What is the effectiveness of nature-based therapy on improved occupational performance for youth with autism spectrum disorder?

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Boggs, Sarah
Croissant, Rachel
Heddens, Bridget
Poling, Audrey
Willmann, Andrea
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Research Projects
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BACKGROUND: While traditional therapies have long been utilized for individuals with autism spectrum disorder (ASD), changes in global perception and attitudes have promoted a shift away from treatment of autism symptoms and toward acceptance and empowerment of function for individuals with ASD diagnoses. In conjunction with increasing rates and prevalence of neurodivergent and ASD diagnoses among pediatric populations, exploration of non-traditional therapies has increased. New and emerging practice settings including the use of animals and outdoor spaces have sought to provide children and families with more robust, comprehensive, and whole-person-centered interventions. AIM: This critically appraised topic (CAT) is aimed at determining the effectiveness of nature-based interventions on increasing occupational performance in youth (18 years and younger) with autism spectrum disorder (ASD). METHODS: A comprehensive search strategy was employed including the databases; EBSCOhost, Google Scholar, CINAHL Complete, SAGE Journals, PSYCINFO, and Cochrane Library. Inclusion criteria were defined to select studies with the highest level of evidence, only peer-reviewed articles published after 2013, interventions falling under the umbrella of nature-based interventions, articles including youth diagnosed with ASD, and outcomes related to occupational performance. Articles meeting the criteria underwent thorough analysis and appraisal and were categorized according to their level of evidence and study design. Studies with levels 1A, 2B, and 3B evidence were included. Limitations of the studies appraised were carefully identified and summarized, shedding light on potential biases and implications for the generalizability of findings. RESULTS: Through a rigorous review process, the critical appraisal gave a comprehensive overview of the current evidence regarding nature-based interventions for youth with ASD, informing practice, research, and policy development in occupational therapy (OT). Nature-based interventions are within the occupational therapy scope of practice and from the studies appraised have been shown to promote motor skills, sensory function, emotional well-being, skill acquisition, social engagement, executive functioning, and communication. However, the evidence is limited due to a lack of high-level research and small sample sizes. Occupational therapists should continue to conduct more research on the effectiveness of nature-based interventions for youth with autism as a client-centered, holistic approach to care.
Creighton University
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