Systematic review: Neurodevelopmental benefits of active/passive school exposure to green and/or blue spaces in children and adolescents

Díaz-Martínez, F., Sánchez-Sauco, M. F., Cabrera-Rivera, L. T., Sánchez, Ojeda, Hidalgo-Albadalejo, M. D., Claudio, L., & Ortega-García, J. A. (2023). Systematic review: Neurodevelopmental benefits of active/passive school exposure to green and/or blue spaces in children and adolescents. International Journal of Environmental Research and Public Health, 20. https://doi.org/10.3390/ijerph20053958

Nature in the school environment supports children’s and adolescents’ healthy neurodevelopmentHealthy school environments, including elements of nature, can benefit the overall well-being and academic performance of children and youth. Exposure to nature in schools may be passive or active. Passive exposure involves being “surrounded by nature without direct interaction,” and is measured using the normalized difference vegetation index (NDVI) or other assessments of vegetation cover. Active exposure involves children’s direct engagement with nature through outdoor learning or nature-based activities. This review aims to explore how passive and active interactions with nature at school may benefit the neurodevelopment of children and adolescents.

A search of the literature was conducted to identify studies that investigated active or passive exposure to green and blue spaces in school settings and the neurodevelopment or neurobehavior of children and adolescents (under the age of 18). The search was conducted in both English and Spanish, however, only articles written in English were found. A total of 28 studies, published from 2017–2022, were included in the final review. Most of the research was based in the United States or Europe. An assessment of study quality determined the studies to be of high quality. Methods used to assess green and/or blue space exposure varied across studies. Most studies investigated the passive effect of nature (n = 19) and measures focused on availability of surrounding greenery (NDVI), accessibility of green and/or blue spaces (such as parks), or other indicators (% of the tree canopy or vegetation inventories). Studies of active nature interventions (n = 9) mainly considered outdoor learning or recreational experiences in nature, although some studies focused on green walls or other classroom-based forms of nature engagement.

The review identified gains in children’s and adolescents’ cognitive and academic performance, attention restoration, behavior and impulsivity, conduct and social interaction, neurodevelopmental diseases and disorders, working memory, and emotional well-being. Fifteen studies evaluated academic/cognitive outcomes. The majority of studies (8) associated higher levels of nature exposure with significant improvements to academic performance, mainly measured by reading and math scores. Conversely, two studies reported significantly lower test or IQ scores with green exposure and several studies found no relationship. Two studies of blue space exposures reported mixed findings. Attention restoration was investigated by eight studies. Five studies found exposure to natural environments to positively impact attention control. On the other hand, three studies did not detect significant differences in attention. The influence of nature on working memory was explored by three studies. Two of these studies indicated that nature exposure (both active and passive) had a significant positive effect on working memory as compared with control groups; however, the third study did not. Students’ emotional well-being was found to increase as nature exposure increased in all three studies assessing this outcome. Student behavior was investigated by eight studies that focused on aggressiveness, self-control, or impulsivity. Half of these studies found improved behavior with more nature exposure, including reduced aggression and bullying, as well as increased positive social interactions. The other four studies did not detect significant associations between nature exposure and student behavior. Five studies that investigated students’ conduct and social interaction all reported positive gains in relation to nature exposure. Four of these studies involved passive exposure to school greenery, and one focused on an active engagement with nature. Improvements were noted in behavior and self-regulation, while chronic absenteeism and obsessive-compulsive disorders were reduced. Four studies focused on neurodevelopmental diseases and disorders all reported positive findings. Children with autism experienced reduced symptoms through active participation in a forest school and reduced autism risk was related to increased tree cover. Increased greenery was also associated with a lower likelihood of ADHD symptoms and decreased developmental behavioral syndromes.

Overall, the review indicates that though the evidence is sparse, “contact with nature in the school environment seems to positively influence cognitive and behavioral development in children and adolescents.” Findings provide evidence of the many positive effects of nature exposure regarding academic performance and other neurodevelopmental processes that enable children’s success in school, such as attention and behavior. Further, beneficial outcomes were consistent across both passive and active nature interventions. While additional research is needed, findings suggest that greening schoolgrounds and incorporating nature into the curriculum will support children’s and adolescents’ healthy neurodevelopment.

The Bottom Line

Nature in the school environment supports children’s and adolescents’ healthy neurodevelopment