Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder

by Louv, Richard

  One child psychiatrist explains: “My prejudice is that girls with ADHD whose symptoms are similar to boys with typical symptoms of ADHD are not common.” Notice that he said “prejudice.” Much about ADHD remains a medical and political mystery.

  The massive increase in ADHD diagnoses and treatment may, in fact, be a matter of recognition: ADHD has been there all the time, called by other names or missed entirely, causing suffering for children and their families. Another explanation boils down to availability: three decades ago, the currently used medications were not widely known or as intensely marketed by pharmaceutical companies, and not yet fully trusted by physicians—and we’re lucky to have them now. Nonetheless, the use of such medications and the causes of ADHD are still in dispute. As of this writing, the latest culprit is television. The first study to link television-watching to this disorder was published in April 2004. Children’s Hospital and Regional Medical Center in Seattle maintains that each hour of TV watched per day by preschoolers increases by 10 percent the likelihood that they will develop concentration problems and other symptoms of attention-deficit disorders by age seven.

  This information is disturbing. But television is only part of the larger environmental/cultural change in our lifetime: namely, that rapid move from a rural to a highly urbanized culture. In an agricultural society, or during a time of exploration and settlement, or hunting and gathering—which is to say, most of mankind’s history—energetic boys were particularly prized for their strength, speed, and agility. As mentioned earlier, as recently as the 1950s, most families still had some kind of agricultural connection. Many of these children, girls as well as boys, would have been directing their energy and physicality in constructive ways: doing farm chores, baling hay, splashing in the swimming hole, climbing trees, racing to the sandlot for a game of baseball. Their un-regimented play would have been steeped in nature.

  The “Restorative Environment”

  Even without corroborating evidence or institutional help, many parents notice significant changes in their children’s stress levels and hyperactivity when they spend time outside. “My son is still on Ritalin, but he’s so much calmer in the outdoors that we’re seriously considering moving to the mountains,” one mother tells me. Could it simply be that he needs more physical activity? “No, he gets that, in sports,” she says. Similarly, the back page of an October issue of San Francisco magazine displays a vivid photograph of a small boy, eyes wide with excitement and joy, leaping and running on a great expanse of California beach, storm clouds and towering waves behind him. A short article explains that the boy was hyperactive, he had been kicked out of his school, and his parents had not known what to do with him—but they had observed how nature engaged and soothed him. So for years they took their son to beaches, forests, dunes, and rivers to let nature do its work.

  The photograph was taken in 1907. The boy was Ansel Adams. “Our brains are set up for an agrarian, nature-oriented existence that came into focus five thousand years ago,” says Michael Gurian, a family therapist and best-selling author of The Good Son and The Wonder of Boys. “Neurologically, human beings haven’t caught up with today’s over-stimulating environment. The brain is strong and flexible, so 70 to 80 percent of kids adapt fairly well. But the rest don’t. Getting kids out in nature can make a difference. We know this anecdotally, though we can’t prove it yet.”

  New studies may offer that proof.

  This research builds on the well-established attention-restoration theory, developed by a husband-and-wife research team, Stephen and Rachel Kaplan. Environmental psychologists at the University of Michigan, the Kaplans were inspired by philosopher and psychologist William James. In 1890, James described two kinds of attention: directed attention and fascination (i.e., involuntary attention). In the early 1970s, the Kaplans began a nine-year study for the U.S. Forest Service. They followed participants in an Outward Bound–like wilderness program, which took people into the wilds for up to two weeks. During these treks or afterward, subjects reported experiencing a sense of peace and an ability to think more clearly; they also reported that just being in nature was more restorative than the physically challenging activities, such as rock climbing, for which such programs are mainly known.

  The positive effect of what the Kaplans came to call “the restorative environment” was vastly greater than the Kaplans expected it to be. According to the Kaplans’ research, too much directed attention leads to what they call “directed-attention fatigue,” marked by impulsive behavior, agitation, irritation, and inability to concentrate. Directed-attention fatigue occurs because neural inhibitory mechanisms become fatigued by blocking competing stimuli. As Stephen Kaplan explained in the journal Monitor on Psychology, “If you can find an environment where the attention is automatic, you allow directed attention to rest. And that means an environment that’s strong on fascination.” The fascination factor associated with nature is restorative, and it helps relieve people from directed-attention fatigue. Indeed, according to the Kaplans, nature can be the most effective source of such restorative relief.

  In a paper presented to the American Psychological Society in 1993, the Kaplans surveyed more than twelve hundred corporate and state office workers. Those with a window view of trees, bushes, or large lawns experienced significantly less frustration and more work enthusiasm than those employees without such views. Like similar studies on stress reduction, this study demonstrated that a person does not have to live in the wilderness to reap nature’s psychological benefits—including the ability to work better and think more clearly.

