “Use it or lose it”.
252. Neuroscience and Architecture
2.2.1 Neuroscience and Perception
Our understanding of the neural basis of spatial perception and memory has been advanced by recordings of neural activity within the hippocampus as rats explore an environment. Such studies reveal that individual neurons respond when the animals move to certain locations in that environment, with different patterns of neural activity correspondingto different locations.
Our perception changes while we move between different environments. The individual neurons responding to the sense of the place are more than our sensory organs, but more internally and may be referred as place neurons. As our spatial perception depends on strong sense of orientation, different environments relate to different pattern of neural activity. Therefore architectural elements stimulate different activities in our brains, while we perceive environments.2
Haptic Sense:
Unlike neurons in sensory areas of the brain, these “place” neurons are not activated by any one type of stimulus, such as a visual feature, or a sound, or a smell, but rather by the combination of features that serve to define the animal’s internal sense of place (Nakazawa et al., 2004)2. (Perhaps this is the neuroscience equivalent of what is known in architecture as the “haptic sense,” that is, an awareness of one’s surroundings.)
.Spatial Perception
Our perception changes while we move between different environments. The individual neurons responding to the sense of the place are more than our sensory organs, but more internally and may be referred as place neurons. As our spatial perception depends on strong sense of orientation, different environments relate to different pattern of neural activity1.
1. Inquiry by Design .John Zeisel
2. Ester, Sternberg, Neuroscience and Architecture: Seeking Common Ground
2.2 Learning with Neuroscience
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. Hippocampus
Hippocampus is where the long term memory is formed but not stored. Hippocampus is also the same area where new cells are born all the time, and our environments determines the rate of the new cells.
Most of the activities of forming and recalling memories depend on the hippocampus for processing. Hippocampus is involved in laying down and retrieving memories, particularly personal ones and those related to finding your way about.1 During the storage time which is about 2-3 years, hippocampus replays the experiences back up to the cortex until they are firmly established- so hippocampus is no longer needed for retrieval.
.1 Inquiry by Design .John Zeisel
2. Fuster, Joaquin M. Memory in the Cerebral Cortex
3. Squire, L.R. ; Memory systems of the brain: a brief history and current perspective. Neurobiology of Learning and Memory
272. Neuroscience and Architecture
2.2.2 Environment and Memory
. How memory connects to architecture?
It all starts with a simple question: How do we use our brain in the buildings? We see them, we enter, we perceive the light and shadow, sound and echo, sense the material, see the geometry. We all perceive them with our sensory organs and note them to our brain, where our hippocampus will work on passing them to long term memory.
With the light of our memories the buildings gives us the “feeling” of what they reveal about their types and affect the way we behave. 1 For example, we can never make a comment like “This school looks like a prison” if we haven’t seen a prison. From the functions, planning, materials and orientation of buildings, we build up our own database of perceptions.1 The next step is that anything we perceive from built environment, our brain retrieves a memory, and that’s one way of how it affects our brains.
.1 Brain Landscape. J.Eberhard
Memory and brain:
Long term memory is associated with many different areas of the brain including the hippocampus, amygdala, thalamus and hypothalamus, peripheral cortex and temporal cortex. The hippocampus and amygdala have been connected with transference of memory from short term memory to long term memory.2The thalamus is also related to reception of information and transferring the information, in the case of memories, to the cerebral cortex.
Consciousness
Consciousness begins as a feeling of what is happening to us when we see, hear, or touch an object.1 Why it is important for our brain is that it is connected with memory and perception, since it resolves the interaction between perception and mapping the image, retrieving the earlier information.
2.3 Environment, brain and stimuli
Departing from plasticity of our brain and impact of the environments we are living in, neuroscientists work with experiments on how people vary on responding to certain environments. Perception of environments have different meanings from person to person and depending on their ages, health condition or memories.
While we are responding to perceptions, our brains are continuously stimulated from what we sense. “Suppose an insect lands on your leg. Instantly the touch receptors on the affected leg fire a message that travels through your spinal column and up to your brain. There it crosses into the opposite hemisphere to alert brain cells at a particular spot on a sensory map of the body.”1
Considering the affect of environments on our brain and consequently on our behaviors, it is possible to involve the relationship in design research to achieve desired behaviors or avoiding undesired circumstances.
281. Inquiry by Design .John Zeisel
1. Inquiry by Design .John Zeisel
2. Brain landscape .John Eberhard
3. Howard Hughes Medical Institue www. hhmi.org
2.3.1 Environment/Behavior+Neuroscience
Place
Personalization
Territory
Wayfinding
292. Neuroscience and Architecture
While environment-behavior was examined together, with the observation of brain influenced by environment, expanded the scope which now includes the concepts of place, personalization, territory and way finding.1
.Place:When space is evaluated to be defined as “place” and when it gains additional meaning for users, the term enters the research field of cognitive neuroscience.
Place neurons are dependent upon a strong sense of orientation within the environment, and different environments are associated with different patterns of neural activity. Because our sense of “place” may be defined by the activity of these neurons, understanding the factors that influence them may help to elucidate how we are impacted by architectural design elements.2
.Personalization: Engaging oneself to a place, connects to memory cues
.Territory: extension of familiar zone, where one feel safe. It is hard-wired for the brain.
.Wayfinding: Mental and physical activities to find our way, linking place and territory. Humans tend to be more aware of the surroundings under eye
The experiment1
Thirty six rats were sorted into three experimental conditions using 12 animals in each group: 1) enriched 2)standard or 3) impoverished environments. All animals had free access to food and water and similar lighting conditions. For the enriched environment, were providedobjects to explore and climb upon. The objectswere changed two to three times a week to provide newness and challenge; the frequent replacement of objects is an essential component of the enriched condition. For the standard environment, the animals were housed 3 to a small cage with no exploratory objects.
After 30 days in their respective environments, all animals were anesthetized before the brains were removed for comparison among the three groups. Results indicated clearly that the cortex from the enriched group had increased in thickness compared with thatliving in standard conditions, whereas, the brains from the impoverished group decreased compared to the standard.
2.3 Environment, brain and stimuli
30.1 Response of the Brain to Enrichment, Marian Cleeves Diamond
.1 Response of the Brain to Enrichment, Marian Cleeves Diamond
2.3.2 Enriched environments
Long before the rat experiment the development of brain by outer sources was a question of scientists. A scientist called Spurzheim investigating if brian can grow with exercise concluded his question as: because the blood is carried in greater abundance to the parts which are excited and nutrition is performed by the blood.”
Brain stimuli and Environment
Brain stimuli with enriched environments has been proved with an experiment on rats kept in different environments. Changes in brain development (neuron production) between the rat kept in its regular cage and the rat which was taken to a living home of the scientist was measured. The rat which is kept at home, with an enriched environment got more brain cells- more intelligent.
In response to appropriate stimuli the brain creates an urge that demands to be satisfied.2 It can be also other way around, a negative stimuli such as departing from territory, will give a felling of emptiness. Yet in both cases result is the same, it triggers action. Environmental installations stimulates our brain, stimulating it perceive, think, understand and write or connect to memories, which makes the brain vitalize, and develop new neurons.
312. Neuroscience and Architecture
1. Interview with Gunnar Bjursell and Cecilia Bjursell, Göteborg March 2011
2. University of Gothenborg, Centre for Culture and Health http://www.ckh.gu.se/
The scientific studies proves the link between brain health and stimuli of our senses. As art, music and enriched environments stimulates our brain. It gives inspiration and motivation to move, to hear and stimulates the brain.
Centre for Culture and Health [Kultur och Hälsa]
.Purpose of the center
The aim of Center for Culture and Health is to collect information on new researches about brain stimuli and spread the information to be used in health care. They work with interdisciplinary research groups to develop methodologies involving culture for brain excersices.
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2.3 Environment, brain and stimuli
2.3.3 Alternative methods for brain stimuli
.Stress, stimuli and socializationStress until some limit is needed for brain stimuli, because it helps to give snap cells to the neurons. In order to avoid raising the stress, the brain should be periodically rested. Humans are social animals. If the patient is with someone, his attention is distracted and doesn’t feel pain. Music works the same for distraction.
Culture, brain, and other interactions
.Art and BrainPictures and paintings have the similar effect to improve the memory. Museum of modern arts and University of New York works together.Music reveals emotions and memory which makes people “think”. Music memory is a genetic heritage. Music has a reward system in the brain, and brain releases dopamine, which makes you happy. It is the reason why music is used in therapies.
.Stimuli after strokeEnriched environment is affective on brain strokes at any level, as long as the person is alive. Brain recovers itself. Even on patients that are diagnoses as brain dead, can respond brain stimuli. Rehabilitation of stroke is generally treated medically than rest is given. However after resting, the exercises are only on improving the healthy part. Although the best approach is to start stimulation from the first day, it is still not spread in practice.
332. Neuroscience and Architecture
2.4 Research Methods Connected to Neuroscience
Involving [relating to] end user in design
Research methods in design can involve different studies, such as searching through literature, existing buildings, post occupancy observations or interviews with the users. A successful design brings all the research methods together and combines them in design.
Observations may vary upon post occupancy tests of existing buildings, or investigating through building, studying physical traces and observing how the spaces are actually used.
Collaborating with the user is important for evaluating users needs, analyzing the problems of the users from their previous experiences or current status, and questioning the needs for the new progress. In addition to workshops with staff it can be practical if patients and visitors view is also taken into consideration.
For children’s healthcare, the negative effect of hospital spaces are aimed to reduce by creating atmospheres that are not recalling the traditional hospital atmosphere. For a new project of children’s hospital in USA, children and families are interviewed about how do they feel and what hospital represents for them. The result of the research showed that hospital means “transformation” for children, and the new concept was designed with abstract transformation themes which distracts their attention from their process in the hospital.
341. Designinformed, lecture by Gordon H. Chong www.anfarch.org
1. A Review of the Research Literature on Evidence-Based Healthcare Design, R. Ulrich
2.4.1 Evidence Based Design
Architectural design in larger scales have to stand on proved studies. Standards for healthcare design, can be supported by other investigation based on statistics of outcomes of different hospitals. Evidence based design is a method using credible data based on detailed studies on hospitals.
Evidence based design (EBD) is based on studies linking the physical environments of hospitals to health outcomes of the patients. It is an approach used in healthcare improving the wellbeing of both patients and staff, healing process, stress and safety. Research group conducted by Roger Ulrich measured the efficiency by evaluating duration of patient stay, amount of accidents occurring in hospital, time spent with orientation in the building, privacy, satisfaction of patients and visitor, and efficiency of staff.
The research has a very wide scale, concerning both medical and patients, investigating deeply on parts of spaces, facilities, equipment they are using, or the variables (sound, light) that affect their work or healing.
. Post Occupancy:The post occupant research is based on interviews or reports after the building is used to serve its duty. Evidence based design usually studies the post occupancy tests, comparing the numbers and reports of previous condition and the improved one.
352. Neuroscience and Architecture
A good healthcare environment for children should enable to navigate for some activities alone,
encourage children to use their abilities, and make them feel safe as home.
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A good healthcare environment for children should enable to navigate for some activities alone, encourage children to use
their abilities, and make them feel safe as home.
3.
Healthcare environments for children
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3. Healthcare environments for children
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Physcial differencesChildren are smaller in size than adults. While furniture sizes are adapted for children, thearchitectural dimensions are also to be considered in design.
- shorter steps > longer distances > hesitation(also affects wayfinding)
- high window sills > disable the visual contact
Buildings we are using in daily life are planned for the use of adults, such as orientation of functions, circulations, distances and dimensions.
Children are mostly expected to be guided by adults and also not expected to use all the functions. When we think of a child staying in a hospital, there are some facts that make them more sensitive than adults. For example a child who is detached from home environment, sometimes away from parents, not able to continue school, therefore away from friends and education, cannot play properly and going through a painful situation. A good healthcare environment for children should enable to navigate for some activities alone, encourage children to use their abilities, and make them feel safe as home.
Many design concepts intend to include more colors or cartoon images to adapt environments for children. Although some of these elements are important for distraction, children also require special planning for their circulation, needs for relaxation and privacy.
3. Healthcare environments for children
39
Evalina children’s hospital
3.1 Designing for children
40
Children differ from adults in perceiving environments. The difference comes from the limited experience they have, the scale of their bodies and memories.
Children intend to experience their surroundings to learn, through their senses. Since they are significantly smaller than adults, they take more time to reach to certain points. This also makes them more aware to environment, and more open to influences.
3.1.1 Planning, Circulation
.Plasticity vs. Memory
When our brains continues remodeling by our environments, the amount of impact is determined by the plasticity of our brains. Children had a greater plasticity compared to adults, which makes them more open to stimuli. While plasticity gives the children a high ability to adapt themselves to new environment and use their capacities, there are also some functions that children are lacking due to their age; such as memory and experience.
When I asked about how environments affects children compared to adults, to Michael Nilsson, Professor of Neurology in Sahlgrenska, he replied that it is proportional with plasticity; “Take the plasticity of adults and multiply it with four or more”.Smallest changes in the environment can have a greater effect in children, and we can use it in a positive way in the design.
1. Based on interview with Michael Nilsson, Professor of Neurology and Rehabilitering, Sahlgrenska University Hospital
3.1.2 Children’s Perception
413. Healthcare environments for children
*More detailed information about navigation and wayfinding is found on the Chapter 4. Design Interventions
While children navigate in the buildings, it is also important to make them remember the routes themselves. Spaces, corners, directions can be designed to attract their attention so they will recall the images easily.
Memory and connections
Memory of space is the link connecting us to the place. When we are connected, we know the directions and feel comfortable when we navigate. Children with limited collection of memories fail to connect places to each other. They have difficulties in finding their way or remembering the routes alone.
Therefore spaces designed for children should be easily read and understood by children. Children’s physical participation with the architectural features and natural landscape elements extend to satisfaction and the experience stay in their memory1.
Once children store the data, they tend to remember better, since they don’t confuse it with other information.*
3.2 Children’s healthcare
421Neuroscience and Architecture: Seeking Common Ground Esther M. Sternberg1, Matthew A. Wilson
Adult circulation
Children and extended circulation
Enabling motor skills:A hospital indoor environment limits children to practice different motoric and sensorial activities (they are object to treatments and mentally or physically they are limited). Allowing the child to move more has a positive impact on brain activity and motor skills.
1. Architecture for Children, Ismail Said
43
3.2.1 Neurologic needs for children’s healthcare
A children’s healthcare, in addition to medical treatments are usually supported by environmental therapies, such as interacting with other children, socializing, or improving their skills thorough plays and enriched spaces. In order to have an efficient therapy, the spaces should enable concentration, relaxation and disable stress, Therefore environment should provide appropriate light, acoustics, volume, way finding, needs for privacy and relaxation while avoiding stress. At a cognitive level, both acute and chronic stress are known to be associated with impaired problem solving ability and increased error rates in decision making.1 Chronic activation of the stress response is also associated with suppressed immune responses resulting in health effects such as prolonged wound healing, a decreased antibody response to vaccination, and increased severity and frequency of viral infection (Sternberg, 2006).
