The Great Outdoors Is Great For Kids With ADHD

There’s another “deficit disorder” that’s in the news-nature-deficit disorder, a term coined by Richard Louv, author of Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder. Louv’s thesis:

“Experiences in the natural world may reduce the symptoms of Attention Deficit Hyperactivity Disorder, serve as a buffer to depression and anxiety, help prevent or reduce obesity and myopia, boost the immune system, and offer many other psychological and physical health benefits. Time spent in nature may also improve social bonding and reduce social violence, stimulate learning and creativity, strengthen the conservation ethic, and even help raise standardized test scores.” [1]

That quote is from Louv’s newest book, Vitamin N, which offers “500 Ways to Enrich the Health & Happiness of Your Family and Community” by establishing a “nature-rich” life. (more here)

In the chapter on mindfulness in my book Finally Focused (Harmony, May 2017), I tell the story of an ADHD boy who was naturally attentive whenever he would spend time rowing around a pond, fishing. I think the “great outdoors” is great for kids with ADHD, and an important part of an overall treatment program.

And so, paging through and enjoying Vitamin N, I wanted to share with the readers of the Finally Focused blog both the scientific evidence that nature is good for kids and adults with ADHD-and a couple of easy ways to make life more “nature-rich,” as Louv advises us to do.

First, let’s look at the evidence-with the most recent study, published in April of this year, showing that the everyday noise of a busy city can be tough on kids with ADHD…

Traffic noise worsens the symptoms of ADHD. A team of European researchers studied children 7- to 11-years-old who were living in Barcelona, a city with more than 1.6 million inhabitants. They found that traffic noise in the classroom increased the severity of ADHD symptoms by about 25%. [2]

But “green space” eases symptoms. The same team of researchers studied more than 2,000 school children in the second to fourth grades who were living in Barcelona. Over 12 months, they measured the children’s’ memory and inattentiveness. And they found children exposed to more “green space” (any area of grass, trees or other types of vegetation in the urban environment) had better memory and were less likely to be inattentive. Green space at home…green space on the commute to school…green space around the school-the more there was of it, the better a child’s recall and focus. [3]

“Blue space” works, too. In another study on the same children, researchers looked at green space and “blue space” (beaches)-and behavior. Once again, they found that children with greater exposure to green and blue spaces were less likely to have ADHD symptoms and “emotional symptoms”…had better relationships with their peers…and had more “prosocial” behavior. “Our findings,” they concluded, “support beneficial impacts of contact with green and blue spaces on behavioral development in schoolchildren.” [4]

The closer the green, the better. In another study, just having proximity to nature-“the distance between a child’s residence and the nearest urban green space”-made it less likely a child would develop the symptoms of ADHD. Kids who lived more than 1/3rd of a mile (500 meters) from a green space were 20 percent more like to develop hyperactivity and inattentiveness than children with a green space within 1/3rd of a mile. [5]

If you want your child to focus-take a 20-minute walk in the park. Researchers at the University of Illinois studied ADHD children 7- to 12-years-old, taking them on three types of 20-minute walks: downtown, in the neighborhood, or in a city park. “Children with ADHD concentrated better after the walk in the park,” the researchers wrote in the Journal of Attention Disorders. In fact, the effect was comparable to methylphenidate (Ritalin, Concerta, Daytrana, Methylin, Apetensio). [6]

Green is a go for ADHD. In an earlier study, the same scientists asked nearly 500 parents of children 5- to 18-years-old to rate the “aftereffects” of 49 after-school and weekend activities on the symptoms of children with ADHD. The result: “…green, outdoor activities reduced symptoms significantly more than did activities conducted in other settings,” wrote the researchers in theAmerican Journal of Public Health. [7]

Like the researchers from the University of Illinois, I think that outdoor activity is not the answer to ADHD-but is can be very helpful in an overall treatment regimen that might or might not include medications. Here’s how those researchers put it. Like Louv, they see nature as a treatment-vitamin N-and mention the “dose” of green that might do the trick…

“In the case of children for whom medication is tolerable and effective, exposure to green settings as part of their daily routine might augment the medication’s effects, offering more complete relief of symptoms and helping children function more effectively both at school and at home. In addition, a green dose or series of green doses might conceivably reduce the need for medication by 1 dose per day, allowing growing children to recover their appetites in time for dinner and get a good night’s sleep.”

How do you help your child get his or her vitamin N? Here are three of Louv’s many suggestions…

Walk this way. As you saw from the research, walking works. “On their first hike, younger children can enjoy playing a game called ‘walk this way’-imitating different animals along the way,” Louv writes. He also suggests bringing toys and props along, like hats and fake swords. Walk-talkies are also a big hit, he notes. “To help kids pay attention during longer hikes,” he advises, “play find ten critters-which means discovering footprints or other signs of an animal passing through.”

Turn your commute into a nature safari. Remember, even seeing green space on a commute eased ADHD symptoms. “If you’re stuck in traffic, entertain yourself and your kids by keeping an eye out for plants, animals, or other natural curiosities on the side of the road,” Louv writes. “If you see something really intriguing, pull over and take a look.” He quotes a mother who enthusiastically endorses this approach: “We’ve pulled over more times than I can count because one of us spotted something worth watching,” she said. “Cool cloud formations, gorgeous sunsets and make-you-smile rainbows. And the birds-oh, the birds-they never disappoint!”

Make the “green hour” a family tradition. Give your kids a daily green hour for unstructured play and interaction, he suggests. If you can’t spare a green hour, start with 15 minutes.

Vitamin N-different “doses” for different ages. Louv gives these vitamin N guidelines for children of different ages. Infants: Recognize they need nature; stay close by. Toddlers. Give them the space to explore. Middle schoolers: Encourage them to hunt, gather, and navigate. Preteens and teenagers: Don’t assume they no longer need nature, says Louv: “…nature provides young adults with rich opportunities to build personal identity, connections to other people, and social and environmental responsibility.”

Yours for focus and health,

James Greenblatt, MD

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