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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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9

1012

16

202122

242527

282930

32

34

35

384041

42

4648

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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5254

5557606263

6465

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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

9

...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

15

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.


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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


neıroscientists and ar-chitects unite for better environments

Academy of Neurosciencefor Architecture [ANFA]


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.


1. Inquiry by Design, J. Zeisel


.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”.


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


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.



2. Brain landscape .John Eberhard

3. Howard Hughes Medical Institue www. hhmi.org

2.3.1 Environment/Behavior+Neuroscience

Place

Personalization

Territory

Wayfinding


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.


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.


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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2.3.3 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.


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.


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

38

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.


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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


*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).


3.2 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.


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


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


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.


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


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


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.


58


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.


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


4.1.3.1 Natural Impact

61


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


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

63



64


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.


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

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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

��

��

��

�

��

��

�� entr

ance

��

��

��

��

��

��

��

��

��

��

��

��

��

�

staf

f

��

��

��

�

��

��

� ��

��

�

��

�

squa

re

��

��

��

�

sens

es

��

silen

t

squa

re

staf

f��

��

�

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.

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