3. Healthcare environments for children
3.2 Children’s Healthcare
easily distracted, forgetful about daily activities, dislikes activities that require sitting still, tendency to daydream
Hyperactivity: does not stay seated as expected, difficulty playing
quietly, in motion, restlessness
changing the environment to reinforce (increase) desirable behaviors while punishing (diminishing) undesirable behaviors.
Set up the environment to support the child's efforts
(e.g., minimize distractions
Acute stage:ensuring proper oxygen supply, maintaining adequate cerebral blood flow, and controlling raised intracranial pressure., neuroimaging, surgery..
Chronic stage: Rehabilitation, Treatment of neuropsychiatric symptoms such
as emotional distress and clinical depression may involve mental health professionals such as therapists, psychologists, and
psychiatrists, while neuropsychologists can help to evaluate and manage cognitive deficits
To maximize the effectiveness of rehabilitation therapies
after stroke, it is critical to determine how the brain respondsto different types of stimuli.
Enriched Environments has profound effects that can be utilized to develop and improve cognitive abilities or to resist the negative consequences of different types of stressors.
.Visual enrichment (bright colors, shapes), memories (pictures), easy .wayfinding , social interaction spaces (efficient spaces for visitor meeting), use of art (good lighting) music (clear acoustics)
Architectural
reflection
Behaviors
Environmental
treatments
Neurologic
condition
common mental
disorders in children
Attention-deficit/ hyperactivity disorder Traumatic brain injuries (TBI)
Treatment methods
Cognitive behavioral therapy (Psychotherapy to teach a person to think about his motivations before he acts.)
Art therapy, music, or dancing helps to calm down and focus better, Biofeedback ( focus by training him, to control his body's responses to stress,)
.calm design
.allowing small changes in the rooms .avoid distraction.opening to nature
caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance;
such as cognition; language; memory; attention; reasoning; abstract
thinking; judgement; problem-solving; sensory, perceptual, and
motor abilities; psychosocial behavior; physical functions; information processing; and speech.
44http://www.braininjury.com/children.htmlhttp://www.mentalhelp.net/poc/view_doc.php?type=doc&id=13866&cn=3http://www.keepkidshealthy.com/welcome/conditions/anxiety_disorders.html
3.2.1 Neurologic needs for children’s healthcare
Learning and communication disorder Anxiety disorders
panic disorder, obsessive compulsive d., post traumatic stress d., social anxiety d., specific phobias, and generalized anxiety disorder
worry and fear are constant and overwhelming, and can be crippling.
Medication, anti depressants
Psychotherapy (a type of counseling) Relaxation therapy, guided imaginary
Avoidance or minimization of stimulants
Good sleep: adequate, restful sleep improves response to interventions to treat anxiety disorders.
Reduction of stressors. Identify and remove or reduce stressful tasks
.silent (avoiding environmental noises).dark room for sleepavoiding .avoiding hesitation in wayfinding (less doors, less decision making) calm colours-clear design
may include difficulty in following directions, attending to a conversation, pronouncing words, perceiving what was said, expressing oneself, reading, spelling.Difficulties with speech may include being unintelligible due
to a motor problem or due to poor learning.
Speech Therapy to help children learn new vocabulary, organize their thoughts and beliefs. Behavior
Therapy to increase children's use of desirable communication behaviors, use of maladaptive coping strategies, and to promote their
development of useful interpersonal skills.
Environmental Modification (ex.giving extra time during school-based tasks to more adequately formulate responses.
.avoiding distractions..
.maximized lighitng for concentration, .good acustics for clearity of speech .Promoting the focus and self courage (privatized spaces, low ceilings)
In presence of mental disorders, environment can become a part of the treatment itself.
Some of the behaviors in mental disorders can be consequences of other disorders, diseases or physical disorders.
The chart shows the common mental disorders seen on children, and clinical description and treatment methods. Both clinical and non clinical treatments have requirements for environment. (For example: a good sleep is important for efficiency of medication, while it can be used as a relaxation method)
Architectural conclusions refers to my own conclusions, considering the required environmental setting for the related treatments or the mental state.
453. Healthcare environments for children
3.3 New approaches in children’s hospitals
461. www.montgomerysisam.com
Groot Klimmendaal Children’s Rehabilitation
The rehabilitation center designed by Koen van Velen is located in Arhem, Holland. It is one of the major rehabilitation clinics in Holland and has a capacity of 120 beds.
Tucked between the trees, merging through the natural pattern of the woods, the impression of the building is more like a spa rather than a rehabilitation center according to the therapists. Some doctors are critical to evidence based design, yet they don’t deny the positive feeling having an open view to the nature.
Although the building is highly appreciated in Holland, it is hard to find information in international sites, not even on the web site of the architect. The impression the building gives me is abundant daylight and natural scenes will be helpful for families to reduce stress. When we take from medical staff’s view, the transparency between the spaces provides an easy supervision in my opinion.
However there are some post occupancy problems that shows us the dark side of the building, such as maintenance costs. Huge glass facades for the climate of Holland adds to heating costs. Another complaint comes for hygiene, as the corners and edges is hard to clean, which can be problematic for open wounds. Some other problems were expressed about the transfers within the building.
3.3.1 Groot Klimmendaal Children’s Rehabilitation
473. Healthcare environments for children
1. Rehabilitation under Architectural Image, Ingrid Lutke Schipholt
The planning problems and technical problems (insulation, heating, shading) could have been solved initially or adapted with other solutions but the building itself still introduces a new approach that inspires the healthcare designers. I find the building challenging with its contemporary architecture, which is not very common to have a brave approach when it comes to a rehabilitation center.
From view from neuro-architecture, the building strongly emphasizes the relaxation of both patients and staff. Relaxation and decreased stress will increase the efficiency of treatments, that can eventually reduce the healing duration.
3.3 New approaches in children’s hospitals
Holland Bloorview Kids Rehabilitation
New children’s rehabilitation center in Toronto, designed by Montgomery Sisam Architects is a fairly complex project with amalgamation of pediatric rehabilitation and complex continuing care teaching hospital. The Project hosts clinical care and rehab therapy for both inpatients and outpatients, an integrated school, a creative arts programme, recreational programmes, assisting technologies and prosthetic labs, a research institute and a hotel for families.1
First key driver for the design approach was to reconnect the hospital to urban fabric, discussing against the 60s approach of pulling hospitals from urban centers and internalized planning. The new design will emphasize that kids with disabilities are also a part of city, and bring variety. Connecting the new hospital to urban, another key element the architects emphasized was blending exterior and interior together, bringing the exterior to interior, as daylight or nature, extending the borders of therapy spaces to outside. Determining the facilities and planning, with help of workshops, views from client, hospital staff, patients and their families were taken into consideration, ensuring to satisfy all the users.
481. www.montgomerysisam.com
The inpatient section was set as a focal point to the building, and all the facilities concerned with inpatients 24 hours placed in the same level with patient rooms. Single patient room is considered to be a better solution in EBD since it decreases injuries, and promotes individual patient comfort, when it comes to children’s hospital staying over parents are also taken into consideration. For example the architects chose to use both single and double rooms, making the families feel safer that they are not alone.
Each of the three inpatient units have their own social space, including dining facilities. The common and social units in the large scale have flexible planning, with ability to open to the outdoor terraces. When the building links to outdoor with public spaces, the common therapies in the building also links into the building’s internal public spaces. Facilities requiring double height such as swimming pool or exercise hall is seen from circulation halls in the other floors which brings a visual connection between the building, letting the whole facilities flowing through each other.
Another emphasize is about nature and natural visions. The connection to exteriors brings in the nature and natural light which creates more open and lighter spaces inside, and gives calm feeling. Wood was used as interior material which also strengthens the feeling of nature, isolating from the traditional hospital atmosphere.
3.3.2 Holland Bloorview Kids Rehabilitation
493. Healthcare environments for children
Environmental setting, includes architectural solutions of healthcare spaces, and it gains a more delicate approach when we
focus on the children as users.
Design principles which going to be listed under this chapter, are essential in any healthcare design, yet it is more
problematic for children as for their limited sight, lack of navigation and limited understanding due to their age.
50
.Groot Klimmendaal, Children Rehabilitation, Koen Van Velse, Netherlands
4.
Design Interventions for Children's healthcare
51
4. Design interventions for children’s healthcare
Children in healthcare
Mental State
Treatments
Neurologic
Condition
Behaviors
Clinical
Treatments
Environmental
Approaches
52
There are numbers of design parameters related to healthcare environments. Classifying the parameters under different aspects of the spaces, gives a clearer perspective for architectural design. Adaptation of these parameters for children’s hospital
.Children & BrainCollecting information on children in healthcare environments. Searching on disorders can be treated with environments. Learning about mental disorders and therapy methods. How healthcare environments affect children
.Environmental approach
.The data involving architectural setting is related with the information gathered from children and healthcare. The design concept is handled with 5 aspects that involves/reveals/stimulates brain in different ways. Each aspect handles different parameters, to be studies individually.
The parameters vary between different conditions of children, or unites for shared spaces, for the common qualities of a children’s healthcare environment.
4. Design interventions for children’s healthcare
53
4.1 Determining parameters for architecture
Wayfinding
Social aspects
Enrichment
Variables
Environmental
Concept
Orientation
Circulation
Social interaction
Privacy
Volumes, shapes
Natural impact
Light
Sound
Colours
Artwork
Air
4.1 Determining parameters for architecture
54
4.1.1.1 Clear planning and Simple Circulation
Clear planning should be a principle in every healthcare center, yet adult users are more capable to find their way, or form a mental map of a hospital as they have been to previously. Easy planning is also important for medical staff, since it avoids delays and injuries.
In a children’s hospital, the circulation should be visible, from the corridor, so the child can feel confident that he/she can find her way alone. In a children’s hospital, the authority might ask for limited circulation for patients, but the organization can set an easy planning within the limits, and encourage them to stay in desired spaces.
.Please don’t hide toilets from children!
.easy access from common spaces
A good environmental image gives its possessor an important sense of emotional security.1 We normally do not get lost in the environments that we are used to, or if a new city has a well ordered design, it also serves a reference plan to our mental maps.
Feeling of being lost, hesitation, delay in navigation, causes stress. Patients are highly affected by stress as it affects their medication, state and so as the duration of their healing.2 When we compare children with adults, children are more likely to lose their route, and be distracted, for their limited memory. Therefore the cognitive memory of the child should be reinforced by the surroundings while the child circulates within the building.
4.1.1 Wayfinding and Navigation
554. Design interventions for children’s healthcare
4.1.1.2 Landmarks
Hippocampus related with memory is very essential for way finding. How do we remember our ways in buildings, is either from memories from previous visits to similar buildings or by learning thorough the spatial planning by recalling the landmarks. A child might not remember where a certain room in the building is, but have higher possibility to remember, if he recalls the landmark. Hence landmarks don’t help when they are used abundantly. Landmarks lose their function if they cannot be recalled separately, and gets confusing for children’s orientation.
The landmarks can be perceived in a different way when, they are viewed from different angles, especially for a child recalling the certain view of the mark. A test was made to children, showing pictures of landmarks alone, and the answers were more accurate comparing to the pictures taken with their natural surroundings.3 For healthcare environments, the result can be concluded that the location of landmarks, shouldn’t have other distractions that weakens the cognitive memory.
4.1.1.3 Color references, symbolsUsing colors for certain floors and functions is a widely used method in hospitals. Using colors from different palettes, referencing an activity, or dominant color of the room (furniture, curtains…) helps the children to find their way to the target. The use of colors can be a part of the directions lines, signals or lights. Combining the colors with landmarks, can be suggested as they can also help rotation.
.Landmark and direction
Confusion between landmarks
Color, landmark and direction
56
4.1 Determining parameters for architecture4.1 Determining parameters for architecture
Humans are social animals and social interaction is something we often have either with our families, friends or in public environments we share with others. During treatments the only interaction the patients have are with their families and medical staff.
New approaches in healthcare for children, encourage more and more interaction with other people, which also makes them feel more valuable as a part of a bigger group. While some therapies are involving group activities with other patients, some therapies involves member of their own families to maintain the closeness of their home environment.
4.1.2 Social Interaction
57
Setting for families and children, Bräcke children’s rehabilitation
4.1.2.1 Socialization Vs. Privacy
Other concern about privacy in healthcare, children in an unhealthy condition can be disable to achieve some activities as healthy children do. And learning, regaining or training this physical or mental activities can be difficult for a child, and do not want to be exposed while trying and failing during the treatments. The spaces related with training can be kept partly isolated to keep them comfortable and also to support their concentration.
Involving social interactions and encouraging the children for social interaction with other children or with their families distracts them from their pain and makes them a part of a bigger social group. However involving social connections cannot be an optimum solution for every occasions. A child spending time with his/her family has right to have privacy, without stressing that they can be disturbed, or interrupted. Giving semi-private spaces for family gatherings in hospitals can be an alternative approach. Children rehabilitation unit (of Drottning Silvia’s children’s hospital) in Bräcke creates semi-private sitting corners for families to spend time with their children.
4. Design interventions for children’s healthcare
58
4.1 Determining parameters for architecture
Perception
Brain stimuli
New neurons & synapses (connections)When our brains are stimulated new connections between neurons occur and also new neurons are produced in the hippocampus.
Effect of enriched environments:What happens when we perceive more?
Our brains receive stimulli
4.1.3 Enriching Environments
Definition from Wikipedia : Environmental enrichment concerns how the brain is affected by the stimulation of its information processing provided by its surroundings (including the opportunity to interact socially). Brains in richer, more stimulating environments, have increased numbers of synapses, and the dendrite arbors upon which they reside are more complex.
In earlier chapters it was mentioned about how our brain is responding enriched environments and how important this is for brain stimuli. In healthcare environments, when we consider about the disorders and condition of the patients, enriched environments can have a positive impact on patients having brain injuries.
The elements of spaces the children are using, can increase their perception, therefore can help the process of recovery. Not only for brain injuries, but an enriched environment also serves as an distraction from pain, attracting the attention away from the pain or helping the concentration on other activities. Architectural and conceptual elements of enriched environments are explained in this section.
594. Design interventions for children’s healthcare
Östra Psychiatry, Göteborg
A relevant example involving nature can be given, Östra Psychiatry clinic that I personally visited in Göteborg, design by White architects. The design doesn’t only face the surrounding green areas that can be viewed from patient rooms, but the nature is brought into the building by courtyards. The courtyards are designed to reach to the other floors, where patients from different floors have the possibility to reach to the garden from different levels. Embracing the green is also made possible to the waiting units merging into the courtyards with glazed frames.
60
4.1 Determining parameters for architecture
4.1.3.1 Natural Impact
61
4.1.3 Enriching Environments
4. Design interventions for children’s healthcare1. A Review of the Research Literature on Evidence-Based Healthcare Design, R. Ulrich
When it comes to stimuli, nature with varieties in color and geometries is a rich stimuli, that we are naturally encoded to be stimulated. In other words nature provides a source of neurological nourishment. Nature exhibits ecological complexity: interacting plants that in turn provide visual complexity, which is a source of neurological nourishment. (K.G. Medsen 2006) While artificial stimuli is not perceived in the same way by everyone, natural stimuli serves both for distraction and relaxation.
