Ergonomics for children with autism

By DANG U. KOE, ASP Chair Emeritus

MANILA, Philippines — Ergonomics plays an important role in making our lives easier, whether it is the cell phone we cannot seem to live without, the water bottle that we lug around everyday, or the pen we use to write our thoughts with.

Any feature that has made tools or the environment safe and comfortable can, in some way, be attributed to ergonomics.

This week’s Angel Talker, Thea Sheila Ocheda-Alonto is a graduate of University of the Philippines Manila, with a Bachelor of Science in Occupational Therapy and a master’s degree in Occupational Health.

She divides her time practicing as a pediatric occupational therapist and as an ergonomics consultant. She is also the program director of TW Community Enablers, a center which helps adolescents with special needs lead meaningful and productive lives.

Ergonomics is derived from the Greek word “ergon” (work) and “nomos” (laws) to denote the science of work. Ergonomics is a systems-oriented discipline, which applies to all aspects of human activity. It means “fitting the task to the man”. In recent years, there has been an increased interest in focusing on ergonomics for children.

In June 2001, an initiative was formed by the International Ergonomics Association in creating a technical committee on Ergonomics for Children and Educational Environments (ECEE). The committee aims to apply ergonomics in all educational environments, and promote public awareness of ergonomics related to children of all abilities in all aspects of their lives.

POSITION IT RIGHT – Left photo shows the improper positioning of desk equipment, which can lead to different physical discomforts, while the right photo shows how it should be done properly.

Providing a Sensory Environment for CWAs

A number of children with autism have sensory integration or processing issues that affect their ability to interpret what they see, hear, feel, or even smell. Some children with autism have difficulty following environmental cues, have short attention span, have difficulty distinguishing between important and unimportant stimuli or may be sensory defensive.

They can either react adversely to ordinary sensory stimuli or barely respond given a barrage of sensory inputs.

For example, one child may become distracted by light or by soft music playing in the background while another may refuse to go inside a room with colorful wallpaper. Since sensory stimuli largely affect the performance of a child with autism, experts agree that simplifying his or her environment is best.

This means: a bare room with basic furniture (table and chairs in natural finish); painting the walls, windows, and other fixtures in muted tones; and removing wall hangings or any other stimuli. Also choose lighting carefully – using glaring florescent lights against those non-glaring or diffused.

Toys and other equipment should also be out of reach, to encourage the child to communicate what he or she needs. But any fixture which facilitates independence (e.g. a rack where the child can keep his shoes) can be retained.

Because of this design, elements the child prefers or needs, can easily be added to the room (e.g. bean bag, rocking chair, etc.). To know what the child likes: observe the type and kind of input that the child find relaxing or comfortable (loud or soft sound, soft or textured objects, etc.).

Teachers or therapists who usually work with the child will most probably be able to provide additional valuable information regarding the child’s preferences.

Although it is ideal to change all the areas in which the child is expected to be in, this can be particularly overwhelming to parents. Prioritizing areas in the house which can affect learning - such as the dining area, the child’s bedroom, and study room - is beneficial. Identify which situations, visual cues, or sensory experience affect or encourage the child. Work with your therapist. Learn to adjust, modify, add, or reduce items in the environment as necessary.

Providing a Tailorable Environment

During the Ergonomics Society Annual Conference in 2004, an initial paper called Project Spectrum: Designing a Tailorable Environment for Children with Autism Spectrum Disorders was submitted by Dr. Andree Woodcock, pioneer researcher in the field of educational ergonomics in UK; Jacqui Jackson, mother of four autistic children, author and speaker; Darryl Georgiou, design and digital media artist, and Alex Woolner, media arts practitioner.

Project Spectrum aims (1) to take a user-centered approach to the development of the environment, based on an understanding of the needs of children with autism (CWA), (2) to provide a polysensory environment that could be tailored to meet the needs of individual children and (3) to develop a means of evaluating this and other systems.

From 2003 to 2006, their research led to the design and building a sensory environment for children with autism; exploring the use of digital technology to provide sensory stimuli in a fun and engaging way for the children. This has led them to research, design and build Sensory Classrooms for Children with Autism.

Designing a Mainstream Classroom

Let’s take for example a mainstream school setting. The basic set-up will be an empty low sensory room, must be accessible to all children, easy to use, adaptable to everyday spaces found in schools, plus including both digital and tangible materials.

Example of a local primary school set-up: The primary consideration in designing should be the student with autism who use the environment, and its effects on sensory stimulation (sensory stimulation/integration/processing issues). The development of the environment, positioned in the school can be tailored to meet the individual and curricular needs. This will be crucial in enabling children with autism to integrate in main school environments.

Ergonomics in Computer and Gaming Devices Computers have become an essential part of learning in the mainstream school systems, but the usual concern of students with autism in computer use is the mismatch between tools or equipment.

Other concern is the lack of knowledge regarding safe and healthy practices in the performance on computing tasks – such as sustained awkward postures and repetitive motions. Some computers are equipped with gaming devices.

There is an increase in the incidence of “Nintendo Thumb” or a repetitive stress injury (RSI ) to the thumb due to excessive game playing. It causes a swelling at the base of the thumb.

Overuse can also lead to an increase incidence of muscle pain, eye strain, wrist related repetitive strain injuries. Other factors to consider are posture, workstation and usage.

Here are some ergonomic guidelines for students with autism who use computer:

1) Encourage neutral posture at all times

2) Place monitor correctly on the desk

3) Make sure monitor is glare-free

4) Keyboard and mouse which are fit for the child’s hands

5) Make sure furniture and equipment are adjustable

6) Use ergonomic chair appropriate to the size of the child with stable desk or work surfaces

7) Organize a work area near the computer

8) Manage gaming device and computer use

9) Have the student take frequent breaks.

The recommended sensory-friendly and ergonomically-equipped environment suitable for children or students with autism validates the design of several special schools and therapy centers in the country. Perhaps ergonomics as a basis for design has been merely incidental. But, without doubt, the needs of children or students with autism, if not of children with special needs in general, were taken into consideration in the process of building these schools and centers.

After all, the user design approach that is, designing for end-users is the foundation of ergonomics for children with special needs. Eventually, we hope to see this integrated in mainstream schools.

Uploaded with permission Acknowledgment Manila Bulletin: Ergonomics for children with autism