One of the challenges faced by children with attention deficit/hyperactivity disorder (ADHD) is paying attention and staying on-task during classroom instruction. Because of this, they often experience lower academic performance than other children. The purpose of this study was to examine the effectiveness of two interventions among early elementary students diagnosed with ADHD: child-centered play therapy (CCPT) and nature-based child-centered play therapy (NBCCPT). CCPT uses a nondirective play approach and seeks to establish a safe, nurturing environment to promote children's growth. Play materials used during a CCPT session often include manufactured toys, such as dolls and clay. NBCCPT uses a similar approach but differs from CCPT by conducting sessions in an outdoor natural environment versus indoors and uses natural materials (sticks, leaves, sand) versus manufactured toys for play.
Researchers randomly assigned eight children to one of three groups: CCPT, NBCCPT, and waitlist. All of the children were diagnosed with ADHD and all attended the same school. Children in the CCPT and NBCCPT groups participated in corresponding 30-minute therapy sessions twice a week for six weeks. Children in the waitlist group did not participate in any type of intervention during this 6-week period.
Trained observers collected data on the participants' on-task behaviors during class time starting three weeks prior to the children's participation in the therapy sessions and continued throughout the six weeks of intervention. Results from the CCPT intervention ranged from debatable to effective. Results from the NBCCPT intervention ranged from debatable to very effective. Children on the waitlist showed no improvement in on-task behavior. Overall results indicated that the children who participated in either the CCPT or the NBCCPT intervention were almost 5 times more likely to improve on-task behaviors across the 6-week intervention period than children on the waitlist.
Results for the NBCCPT intervention are consistent with other research supporting the use of NBCCPT to address behavior problems in children. The current study adds to the existing research by comparing the effects of using CCPT, NBCCPT, and no intervention with children with an ADHD diagnosis. In addition to offering specific recommendations for further research on NBCCT, the authors also encourage school counselors and other practitioners to consider NBCCPT as a supplement to other types of intervention.
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