Effect of nature on reducing patient stay have been studied comparing the process of patients in different rooms according to their view to nature . Including that from prospective randomized controlled studies, it has shown that exposing patients to nature can produce substantial and clinically important alleviation of pain (Ulrich, 2008)1. Therefore nature in healthcare environments is emphasized by evidence based design, gaining more importance in hospital design. Maximizing the opening to the nature will maximize the effect of treatments and speed up the healing process.
62
4.1 Determining parameters for architecture
The volume of room has also other impacts on our brain which influence our behaviors. One of the most dominating element of volume is ceiling. Changes in ceiling height is a large field of study which concerns widely environments for research and productivity and places for consumption.
The ceiling impact debate has a background of architectural settings that we experience in our daily lives, as how the volumes change our behaviors, volume of our speech, or how broad we can think. Experiments on low and high ceilings, analyze both observations of behaviors and changes in the body states. High ceilings reveals freedom and thinking independently . However low ceilings signifies confinement therefore it collects the attention to certain point which increases focus.1
The perception of height is not only limited with ceiling. Different installations in the heights, such as suspended ceilings, height of lighting armatures change the perception of the volume of the rooms. The different effects of heights can be used to strengthen ability of concentration or encourage creativity for the children. For example, children in healthcare exposed to medication and maybe dealing after a trauma might experience difficulties in learning and lack of concentration. Spaces designed with lower ceilings, for rooms involving learning, can help gathering attention. On the other hand when more creativity is desired, such as workshops to encourage the child to discover his/her abilities, higher volumes might support thinking broadly. 1
4.1.3.2 Volumes, Room height
1. Influence of Ceiling Height , Joan Meyers
The more brain perceives, the more the brain is stimulated and developed. Colors, heights and different dimensions in the room serve for brain stimuli.
1. Bear, Connors, & Paradiso Neuroscience, Exploring the brain, 2. University of Rochester, Color Perception Is Not in the Eye of the Beholder: It’s in the Brain
Perceived color is based on the relative activity of ganglion cells whose receptive field centers receive input from red, green, and blue cones. It appears that the ganglion cells provide a stream of information to the brain that is involved in the spatial comparison of three opposing processes: light versus dark, red versus green, and blue versus yellow (Bear, Connors, & Paradiso, 2001).1
Since perception of colors differ from age to age and between mental states, for enriched environments it will be a more common approach to determine the colors by their brightness colors instead of grouping them with their perceptions.
When colors are brighter they will behave as a stimuli since they are more recognizable. Brains remember the things easily that are more remarkable. If the colors are used in connection with the spaces, it can strengthen the position in the mental map, and stimulates the memory.
However same stimuli is not desired for every function. The brighter the colors , the more attention they attract, and if they are used in rooms where attention is expected, the attention will be collected in the wrong place. It will a better solution to involve neutral colors, with less contrast, and preferably light colors to perform with lighting.
4.1.3.3 Colors
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4.1.3 Enriching Environments
4. Design interventions for children’s healthcare
64
4.1 Determining parameters for architecture
1. Brain Landscape, J.Eberhard
Not all the spaces in the healthcare buildings require the same amount of light. Especially it is important that patients have dim light in their rooms, when they spend all their days in the rooms. Another thing it is important that the room can be blinded totally during the sleep, since a good sleep is desired for all patients, while it is more essential for patients going through a trauma.
Daylight is a solution for lighting general spaces, when it is possible. As mentioned earlier involving nature as much as possible will bring more daylight if it is opening directly to outside. However for activities involving attention, for example therapy rooms with workshops or teaching activities in children hospitals, direct day lighting will also bring the problem of glare. Unless the glare is prevented, it will distract the attention from task, make it hard to read and see which will later discourage children’s will to learn. These type of rooms can be designed with low transmitting glasses, or shadings, or another solution is to use artificial lighting for task lights to gather the attention.
Light serves for various purposes: to make spaces to find the orientation, to reveal or conceal the spatial volume or features, or to draw attention to a task. Our perception and desire for light also varies among the purposes we will need the light for, for example while a light for dining can be sufficient, whereas the same light will be insufficient for studying.
When performing a visual task, the light that reaches our eyes and is therefore laden with the raw information for our mind is usually reflected light—that is, light reflected off the details of the task (typed letters), the immediate background (paper), and the surround (desk top and room). In this context, light is defined as electromagnetic radiation that can be detected by the human eye. 1
4.1.4.1 Light
4.1.4 Variables: Light & Sound
65
4.1.4.2 Sound
Sound is another variable handled in the architectural setting and it shows similarity with light when it comes to purposes. Level of sound also varies for different purposes, while sometimes it is sufficient to be perceived only as a sound or a melody, sometimes it needs to be carefully understood so the levels and clarity gain importance.
As mentioned earlier, children are more likely to be distracted and it is hard to get them concentrated. In rooms for conciliations, teaching, or training where children are listening and talking, the room should provide a clear understanding. While sounds can cause distractions should be prevented or insulated from the room, another important value is the clarity of speech. To increase the acoustic quality of the room, a simple solution can be using absorbers in the ceilings, to prevent echoes.
When it comes to patient rooms, when the light in the room is dimmed and even be blinded for a good sleep, it is hard to prevent the expected sounds since there are many machines or functions running all through the night. Lowering the transmission of sound to the room can be provided by having absorbers in the corridors, (e.x dampers in the floors) or door with sound absorbers.
4. Design interventions for children’s healthcare
References
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Literature:Inquiry by Design; Environment / Behavior/ Neuroscience in Architecture, Interiors, Landscape and Planning; John Zeisel, 2006
Brain Landscape: Coexistance of Neuroscience and Architecture, John.P Eberhard 2009
A Review of the Research Literature on Evidence-Based Healthcare Design, R. Ulrich; C. Zimring,; X. Zhu; J. DuBose, H. Seo; Y. Choi; X. Quan; A.Joseph, Herd Journal Vol.1, 2008
The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime OpportunityRoger Ulrich, Xiaobo Quan, , Texas A&M University; Craig Zimring, Anjali Joseph, Ruchi Choudhary, Georgia Institute of Technology
Architecture as Medicine; edited by Lena From, Stefan Lundin; ARQ Architecture Research Foundation 2010Architecture and the Brain; John. P. Eberhard, 2007
Place recognition and way finding by children and adults; Edward H. Cornell, C. Donald Heth, Denise H. Alberts, University ofAlberta, Canada, Memory & Cognition.22; 1994
Neuroscience, the Natural Environment, and Building Design. Nikos A. Salingaros, Kenneth G. Masden, University of Texas, 2006
Image of the City; Kevin Lynch, 1960
Medical Sources:
Neuroscience, An Introduction , J.F. Stein with C.J. Stoodley, Wiley 2006
Brain Facts, A Primer on the Brain and Nervous System; Society For Neuoscience; 2006
Enriched Environment and Astrocytes in Central Nervous System Regeneration, Michael Nilsson, MD, PhD and Milos Pekny, MD, PhD, Institute for Neuroscience and Physiology at Sahlgrenska Academy, 2007
Mapping the Mind; Rita Carter; University of California Press, 2010
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Internet Sources:
Kultur och Hälsa, Göteborgs Universitetet, www.chk.gu.se
Academy of Neuroscience for Architecture, www.anfarch.org
An Architect and a Neuroscientist Discuss How Neuroscience can influence architectural design http://www.sfn.org/index.aspx?pagename=neuroscienceQuarterly_03fall_architect&p
The Recovery Position, Edited by: Giovanna Dunmall, Netherlandshttp://www.erikveldhoen.nl/data/files/alg/id23/Pages%20from%20F78_recovery%20position.pdf
Is there a Psychologist in the Building? , Christian Jarrett, The Psychologist 19/10, 2006 http://www.thepsychologist.org.uk/archive/archive_home.cfm/volumeID_19-editionID_140-ArticleID_1089-getfile_getPDF/thepsychologist/1006jarr.pdf
Response of Brain to Enrichment; Marian Cleeves Diamond; 2001http://www.marthalakecov.org/~building/neuro/diamond_brain_response.htm
Rehabilitation under Architectural Image, Ingrid Lutke Schipholt ; Medisch Contact 65 number 37. 2010http://medischcontact.artsennet.nl/Tijdschriftartikel/Revalideren-onder-architectuur.htm
.Cagil Kayan .Master Thesis .Examiner: Peter Fröst .Chalmers .VT2011
.Enriching healthcare environments for children
please continue with part II.
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plan
s ..
....
....
....
....
....
....
....
....
.
5.4.
1. E
ntra
nce
....
....
....
....
....
....
....
....
...
5.
4.2
Livi
ng S
quar
e ..
....
....
....
....
....
....
....
.
5.4.
3 Mu
lti
Play
...
....
....
....
....
....
....
....
...
5.
4.4
Sile
nt s
quar
e ..
....
....
....
....
....
....
....
.
5.4.
5 Te
en P
lay
....
....
....
....
....
....
....
....
...
5.
4.6
Lear
n Pl
ay .
....
....
....
....
....
....
....
....
.
5.5
Conc
lusi
ons
....
....
....
....
....
....
....
....
....
...
2 3 4 5 6 11 13 14 15 17 18 19 23 26 27 28 29 30 31 32 33
5. D
esig
n A
pplic
atio
ns w
ith
Neu
rosc
ienc
e +
Arc
hite
ctur
e
pro
posa
ls fo
r Pla
y th
erap
y de
parm
ent i
n ne
w C
hild
ren’
s hos
pita
l in
Öst
ra
This
par
t of
the
the
sis
is a
bout
how
neu
rosc
ienc
e ca
n be
app
lied
on
arch
itec
ture
for
chi
ldre
n’s
heal
thca
re.
The
rese
arch
par
t of
the
the
sis
work
bec
omes
mor
e vi
sual
ized
how
spa
ces
can
be a
rran
ged
cons
ider
ing
chil
dren
in
heal
thca
re.
Whit
e Ar
chit
ects
are
wor
king
new
ext
ensi
on b
uild
ing
for
Drot
tnin
g Si
lvia
’s H
ospi
tal
for
Chil
dren
and
Ad
oles
cent
s. F
or a
ppli
cati
on p
art
of m
y th
esis
, I
stud
ied
on h
ow t
he n
ew p
lay
ther
apy
depa
rtme
nt c
an b
e de
sign
ed u
sing
my
rese
arch
on
neur
o-ar
chit
ectu
re.
The
depa
rtme
nt i
s pl
anne
d to
be
loca
ted
on t
he g
roun
d flo
or,
and
my p
roje
ct i
s on
des
igni
ng t
he s
pace
ass
igne
d fo
r th
e pl
ay t
hera
py d
epar
tmen
t.
The
prog
ram
for
the
unit
was
tak
en f
rom
the
hosp
ital
an
d d
esig
n pr
oces
s wa
s de
velo
ped
with
res
earc
hes,
in
terv
iews
wit
h me
dica
l st
aff
and
with
tut
oria
ls f
rom
both
Whi
te a
rchi
tect
s an
d my
exa
mine
r Pe
ter
Frös
t.
5. D
esig
n A
pplic
atio
ns w
ith N
euro
scie
nce
& A
rchi
tect
ure
The
hosp
ital
is s
ervi
ng a
s a
regi
onal
hos
pita
l in
Wes
t G
otla
nd r
egio
n w
ith it
s 18
50 m
edic
al s
taff
and
250
bed
s ca
paci
ty. E
very
day
arou
nd 5
50 c
hild
ren
and
adol
esce
nts
visi
t ho
spita
l, ou
t of
whi
ch 1
50 c
hild
ren
stay
mor
e th
en
10 d
ays
in t
he h
ospi
tal.
Öst
ra h
ospi
tal
zone
pro
vide
s re
side
nces
for c
hild
ren’
s fa
mili
es v
isiti
ng fr
om o
utsi
de o
f G
öteb
org.
Not
onl
y fr
om V
ästr
a G
ötal
and
but t
he h
ospi
tal
has m
any
patie
nts f
rom
all
arou
nd S
wed
en a
s the
hos
pita
l is
est
ablis
hed
for e
xper
ienc
e in
hea
rt s
urge
ry.
Child
ren’
s H
ospi
tal i
n G
öteb
org
has
a hi
stor
y fo
r al
mos
t 15
0 ye
ars.
Firs
t ch
ildre
n’s
hosp
ital w
as o
pene
d in
Öst
ra
ham
ngat
an w
ith d
onat
atio
n of
Car
negi
e co
uple
in 18
59.
Late
r in
1909
the
hosp
ital w
as m
oved
to th
e ne
w b
uild
ing
in A
nned
al. T
he h
ospi
tal w
as sp
ecia
lized
in h
eart
surg
erie
s.
In 1
973
the
hosp
ital
exte
nded
as
child
ren’
s cl
inic
and
ho
spita
l an
d m
oved
to
new
loc
atio
n in
Öst
ra H
ospi
tal
whe
re it
bec
ame
a re
gion
al h
ospi
tal o
f al
l chi
ldre
n an
d yo
uth
care
.
In
1997
, th
e ho
spita
l be
cam
e pa
rt
of
Sahl
gren
ska
Uni
vers
ity H
ospi
tal.
The
hosp
ital
was
nam
ed a
fter
the
qu
een,
Dro
ttni
ng S
ilvia
in
1999
and
stil
l se
rvin
g as
a
regi
onal
hos
pita
l in
Göt
ebor
g.
The
hosp
ital
still
gro
ws,
and
now
the
y ne
ed a
new
bu
ildin
g, t
o ga
ther
all
the
faci
litie
s to
geth
er in
ext
ende
d sp
aces
whi
ch w
ill b
e al
so lo
cate
d in
Öst
ra.
The
spec
ializ
atio
n fie
lds
of th
e ho
spit
al a
re:
.Med
icin
e.O
ncol
ogy
.Car
diol
ogy,
incl
udin
g ca
rdia
c su
rgic
al c
are
.Neu
rolo
gy, n
euro
psyc
hiat
ry a
nd h
abili
tatio
n.N
eona
tolo
gy.S
urge
ry.A
cute
in
gest
ion,
ac
ute
shor
t-te
rm
serv
ice
and
rece
ptio
ns.C
hild
and
ado
lesc
ent p
sych
iatr
y.R
adio
logy
and
Clin
ical
Phy
siol
ogy
.Sur
gery
, Ane
sthe
sia
and
ICU
5.1.1
.1 Ba
ckgr
ound
5.1
Dro
ttni
ng S
İlvia
’s C
hild
ren
Hos
pita
l
35.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
5.1 D
rott
ning
Silv
ia’s
Chi
ldre
n H
ospi
tal
5.1.2
The
rapy
Dep
artm
ents
For l
ong
last
ing,
and
chr
onic
dis
orde
rs, t
he h
ospi
tal h
as a
se
para
te c
hild
ren
reha
bilit
atio
n un
it in
Brä
cke,
His
inge
n.
Dro
ttni
ng S
ilvia
’s C
hild
ren’
s ho
spita
l in
Öst
ra h
as it
s ow
n th
erap
y de
part
men
t fo
r st
ayin
g an
d vi
sitin
g pa
tient
s.
