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"Research Suggests a Green Approach to Treating ADHD"
By David Wild.  Reprinted from CNS News, with permission.  January 2005

 

Researchers get closer to understanding the specifics of how certain activities in certain settings affect the symptoms of attention-deficit/hyperactivity disorder.
Spending time in green outdoor settings may reduce the symptoms of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, a questionnaire-based study suggests. According to the investigators, these are some of the strongest data to date demonstrating a link between such surroundings and subsiding symptoms.

Investigators Frances Kuo, PhD, associate professor in the Departments of Natural Resources/Environmental Sciences and Psychology, and Andrea Faber Taylor, PhD, also from the Department of Natural Resources and Environmental Sciences, both at the University of Illinois at Urbana-Champaign, examined data from the parents of 452 children or adolescents with clinically diagnosed ADHD. The participants had completed questionnaires that were posted on the Web site of the national organization Children and Adults with Attention-Deficit/Hyperactivity Disorder.


Responders rated the effects of common after-school and weekend activities on four of their children’s ADHD symptoms. These included difficulties with remaining focused on unappealing tasks, completing tasks, listening to and following directions and resisting distractions. Green spaces were defined as "mostly natural areas–parks, farms or just a green backyard or neighborhood space." Questionnaires also included an item examining possible responder bias regarding the effects of green spaces on ADHD symptoms. The researchers also conducted multiple statistical analyses to control for activity type and social setting.


Drs. Kuo and Faber Taylor found that most of the ADHD sufferers were males who had been diagnosed with the hyperactive subtype and that the majority were between the ages of 7 and 13 years. Questionnaire responders derived from large cities (14%), suburban areas (40%), medium-size towns (16%), small towns (14%) and rural areas (16%). Also, the sample represented wide regional variation, with 29% from the Northeastern United States, 22% residing from the South, 23% from Western states and another 26% living in the Midwest.


Outdoor activities in green environments led to significant symptom abatement among all patients with ADHD across all regions and environments, as well as among those with comorbid conditions and those with varying levels of symptom severity (P<0.002 for all). In contrast, activities conducted in "built" outdoor settings such as parking lots, downtown areas or neighborhood spaces, significantly reduced ADHD symptoms only when they were conducted alone but did not reduce symptoms when conducted in larger groups (P<0.0001 and P=0.41, respectively). Likewise, indoor activities conducted alone were associated with reduced symptoms, but those conducted in larger groups exacerbated ADHD symptoms (P<0.0001 for both).


Findings from a previous, smaller study suggested that exposure to natural outdoor environments may alleviate symptoms of ADHD (Environ Behav 2001;33:54-77), but that study only examined children aged 7 through 12 and was restricted to the Midwestern United States. "Some of the specific findings of this study argue against potential alternative explanations for the green advantage," the investigators wrote.


Details about the study can be found in the American Journal of Public Health (2004;94:1580-1586).