Designing for Special Neurological Conditions: Architecture Design Criteria for Anti-Misophonia and Anti-ADHD Spaces for Enhanced User Experience

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

1-The introduction's main weakness is its failure to clearly define the specific research problem, leaving the study's purpose and justification unclear.

2-The biggest problem with this study is that it doesn’t actually test its ideas in real life. Secondly, the lack of validation of the results in methodology section.

3-There’s no data from experiments, before-and-after comparisons, or patient feedback to show these designs make a difference.

4-The study's conclusions are unproven ideas from books and theories—not verified facts from real-world tests. The conclusions presented in this study are not empirically supported and remain theoretical propositions rather than evidence-based findings.

Comments for author File: Comments.pdf

Author Response

Comment Number 1: The introduction's main weakness is its failure to clearly define the specific research problem, leaving the study's purpose and justification unclear.

Answer to comment number 1: Done, the introduction was restructured to state clearly the problem of the research, which is the special neurological needs of the ADHD and Misophonia patients, and the lack of previous architecture design criteria or considerations of designing for these two specific neurological disorders that affect the well-being and productivity of their patients. The objective of the current study is to propose architectural design criteria based on a theoretical approach that employs minimal and metaphysical architectural trends as suitable design criteria for architectural spaces related to these specialized neurological conditions. By comparing these architectural trends criteria with the special needs of misophonia and Adhd patients. Thus, the current work is a manifesto of this concept before its clinical experiments that will be published in a future study. The modified section of the introduction with this specific explanation was highlighted in yellow in the text. 

Comment Number 2: The biggest problem with this study is that it doesn’t actually test its ideas in real life. Secondly, the a lack of validation of the results in the methodology section.

Answer to comment number 2: The current study objective is to propose the concept of designing architectural spaces as a therapeutic approach for misophonia and ADHD neurological conditions. based on a theoretical proposal of this novel concept of employing minimal and metaphysical architecture with extended features through virtual and augmented reality. In the current study, presenting this proposal through an analytical deductive approach, the study compares the minimal and metaphysical design principles with the special neurological needs of Misophonia and ADHD architecture as a first step before clinical experimentation and application of this novel concept. Thus, the clinical experiments with quantitative results and validation will be presented in a future study. 

Comment Number 3: There’s no data from experiments, before-and-after comparisons, or patient feedback to show these designs make a difference.

Answer to comment number 3: as explained in reply to comment 2, this study is the presentation of the theory: the novel concept and proposal of designing architecture spaces following minimal and metaphyiscal architecture trends and the extended virtual and augmented reality environments as a suitable spaces for misophonia and ADHD patients. which wasn´t presented before in litrature up to the author´s knowledge and extended review. The theory is always the first step that drives and inspires the experimental study to achieve a specific objective. Therefore, the current study scope is limited to the proposal and presentation of the theory. while the clinical experimentations with control groups, and before and after results will be exhibited in the future study. 

Comment Number 4: The study's conclusions are unproven ideas from books and theories—not verified facts from real-world tests. The conclusions presented in this study are not empirically supported and remain theoretical propositions rather than evidence-based findings.

Reply to comment number 4: the conclusion section, as well as the entire manuscript, was revised to express clearly the objective and methods, and limitations of the current study, which does not include clinical experimentation at this stage of theory presentation, as explained in reply to comments number 2 and 3. Therefore, the conclusion section was revised and modified to ensure clarity and avoid confusion following the reviewer's comments. 

Reviewer 2 Report

Comments and Suggestions for Authors

The point of departure needs to be more clearly stated. What percentage of people suffer from ADHD and Misophonia? The methodology of the research could be more clearly justified. How was the literature review undertaken (key search terms etc). What determined the research methodology and the sample size. What level of alignment of the results was achieved. Moving on from this research what would be the most appropriate follow on research to be conducted? What design guides are already in place (I use PAS 6463 as an example but there are others). What do these design guides achieve and where do they fall short? Work on the effect of view quality using VR has also be undertaken which could be considered. You mention biophilia how important is this as suggested in the literature? You talk about ADHD and Misophonia some comment (even if outside the research conducted) on the appropriateness of these approaches to other conditions and designs would seem appropriate. Are there lessons to learnt possibly for hospital design ? The differences between VR and AR could have been better explained.

Author Response

Comment Number 1: The point of departure needs to be more clearly stated.