The
ther
apy
units
in t
he h
ospi
tal i
n se
rve
to r
etrie
ve a
nd
prac
tice
the
abili
ties
of t
he c
hild
ren
both
phy
sica
lly a
nd
men
tally
. The
ther
apie
s ar
e ga
ther
ed in
thre
e gr
oups
:
Occ
upat
iona
l the
rapy
: Pr
omot
es h
ealth
, by
tea
chin
g pu
rpos
eful
occ
upat
ions
. Th
e th
erap
ies
in t
he h
ospi
tal
ofte
n ai
m t
o en
able
the
pa
tient
s to
mai
ntai
n th
eir d
aily
act
iviti
es.
Phys
ioth
erap
y:
Hel
ps t
he p
atie
nts
who
hav
e ph
ysic
al i
mpa
irmen
ts t
o re
stor
e th
eir
func
tiona
l ab
ilitie
s. T
he u
nit
has
a gy
m
and
an e
xerc
ise
pool
whe
re t
he c
hild
ren
trai
n w
ith t
he
ther
apis
ts o
ne to
one
.
Play
ther
apy
Serv
es fo
r all
child
ren
stay
ing
or v
isiti
ng th
e ho
spita
l. Th
e pu
rpos
e is
to
help
chi
ldre
n ex
pres
s th
eir
expe
rienc
es in
a
natu
ral a
nd s
elf
guid
ed w
ay t
hrou
gh p
lays
, and
oth
er
activ
ities
that
they
can
’t jo
in d
ue to
thei
r con
ditio
n.
The
unit
serv
es fo
r a w
ide
age
rang
e, p
rom
otin
g ch
ildre
n’s
inte
grat
ion
and
soci
aliz
atio
n. C
hild
ren
can
both
att
end
activ
ities
gui
ded
by t
hera
pist
s, o
r sp
end
time
with
the
ir pa
rent
s, o
r pla
y ga
mes
with
thei
r sib
lings
.
My
pers
onal
obs
erva
tion
of t
his
sect
ion
is a
s a
hidi
ng
zone
fr
om
real
ity,
dist
ract
ing
the
stre
ss
of
hosp
ital
envi
ronm
ent.
It
allo
ws
a w
ide
varie
ty o
f ac
tiviti
es a
nd
enco
urag
es c
hild
ren
to m
ingl
e an
d ex
perie
nce.
Pl
ay th
erap
y is
defi
ned
by S
wed
ish
law
, as
all t
he c
hild
ren
and
adol
esce
nts
stay
ing
in h
ospi
tals
mus
t hav
e th
e sa
me
oppo
rtun
ity t
o pl
ay a
s th
e he
alth
y ch
ildre
n , t
here
fore
it
is th
eir l
egal
righ
t to
rece
ive
the
play
ther
apy.
The
goal
s of P
lay
Ther
apy
desc
ribed
by
Child
Car
e Pr
ogra
m
“Pro
mot
e no
rmal
, he
alth
y gr
owth
and
dev
elop
men
t by
pr
ovid
ing
ther
apeu
tic
play
an
d cr
eativ
e ar
ts
oppo
rtun
ities
.En
able
chi
ldre
n an
d ad
oles
cent
s to
wor
k th
roug
h th
e st
ress
ful e
xper
ienc
e of
hos
pita
l env
ironm
ent,
res
olvi
ng
anxi
ety
and
rega
inin
g st
reng
th.
In c
oope
ratio
n w
ith
med
ical
sta
ff, p
rovi
de s
uppo
rt to
par
ents
and
sib
lings
.” 3
The
play
ther
apy
unit
is s
ervi
ng to
chi
ldre
n fr
om d
iffer
ent
age
grou
ps (
smal
l ch
ildre
n -
teen
ager
s).
The
hosp
ital
wan
ts t
o ha
ve fl
exib
le s
hare
d-sp
aces
bet
wee
n un
its a
nd
a pl
an th
at a
llow
s th
e se
ctio
ns w
ork
Lekt
erap
i : P
lay
ther
apy
45.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
5.2.
1 Obj
ectiv
es fo
r the
new
dep
artm
ent
The
new
hos
pita
l pla
ns to
hav
e th
e co
mm
on fa
cilit
ies
for
child
ren
on th
e gr
ound
floo
r (en
tran
ce le
vel),
to b
e vi
sibl
e to
the
out
side
, for
dai
ly v
isito
rs, a
nd g
athe
r th
e pa
tient
s on
a c
omm
on fl
oor.
The
faci
litie
s fo
r ch
ildre
n in
clud
es g
roup
the
rapy
roo
ms
(pla
y th
erap
y), g
athe
ring
squa
res,
phy
siot
hera
py s
pace
s (in
clud
ing
gym
and
poo
l), ro
oms
for t
eena
gers
, dai
ly c
are
for
smal
l ch
ildre
n, t
hera
py r
oom
s fo
r ch
ildre
n op
en t
o in
fect
ion,
libr
ary
and
clas
sroo
ms.
The
obje
ctiv
e fo
r th
e ne
w b
uild
ing
is t
o m
ake
child
ren
spen
d as
muc
h tim
e as
pos
sibl
e to
geth
er i
n co
mm
on
spac
es in
stea
d of
sta
ying
in th
eir r
oom
s. G
athe
ring
all t
he
faci
litie
s cl
ose
to e
ach
othe
r; e
nhan
ces
the
inte
ract
ion
betw
een
diff
eren
t ag
e gr
oups
and
vis
ual c
onne
ctio
n of
sp
aces
att
ract
s at
tent
ion
of c
hild
ren
invo
lved
in d
iffer
ent
activ
ities
.
Espe
cial
ly s
ince
the
play
ther
apy
unit
is a
s a
key
gene
rato
r to
in
tera
ct
child
ren
with
so
cial
ac
tiviti
es,
the
new
ap
proa
ch is
est
ablis
h m
ore
conn
ectiv
ity t
o th
e ou
tsid
e w
ith g
arde
ns.
5.2
Des
ign
App
roac
hes
for t
he P
lay-
ther
apy
Dep
artm
ent
55.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
5.2.
2 Ex
istin
g Bu
ildin
g
Acc
ess:
The
play
-the
rapy
uni
t in
the
hosp
ital is
on
the
grou
nd le
vel,
whe
re y
ou p
ass t
he m
ain
entr
ance
hal
l in
the
hosp
ital a
nd
follo
w t
he lo
ng c
orrid
or t
o fin
d th
e un
it. T
he d
ista
nce
to
the
unit
is s
olve
d w
ith g
uidi
ng li
nes
on th
e co
rrid
or fl
oor,
an
d gl
azed
doo
r to
the
unit,
how
ever
it is
har
d fo
r a c
hild
to
find
his
way
dire
ctly
to
ther
e w
ithou
t he
lp.
Ano
ther
di
sadv
anta
ge o
f th
e lo
catio
n is
, sin
ce it
is in
the
mid
dle
and
not
faci
ng t
he f
ront
faç
ade,
it is
not
pos
sibl
e to
run
in
depe
nden
t fro
m th
e m
ain
hosp
ital.
play
ther
apy
entr
ance
hal
l
Phys
ioth
erap
yex
m.ro
om
labo
rato
ries
laboratories
expedition
staff
expe
ditio
n te
chni
cal
offices
1. Fl
oor p
lan
1/10
00
5.2
Des
ign
App
roac
hes
for P
lay-
ther
apy
Dep
artm
ent
65.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
mul
ti-pu
rpos
e ro
om
wor
ksho
p
expe
ditio
n
expe
ditio
n
clas
sroo
m
exp.
te
ache
r
“squ
are”
smal
l ch
ildre
n r.
hosp
ital
play se
win
g r.
teen
ager
s’ r.
billa
rd r.
libra
ry
stor
age
stor
age
conf
eren
ce
room
exp.
sens
es
room
diap
er r.
war
drob
e
hall
hall
expe
ditio
n ro
oms
expe
ditio
n ro
oms
conf
eren
ce r.
te
ch. r
.co
nfer
ence
r.
lab.
exp
editi
on r.
f-lab
.
prin
t r.
doct
or
chem
. lab
.
urin
lab.
staff
r.
exp.
exp.
stor
age
stor
age
radi
ogra
phy
dept
.
x-ra
yx-
ray
exp.
exp.
exp.
prin
t r.
office
stor
age
stor
age
ultr
asou
nd
doct
or
appa
ratu
s ro
om
5.2.
2 Ex
istin
g Bu
ildin
g
1. Fl
oor/
Pla
y Th
erap
y pl
an 1/
200
5.2.
2.1 A
naly
sis
of s
pace
s 75.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
Squa
re [t
orge
t]Fu
ncti
on: T
he s
quar
e is
the
hear
t of t
he p
lay-
ther
apy
part
w
here
all
the
corr
idor
s an
d co
mm
on ro
oms
are
open
ing
to,
and
whe
re
the
child
ren,
th
erap
ists
an
d pa
rent
s ga
ther
in o
ne c
omm
on u
nit.
It
is lo
cate
d on
the
sid
e of
th
e en
tran
ce w
hich
giv
es t
he fe
elin
g of
a s
epar
ate
spac
e al
so s
urro
unde
d by
func
tions
. Kitc
hen,
pia
no, a
nd s
eatin
g m
akes
it a
livi
ng s
pace
.
Cond
itio
n: T
he s
quar
e is
whe
re th
e ch
ildre
n, p
aren
tsan
d th
erap
ists
gat
her a
nd s
pend
tim
e to
geth
er, a
ndso
met
imes
they
can
sta
y fo
r lon
ger h
ours
. The
squ
are
is la
ckin
g co
nnec
tion
to o
utsi
de, v
isio
n to
nat
ure,
and
dayl
ight
, whi
ch d
oesn
’t p
rovi
de a
cal
min
g en
viro
nmen
t.
Wor
ksho
p [s
nick
eri]
Func
tion
: Roo
m fu
ll of
cre
ativ
e fe
atur
es, p
last
er, w
ood,
pain
t for
chi
ldre
n’s
disp
osal
.
Cond
itio
n: T
he ro
om h
as b
oth
eye
cont
act t
o th
e co
rrid
or
and
to o
utsi
de. I
t is
fac
ing
to a
qui
et c
ourt
yard
, whi
ch is
go
od fo
r the
m to
be
conc
entr
ated
on
thei
r act
iviti
es.
Sew
ing
room
[syr
um]
Func
tion
: Rel
ativ
ely
smal
l roo
m w
ith s
ewin
g m
achi
nes.
Cond
itio
n: It
has
acc
ess
both
fro
m c
orrid
or a
nd m
edic
al
play
roo
m,
how
ever
it
is p
ropo
sed
to b
e a
part
of
teen
ager
s’ s
ectio
n.
Mul
ti p
urpo
se ro
om [A
llrum
]
Func
tion
: Th
e ro
om w
here
the
chi
ldre
n ca
n pe
rfor
m
a th
eate
r, w
atch
a v
isiti
ng a
ct, p
lay
gam
es in
the
whi
te
scre
en, o
r pla
y pi
nbal
l. It
is a
flex
ible
room
, may
be la
ckin
g so
me
clos
ed s
tora
ge u
nit a
s so
me
deco
ratio
ns a
re h
idde
n be
hind
the
curt
ains
.
Cond
itio
n: T
he ro
om is
lack
ing
visu
al c
onta
ct to
the
activ
e se
ctio
ns in
the
the
rapy
dep
artm
ent.
Sin
ce it
hos
ts b
road
va
riety
of
activ
ities
, it
can
have
mor
e op
enin
g to
mai
n ha
lls a
nd w
elco
min
g fo
r ch
ildre
n, s
o ch
ildre
n ca
n ch
oose
w
ith th
eir o
wn
will
to jo
in th
e ac
tiviti
es.
Smal
l chi
ldre
n’s
room
[sm
åbar
nsru
m]
Func
tion
: Fo
r ch
ildre
n ag
ing
betw
een
2-5,
gui
ded
with
th
erap
ists
. It i
s vis
ible
from
the
squa
re, s
o th
e pa
rent
s can
w
atch
thei
r chi
ldre
n.
Cond
itio
n: T
he r
oom
is
only
acc
essi
ble
from
the
pla
y th
erap
y un
it an
d it
is d
esire
d to
hav
e a
free
ent
ranc
e fo
r th
e ne
w b
uild
ing.
Par
ents
are
lack
ing
priv
ate
spac
e w
hen
they
acc
ompa
ny th
eir c
hild
ren
for w
hole
day
.
Med
ical
pla
y [s
jukh
usle
k]Fu
ncti
on: T
he th
erap
ists
hel
p ch
ildre
n to
lear
n ho
spita
lw
ithin
a g
ame
to m
ake
them
fee
l co
mfo
rtab
le a
bout
ho
spita
l.
Cond
itio
n: It
is n
ow a
cces
sed
thro
ugh
sew
ing
room
, but
need
s to
be
in a
qui
et z
one,
sin
ce it
ser
ves
for a
sen
sitiv
eac
tivity
and
the
y sh
ould
n’t
be d
istr
acte
d to
hav
e fu
ll at
tent
ion.
5.2.
2 Ex
istin
g Bu
ildin
g
5.2.
2.1 A
naly
sis
of s
pace
s
5.2
Des
ign
App
roac
hes
for P
lay-
ther
apy
Dep
artm
ent
85.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
Sens
es ro
om
Func
tion
: A s
peci
al r
oom
with
out
dayl
ight
, lit
by s
peci
al
light
sys
tem
s, c
hang
ing
colo
r an
d br
ight
ness
. Onl
y us
ed
with
a th
erap
ist,
and
boo
ked
for c
erta
in h
ours
.
Cond
itio
n: S
ense
s th
erap
y is
a v
ery
conc
entr
ated
and
se
nsiti
ve
ther
apy.
W
hen
they
le
ave
the
room
, th
ey
shou
ld s
tay
calm
to p
rese
rve
the
effec
t of t
he tr
eatm
ent.
H
owev
er w
hen
they
com
e ac
ross
to
soun
d an
d cr
owd
in t
he m
ain
squa
re, t
hey
get
anxi
ous,
whi
ch r
educ
es t
he
effec
t of t
reat
men
t.
Libr
ary
Func
tion
: Ver
y op
en a
nd fl
exib
le ro
om, w
here
chi
ldre
nlo
an b
ooks
or p
lays
for t
he m
ultip
urpo
se ro
om.
Cond
itio
n:
The
disa
dvan
tage
is
it
is
disc
onne
cted
co
mm
on u
nits
, mor
e co
nnec
ting
to t
he t
eena
ger’
s un
it,
whi
ch k
eeps
it h
idde
n fr
om c
hild
ren
whe
n th
ey c
ircul
ate
by th
emse
lves
.
Clas
sroo
m
Func
tion
: For
chi
ldre
n to
kee
p up
with
the
less
ons
with
gu
idan
ce o
f a
teac
her
in c
omm
unic
atio
n w
ith h
ome
scho
ol. U
sual
ly 3
chi
ldre
n at
the
sam
e tim
e, m
axim
um 5
ch
ildre
n at
the
sam
e tim
e.
Cond
itio
n: It
is q
uite
far a
way
from
libra
ry, h
ard
for c
hild
ren
to d
isco
ver w
ithou
t bei
ng g
uide
d by
thei
r tea
cher
s.
