Scoping review identifies current evidence and research gaps on nature’s benefits for individuals with autismA substantial body of research has established connections between nature and improved well-being, cognition, and behavior among neurotypical individuals; however, relatively little attention has been given to examining nature’s effects for individuals with autism spectrum disorder (ASD). This scoping review was conducted to explore the existing evidence of nature’s benefits for children and adults with ASD. The review was guided by the question: “Does proximity to “greenness” or time spent in “nature” affect behavior, function, and well-being among individuals on the autism spectrum?” Specifically, the review aimed to identify (1) the types of studies conducted with individuals with autism, (2) the populations and outcomes investigated and (3) the gaps that remain in the research on nature and autism.
A comprehensive search of 12 academic databases and the gray literature was conducted to identify research focused on exposure to nature and people with autism. Specifically, the studies were required to examine the influence of nature-based interventions or exposure to nature on outcomes related to well-being, behavior, or function for individuals with autism. Studies reporting empirical research, either published in a peer-reviewed journal or as a thesis or dissertation, were considered for inclusion in the review. Only studies published in English were included. Identified articles were screened based on these criteria, resulting in 36 studies that were selected for inclusion in the review. The studies were conducted in more than 12 countries, with the majority conducted in the U.S. or the U.K. For the most part, the studies were published between 2016 and 2023 (86%) in peer-reviewed journals (75%). Four studies were master’s theses and five were PhD dissertations. Fourteen studies employed quantitative designs and 22 used qualitative or mixed methods. Sample sizes ranged widely between studies. Nearly half of the studies had 10 or fewer participants. On the other hand, three large epidemiological studies utilized national data, which included over 1500 participants with ASD. The studies collected data from individuals with ASD as well as from their teachers, paraprofessionals, caregivers, or parents. Most studies focused on children and adolescents, although three studies were conducted with adults only. Overall, the studies involved more male than female participants.
The studies also varied by type of nature activity investigated, which included: (1) nearby nature outings (14 studies), (2) gardening or horticulture therapy programs (8 studies), (3) multi-day or week nature trips involving activities such as hiking, camping, and rock-climbing (5 studies), (4) aggregate scale nature exposure studies that examined green space proximity (3 epidemiological studies), and (5) non-specific nature access studies that examined perceived benefits of or barriers to nature exposure for people with ASD (7 qualitative studies). Well-being was the most frequently investigated outcome among the studies, which included constructs for quality of life, social-emotional benefits, sensory benefits, physical wellness, nature connectedness, self-esteem, and independence. Outcomes related to behavior assessed by the studies focused on maladaptive behaviors or conduct problems, internalizing and externalizing behaviors, and attention problems. Finally, outcomes related to function included positive social skill development, overall function or communication, emotional intelligence, and motor function.
Main findings of the review highlight several current knowledge areas and gaps. First, quantitative and qualitative studies have focused on different types of nature and autism relationships. Second, results from quantitative and mixed methods studies suggest that gardening/horticulture programs and nearby nature outings may have a positive effect on several well-being, behavior, and function outcomes. Third, there is a paucity of quantitative studies examining aggregate scale nature exposure, nature trips, and non-specific nature access. Fourth, qualitative research has mainly examined the influence of non-specific nature access on well-being.
This scoping review provides an overview of 36 studies that offer insight into how nature may support the well-being, behavior, and function of children and adults with autism. Overall, findings suggest that “if safety and risk factors are thoughtfully addressed, nature – particularly nearby, accessible nature – offers a low-stakes opportunity to affect the health and function of people with autism.” In school or home contexts, this may be accomplished by daily time outdoors through activities such as nature walks or gardening. In other settings, such as parks, designers might consider modifications to improve accessibility or the addition of design elements that support a “multisensory experience that is tailored to the neurodivergent community.” Importantly, the reviewed studies also provide “the groundwork for future research that can further illuminate the potential for nature to benefit humans – beyond neurotypical individuals.” Specific opportunities for future research regarding the effects of nature on individuals with ASD are offered.
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