Reply to Comment Number 1: Done. The research problem, hypothesis, objective, and methodology were clearly stated in the abstract (lines 15-30; 44-48) and introduction (lines 56-87), with a new section specifically identifying them. All highlighted in yellow in the manuscript. 

Comment Number 2: What percentage of people suffer from ADHD and Misophonia?

Reply to comment Number 2: Done, the percentage of people suffering from Misophonia was added with a supporting reference in lines (91-93) as follows ¨It is considered a widely spread neurological condition that affects 1 in every 5 people according to (Vitoratou et al., 2023). Leading to stress, anxiety, and reduced productivity.¨ highlighted in yellow in the text. while the percentage of people affected by ADHD was already stated in the text: now highlighted in yellow and is in lines (185-187) as follows: "Approximately 5% of children and 2.5% of adults globally are affected by ADHD where it is more commonly diagnosed in males than females, with a ratio of approximately 2:1 in children (Peri and Parveen, 2023)."

Comment Number 3: The methodology of the research could be more clearly justified. How was the literature review undertaken (key search terms etc).

Reply to comment Number 3: Done, the methodology of the current work was stated clearly in the introduction section. where the current work does not present a literature review but rather proposes a customized spatial design for special neurological conditions, specifically misophonia and ADHD, by following two specific architectural trends, which are minimalism and metaphysical architecture.  This is the point of novelty in the current work, which was not proposed before in the literature to our knowledge. The research methodology in the current work follows a theoretical approach by analysing and comparing the needs of Mesophonia and ADHD patients with the characteristics of minimal and metaphysical architecture, and how they can offer a solution for alleviating the symptoms of Mesophonia and ADHD. This is explained in the corrected introduction section as follows: "Therefore, the current work proposes the possible application of specific architecture trends in architectural spaces as a therapeutic approach to alleviate the symptoms of misophonia and ADHD disorders. This is achieved by following a theoretical analytical methodology where, first, misophonia and ADHD are identified and analysed in relation to possible triggers and stimuli in an architectural space. Then the proposed hypothesis of employing minimal and metaphysical architecture will be theoretically analysed by identifying these two architectural trends and their design characteristics, and how they would answer the special neurological needs of misophonia and ADHD patients. Then a further level of this therapeutic approach is proposed by employing Virtual and Augmented reality as an add-on to the architectural spaces to extend the spatial user experience beyond physical constraints, enhance spatial cognitive capacities, and lead the sensory experience in the space. This is aimed at enhancing the efficiency of this proposed therapeutic approach, highlighted in yellow in the text. 

Comment Number 4: What determined the research methodology and the sample size?

Reply to comment Number 4: the current work follows a theoretical methodology to propose a novel concept of employing minimal and metaphysical architecture spatial design to alleviate the symptoms of misophonia and ADHD neurological conditions. the current work employs analytical deductive methodology by identifying and analysing misophonia and ADHD conditions and analysing the characteristics of minimal and metaphysical architecture and deducting a relation of congruency between the spatial design of minimal and metaphysical architecture and the spatial design needs for misophonia and ADHD patients. this is as a first step since this concept of following specifically minimal and metaphysical architecture to alleviate the symptoms of misophonia and ADHD was not presented before in literature. As a proof of concept, before the adoption of clinical experimentations on adopting these architectural trends in alleviating the symptoms of misophonia and ADHD. This was explained in the modified abstract and introduction section. Thus, the current study does not include clinical tests at this stage. 

Comment Number 5: What level of alignment of the results was achieved?

Reply to comment Number 5: The current work follows an analytical deductive theoretical methodology. based on comparing the special neurological needs of misophonia and ADHD patients and the required spatial criteria with two architectural trends, which are minimal and metaphysical architecture. To deduce the key design criteria for the customized spatial design for misophonia and ADHD conditions. The reached design criteria were presented in a diagram in Figure 8. 

Comment Number 6: Moving on from this research, what would be the most appropriate follow-on research to be conducted?

Reply to comment Number 6: the next step is the clinical tests of this proposed customized spatial design and its add-ons in Virtual and Augmented Reality. Such clinical experimentation requires an interdisciplinary team of architects, physicians, psychologists, and psychiatrists. It also requires the design of measuring tests of the symptoms of misophonia and ADHD, which usually vary from one patient to another, making this process of measuring the effect of the customized spatial design on alleviating or worsening the symptoms of ADHD and Misophonia challenging. Therefore, the author dedicated the following study to this clinical experimentation. 

