Beyond one-size-fits-all: sensory regulation and age-specific design in pediatric healthcare environments

Pediatric healthcare design often applies generalized child-friendly principles across a broad age range, from neonates through adolescence, despite well-established developmental differences in sensory processing, autonomy needs, and emotional regulation. Visual elements such as artwork and visual openness (e.g., window or corridor exposure) are commonly assumed to function as positive distractions across pediatric settings. However, evidence supporting these assumptions across developmental stages remains limited. This paper proposes a shift from one-size-fits-all approaches toward age-sensitive, regulatory framing of art and visual design in pediatric healthcare environments. Drawing on literature from pediatric healthcare design, developmental psychology, and sensory modulation, we synthesize evidence suggesting that visual environments may support or undermine wellness depending on developmental stage, context, and cumulative sensory load. To situate this framework within an applied design context, we present empirical observations from an immersive virtual reality evaluation integrating eye-tracking and physiological sensing. Responses of younger children (8-11), older children (12-17), and parents were examined across variations in artwork, a large exterior window, a multi-feature visual condition, and a low-stimulation reference condition in pediatric patient rooms. Observed patterns indicate that visual features intended to promote comfort and engagement can have divergent regulatory responses across age groups, particularly in relation to perceived autonomy and visual complexity. We conclude by outlining implications for pediatric healthcare design that emphasize calibration rather than amplification of sensory input, and discuss how immersive, data-informed approaches can support developmentally responsive decisions about art and visual environments across pediatric settings.