Mus
ic s
tudi
o
Func
tion
: A st
udio
to e
xper
ienc
e m
usic
, in
a fu
lly e
quip
ped
room
.
Cond
itio
n: H
as a
dou
ble
entr
ance
but
the
doo
r is
usu
ally
ke
pt o
pen,
to le
t the
sou
nd b
e he
ard,
to a
ttra
ct c
hild
ren’
s at
tent
ion.
Teen
ager
s’ ro
om
Cond
itio
n: A
sty
lish
room
, re
ferr
ing
to t
eena
gers
and
yo
ung
patie
nts
up t
o ag
e 25
. Th
ey c
an g
athe
r, p
lay
a ga
me
or w
atch
a m
ovie
with
the
ir fr
iend
s fr
om o
utsi
de
in th
is ro
om.
Cond
itio
n: F
luen
t con
nect
ion
betw
een
pool
room
and
the
livin
g ro
om p
rovi
de a
priv
ate
faci
lity
for t
he te
enag
ers.
Pool
room
Func
tion
: A
cces
sed
from
tee
nage
rs’
unit,
poo
l ro
om
whi
ch a
lso
host
s m
usic
libr
ary.
Cond
itio
n: T
eena
ger’
s un
it se
rves
as
a so
cial
uni
t, w
ithou
t th
e se
nse
of a
hos
pita
l, gi
ving
the
teen
ager
s po
ssib
ility
to
keep
on
thei
r usu
al a
ctiv
ities
.
5.2.
2 Ex
istin
g Bu
ildin
g
5.2.
2.1 A
naly
sis
of s
pace
s
5.2
Des
ign
App
roac
hes
for P
lay-
ther
apy
Dep
artm
ent
95.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
Wha
t sho
uld
be k
ept?
.Inte
rcon
nect
ion
of th
e ro
oms
The
child
ren
can
see
or h
ear
the
activ
ities
in t
he o
ther
ro
om,
and
the
plan
ning
allo
ws
them
to
mov
e fr
eely
be
twee
n ro
oms.
Sofia
Mån
sson
: Th
e lib
rary
is n
ot t
he t
radi
tiona
l lib
rary
fo
rm w
here
you
are
not
allo
wed
to
talk
. Her
e w
e do
n’t
wan
t si
lenc
e, w
e w
ant
them
to
mov
e, t
o ta
lk, t
o he
ar t
o ex
perie
nce
othe
r act
iviti
es.
.Vis
ual c
onta
ctTh
e ro
oms
are
mos
tly v
isib
le f
rom
the
cor
ridor
s, w
hich
en
cour
ages
chi
ldre
n to
join
.
S.M
: Vis
ual c
onta
ct is
als
o im
port
ant
for
child
ren
com
ing
with
the
ir pa
rent
s. T
hey
feel
sec
ure
seei
ng t
heir
fam
ily.
We
also
enc
oura
ge t
hem
to
join
act
iviti
es w
ith t
heir
sibl
ings
to
mak
e th
em f
eel t
hey
are
a pa
rt o
f un
its, t
hey
have
an
iden
tity.
.Squ
are
S.M
: The
squ
are
is w
here
we
gath
er, a
nd w
here
par
ents
so
met
imes
wai
t al
l da
y lo
ng f
or t
heir
child
ren
so i
t is
im
port
ant t
o off
er th
em s
ome
priv
acy.
Func
tion
s to
be
adde
d or
cha
nged
:
.Whi
le t
he r
oom
s op
en u
p to
the
mai
n sq
uare
, it
give
s m
ore
inte
ract
ion,
but
cer
tain
fun
ctio
ns s
uch
as s
ense
s th
erap
y,
requ
ire a
qui
et e
ntra
nce.
S.M
: It
is
a ve
ry q
uiet
and
sen
sitiv
e ac
tivity
, an
d si
nce
it is
ope
ned
to t
he s
quar
e in
the
cur
rent
con
ditio
n, t
he
child
ren
get d
istr
acte
d an
d af
raid
whe
n th
ey c
ome
acro
ss
to a
cro
wde
d sp
ace.
.Pla
y-th
erap
y re
fers
to
diff
eren
t ag
es v
aryi
ng b
etw
een
0-25
, and
ther
e ar
e ce
rtai
n ro
oms
serv
ing
to o
nly
one
age
grou
p. F
unct
ions
rel
ated
with
the
m c
an b
e gr
oupe
d in
di
ffer
ent s
ectio
ns.
.Flo
or p
lan
enha
nces
flue
ncy
and
open
ness
bet
wee
n fu
nctio
ns
but
it is
la
ckin
g cl
earn
ess,
w
hich
br
ings
co
nfus
ion
in o
rient
atio
n.
.Roo
m f
or c
hild
ren
open
to
infe
ctio
ns: T
hey
cann
ot u
se
the
play
the
rapy
whe
n th
e ot
her
child
ren
do, b
ecau
se o
f in
fect
ion
risk.
The
y ca
n on
ly c
ome
afte
r 4
o’cl
ock,
whe
n th
e ot
her
child
ren
have
alre
ady
left
, an
d th
e ac
tiviti
es
have
end
ed.
For
exam
ple
if a
thea
ter
visi
ts,
it is
at
day
time,
and
they
mis
s it.
Inte
rvie
w w
ith
play
-the
rapi
st S
ofia
Mån
sson
5.2.
2 Ex
istin
g Bu
ildin
g
5.2.
2.2
Com
men
ts a
nd c
ritiq
ues
5.2
Des
ign
App
roac
hes
for P
lay-
ther
apy
Dep
artm
ent
105.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
5.2.
3 Li
nkin
g to
Neu
rosc
ienc
e
Wha
t is
impo
rtan
t in
Play
The
rapy
?
Ther
apy
units
ref
er t
o a
wid
e va
riety
of
child
ren
from
di
ffer
ent a
ge g
roup
s, o
r with
var
ious
illn
esse
s and
inju
ries.
In
a w
ider
per
spec
tive,
wha
t un
ites
them
is t
hat
they
are
no
t hea
lthy,
and
the
play
ther
apy
unit
aim
s to
enc
oura
ge
them
to e
njoy
thei
r tim
e, a
s if
they
wer
e he
alth
y.
Child
ren
in p
lay
ther
apy
join
the
act
iviti
es a
s a
part
of
thei
r ho
spita
l st
ay,
or a
s a
free
vis
it w
hen
they
com
e fo
r a
regu
lar
day
visi
t. In
add
ition
to
activ
ities
gui
ded
by
ther
apis
ts, p
aren
ts a
nd s
iblin
gs a
re a
lso
invo
lved
in t
he
proc
ess,
allo
win
g ch
ildre
n to
spe
nd m
ore
time
with
thei
r fa
mili
es, g
ives
them
indi
vidu
al v
alue
.
Diff
erin
g fr
om t
heir
daily
rou
tine,
her
e th
ey h
ave
the
free
dom
to
choo
se t
he a
ctiv
ities
the
y w
ant
to jo
in a
nd
lear
n ne
w s
kills
. In
othe
r w
ords
, the
y ar
e en
cour
aged
to
expl
ore,
lear
n, d
isco
ver,
soci
aliz
e w
hile
they
are
dis
trac
ted
from
thei
r pai
n.
Way
find
ing
Priv
acy
Stim
uli
Conc
entr
atio
n
Mot
orab
ility
Stre
ssM
emor
y
Rela
xati
onEnri
ched
env
iron
men
t
Visu
al c
onne
ctio
n
Ori
enta
tion
Circ
ulat
ion
Self
est
eem
(-)
(+)
(-)
(+)
(+)
5.2
Des
ign
App
roac
hes
for P
lay-
ther
apy
Dep
artm
ent
115.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
Stre
ss- W
ay fi
ndin
g
As
the
ther
apy
unit
enco
urag
es t
he c
hild
ren
to d
ecid
e th
e ac
tiviti
es t
hey
wan
t, I
t is
impo
rtan
t to
ena
ble
them
to
ach
ieve
thi
ngs
on t
heir
own.
Jo
inin
g th
e ac
tiviti
es
in t
he u
nit,
chi
ldre
n sh
ould
be
capa
ble
to fi
nd t
heir
own
rout
e, n
avig
ate
to d
isco
ver,
with
out
stre
ss a
nd
hesi
tatin
g of
“W
ill I
be a
ble
to fi
nd it
? Wha
t if
I get
lost
?”
The
desi
gn in
terv
entio
n ca
n st
art
with
“w
ay-fi
ndin
g” t
o en
able
the
child
to fi
nd h
is/h
er o
wn
rout
e in
the
build
ing.
W
hen
child
ren
are
unhe
alth
y, t
hey
have
diffi
culti
es i
n re
mem
berin
g. T
here
fore
the
pla
nnin
g sh
ould
ref
er t
o th
eir
mem
orie
s, e
asy
to u
nder
stan
d, a
nd r
emar
kabl
e so
th
ey c
an re
call
and
mak
e co
nnec
tions
.
Conc
entr
atio
n - D
istr
acti
on
Play
ther
apy
is n
ot o
nly
focu
sed
on h
avin
g a
fun
time,
the
actu
al a
im is
to
help
the
m r
etrie
ve t
heir
abili
ties,
or
to
teac
h th
em n
ew s
kills
eith
er w
ith le
sson
s or
wor
ksho
ps.
Som
e ch
ildre
n du
e to
the
ir ag
e, o
r du
e to
inju
ries
have
di
fficu
lties
to
conc
entr
ate.
Spa
ces
for
lear
ning
can
be
desi
gned
to
have
min
imiz
ed d
istr
actio
ns, s
uch
as p
aste
l co
lors
, cal
m im
ages
, or a
view
to a
quie
t par
t. Lo
wer
ceili
ngs
and
smal
ler d
ivis
ions
pro
ved
to h
elp
conc
entr
atio
n, w
hich
ca
n be
sup
port
ed w
ith e
ffici
ent
light
ing,
and
aco
ustic
so
lutio
ns fo
r spe
ech
clar
ity.
5.2.
3 Li
nkin
g to
Neu
rosc
ienc
e
Stim
uli -
Enr
iche
d En
viro
nmen
t
All
activ
ities
in p
lay
ther
apie
s ar
e to
stim
ulat
e th
e br
ain
in
diff
eren
t w
ays:
one
ref
ers
to t
hink
ing,
one
ref
ers
to t
he
sens
es o
r on
e re
fers
to
mot
or a
bilit
y.
The
arch
itect
ural
se
ttin
g ca
n al
so b
e de
sign
ed t
o st
imul
ate
the
chi
ldre
n’s
brai
ns,
givi
ng l
inks
to
diff
eren
t ac
tiviti
es,
with
a v
isua
l im
puls
e an
d cu
riosi
ty. N
atur
e, a
s a
very
eff
ectiv
e st
imul
i , c
an b
e in
volv
ed in
the
plan
ning
con
cept
with
vis
ual a
nd/
or p
hysi
cal c
onne
ctio
ns.
Anx
iety
– P
riva
cy
Child
ren
do n
ot fe
el s
tres
sed
to fi
nd th
eir d
irect
ion
whe
n th
ey n
avig
ate
in a
bui
ldin
g w
ith c
lear
orie
ntat
ion.
Priv
acy
also
has
a s
imila
r eff
ect
as w
ay-fi
ndin
g. W
ith s
ense
of
priv
acy,
a c
hild
feel
s m
ore
secu
re, a
nd e
ven
confi
dent
. A
child
try
ing
to le
arn
or e
xerc
ise
wou
ld f
eel a
nxio
us a
nd
unco
mfo
rtab
le w
hen
he/s
he fe
els o
ther
s wat
chin
g, w
hich
ca
n al
so c
ause
dis
cour
age
and
dist
ract
ion.
The
leve
l of
stre
ss is
ver
y im
port
ant
in a
hea
ling
proc
ess,
and
sin
ce
child
ren
are
cont
inuo
usly
dev
elop
ing,
it m
ight
hav
e m
ore
pow
erfu
l eff
ects
.
5.2
Des
ign
App
roac
hes
for P
lay-
ther
apy
Dep
artm
ent
125.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
5.2.
4 Re
fere
nces
for P
lann
ing
and
func
tions
The
habi
litat
ion
cent
er i
s ou
tsid
e ce
nter
, aw
ay f
rom
de
nsity
, clo
ser t
o na
ture
. The
nei
ghbo
urho
od h
osts
oth
er
reha
bilit
atio
n ce
nter
s as
wel
l.
The
build
ing
is c
onst
ruct
ed i
n 19
80s,
to
serv
e as
a
habi
litat
ion
cent
er
from
th
e be
ginn
ing,
sa
ys
Kate
H
imm
elm
ann,
chi
ldre
n’s
neur
olog
ist.
The
siz
e of
the
bu
ildin
g is
allo
win
g ge
nero
us s
pace
s fo
r all
the
func
tions
w
ithin
the
bui
ldin
g. I
t ha
s a
capa
city
to
host
10
child
ren
for o
vern
ight
sta
ys, a
nd u
sual
ly 5
(or m
axim
um u
p to
10)
child
ren
for d
ay v
isits
.
The
plan
ning
allo
ws
abun
dant
lig
ht i
nto
the
com
mon
sp
aces
and
cor
ridor
s, a
nd e
nric
hed
with
vie
ws
to n
atur
e.
On
the
grou
nd fl
oor,
the
re i
s an
ext
rem
ely
wid
e pl
ay
room
, whi
ch a
llow
s ch
ildre
n to
mov
e fr
eely
whe
ther
on
foot
or
on w
heel
chai
r, a
nd t
hey
can
even
rid
e a
bicy
cle.
Th
e si
ze a
nd fl
uenc
y of
the
room
enc
oura
ges t
he c
hild
ren
to d
evel
op t
heir
mot
or-a
bilit
ies
and
allo
ws
doct
ors
to
mon
itor
thei
r pr
oces
s. T
he t
hera
py r
oom
s ar
e ac
cess
ed
from
the
mai
n pl
ay h
all.
Alth
ough
acc
ess
to t
he t
hera
py r
oom
s is
not
cle
ar
with
out
the
tabl
es o
n th
e do
ors,
the
sym
bol
lang
uage
an
d de
scrip
tive
imag
es m
akes
them
cle
ar fo
r all
child
ren.
It
is a
n im
port
ant a
ppro
ach,
giv
ing
cour
age
to c
hild
ren
to
prom
ote
thei
r abi
litie
s.
Regi
on’s
Hab
ilita
tion
Uni
t of D
rott
ning
Silv
ias
Child
ren’
s an
d Yo
uth
hosp
ital
His
inge
n
Visu
al c
onta
ct v
s. P
riva
cy:
Whe
n it
com
es t
o vi
sual
con
tact
, th
e ha
bilit
atio
n un
it di
ffer
s fr
om t
he p
lay
ther
apy
unit
in Ö
stra
. H
ere,
the
th
erap
ies
are
sche
dule
d in
divi
dual
ly fo
r eve
ry p
atie
nt, s
o jo
inin
g to
the
the
rapi
es s
pont
aneo
usly
is
not
very
like
ly.