Comment Number 7: What design guides are already in place (I use PAS 6463 as an example, but there are others). What do these design guides achieve and where do they fall short?

Reply to comment Number 7: the current work discusses two particular neurological conditions, which are misophonia and ADHD; these two conditions have specific requirements each in the spatial design of architecture, and this point was not discussed in literature before up to the author's knowledge. And this is what defines the novelty of the current work; the proposal of particular architecture trends: minimal and metaphysical architecture design crieteria as the compatible trends that offer the solution to alleviate the symptoms of misophonia and ADHD. The mentioned design guides of PAS 6463 are for neurodiversity, and this is a generalised design crieteria in comparison to the current work scope and objective. Thus, the mentioned PAS 6463 cannot be applied or reviewed in the current work that focuses on specific neurological conditions that are proven to be a medical condition, as mentioned in the literature as well, not as a sort of neurodiversity but rather a neurological disorder. Therefore, the current work proposes the application of minimal and metaphysical architecture design criteria as a solution to alleviate the symptoms of misophonia and ADHD through customized architectural spatial design. 

Comment Number 8: Work on the effect of view quality using VR has also be undertaken which could be considered.

Reply to comment Number 8: The quality of VR and AR tools is an interesting point indeed, since it affects the level of immersion of the user; however, such a technical point does not affect the proposal of employing VR and AR scenarios as a second level of customized spatial design as a therapeutic approach for misophonia and ADHD symptoms. Since the current work proposes the use of VR and AR as an add-on to the customized spatial design already following minimal and metaphysical architecture, however, the quality of VR and AR can be compared and discussed in a separate study that measures the effect of the view quality on the level of immersion in general. Furthermore, the level of immersion can be studied as well on its effect on various neurological disorders; however, it would be more appropriate for a clinical experimental study, which falls out of the scope of the current work. 

Comment Number 9: You mention biophilia. How important is this, as suggested in the literature?

Reply to comment Number 9: Biophilia was reported to have a favourable effect on mental and physical health, and has been proven to cope with stress and anxiety as reported in literature (Yin et al., 2020; Gaekwad et al., 2022). which is congruent with the spatial design criteria required for anxiety and stress relief, which are usually products of misophonia and ADHD. Therefore, the author used it as an example of possible VR and AR scenarios as an add-on to the customized spatial design. An extended explanation was added in the manuscript, highlighted in yellow, justifying the use of biophilia in VR and AR scenarios as an add-on to the customized spatial architecture design. 

Comment Number 10: You talk about ADHD and Misophonia some comment (even if outside the research conducted) on the appropriateness of these approaches to other conditions and designs would seem appropriate.

Reply to comment Number 10: the current research objective and scope focus specifically on these two neurological conditions: Misophonia and ADHD, since they both affect productivity daily and affect well-being in the long run. On the other hand, it is well known that each neurological condition or disorder has its particular symptoms and how it could be affected by the surrounding environment. Thus, in the current study, the author insists on focusing on these two specific neurological disorders that are logically affected by the architectural spatial environment that might alleviate or worsen their symptoms. Furthermore, since clinical studies of testing these deducted spatial design criteria affect Misophonia and ADHD patients specifically, it is more appropriate to maintain the limits and scope of the current work to these two specific neurological conditions. 

Comment Number 11: Are there lessons to be learnt, possibly for hospital design ?

Reply to comment Number 11: This is an interesting question. However, ADHD and Misophonia are common neurological disorders that affect a considerable percentage of people, as mentioned in detail in the introduction section; therefore, the current work presents the architectural spatial design criteria for these two common conditions following minimal and metaphysical architecture. With the presented design proposal of a student´s room, studying is the activity most relevant to productivity and most affected by both misophonia and ADHD symptoms. Therefore, the author believes that productivity-related activities in architecture typology are the most relevant to the proposed hypothesis in the current work. Also, that Misophonia and ADHD conditions are not usually the conditions that require hospitalization. This was explained in the methodology sections supported by references. 

Comment Number 12: The differences between VR and AR could have been better explained.

Reply to comment Number 12: Done, an extended explanation of VR and AR is presented in the methodology section, highlighted in yellow in the text. 

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Acceptable