Supporting autistic people to flourish at home and beyond – the webinar

In October 2021 LGA CHIP and NDTI delivered a webinar about “Supporting autistic people to flourish at home and beyond by considering and meeting the sensory needs of autistic people in housing.” You can watch the webinar recording and read the answers to questions asked at the webinar.

Watch the webinar

Questions and answers from the webinar

Can we get a link to the report?

Yes: You can read the executive summary and the full report.

Can autism be diagnosed with a brain scan in all cases?

Autism is usually diagnosed with observation and interview from a qualified clinician. The MRI scans we referenced in the presentation are linked to research that shows brain differences between autistic and neurotypical people.

How can we support when it comes hair clippers and driers please?

Is someone upset by them? In which case, you could avoid using them and go for long hair / scissors / natural drying instead.

If the person finds them challenging but is keen to use them, support them to have choice and control over when and be clear that it’s their choice. Tell them they can stop when they want to and let them know how long it will last. Try to make sure the haircut doesn’t go on for longer than you say.

For challenges in public spaces, help people prepare for them by letting them know what to expect and that there may be challenges. You can support people with the option of noise cancelling headphones and the option to leave a challenging sensory environment at any time.

Which bird (crow?) is on the slides? Does it have special significance or represent something?

The artwork you mention was done by the fabulously talented Jon Adams and T.E. Yates, supported by Flow Observatorium. The report says, “Flow Observatorium was pleased to support connection and collaboration on this project, with Tom and Jon producing artwork that gives an additional autistic flavoured visual metaphoric contribution.”

We haven’t asked the artists about the meaning of corvids (crow family), but there are some interesting interpretations available online you can look at.

We are already doing much and actively considering all this for our council new-builds in LB Wandsworth. One of things I'd like to do is set up a team of volunteers with physical/sensory disabilities and autism (probably from within our staff group) to review our designs, products and new buildings and would value some advice on how to do this properly? Can you advise on this?

It's great to hear that you are seeking autistic involvement in the work you are doing. We have found that the best way to involve people is to work with an autistic advisor to support the team to consider how and when to involve people, how to ensure the approach is autism informed, and to help us get our communication and support right. We also encourage payment for people’s time whenever possible.

NDTI guidance on co-production can be found here

I know a stroke recovered person showing such behaviours, is there any connection between stroke and autism?

Both autistic people and neurotypical people might experience stroke. Some people who are affected by stroke might subsequently have hyper or hypo sensory sensitivity.  This is because of neurological changes because of the stroke, rather than autism. People who experience sensory sensitivity might benefit from changes and adjustments to the environment as recommended in this report. (Note Hypersensitivity is when people are extremely reactive to sensory stimulation. They may find these stimuli overwhelming. Hyposensitivity is when people are under-sensitive to stimulation.)

Is the sometimes contradictory nature in which autism presents from one individual to another, means that designing a shared living environment will be a challenge for designers? How might these be overcome?

Everyone is different. We recommend aiming for a calm and neutral, low arousal, sensory environment, then tailoring to meet individual need. It’s helpful to understand what particular sensory sensitivity people have, to personalise their environment and support.

The autistic people who contributed to the paper expressed a strong preference for not living in shared accommodation – unless they were sharing with partners or family of their choice. So NDTI encourage individual accommodation wherever possible.

If considering pan disability design, most of what you have spoken about so far can be incorporated excluding maybe the everyday noises from neighbours?

Inclusive design approaches aim to make buildings accessible to people regardless of their needs, rather than making specific adjustments in response to need. Inclusive design will often consider the sensory environment. Designers and planners might need support and involvement from autistic experts to ensure the sensory processing differences are considered.

External noise is a challenging factor that is sometimes beyond control. It’s not always possible, but helpful to consider external noise when identifying / purchasing / renting the property. Not everyone has auditory sensitivity but in our experience it is one of the more common sensory challenges for autistic people.

I am hoping people are aware of the consultation currently out from the British Standards Institution on PAS 6463 Design for the Mind - Neurodiversity and the Built Environment -  it ends on 4 November. Could you add the link please?

Consultation link

Note that from the end of the consultation the PAS won’t be available to access until it is finalised and shared in 2022.

Are / can sensory differences part of the scoring criteria for re- housing / council housing?

Each council is different depending on their lettings policies but generally speaking vulnerabilities are taken into account when assessing housing need.

If the sensory issue makes the person more vulnerable, it may then contribute to their overall score/banding. It may also warrant a referral to a health and housing team who could make recommendations for a certain type of housing. It all comes down to whether that sensory issue makes the housing need more urgent e.g. if a family has an autistic child who cannot share with a sibling, it may warrant a priority on the grounds of overcrowding. Another example would be if an autistic person becomes homeless and the impact of being autistic makes them particularly vulnerable, that may warrant a higher priority.

Government guidance for local authorities on housing allocations

EHRC advice on housing and the rights of disabled people 

Loving all the explanations, very concise, informative without being too complicated/wordy. I would have liked to hear a bit more around smell as this is a huge stressor for a lot of autistic people and isn't nearly considered enough.

Executive summary and the report

Smell is covered in the executive summary and on pages 41 to 42, 44 and 68 in the full report.

I work with someone who won’t leave indoors due to the sensory difficulties, finding the appropriate supported environment proves extremely difficult.

It’s hard to answer this question for the specific person without knowing what is meant by the appropriate supported environment, or specifically why it’s difficult for the person you are thinking of (there are lots of ways it can be challenging).

Sometimes it can be challenging to leave known environments for areas or activities that are uncertain or may have led to upset or sensory overwhelm in the past.

