The relationship between greenspace and child neurobehavioral health may differ by both environmental attributes and the child's neurobehavioral traitsExposure to greenspace in urban environments has received increasing attention as a modifiable factor that may support children’s neurobehavioral health, including mental and cognitive functioning. An expanding body of research has linked greater residential greenspace exposure to improved working memory and attention, reduced attention-deficit behaviors, and a lower prevalence of mental health disorders. However, this study argues that the evidence base is limited by methodological approaches that examine cognitive and psychological outcomes separately and rely on simplified measures of greenspace exposure. Such approaches may fail to capture the interconnected nature of cognitive and psychological traits in children’s everyday lives. To address these gaps, the study: (1) integrated measures of cognitive functioning (executive function) and mental health to identify distinct neurobehavioral profiles in children; (2) examined associations between children’s neurobehavioral profiles and multidimensional measures of greenspace exposure, combining objective measures from satellite and street-view imagery with caregiver-reported exposure data; and (3) identified which neurobehavioral domains were most strongly related to greenspace and examined whether these associations differed across neurobehavioral profiles (such as children characterized as “well-adapted” versus those experiencing “pervasive difficulties”).
Children in grades 1 through 6 were randomly recruited from 15 schools in Zhongshan City, Southern China, to participate in the study. Complete data were obtained from 5344 children (mean age 8.5), 54% of whom were boys. Greenspace exposure was assessed using both objective metrics and caregiver-reported greenspace experience and engagement. Objective metrics used satellite-based vegetation indices to estimate greenspace within a 500-meter circular buffer around each participant's residence, using three indices: the normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and soil-adjusted vegetation index (SAVI). Additionally, the green view index (GVI) captured eye-level greenspace exposure along all pedestrian-accessible roads within the same residential buffers. Caregiver-reported greenspace experience and engagement were assessed with a researcher-developed questionnaire. The questionnaire evaluated multiple domains of perceived greenspace exposure: (1) accessibility of recreational green space within a 15-minute walk of home, (2) home window views of green space, and (3) indoor greenness (houseplants). The questionnaire also examined greenspace usage patterns through caregivers’ reports of their child’s monthly visit frequency, visit duration, and perceived quality of the most frequently visited green space (quantity, visual quality, cleanliness, facilities, safety, tranquility, and vegetation richness). Children's executive function in daily life over the previous six months was assessed with the caregiver-reported Behavioral Rating Inventory of Executive Function (BRIEF), which included eight subscales: inhibit, shift, emotional control, initiate, working memory, plan/organize, organization of materials, and monitor. Children's emotional and behavioral functioning over the preceding six months was evaluated using the caregiver-reported Strengths and Difficulties Questionnaire (SDQ), which assessed emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Caregivers also reported their education level and household financial status, which were incorporated in data analysis. Statistical analyses examined the relationships between greenspace metrics and neurobehavioral profiles.
Children were classified into four neurobehavioral profiles based on their BRIEF and SDQ scores. Profile 1, “Well-Adapted” (31.6% of children), had the most favorable scores across all domains. Profile 2, “Normative Development” (35.2%), was characterized by typical executive functioning and behavioral attributes. Profile 3, “Hyperactive–Cognitive Dysregulation” (24.0%), showed moderate elevations across all BRIEF executive function scales and the SDQ Hyperactivity scale, along with relatively lower prosocial behavior. Profile 4, “Pervasive Difficulties” (9.2%), exhibited pronounced elevations across all BRIEF and SDQ difficulty scales and the lowest prosocial behavior scores. The relationships between greenspace exposure and these neurobehavioral profiles differed between objective and self-reported greenspace measures. For objective measures (satellite-derived vegetation indices), higher greenspace exposure within 500 meters was linked to lower rates of the most severe “Pervasive Difficulties” profile (Profile 4). Specifically, an increase of one interquartile range (IQR) in NDVI was linked to a 16% reduction in the odds of being in Profile 4 rather than Profile 1 (“Well-Adapted”). As greenspace increased, the likelihood of being in Profile 4 decreased. Profile 4 was the only profile showing this significant relationship with NDVI, and similar relationships were found for the other objective greenspace metrics (EVI and SAVI). Street view-based greenspace (GVI) was also related to neurobehavioral profiles. A 10% increase in GVI was linked to lower odds of membership in both the “Hyperactive-Cognitive Dysregulation” profile (Profile 3) and the “Pervasive Difficulties” profile (Profile 4). Children with the highest GVI exposure had significantly lower odds of belonging to Profile 4 and Profile 3 compared to children with the lowest GVI exposure.
Caregiver-reported greenspace measures were related to a broader range of neurobehavioral profiles. Children with recreational greenspace within a 15-minute walk from home had significantly lower odds of belonging to Profile 2, Profile 3, or Profile 4 compared to Profile 1. Similar relationships were found for children with green views from their home windows. “Extensive continuous” green views were associated with lower odds of belonging to Profile 2 compared to “no visual green space.” Children with more indoor potted plants were also less likely to belong to less-adaptive profile groups. The frequency of greenspace visits or the duration of stay per visit were not significantly related to any neurobehavioral profiles; however, higher perceived greenspace quality was consistently linked to lower odds of belonging to Profile 2, Profile 3, and Profile 4.
The final stage of analysis examined the interrelationships between multidimensional green space metrics and neurobehavioral profiles. Findings suggest that emotional dysregulation in particular, as well as attentional/working memory difficulties, act as important links in the relationship between greenspace and neurobehavioral profiles. Emotion regulation was closely related to greenspace exposure and neurobehavioral health, especially for children with greater neurobehavioral difficulties. Different greenspace aspects were also found to be important for different groups of children. Perceived quality was most important for well-adapted children, while the amount and accessibility of greenspace were more important for children with difficulties. This suggests that the benefits of greenspace may vary depending on children’s neurobehavioral profiles.
The researchers conclude that “this person-centered study shows that the associations between green space and child neurobehavioral health exhibit a dual-specificity pattern: they differ by both the environmental attribute and the child's neurobehavioral characteristics.” Importantly, emotional symptoms were found to play a “consistent bridging role” in the complex interrelationships between greenspace and neurobehavioral health. In particular, findings suggest that children with pervasive neurobehavioral difficulties may be an environmentally sensitive subgroup and that nature contact may serve as a pathway to support their emotion regulation and overall development. These findings support the development of environmental health strategies and interventions that address community needs, promote equitable access to greenspace, particularly for vulnerable populations, and enhance the restorative quality of natural environments. Future longitudinal studies are needed to determine whether greenspace directly influences children’s neurobehavioral health and to better understand the underlying biological and psychological mechanisms. Because this study used a cross-sectional design, causal relationships cannot be established. Further research is also needed to determine whether these findings apply to children living in different geographic, climatic, and sociocultural settings.
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