Visu
al c
onta
ct i
s re
plac
ed w
ith p
rivac
y co
ncer
n he
re,
sinc
e ch
ildre
n m
ight
fee
l anx
ious
or
stre
ssed
whe
n th
ey
feel
that
they
are
wat
ched
.
Priv
acy
for a
ll:
Patie
nts’
room
are
one
floo
r up,
sepa
rate
from
ther
apis
ts
allo
win
g th
em t
o ha
ve it
like
the
ir pr
ivat
e ho
me.
Par
ents
ca
n ha
ve fr
ee ti
me
with
thei
r chi
ldre
n he
re, t
hey
can
also
us
e th
eir
own
kitc
hen
on t
his
floor
. Pe
rson
aliz
atio
n an
d pr
ivac
y su
ppor
t the
ir co
mfo
rt o
f sta
y.
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
13
5.3
Des
ign
Proc
ess
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
14
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
5.2.
1 Site
Göt
ebor
g
Öst
ra S
jukh
uset
5.3
Des
ign
Proc
ess
15
Swed
en >
Vas
tra
Göt
alan
dG
öteb
org
Exis
tinag
con
ditio
n of
the
site
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
5.3
Des
ign
Proc
ess
5.3.
1 Site
5.3.
1.1 C
urre
nt S
ituat
ion
& F
utur
e pl
an 16
Futu
re d
evel
opm
ents
and
pro
pose
d ho
spita
lPl
an 1/
2000
Dro
ttni
ng S
ilvia
s ba
rn o
ch
ungd
omss
jukh
us
Psyc
hiat
ry C
linic
The
site
The
site
is lo
cate
d in
Öst
ra S
jukh
uset
hos
pita
l zon
e, w
ith
an e
xten
ded
area
of h
ealth
care
bui
ldin
gs, s
urro
unde
d by
gr
een
area
s.
The
site
for t
he c
hild
ren’
s ho
spita
l has
gre
en z
ones
in th
e so
uth.
The
ext
ensi
on b
uild
ing
will
be
loca
ted
on t
he s
ite
behi
nd th
e ex
istin
g ho
spita
l, w
here
they
hav
e ca
r par
king
ar
ea n
ow.
The
new
app
roac
h te
nds
to in
clud
e m
ore
gree
n on
the
si
te w
ith in
ner c
ourt
yard
and
out
er y
ards
s, a
nd b
y le
ttin
g th
e bu
ildin
g op
en u
p it
self
to th
e su
rrou
ndin
gs.
[ ]
Exte
nsio
n Bu
ildin
gof
Hos
pita
l for
Chi
ldre
n an
d A
dole
scen
tspr
opos
ed b
y W
hite
Arc
hite
cts
Play
The
rapy
(o
n th
e gr
ound
floo
r)m
y pr
opos
al re
late
d w
ith m
y re
sear
ch
Futu
re B
uild
ing
for A
dult
Surg
ery
(Bui
ldin
g si
ze is
not
cer
tain
yet
)
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
5.3
Des
ign
Proc
ess
5.3.
2 Pr
opos
ed B
uild
ing 17
Dis
trib
utio
n of
the
faci
litie
sPl
ay t
hera
py u
nit
has
man
y fa
cilit
ies
and
refe
rs t
o al
l ch
ildre
n w
ho a
re tr
eate
d in
the
hosp
ital,
whi
ch m
eans
they
ha
ve a
larg
e va
riety
of a
ge g
roup
and
hea
lth c
ondi
tion.
Alth
ough
all
child
ren
are
wel
com
e to
par
ticip
ate
in a
ny
activ
ity,
the
faci
litie
s ar
e gr
oupe
d ac
cord
ing
to r
elat
ed
activ
ities
or t
arge
t gro
up.
Her
e is
the
sim
plifi
ed p
rogr
am fr
om h
ospi
tal:
Squa
re [T
orge
t]: F
or g
athe
ring,
fika
, lun
ch, a
cces
sibl
e fo
r
gurn
ey, v
isua
l con
tact
to n
urse
ry a
nd li
brar
y
Nur
sery
[Sm
åbar
nsru
m]:
pla
ys w
ith le
gos,
dol
lhou
se,
sa
nd ta
bles
, vis
ual c
onta
ct fo
r wai
ting
pare
nts
Mul
ti-fu
nctio
nal r
oom
[Allr
um]:
Tab
le g
ames
, the
ater
,
tabl
e te
nnis
, mov
ie s
cree
ning
, dan
ce
room
hei
ght i
s im
port
ant
Wor
ksho
p [s
nick
eri]:
cer
amic
s, w
oods
, pai
ntin
g, p
last
er
Infe
ctio
ns s
afe
room
[inf
ektio
nskä
nslig
as ru
m]:
sepa
rate
ent
ranc
e
Sens
es ro
om [S
inne
nas
rum
]:Bl
ack
room
[sva
rta
rum
met
] res
t and
mas
sage
,
no d
aylig
ht
Hos
pita
l sim
ulat
ion
r.[s
jukh
usle
k]: p
layi
ng w
ith m
edic
al
toys
, im
itatin
g ho
spita
l env
ironm
ent
Teen
ager
s’s
room
[to
nårs
rum
]: c
ompu
ter,
vid
eo g
ames
, m
usic
, gat
herin
g w
ith fr
iend
s
Libr
ary
[bib
liote
ket]
: for
loan
ing
book
s, m
ovie
s, m
usic
,
com
pute
r gam
es, v
isib
ility
from
circ
ulat
ion
hall,
a
sep
arat
e en
tran
ce
Stud
y Pl
ay [B
iblio
Lek]
Teen
Pla
y [T
onår
sLek
]
Livi
ng S
quar
e [V
arda
gsto
rget
]
Mul
ti P
lay
[Allr
umsL
ek]
Sile
nt S
quar
e [T
ystt
orge
t]
Entr
ance
Hal
l [En
tré]
teen
ager
s‛ ro
om
pool
roo
m
mus
ic s
tudi
o
Libr
ary
nurs
ery
clas
sroo
m
grou
p ro
om
cosy
roo
m
expe
diti
onwo
rksh
op
infe
ctio
n sa
fe
room
blac
k ro
omse
nses
roo
m
hosp
ital
si
mul
atio
n p.
mul
ti f
unct
iona
l ro
om
teac
her‛s
exp
edit
ion
Gro
und
leve
l:Pl
ay th
erap
y de
part
men
t
phys
ioth
erap
y de
part
men
t
hospital services
hospital services
occu
pati
onal
ther
apy
com
mon
: ent
ranc
e, d
aily
squ
are,
nur
sery
, the
rapi
sts’
ex
pedi
tion,
cos
y ro
om, s
ervi
ces
crea
tive
: mul
ti pu
rpos
e ro
om, a
teile
r
sile
nt:
sens
es ro
om, b
lack
room
, sile
nt s
quar
e
teen
ager
s: p
ool a
nd le
isur
e ro
om, s
ewin
g ro
om
stud
y: li
brar
y, c
lass
rooo
m, g
roup
stu
dy,
teac
her’s
exp
editi
on
N
existing building
oute
r yar
d (o
pen
play
grou
nd)
inne
r yar
d
185.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
0. L
evel
Plan
1/50
0
play
ther
apy
depa
rtm
ent
[Lek
tera
pi]
Dis
trib
utio
n of
zon
es a
nd o
pen
spac
es
The
ther
apy
depa
rtm
ents
are
loca
ted
on th
e gr
ound
floo
r of
the
new
ext
ensi
on b
uild
ing.
The
y bo
th s
erve
for
in-
patie
nts
and
out-
patie
nts.
Acc
ess
to th
e Pl
ay T
hera
py:
Entr
ance
for
the
pla
y th
erap
y is
on
the
grou
nd l
evel
op
enin
g to
the
cou
rtya
rd, w
hich
is c
over
ed w
ith a
gla
ss
roof
pro
vidi
ng a
wea
ther
pro
of i
nner
gar
den.
Pat
ient
s ar
rive
to th
e th
erap
y de
part
men
ts e
ither
from
out
side
or
the
mai
n ho
spita
l.
. Vis
itor
s fr
om o
utsi
de: T
hey
pass
thr
ough
the
pas
sage
fr
om th
e m
ain
hosp
ital.
. Vis
itor
s fr
om h
ospi
tal:
They
reac
h th
e de
part
men
t with
el
evat
ors
to th
e in
ner y
ard.
Dir
ecti
ng to
ent
ranc
e:
Whe
n th
e pa
tient
s fr
om o
utsi
de a
rriv
e, a
fter
the
y ar
rive
to th
e m
ain
build
ing,
they
pas
s th
e m
ain
entr
ance
for t
he
exte
nsio
n an
d pa
ss t
he fi
rst
build
ing
(A)
to a
rriv
e to
the
th
erap
y de
part
men
ts.
A s
trai
ght
pass
age
lead
s th
e pe
dest
rians
with
a s
trai
ght
dire
ctio
n, w
hich
blo
cks t
he ch
oice
to g
o to
oth
er d
irect
ions
. Fo
r phy
siot
hera
py a
nd o
ccup
atio
nal t
hera
py it
is th
e rig
ht
way
to g
o st
raig
ht, b
ut fo
r the
pla
y th
erap
y th
e en
tran
ce
is f
rom
the
cen
ter
of t
he c
ourt
yard
, the
refo
re t
hey
have
to
find
the
entr
ance
with
thei
r ow
n ob
serv
atio
n.
Dis
turb
ing
the
para
llel w
alls
of t
he p
assa
ge in
to a
n op
en
path
will
giv
e a
wid
er v
iew
to
the
inne
r yar
d. O
rient
atio
n of
the
inne
r yar
d ca
n be
sup
port
ed w
ith p
aths
and
col
ors.
To
mak
e th
e en
tran
ces
visi
ble
from
diff
eren
t an
gles
, the
en
tran
ce i
s pu
lled
out
whi
ch a
lso
brin
gs i
n m
ore
light
fr
om g
laze
d w
alls
.
Ther
e is
an
addi
tiona
l en
tran
ce f
or t
he c
hild
ren
with
in
fect
ions
. Th
eir
entr
ance
is
also
pul
led
out
lett
ing
a st
raig
ht e
ntra
nce
whe
n th
ey a
rriv
e w
ith e
leva
tors
fro
m
othe
r floo
rs.
5.3.
3 Pl
anni
ng
5.3.
3.1 W
ayfin
ding
> E
ntra
nce
libra
ry
E
infe
ctio
n r.
phys
ioth
erap
ym
ain
E.
?
?
?
?
!
?
(b)
A
B
C
A
B
C
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
19
5.3
Des
ign
Proc
ess
5.3.
3 Pl
anni
ng
5.3.
3.1 W
ayfin
ding
> O
rient
atio
n 205.
Desig
n ap
plica
tions
with
Neu
rosc
ience
+ Ar
chite
ctur
e
Corr
idor
Vs
Squa
res
Child
ren
have
wea
ker s
ense
of o
rient
atio
n co
mpa
red
to a
dults
. Alth
ough
st
raig
ht c
orrid
ors
mig
ht b
e fu
nctio
nal f
or c
ircul
atio
n in
a h
ospi
tal,
for
a de
part
men
t w
here
chi
ldre
n ar
e ex
pect
ed t
o ci
rcul
ate
by t
hem
selv
es,
the
plan
nee
ds to
be
mor
e ea
sily
per
ceiv
ed.
The
stra
ight
cor
ridor
s ar
e br
oken
into
squ
ares
and
sho
rter
cor
ridor
s co
nnec
ting
them
, to
incr
ease
the
var
iety
of
the
spac
es, a
nd m
ake
an
easi
er o
rient
atio
n. E
very
squ
are
host
a d
iffer
ent g
roup
of a
ctiv
ities
, and
ea
ch h
as a
diff
eren
t con
cept
whi
ch g
ives
an
indi
vidu
al id
entit
y.
Mem
ory
and
Plac
e
Ano
ther
aim
of
the
“squ
are
plan
ning
” is
to
enha
nce
mem
ory,
m
akin
g th
e pl
aces
ea
sily
re
cogn
ized
an
d m
emor
able
for
the
child
ren.
It is
esp
ecia
lly im
port
ant
for
child
ren
to f
eel e
ncou
rage
d to
find
an
activ
ity t
hey
wan
t to
join
, with
out h
esita
ting
abou
t the
dire
ctio
n an
d w
ithou
t as
king
hel
p.
The
conc
ept
of
each
squ
are
and
its r
elat
ed a
ctiv
ities
is
supp
orte
d by
a co
lor p
alet
te, a
geo
met
ric p
atte
rn (w
indo
w
fram
e or
sha
pe o
f fur
nitu
re) a
nd a
land
mar
k.
Her
e I
sugg
este
d th
e co
ncep
t as
sky
, w
ith s
un,
moo
n an
d st
ar a
s la
ndm
arks
for
the
squ
ares
, and
usi
ng r
elat
ed
text
iles
and
deco
rativ
e el
emen
ts (t
oys,
ligh
ts, g
low
s..).
Land
mar
ks
Land
mar
ks a
re v
isib
le f
rom
the
oth
er p
arts
of
the
floor
and
hav
e an
eas
ily r
ecog
niza
ble
sign
for
the
sq
uare
. It
can
be
easi
er f
or t
he c
hild
ren
to r
ecal
l th
e sq
uare
s us
ing
the
land
mar
ks t
hey
see,
or
to
rem
embe
r the
dire
ctio
ns b
y th
e ob
ject
s th
ere.
Entr
ance
an
d te
enag
ers
part
: St
ar
(wel
com
e,
enco
urag
e)Li
ving
squ
are
and
mul
ti pl
ay:
Sun
(insp
iratio
n,
crea
tivity
)Si
lent
squ
are:
Moo
n (c
alm
, rel
axed
)
5.3
Des
ign
Proc
ess
5.3.
3 Pl
anni
ng
5.3.
3.1 W
ayfin
ding
> C
ircul
atio
nM
otor
ski
lls
The
heal
th c
ondi
tion
of t
he c
hild
ren
in p
lay
ther
apy
are
varie
d. P
aul
Uve
bran
t, n
euro
logi
st i
n ch
ildre
n’s
hosp
ital,
emph
asiz
es th
e im
pota
nce
of u
sing
mot
or s
kills
in a
a p
hysi
cal a
ctiv
ity to
impr
ove
cogn
itive
abi
litie
s.
In D
rott
ning
Silv
ia’s
Chi
ldre
n re
habi
litat
ion,
the
build
ing
allo
ws
very
larg
e sp
aces
for c
hild
ren
to p
erfo
rm th
eir a
bilit
ies
for w
alki
ng, r
unni
ng a
nd e
ven
ridin
g a
bicy
cle.
The
y ar
e ha
ving
pos
sibi
lity
to m
ove
free
ly in
spa
ces
that
they
can
’t h
ave
in th
eir h
omes
or h
ospi
tal fl
oors
. Con
side
ring
this
app
roac
h, I
plan
ned
the
floor
to g
ive
roun
d ci
rcul
atio
ns. C
hild
ren
can
follo
w e
ither
a re
gula
r pat
h to
reac
h th
eir a
ctiv
ities
, or t
hey
can
choo
se to
alte
rnat
e th
eir m
ovem
ent,
or j
ust p
lay.