In this instance, it’s helpful to clarify what this person has sensory sensitivity to. I’d try and reduce the ‘sensory load’ as much as possible when they are at home.

In going out, plan ahead to manage the sensory load (eg avoiding places that are noisy, not giving too much verbal information, ensuring people have noise cancelling headphones / cap / sunglasses etc). You might want to make sure that they have detailed information about the trip outside such as where they are going/ when / who with / how long for.

Consider how to incorporate their interests and passions and ensure that there is down time and opportunity to regulate.

It’s so difficult when working with adults with learning disabilities who can't tell us. Also difficult with modulation difficulties which change multiple times in the day.

We all use nonverbal communication – and there are often signs and indicators that we can pick up on if we get to know people. Remember that autistic communication (including nonverbal communication) is often more subtle, until autistic people feel they need to ‘shout’.

It’s really common for tolerance (including sensory and social tolerance) to vary through the day. This is often predictable, when we look at the inputs and the signs people give us. Involve a verbal autistic person with sensory awareness (probably in a paid, professional capacity) in helping assess the situation and get their support to identify likely sensory triggers, and to support with understanding the communication from the person’s point of view.

We have people who are based in inpatient mental health settings due to the nature of their complex needs. There are many guidelines around the safety of the environment settings and I would be interested to know what your thoughts are around these types of environments and what services should really consider?

See the ‘It’s not rocket science’ report that NDTI wrote about inpatient sensory environments. There’s also a webinar recording on the NDTi website. This report is focused on children and young people services because it was commissioned by the CAMHS mental health taskforce, but most of the learning is applicable to all ages.

Who would you approach for a sensory needs assessment?

These tend to be done by suitably qualified Occupational Therapists. Sometimes autistic people with relevant personal and professional experience are asked to provide insights from a lived experience perspective, but this isn’t a sensory needs assessment.

We are architects working in this field for the last 10 years. Have issues with air quality, provision of ventilation, off gassing from manmade materials come up in your reviews?

Thanks so much for joining the webinar. Ventilation has been a major issue that we’ve noticed – forced air is often very noisy and sounds like an out of tune flute is being played through the building. We don’t have technical knowledge ourselves but would love to hear if you have any solutions. It’s fantastic that you’re considering this.

Has there been any research done on products in new-build homes (i.e. MVHR units) which are good for people who experience sensory overload? But which also meet sustainability criteria etc.?

We are not aware of any research on this. If you’re interested in pursuing it then let NDTI know and we can support with some introductions to autistic researchers who work in a participatory way.

In our experience, most sustainability guidance notes that sustainability ambitions shouldn’t be pursued if it negatively impacts the end user. It’d be great to see this being considered at an earlier stage.

Please could you give me the link to the CQC report?   

The link to the July 2021 CQC report: Home For Good: Successful community support for people with a learning disability, a mental health need and autistic people

Thanks for doing this and engaging with autistic people to obtain their view.  It’s very timely in mind of working on housing for autistic people now.  My ask is, what was the range of autistic people involved?  Was it those currently in hospital environments, residential, supported living, supported living, shared lives schemes, independent living?

Thanks. We think it’s really positive and important that the authors, contributors and artists to this paper are autistic people. This paper focuses on housing rather than inpatient services, so we didn’t involve anyone currently in hospital. A range of people were involved including people who own their own home, people who rent a home, and people receiving support.

For people in hospital environments please see the ‘It’s not rocket science’ report that NDTI wrote about inpatient sensory environments. There’s also a webinar recording on the NDTi website. This report is focused on children and young people services because it was commissioned by the CAMHS mental health taskforce, but most of the learning is applicable to all ages.

From a housing point of view how can we help anyone who is autistic as there seems to be a varied aspect to it and one property cannot meet the needs of all the service users.  With shortfall of appropriate housing, it’s almost impossible to meet the needs.  How can we address this?

No housing will be perfect. However, understanding sensory sensitivity and individual sensory need will help to identify which aspects might need to be prioritised (eg. sound / smell / lighting).

Regarding noise when rehousing how can you plan for this?

There are some suggestions about how to consider this in the report.

Executive summary and the report.

Can family do more to support their loved ones to support as when dealing with some cases. It’s more of a housing issue than anything else.

Families can support autistic people by understanding that they do not share the same ‘sensory reality’. ‘Listen’ to what the person shows and says about their sensory needs, and support the person by validating their experience, minimising distressing sensory inputs, and making personal adjustments (headphones, sunglasses, masking smells etc) where possible.

Will new builds therefore have better soundproofing installed? Any good products used for this?

Davies (who authored this great report on autistic listening) suggests we may be able to learn from environments such as auditoriums and concert halls, where sound has been really carefully considered.

Anyone know if the Disabled Facilities Grants been used successfully to help autistic people adapt their home environments?  I see it is mentioned in the Autism strategy.

Yes, the DFG can be used to enable autistic people to make adjustments to their home: Eligibility information.

What do you think of multisensory environments/rooms/Snoezelen* within a home?

(*Note - Snoezelen or controlled multisensory environment (MSE) is a therapy for people with autism and other developmental disabilities, dementia or brain injury. It consists of placing the person in a soothing and stimulating environment, called the "Snoezelen room".)

In the experience of the autistic people writing this report, sensory rooms are often seen as the single answer to really challenging sensory environments, to the exclusion of other areas. They are often poorly planned and located and actually not very pleasant spaces to be in.

When well considered, they can be helpful quiet areas with optional sensory input (a neutral start and the option to add chosen items is helpful). As with other areas, it’s important to involve autistic people in their planning and design. The authors suggest you particularly consider background noise from corridors, nearby rooms and heating systems.