  Subsequent research has supported the Kaplans’ attention-restoration theory. For example, Terry A. Hartig, an associate professor of applied psychology at the Institute for Housing and Urban Research at Uppsala University in Gävle, Sweden, along with other researchers, compared three groups of backpacking enthusiasts; a group who went on a wilderness backpacking trip showed improved proofreading performance, while those who went on an urban vacation or took no vacation showed no improvement. In 2001, Hartig demonstrated that nature can help people recover from “normal psychological wear and tear”—but nature also improves the capacity to pay attention. Hartig emphasizes that he does not test the extremes—say, the Sierras versus East Los Angeles. Rather, his studies have focused on what he describes as “typical local conditions.” As described in Monitor on Psychology, Hartig asked participants to complete a forty-minute sequence of tasks designed to exhaust their directed-attention capacity. After the attention-fatiguing tasks, Hartig then randomly assigned participants to spend forty minutes “walking in a local nature preserve, walking in an urban area, or sitting quietly while reading magazines and listening to music,” the journal reported. “After this period, those who had walked in the nature preserve performed better than the other participants on a standard proofreading task. They also reported more positive emotions and less anger.”

  Nature’s Ritalin

  Attention-restoration theory applies to everyone, regardless of age. But what about children, especially those with ADHD?

  “By bolstering children’s attention resources, green spaces may enable children to think more clearly and cope more effectively with life stress,” writes Nancy Wells, assistant professor at the New York State College of Human Ecology. In 2000, Wells conducted a study that found that being close to nature, in general, helps boost a child’s attention span. When children’s cognitive functioning was compared before and after they moved from poor- to better-quality housing adjacent to natural, green spaces, “profound differences emerged in their attention capacities even when the effects of the improved housing were taken into account,” according to Wells.

  Swedish researchers compared children within two day-care settings: at one, the quiet play area was surrounded by tall buildings, with low plants and a brick path; at the other, the play area, based on an “outdoors in all weather” theme, was set in an orchard surrounded by pasture and woods and was adjacent to a
n overgrown garden with tall trees and rocks. The study revealed that children in the “green” day care, who played outside every day, regardless of weather, had better motor coordination and more ability to concentrate.

  Some of the most important work in this area has been done at the Human-Environment Research Laboratory at the University of Illinois. Andrea Faber Taylor, Frances Kuo, and William C. Sullivan have found that green outdoor spaces foster creative play, improve children’s access to positive adult interaction—and relieve the symptoms of attention-deficit disorders. The greener the setting, the more the relief. By comparison, activities indoors, such as watching TV, or outdoors in paved, non-green areas, increase these children’s symptoms.

  In a survey of the families of ADHD children ages seven to twelve, parents or guardians were asked to identify after-school or weekend activities that left their child functioning especially well or particularly poorly. Activities were coded as “green” or “not green.” Green activities, for example, included camping and fishing. Not-green activities included watching television, playing video games, doing homework. Some activities, such as rollerblading, were labeled ambiguous. The controls in this study were more complex than space allows me to describe, but suffice it to say, the research team was careful to account for variables. They found that greenery in a child’s everyday environment, even views of green through a window, specifically reduces attention-deficit symptoms. While outdoor activities in general help, settings with trees and grass are the most beneficial. As they reported in the journal Environment and Behavior, “compared to the aftereffects of play in paved outdoor or indoor areas, activities in natural, green settings were far more likely to leave ADD children better able to focus, concentrate. Activities that left ADD children in worse shape were far more likely to occur indoors or outdoors in spaces devoid of greenery.”

  They also found that the positive influence of near-home nature on concentration may be more pronounced for girls (ages six to nine) than for boys. On average, the greener a girl’s view from home, the better she concentrates, the less she acts impulsively, and the longer she can delay gratification. This helps her do better in school, handle peer pressure, and avoid dangerous, unhealthy, or problem behaviors. She is more likely to behave in ways that foster success in life, according to the researchers. Perhaps, if girls are less biologically prone to ADHD, as some mental health professionals believe, they may exhibit milder symptoms and may also have a more robust, healthy response to the treatment—whether pharmaceutical or green.

  Based on the study, the University of Illinois issued this informal advice regarding girls to parents, caregivers, and others. The information also applies to boys:

  • Encourage girls to study or play in rooms with a view of nature.

  • Encourage children to play outdoors in green spaces, and advocate recess in green schoolyards. This may be especially helpful for renewing children’s concentration.

  • Plant and care for trees and vegetation at your residence, or encourage the owner to do so.

  • Value and care for the trees in your community. Caring for trees means caring for people.

  In addition to its work in the housing projects of inner-city Chicago, the Human-Environment Research Laboratory has also examined nature’s impact on children with ADHD in middle-class settings. There, as in the public housing development, parents reported that their children exhibited fewer symptoms of ADHD after spending time in green surroundings. “You could say that the kids who had greener settings were just richer,” says Kuo. “But that doesn’t explain the fact that even rich kids do better after being in green settings. . . .” In the report:

  Participants were asked if they had had any experiences, either positive or negative, related to any aftereffects of green settings on their child’s attention. One parent said she had recently begun taking her son to the local park for 30 minutes each morning before school because the weather was nice, and they “had some time to kill.” She then said, “Come to think of it, I have noticed his attitude toward going to school has been better, and his schoolwork has been better this past week. I think it’s because spending time at the park is pleasurable, peaceful, quiet, calming.”

