Liberty, Justice and Design-for-All

April 1, 2004
Barbara Pallat

Designing for cognitive disabilities.

FORUM NCIDQLiberty, Justice and Design-for-AllAs practicing interior designers, we are well aware of the Americans with Disability Act (ADA) Guidelines. In our work we design spaces that are accessible for people with physical disabilities or visual disabilities. Wheelchair turning radii, grab bars, ramps, slip resistant flooring materials, tactile signage . . . we deal with these issues daily. However, there is another segment of disabled persons that interior designers serve: people with mental retardation, cognitive disabilities or other brain-related functional limitations such as psychiatric disability, brain injury (either from trauma or internal injuries like stroke) and learning disabilities. Although it is difficult to find an accurate statistic, the American Association on Mental Retardation (AAMR) estimates that 2.13 million Americans (excluding institutionalized persons) have a mental disability. (See Seven Priciples of
Universal Design
1. Equitable Use: The design does not disadvantage or stigmatize any group of users.2. Flexibility in Use: The design accommodates a wide range of individual preferences and abilities.3. Simple, Intuitive Use: Use of the design is easy to understand, regardless of the user's experience, knowledge, language skills or current concentration level.4. Perceptible Information: The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities.5. Tolerance for Error: The design minimizes hazards and the adverse consequences of accidental or unintended actions.6. Low Physical Effort: The design can be used efficiently and comfortably, and with a minimum of fatigue.7. Size and Space for Approach and Use: Appropriate size and space is provided for approach, reach, manipulation and use, regardless of the user's body size, posture or mobility. (

The Center on Human Policy at Syracuse University defines cognitive disability as: "a disability that impacts an individual's ability to access, process or remember information" ( thechp). AAMR publishes this widely-accepted definition of mental retardation: "Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social and practical adaptive skills. This disability originates before age 18." There are "Five Assumptions Essential to the Application of the Definition." Of these five, the last two seem to be an area where interior design professionals can have the greatest impact:

  • An important purpose of describing limitations is to develop a profile of needed supports.
  • With appropriate personalized supports over a sustained period, the life functioning of the person with mental retardation generally will improve.

Although the authors of this definition may have been thinking of "supports" as therapy, instruments or tools to aid a person's cognitive functioning, I believe that designers of interior environments must be aware of the needs of mentally disabled persons so they can design public and private spaces that meet those needs. It is difficult to generalize what a population requires—there are many different types of cognitive and mental disabilities. When designing a private residence for a person with a cognitive disability, a designer has the opportunity to observe, interview and research that person's particular requirements. When designing public spaces, where it is difficult to know what type of population will be using a facility, applying the principles of Universal Design is one method of designing for "all." Universal Design is different than "barrier-free" or "accessible design." Those terms imply designing for physical accessibility only and call for creating "special" spaces for the mobility-impaired (think of a "handicapped toilet stall"). Adaptive Environments, a 25-year-old educational non-profit organization committed to advancing the role of design, accessibility and best practices in human centered or universal design, provides an explanation of Universal Design:

Universal design is the design of products, environments and communication to be usable by all people, to the greatest extent possible, without adaptation or specialized design. The concept is also called inclusive design, design-for-all, lifespan design or human-centered design. The message is the same: if it works well for people at the edges of the spectrum of functional ability, it works better for everyone. (See

It is clear that more research is needed on the impact of interior design on persons with cognitive and mental disabilities. InformeDesign, a Web site that is a clearinghouse for design and human behavior research, has no fewer than 73 abstracts about users with disabilities. Of these, more than 50 percent of the articles focus on mental/cognitive learning, physical/neurological issues or psychological/emotional issues. Titles of research abstracts include: "Natural Settings Influence Children with ADD," "Wayfinding for Patients with Dementia" and "MS Patient Experiences and Perceptions." However, more specific examples and research is desperately needed so interior designers can provide spaces that meet the needs of all of our society. Abstracts are lacking about the impact of interiors on persons with bipolar disorders, or designing for autistic children, severely depressed or emotionally distressed persons.

Valerie Fletcher, executive director of Adaptive Environments, comments, "I can think of few bigger challenges for the design student or practitioner than to explore the power of design as an asset to the performance of the brain. We can learn by finding solutions that work for people at the edges of the spectrum who have significant cognitive disabilities, but end up benefiting everyone."

Other professionals are becoming aware of the link between cognitive issues and design as well. The American Institute of Architects (AIA) recently announced their establishment of the Academy of Neuroscience for Architecture. In an article in The Washington Post, John P. Eberhard, founding president and executive director of the academy, highlighted potential findings of neuroscience and their application to the interior design of buildings. Two specific areas include:

  • Improving mobility and wayfinding in complex buildings by understanding brain characteristics of
    people who can navigate more easily than others.
  • Improving building design for those suffering from neurodegenerative disorders, which cause Alzheimer's disease, by understanding how brain damage changes perception. (See

The connection between good design and human behavior is just beginning to be considered seriously. Our profession—beginning with our interior design schools—must continue to teach proper methods for gathering data and conducting research including the use of observation and interview techniques. As professionals, we have an obligation to submit our work and findings to InformeDesign to build its body of knowledge and research. As members of professional organizations (ASID, IIDA, IDC and IDEC), we must demand that alliances be built with medical and psychological associations.

AAMR, whose mission statement is to promote progressive policies, sound research, effective practices and universal human rights for people with intellectual disabilities, has adopted a 13-point set of principles to accomplish their mission. Listed in the chart below are three of their principles, with my recommendations on how interior designers can help AAMR achieve its mission. (See chart below.)

AAMR PrincipleInterior Design ResponseAchieving full societal inclusion and participation of people with intellectual disabilities.Research, research, research. Publish findings for interior designers so they may design spaces that allow all persons to participate and be included.Promoting genuine accommodations to expand participation in all aspects of life.Design all spaces to standards of Universal Design (which go beyond the minimum standards of the Americans with Disability Act Guidelines).Establishing partnerships and strategic alliances with organizations that share our values and goals.Establish partnership with American Society of Interior Designers (ASID), International Interior Design Association (IIDA), Interior Design Educators Council (IDEC) and Interior Designers of Canada (IDC).

AAMR states, "Mental retardation is not something you have, like blue eyes or a bad heart. Nor is it something you are, like short or thin. It is not a medical disorder, nor a mental disorder. Mental retardation is a particular state of functioning that begins in childhood and is characterized by limitation in both intelligence and adaptive skills. Mental retardation reflects the 'fit' between the capabilities of individuals and the structure and expectations of their environment" [author emphasis]. Interior designers can have a profound positive impact on the structure of mentally and cognitively disabled persons' environments by employing Universal Design."

And that is designing for all.

  • Barbara Pallat serves on NCIDQ's Board of Directors. She has been a registered designer since 1994 and is an NCIDQ Certificate holder. She is the owner of Barbara Pallat Interiors outside Chicago, IL, and specializes in design for both residential and contract projects. For information about NCIDQ, please visit its Web site at
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