Th
is p
lann
ing
also
allo
ws
mor
e da
ylig
ht to
the
com
mon
spa
ces.
Free
mov
eR
egul
ar m
ove
Floo
r co
lor
Circ
ulat
ion
in t
he h
alls
can
be
supp
orte
d by
col
or o
ptio
ns.
Eith
er p
rom
otin
g na
ture
and
acc
ess
to t
he g
arde
ns,
or
gath
erin
g th
e ch
ildre
n in
mai
n (li
ving
) squ
are.
The
col
or li
nes
lead
to th
e co
ncep
tual
squ
ares
/sec
tions
, for
exa
mpl
e bl
ue
lead
s to
stu
dy z
one,
pur
ple
lead
s to
teen
ager
s zo
ne.
*It
is a
n ea
rly p
ropo
sal t
o su
ppor
t ci
rcul
atio
n. In
ord
er t
o m
ake
a pr
oper
way
findi
ng g
raph
ics,
it r
equi
res
an e
xten
ded
rese
arch
bas
ed o
n si
gns,
dia
gram
s, a
nd a
wel
l wor
ked
met
hod
of a
pply
ing
the
colo
r pat
hs.
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
21
Libr
ary
Teac
hers
’ exp
editi
on
Clas
sroo
m
Gro
up ro
om
Sew
ing
room
Billa
rd ro
om
Teen
ager
s’ ro
om
Mus
ic s
tudi
o
Nur
sery
Livi
ng s
quar
e
Cosy
rooo
m
Mul
ti pu
rpos
e ro
om
Infe
ctio
n ro
om
Wor
ksho
p
Sens
es ro
om
Blac
k ro
om
Med
ical
Pla
y
Serv
ices
55 m
2
14 m
2
16 m
2
14 m
2
20 m
2
12 m
2
18 m
2
40 m
2
57 m
2
16 m
2
65 m
2
22 m
2
50 m
2
22 m
2
12 m
2
20 m
2
Stud
y Pl
ay [B
iblio
Lek]
.Acc
ess
from
bot
h in
side
and
out
side
, en
ablin
g fle
xibl
e w
orki
ng h
ours
. Cla
ssro
om a
nd g
roup
room
can
uni
te w
ith
adju
stab
le s
eper
atio
n
Teen
Pla
y [T
onår
sLek
]
Livi
ng S
quar
e [V
arda
gsto
rget
].O
pens
to
the
gard
en w
ith a
bund
ant
dayl
ight
.Cor
ner s
eatin
g fo
r nur
sery
form
s its
ow
n sq
uare
giv
ing
priv
acy
for p
aren
ts w
hile
stil
l co
nnec
ted
to th
e m
ain
squa
re
Mul
ti P
lay
[Allr
umsL
ek]
.Mul
tipur
pose
room
and
wor
ksho
p un
ites
with
adj
usta
ble
wal
ls, s
ocia
lly c
onne
ctin
g ch
ildre
n pa
rtic
ipat
ing
in d
iffer
ent a
ctiv
ities
.Roo
m fo
r chi
ldre
n op
en to
infe
ctio
ns h
ave
visu
al a
nd a
udito
rial c
onne
ctio
ns, a
llow
ing
all c
hild
ren
have
equ
al p
artic
ipat
ion
Sile
nt S
quar
e [T
ystt
orge
t].S
ince
sile
nt z
one
incl
udes
ther
apie
s of
re
laxa
tion,
it i
s pl
aced
apa
rt fr
om m
ain
squa
res
.Acc
ess
to th
e ga
rden
, g
ivin
g a
natu
ral
sigh
t to
the
squa
re
Serv
ices
.incl
udes
exp
editi
on ro
om, s
tora
ges,
sta
ff
room
s an
d to
ilets
11 m
2
.Tee
nage
r sec
tion
has
mor
e pr
ivac
y by
ha
ving
an
inte
rnal
ent
ranc
e ha
ll fo
r fac
ilitie
s.V
isua
l and
phy
sica
l con
nect
ion
betw
een
faci
litie
s.M
usic
stu
dio
is o
pen
to u
se fo
r all
the
child
ren,
and
con
nect
s to
ent
ranc
e ha
ll w
ith
a w
indo
w, a
ttra
ctin
g at
tent
ion
with
sou
nd
MA
IN
ENTR
AN
CE
Libr
ary
Entr
ance
inf.
sens
. en
tran
ce
OU
TER
YARD
INN
ER Y
ARD
<- E
ntra
nce
to P
hysi
othe
rapy
elev
ator
s fo
r in
-pat
ient
ro
oms
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
22
play
ther
apy
depa
rtm
ent
[Lek
tera
pi]
Plan
1/20
0
5.3
Des
ign
Proc
ess
5.3.
3 Pl
anni
ng
5.3.
3.2
Enric
hmen
t > V
olum
es
sq
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ance
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����
���
����
����
�
staf
f
����
����
���
�
���
�����
� ��
����
�
������
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squa
re
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sens
es
���
silen
t
squa
re
staf
f��
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�
Sect
ion
A A
Sect
ion
B-B
a
a
b
b
Volu
mes
Act
iviti
es in
the
pla
y th
erap
y re
fer
to d
iffer
ent
abili
ties
and
ther
efor
e re
quire
diff
eren
t en
viro
nmen
ts. T
he w
ay h
ow
child
ren
perc
eive
the
envi
ronm
ents
aff
ects
how
they
beh
ave,
con
sequ
ently
it a
ffec
ts th
e ta
sks
they
are
per
form
ing.
In
the
solu
tion,
vol
umes
are
ada
pted
to th
e ty
pe o
f the
act
iviti
es th
at th
e ro
oms
are
host
ing,
by
cons
ider
ing
the
heig
ht o
f th
e ce
iling
, floo
ring,
win
dow
s, li
ghtin
g an
d co
nnec
tions
.
. Act
iviti
es in
volv
ing
crea
tivity
, abs
trac
t thi
nkin
g: F
or e
xam
ple
mul
ti pl
ay (w
hich
hos
ts d
iffer
ent a
ctiv
ities
: th
eate
r, ta
ble
tenn
is, v
ideo
gam
es...
) has
an
open
vis
ual c
onta
ct to
out
side
, and
hav
e hi
gher
cei
lings
.
.Act
iviti
es re
quiri
ng c
once
ntra
tion:
Stu
dy s
ectio
n ha
s lo
wer
cei
lings
and
hav
e a
clos
ed e
ntra
nce
(not
squ
are)
Wor
ksho
p an
d se
win
g ro
om is
rela
ted
with
cre
ativ
ity b
ut a
lso
requ
ires
focu
s on
the
task
they
are
wor
king
with
. Sus
pend
ed c
eilin
g is
low
ered
on
the
wor
king
tabl
es h
elpi
ng th
em to
con
cent
rate
, als
o w
ith lo
wer
task
ligh
ts.
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
23
5.3.
3 Pl
anni
ng5.
3 D
esig
n Pr
oces
s5.
3 D
esig
n Pr
oces
s
5.3.
3.2
Enric
hmen
t > S
ocia
lizat
ion
Visu
al C
onta
ct
Play
the
rapy
off
ers
free
dom
and
flex
ibili
ty t
o ch
ildre
n.
Whe
n th
ey h
ave
stric
t sc
hedu
les
durin
g th
eir t
reat
men
ts,
here
they
can
dec
ide
wha
t the
y w
ant t
o do
, and
ther
apis
ts
enco
urag
e th
em t
o pa
rtic
ipat
e in
the
act
iviti
es.
In t
he
exis
ting
build
ing,
it is
qui
te fl
uent
, and
whi
le c
hild
ren
mov
e fr
om o
ne to
ano
ther
they
see
or h
ear o
ther
act
iviti
es, a
nd
they
join
to tr
y th
em.
In th
is p
ropo
sal d
iffer
ent r
oom
s ope
n up
to th
e sq
uare
s by
win
dow
s, p
rovi
ding
a v
isua
l con
nect
ion,
whe
re c
hild
ren
can
see
diff
eren
t act
iviti
es a
nd c
hoos
e if
they
wan
t joi
n.Fi
gure
(a)
sho
ws
whi
ch s
pace
s ar
e vi
sual
ly c
onne
cted
to
each
oth
er
Colla
bora
tion
Allo
win
g fle
xibl
e op
enin
gs
betw
een
diff
eren
t ro
oms,
in
crea
ses
inte
ract
ion
betw
een
child
ren
part
icip
atin
g in
di
ffer
ent a
ctiv
ities
.
The
adja
cent
roo
ms
allo
win
g fle
xibi
lity
can
be a
lso
used
fo
r lar
ge a
ctiv
ities
, allo
win
g a
wid
er v
isio
n fo
r sup
ervi
sors
w
hen
child
ren
are
shar
ing
one
volu
me.
The
infe
ctio
n sa
fe r
oom
is
plac
ed i
n th
e m
iddl
e of
w
orks
hop
and
thea
ter,
let
ting
them
see
(w
indo
w)
and
hear
(sp
eake
rs)
or jo
in (
mic
roph
ones
) th
e ac
tiviti
es e
ven
thou
gh th
ey a
re u
nabl
e to
par
ticip
ate
phys
ical
ly.
Priv
acy
Whi
le a
llow
ing
visu
al c
onne
ctio
n, t
he a
mou
nt o
f con
nect
ion
is li
mite
d fo
r the
chi
ldre
n pa
rtic
ipat
ing
in a
ctiv
ities
whi
ch
requ
ire a
tten
tion.
For
exa
mpl
e w
hile
the
activ
ity in
the
wor
ksho
p ca
n be
seen
from
the
corr
idor
, chi
ldre
n in
the
wor
ksho
p do
not
see
the
squa
re d
irect
ly s
o th
eir a
tten
tion
is n
ot d
istr
acte
d.
Priv
acy
for f
amili
es:
Mos
t of
the
tim
e ch
ildre
n, e
spec
ially
you
nger
one
s, a
re a
ccom
pani
es b
y th
eir
pare
nts
in p
lay
ther
apy.
Par
ents
leav
ing
thei
r chi
ldre
n to
the
nurs
ery
spen
d th
eir w
hole
day
in th
e ho
spita
l, si
ttin
g an
d w
atch
ing
thei
r chi
ldre
n w
hile
they
are
in
ther
apy.
Kno
win
g th
e pr
esen
ce o
f the
ir fa
mili
es g
ives
an
emot
iona
l sec
urity
to th
e ch
ildre
n, th
e th
erap
ists
say
. W
hen
pare
nts
are
stay
ing
for
a lo
nger
tim
e, t
hey
do n
ot e
njoy
bei
ng in
the
mid
dle
of r
ush.
In t
he e
xist
ing
build
ing
pare
nts
spen
d tim
e in
the
mai
n sq
uare
. The
new
pro
posa
l allo
ws
them
to
have
the
ir ow
n se
mi-p
rivac
y w
hile
the
are
w
atch
ing
thei
r chi
ldre
n, in
an
exte
nsio
n of
the
livin
g sq
uare
.
posi
tion
ing
inf.
room
ab
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
24
5.3
Des
ign
Proc
ess
5.3.
3 Pl
anni
ng
5.3.
3.2
Enric
hmen
t > N
atur
e
Nat
ural
acc
ess
“...n
atur
e w
hate
ver
the
expl
anat
ion
be g
enet
ic, c
ultu
ral o
r a
com
bina
tion
of t
he t
wo,
has
a t
rem
endo
usly
pow
erfu
l im
pact
on
us h
uman
bei
ngs”
1
The
desi
gn p
ropo
sal f
or t
he n
ew b
uild
ing
enab
les
child
ren
to p
lay
in g
reen
are
as t
hrou
ghou
t th
e ye
ar, u
nder
a g
laze
d ro
of in
the
inne
r yar
d. F
or th
e pl
ay th
erap
y th
e pl
an is
arr
ange
d to
dire
ct th
e ch
ildre
n to
the
gard
en, a
nd a
llow
ing
som
e ac
tiviti
es to
ope
n up
to th
e in
ner y
ard
(wor
ksho
p an
d m
ulti-
play
room
) [c]
. A
vie
w a
nd a
n ac
cess
to th
e na
ture
will
hel
p to
redu
ce th
e st
ress
of p
atie
nts
and
rela
tives
who
spe
nd m
ost o
f the
ir tim
e in
hos
pita
l war
ds.
Espe
cial
ly in
the
sile
nt s
quar
e by
the
rel
axat
ion
ther
apie
s (s
ense
s ro
om, d
ark
room
) na
ture
can
hel
p to
incr
ease
the
effi
cien
cy o
f the
trea
tmen
ts, w
ith a
cal
m v
iew
aft
er th
e th
erap
ies.
.1 H
uman
beh
avio
r, co
gniti
on a
nd a
ffect
in n
atur
al e
nviro
nmen
t Kno
ph R
ichar
d C
.2 A
rchi
tect
ure
as M
edici
ne, S
tefa
n Lu
ndin
3. E
viden
ce b
ased
des
ign
as a
Pro
cess
, For
um v
årdb
yggn
ad 2
010,
Rog
er U
lrich
Day
light
In t
he e
xist
ing
build
ing
the
play
the
rapy
uni
t ha
s a
very
po
or
oppo
rtun
ity
for
dayl
ight
.
Stud
ies
on
patie
nts
havi
ng s
ever
e de
pres
sion
sh
owed
tha
t pa
tient
s st
ayin
g in
sun
nier
roo
ms
have
les
s du
ratio
n of
sta
y.2
Hig
her
dayl
ight
exp
osur
e re
duce
s d
epre
ssio
n an
d st
ress
, whi
ch
may
als
o re
duce
pai
n,
also
red
uces
str
ess
and
incr
ease
w
ork
satis
fact
ion2 (R
oger
Ulri
ch, 2
010)
3 . Alth
ough
chi
ldre
n ar
e us
ing
the
unit
for
a lim
ited
time
it is
impo
rtan
t to
let
dayl
ight
in, e
spec
ially
in w
aitin
g an
d co
mm
on a
reas
.
Ope
ning
to
east
and
wes
t al
low
s an
effi
cien
t da
ylig
ht.
Allo
win
g op
enin
gs b
etw
een
the
room
s le
t th
e m
ore
light
in
to th
e sq
uare
s. [
d]
cd
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
25
5.4
Zoo
m in
to p
lans
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
26
5.4
Zoom
into
pla
ns
A
A
BB
A-A
sec
tion
B-B
sect
ion
Entr
ance
fro
m t
he c
ourt
yard
is v
isib
le w
ith t
he g
laze
d en
tran
ce. A
lthou
gh a
n ai
r loc
k is
not
nee
ded
for t
he in
ner
yard
, it c
an s
till h
elp
for l
eavi
ng th
e m
ud o
r the
sho
es.
The
entr
ance
hal
l doe
sn’t
dire
ctly
see
the
mai
n sq
uare
but
th
e sq
uare
pla
nnin
g gi
ves
a w
ide
visi
on to
the
insi
de.
Nur
sery
is v
isib
le fr
om th
e en
tran
ce h
all.