  Another parent reported that his son could hit golf balls or fish for hours, and that during these times the boy was “very relaxed” and his attention-deficit symptoms minimal. “When I read the results of your study, they hit me in the face,” he told the researchers. “I thought, yes, I’ve seen this!”

  So had some of the parents I interviewed. Noticing that their children’s ADHD symptoms were calmed by natural settings, they applied common sense; they were already encouraging their kids to spend more time outdoors, and they felt affirmed when I told them about the Illinois studies.

  Taylor’s and Kuo’s more recent research findings are equally provocative. According to an unpublished study (which Taylor emphasizes is “a work in progress”), attention performance for unmedicated children clinically diagnosed with ADHD was better after a simple twenty-minute walk in a park, with a natural setting, than it was after a walk through well-kept downtown and residential areas.

  Expanding such knowledge, and applying it in practical ways, will be the next challenge. Although today’s common medications for ADHD offer temporary gains, including sustained attention and academic productivity, these medications may do little for a child’s long-term success, either socially or academically. The medications can also have unpleasant side effects, among them sleep disruption, depression, and growth suppression of approximately half an inch per year on average, as reported in a large randomized trial funded by the National Institute of Mental Health. A second class of treatment—behavioral therapies—teaches children how to self-monitor attention and impulsive behavior, but the success of these therapies has been mixed.

  More time in nature—combined with less television and more stimulating play and educational settings—may go a long way toward reducing attention deficits in children, and, just as important, increasing their joy in life. Researchers at the Human-Environment Research Laboratory believe that their findings point to nature therapy as a potential third course of treatment, applied either in concert with medication and/or behavioral therapy, or on its own. Behavioral therapy and nature therapy, if used collaboratively, might teach the young how to visualize positive experiences in nature when they need a calming tool. One psychiatrist who works with ADHD children relates how he sometimes slides into mild depressions. “I grew up fly-fishing in Michigan, and that was how I found peace as a child,” he says. “So, when I begin to feel depressed, I use self-hypnosis to go there again, to call up those memories.” He calls them “meadow memories.” Though he is a firm believer in the proper use of the currently available medications for ADHD, he is encouraged by the possibility that nature therapy might offer him another professional tool. And, as Kuo points out, prescribing “green time” for the treatment of ADHD has other advantages: it’s widely accessible, free of side effects, nonstigmatizing, and inexpensive.

  If it’s true that nature therapy reduces the symptoms of ADHD, then the converse may also be true: ADHD may be a set of symptoms aggravated by lack of exposure to nature. By this line of thinking, many children may benefit from medications, but the real disorder is less in the child than it is in the imposed, artificial environment. Viewed from this angle, the society that has disengaged the child from nature is most certainly disordered, if well-meaning. To take nature and natural play away from children may be tantamount to withholding oxygen.

  An expanded application of attention-restoration theory would be useful in the design of homes, classrooms, and curricula. New York’s Central Park, the first professionally designed urban park in America, was originally seen as a necessary aid to both civic consciousness and public health. It was construed as a place where all New Yorkers, regardless of class, age, or health, would benefit from fresh air. If nature-deficit disorder, as a hypothetical condition, affects al
l children (and adults) whether or not they have some biological propensity for attention deficit, then nature therapy at the societal and individual levels will do the greatest good for the greatest number of people.

  Research on the impact of nature experiences on attention disorders and on wider aspects of child health and development is in its infancy, and easily challenged. Scientists doing some of the best of this research are the first to point that out. “For many of us, intuition emphatically asserts that nature is good for children,” write Taylor and Kuo, in an overview of the research to date. “Beyond these intuitions, there are also well-reasoned theoretical arguments as to why humans in general—and therefore children—might have an inborn need for contact with nature.” Yes, more research is needed, but we do not have to wait for it. As Taylor and Kuo argue, “Given the pattern of statistically reliable findings all pointing the same direction and persisting across different subpopulations of children, different settings, and in spite of design weaknesses, at some point it becomes more parsimonious to accept the fact that nature does promote healthy child development.” If, as a growing body of evidence recommends, “contact with nature is as important to children as good nutrition and adequate sleep, then current trends in children’s access to nature need to be addressed.”

  Even the most extensive research is unlikely to capture the full benefits of direct, natural experience. One aspect sure to elude measurement—a phenomenon that will be discussed later in these pages—is the contribution of nature to the spiritual life of the child, and therefore to the adult. This we know: As the sign over Albert Einstein’s office at Princeton University read, “Not everything that counts can be counted, and not everything that can be counted counts.” We don’t have to wait for more, needed, research to act on common sense, or to give the gift of nature—even when it might seem to be too late.