Nature Therapy Including Art and Horses Show Promise for Autistic Children

The children involved in the interventions showed improvement in their sensory, social, and behavioral functioning, a new study finds.

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Therapies that entail nature, including activities involving horses, music, and art, have been found to help children with autism, a new study reports.

Children who received so-called nature-based interventions showed significant improvements in behavioral, sensory, emotional, and social functioning, according to the systematic review and meta-analysis of 24 studies conducted by a team of pediatricians from the Nethersole School of Nursing at the Chinese University of Hong Kong (CUHK). It is the first thorough analysis examining how nature-based interventions affect the overall well-being of children with autism, researchers noted.

In the study, published on Dec. 7 in the Journal of American Medical Association (JAMA) Network Open, the 24 nature-based interventions assessed included the following:

• Equine-based therapy.
• Surfing.
• Adventure activities.
• Summer camp.
• Nature therapy.
• Horticultural therapy.
• Outdoor music therapy.
• Outdoor art therapy.

The therapies involved 717 children from around the world: the United States, United Kingdom, Europe, Brazil, Iran, Canada, China, India, and Israel. One hundred percent of the therapy sessions were face-to-face and occurred in natural outdoor settings, and many occurred in group settings ranging in size from four to 116 children. Over half of the interventions were led by qualified instructors.

The children involved in the interventions showed improvement in their sensory, social, and behavioral functioning. In particular, many were able to maintain attention for more extended periods. Additionally, the children who participated in the nature-based interventions showed an improvement in their hyperactivity and irritability. Finally, the researchers noted a correlation between nature-based interventions and overall social functioning. No adverse events were reported.

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a type of developmental disability that typically begins before a child turns 3 years old. Individuals with ASD often behave, interact, or learn differently than most others. They may have difficulty following standard social or cultural norms, making it hard to develop and maintain friendships, communicate with peers, or understand what behaviors are expected of them in social, work, or school settings.

Because symptoms for individuals with ASD vary, current treatment options also vary. According to the U.S. Centers for Disease Control and Prevention (CDC), treatment options fall into categories such as behavioral, pharmacological, psychological, and complementary/alternative. Nature-based interventions fall into the complementary/alternative category, including special diets, herbal supplements, chiropractic care, mindfulness, and relaxation therapies.

Many Families Choose Alternative Therapies

“This systematic review and meta-analysis provides insights to guide treatment decisions and interventions for children with ASD,” the research team wrote. “Although the aspect of emotional functioning remains uncertain ... [previous review] outcomes improved psychological well-being, enhanced self-esteem and resilience, overall well-being and mental health.”

The study outcome indicates experiential learning may be an effective education modality for children with ASD. The researchers also noted that the quality of nature-based interventions can vary and that the cost of participation in such modes of therapy may be prohibitive.

The cost of equine therapy, for example, varies based on several factors, including where you live and the services offered. Therapy sessions can range from $50 to $300 per session, with group lessons costing less. Art therapy fees also come in a range. Some places charge $65 per group session, while an individual session can cost between $175 and $200.

Even with the high costs, many parents who have children with ASD turn to alternative therapies. A study mentioned in an article in the American Medical Association Journal of Ethics noted that up to 95 percent of parents of children with ASD use complementary and alternative therapies to help improve symptoms associated with ASD. In another study published in the Journal of Autism and Developmental Disorders, 74 percent of parents of children with ASD relied on complementary and alternative therapies in lieu of pharmaceuticals due to concerns about side effects.

The CDC recommends that individuals and families connect with their physicians before engaging in complementary or alternative therapy.