Aft
er th
e en
tran
ce
hall
and
the
sem
i priv
ate
corn
er f
or p
aren
ts w
ho le
ave
thei
r chi
ldre
n to
the
nurs
ery.
Nur
sery
Entr
ance
War
drob
e
Pare
nts‛
corn
er
Nur
sery
is
for
child
ren
unde
r 5
year
s ol
d,
whe
re t
hey
play
with
var
ious
toy
s, le
gos,
dol
l ho
uses
, or s
mal
l act
s with
thei
r tea
cher
s. P
aren
ts
can
part
icip
ate
in t
he p
lays
with
the
ir ch
ildre
n.
It c
an b
e en
tere
d fr
om fr
om th
e th
erap
y un
it or
di
rect
ly fr
om o
utsi
de.
Alth
ough
the
nurs
ery
is o
ne s
pace
, the
hal
f wal
l an
d co
lor
diff
eren
ces
is s
ugge
sted
to
mak
e th
e ro
om p
erce
ived
as
two
spac
es,
allo
win
g fle
xibi
lity
to a
rran
ge d
iffer
ent
activ
ities
in t
wo
part
s.
For e
xam
ple:
Whi
le so
me
child
ren
play
with
free
pl
ays
in b
all p
ool,
othe
rs c
an p
lay
with
a c
reat
ive
activ
ity, s
uch
as le
gos.
entr
é
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
5.4.
1 Ent
ranc
e 27
5.4
Dee
per i
nto
plan
s 5
.4.2
Liv
ing
Squa
re
A AA-A
sec
tion
Livi
ng s
quar
e [V
arda
gsto
rget
] It
is th
e ha
rt o
f pla
y th
erap
y de
part
men
t, w
here
chi
ldre
n,
ther
apis
ts,
and
fam
ilies
gat
her
and
mee
t in
form
ally
, fo
r lu
nch,
coff
ee b
reak
s, p
iano
, or
just
to
spen
d tim
e si
ttin
g or
pla
ying
.
The
squ
are
is v
isib
le f
rom
the
who
le fl
oor,
whi
ch m
akes
it
to b
e fo
und
easi
ly, a
nd b
eing
ope
n fr
om a
ll si
des
give
s po
ssib
ility
to th
e th
erap
ists
to s
ee th
e ot
her s
quar
es.
The
squa
re o
pens
to th
e ou
ter g
arde
n, a
nd fi
lls th
e sp
ace
with
day
light
. For
sum
mer
s it
is p
ossi
ble
to b
lock
the
sun
w
ith s
hadi
ngs.
Livi
ng s
quar
e
vard
agst
orge
t
Cosy
roo
mM
ulti
play
sq
uare
Cosy
roo
m [m
ysru
m]
For
the
child
ren
betw
een
8-12
. A
roo
m w
here
the
y ca
n sp
end
time
with
th
e ch
ildre
n fr
om
thei
r age
gro
up, p
layi
ng a
vid
eo
gam
e, w
ii, w
atch
i tv,
or
just
to
sit t
oget
her.
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
5.4
Zoom
into
pla
ns5.
4.2
Livi
ng s
quar
e 28
5.4
.3 M
ulti-
Play
A A
Mul
ti P
urpo
se ro
om +
Wor
ksho
p =
Mul
ti P
lay
[Alr
umsL
ek]
The
room
s ar
e op
en f
or c
hild
ren
from
eve
ry a
ge.
The
mul
ti fu
nctio
nal r
oom
hos
ts
thea
ters
or
othe
r gr
oup
activ
ities
req
uirin
g la
rger
spa
ce,
such
as
tabl
e te
nnis
. Fo
r th
eate
r and
scr
eeni
ng fu
nctio
ns th
e ro
om is
pre
ferr
ed w
ithou
t day
light
. Sin
ce m
ost o
f tim
e th
e ro
om w
ill b
e us
ed fr
eely
, the
day
light
is s
till n
eces
sary
, so
the
win
dow
s ca
n be
de
sign
ed w
ith b
linde
rs.
Infe
ctio
n sa
fe r
oom
:To
ena
ble
all c
hild
ren
to p
artic
ipat
e in
the
activ
ities
, in
addi
tion
to a
cces
sibi
lity,
sec
tion
for c
hild
ren
open
for i
nfec
tions
is
con
side
red
to h
ave
conn
ectiv
ity. P
laci
ng th
e ro
om in
the
mid
dle
of tw
o ac
tivel
y us
ed ro
oms
child
ren
can
be p
art o
f th
e ga
mes
, see
, hea
r and
eve
n ta
lk to
oth
er c
hild
ren
with
inst
alle
d au
dio
sett
ings
. So
they
can
see
the
wor
ksho
p, w
atch
th
e th
eate
r, or
sin
g to
geth
er, w
ithou
t bei
ng is
olat
ed.
A-A
sec
tion
Wor
ksho
p
alru
msL
ek
Mul
ti f
unct
iona
l ro
om
Infe
ctio
n s
afe
room
stor
age
stor
age
entr
ance
fo
r in
f.
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
29
5.4
Zoom
into
pla
ns
W
5.4
.4 S
ilent
Squ
are
[Tys
ttor
get]
A A
BB
Sile
nt S
quar
e [T
ystt
orge
t]Th
ere
are
rela
xatio
n th
erap
ies,
(se
nses
roo
m a
nd b
lack
roo
m)
in p
lay
ther
apy
whe
re th
e ch
ildre
n ar
e ac
com
pani
ed b
y th
erap
ists
, hel
ping
them
sl
eep
or r
elax
. The
roo
ms
are
deco
rate
d w
ith li
ght
play
s, b
ubbl
e lig
hts,
pr
ojec
tions
so
it is
ess
entia
l tha
t th
e ro
oms
are
with
out
dayl
ight
. It
is a
ve
ry s
ensu
al s
essi
on, a
nd a
fter
they
leav
e th
e ro
om, t
hey
are
rela
xed
and
calm
so
to p
rese
rve
the
effec
t of t
he th
erap
y it
is im
port
ant t
o ke
ep th
em
calm
and
aw
ay fr
om s
tres
s.
Med
ical
Pla
yTh
erap
ists
sho
w t
hem
the
func
tions
of h
ospi
tal w
ith a
pla
y an
d ch
ildre
n ex
perie
nce
bein
g a
doct
or b
y pl
ayin
g as
doc
tors
with
med
ical
toys
.
To a
chie
ve a
qui
eter
zon
e, I
chos
e to
set
a s
ilent
squ
are
away
fro
m t
he
livin
g sq
uare
, and
ope
ning
to
the
oute
r ya
rd w
hile
tak
ing
the
bene
fit o
f na
ture
’s c
alm
ing
view
.
tyst
tor
get
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ureA-A
sec
tion
B-B
sect
ion
30
Sens
es r
oom
stor
age
Med
ical
pla
yBl
ack
room
5.4
.4 S
ilent
Pla
y 5
.4.4
Sile
nt P
lay
5.4
Zoom
into
pla
ns
A A
Teen
Pla
y [t
onår
sLek
]Te
enag
ers
from
12-
25 h
ave
a se
para
te s
ectio
n in
pla
y th
erap
y. S
ince
the
y ar
e un
able
to
go o
ut m
eet
outs
ide
with
the
ir fr
iend
s, t
hey
can
call
thei
r fr
iend
s, s
pend
tim
e w
ith th
em in
this
sec
tion.
The
room
can
be
cons
ider
ed a
s a
one
unit
with
the
livi
ng s
pace
and
the
bill
iard
roo
m b
ut
can
be u
sed
sepa
rate
ly w
ith d
iffer
ent g
roup
of f
riend
s.
The
teen
ager
s m
ight
ask
for
mor
e pr
ivac
y an
d si
nce
this
se
ctio
n is
onl
y fo
r te
enag
ers,
the
y ha
ve a
lim
ited
visu
al
cont
act
with
the
cor
ridor
, and
lett
ing
light
in w
ith h
ighe
r w
indo
ws.
tonå
rsLe
k
Sew
ing
room
Sew
ing
room
is a
par
t of t
eena
gers
’ sec
tion
but a
lso
open
to
oth
er c
hild
ren.
To
kee
p th
e ch
ildre
n co
ncen
trat
ed in
th
e ac
tivity
, sus
pend
ed c
eilin
g is
low
ered
dow
n pa
rtly
, so
keep
them
focu
sed.
Mus
ic s
tudi
oA
lthou
gh it
is p
rogr
amm
ed a
s te
enag
ers’
s se
ctio
n,
it is
ope
n fo
r oth
er c
hild
ren,
with
ther
apis
ts.
Mus
ic
stud
io o
pens
up
with
a w
indo
w t
o th
e en
tran
ce
squa
re, w
hich
att
ract
s at
tent
ion
of t
he c
hild
ren
to
try
mus
ical
act
iviti
es.
Dou
ble
entr
ance
and
sou
nd
insu
latio
n bl
ocks
the
soun
d fr
om s
tudy
sec
tion.
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ureA-A
sec
tion
B-B
sect
ion
31
Mus
ic
stud
io
Pool
roo
m
Sewi
ng r
oom
5.4
.5 T
een
Play
5.4
Zoom
into
pla
ns
oom
Poo
P
5.4
.5 L
earn
Pla
y
A A
B
B
Lear
n Pl
ay [B
iblio
Lek]
Lear
n Pl
ay c
onsi
sts
of l
ibra
ry,
clas
sroo
m,
grou
p st
udy
room
and
tea
cher
’s
expe
ditio
n. In
the
exi
stin
g bu
ildin
g lib
rary
is a
cces
sed
only
fro
m t
hera
py u
nit
whi
ch l
imits
chi
ldre
n to
bor
row
boo
ks o
utsi
de w
orki
ng h
ours
. A
sep
arat
e en
tran
ce al
so vi
sibl
e fr
om o
utsi
de ca
n in
crea
se th
e nu
mbe
r of u
sers
and
inte
rest
s,
even
allo
w c
hild
ren
to ta
ke b
ooks
and
read
them
in th
e in
ner c
ourt
yard
. Th
e lib
rary
is d
ivid
ed in
to s
mal
ler
sect
ions
with
she
lves
to
have
sm
alle
r st
udy
units
, for
chi
ldre
n to
stu
dy m
ore
focu
sed.
Bibl
ioLe
k
Clas
sroo
mCl
assr
oom
and
gro
up r
oom
are
hav
e sc
hedu
led
hour
s fo
r stu
dies
and
they
are
pl
aced
apa
rt fr
om t
he m
ain
wal
king
hal
l. Th
ere
will
be
arou
nd 3
-5 s
tude
nts
at t
he
sam
e tim
e in
the
cla
ssro
om. T
wo
room
s ar
e di
vide
d by
larg
e sl
idin
g do
ors
lett
ing
the
two
room
s co
mbi
ne. F
or e
xam
ple
a te
ache
r te
achi
ng i
n cl
assr
oom
can
als
o su
perv
ise
the
grou
p st
udy.
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ureA-A
sec
tion
B-B
sect
ion
32
Libr
ary
Clas
sroo
m Grou
p ro
om
5.4
Zoom
into
pla
ns
yy
5.5
Con
clus
ions
5. De
sign
appl
icatio
ns w
ith N
euro
scien
ce +
Arch
itect
ure
* Fr
eque
ntly
ask
ed q
uest
ions
sec
tion
is
the
sum
and
conc
lusi
on o
f th
e qu
esti
ons
I re
ceiv
ed aft
er my pr
esen
tati
ons an
d wi
th my pe
rson
al add
itio
ns abo
ut wha
t I go
t fr
om
my t
hesi
s, r
esea
rch
and
new
desi
gn s
kill
s.
How we benefit from neuroscience?
Learning neuroscience and
how
the
brain
is connected
to environments opens
another
perspective to architecture.
Can neuro-architecture be a key generator for starting a design?
No.
In brief, neuro-architecture is not
an architectural
concept. We can
not
start
a design, saying we are going to build a “neuro-architectonic building”, same as we don’t
start the design as “acoustic building”. Neuro-architecture is a tool such as any science
or methods that supports and develops architecture. It is about brain, how we are affected
by our surroundings and how we can change/motivate the effect in a positive way.
How do we apply the principles to healthcare?
Play therapy
is a
part of healthcare unit.
The
sub
topics,
way
finding,
enrichment,
privacy are closely related to the overall design of hospitals. In my design part, when
I was connecting research part to architectural design, I searched through principals of
healthcare and filtered them to one single department and deepened a new research on the
related department. To adapt the principals to the other departments, the same topics of
neuro-architecure are going to be applied but an additional research within use of other
departments is needed.
How would the design look like if you didn’t know about neuro-architecture?
Probably I would consider it as another part of hospital, search on existing hospitals,
make s
ome
observations o
n the
existing u
nit
and
add
my a
rchitectural d
esign
approaches
(which w
ere
not
deeply f
ocused o
n user b
rain b
efore).
In o
ther w
ords,
it w
ould s
atisfy
the
architects,
but
wouldn’t evaluate the
wellbeing
of the
patients by architectural
design.
Will you use your research on other fields? Or can you use?
Yes! Because any building affects the brain and the parameters are relevant to everyday
life. For example, we need wayfinding, in a hospital, in school, airport. We should avoid
stress in schools, offices, and houses. We need concentration, relaxation, orientation...
So if it is possible to do better, why not to use the information?
33
The
aim
of s
tudi
es o
n ne
uro-
arch
itect
ure
is ho
w to
dev
elop
arc
hite
ctur
e fo
r bet
ter
envi
ronm
ents
for t
he u
sers
. In
my
thes
is zo
omin
g in
to c
hild
ren
and
heal
thca
re e
nviro
nmen
ts I
foun
d th
e op
portu
nity
to th
ink
for c
hild
ren,
see
ing
the
spac
es fr
om th
eir p
ersp
ectiv
e an
d ho
w
to c
reat
e be
tter e
nviro
nmen
ts to
hel
p th
eir h
ealin
g pr
oces
s.
The
appl
icat
ion
proj
ect i
s an
exa
mpl
e of
how
the
info
rmat
ion
can
be a
pplie
d. I
can
also
sa
y th
at it
is s
till a
roug
h de
sign
since
eve
ry s
ub to
pic
of a
pplic
atio
n is
a w
ide
topi
c re
quiri
ng
deep
stu
dies
to g
ive
accu
rate
ans
wer
s. H
owev
er it
stil
l hel
ps to
aw
aken
new
per
spec
tive
to th
ink
from
chi
ld p
ersp
ectiv
e, c
onsid
erin
g in
fluen
ces
on th
eir b
rain
and
how
to im
prov
e sp
aces
to e
mpo
wer
thei
r dev
elop
men
t.
F.A.Q.
than
k yo
u!
.Cag
il K
ayan
.Mas
ter T
hesi
s .E
xam
iner
: Pet
er F
röst
.C
halm
ers A
rchi
tect
ure
.VT
2011
.Enr
ichi
ng h
ealth
care
env
ironm
ents
for
child
ren
you
can
also
che
ck w
ww
.neu
rotic
arki
tekt
en.b
logs
pot.
com
to
see
the
prog
ress
and
see
rele
vant
topi
cs a
bout
neu
ro-a
rchi
tect
ure.