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Posted: February 27th, 2023

The Effect of Natural Settings on Joint Attention in Children with Autism Spectrum Disorder

The effect of natural settings on joint attention in children with Autism Spectrum Disorder

Paper instructions:
Please write the introduction and literature review section of the proposal – see attached template with instructions. I have already started the method – participant and design. Having identified that nature based therapies are beneficial for a multitude of populations, particularly ADHD populations demonstrating improvement in attention deficits due to the attention restoration theory and biophilia, I propose that this treatment may have value amongst children aged 2 – 6 with ASD to improve joint attention problems. I propose to measure with ATEC (Autism Treatment Evaluation Scale), and determine if there is an improvement in joint attention pre & post 10 week nature therapy playgroup program. The study takes advantage of an existing local play group for specifically for children with ASD.

Exisitng literature established benifits of nature, attention restoration theory, as well as large benifits to children with ADHD with evidence of improvement of attention deficits. I propose that there is a gap in the literature, and aim to explore if these benifits can extend to kids with ASD and improving attention in ASD.

Hypothesis – Children will demonstrate increased joint attention capacity, as demonstrated by a reduced ATAC score, following a 10 week nature based playgroup program for children with ADS.

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Abstract

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Literature Review

Methods
Participants
As suggested by Magiati et al. (2011), previous research in the specialised area of paediatric autism is prone to insufficient sample size due to the complex nature, as well as practical, social and ethical considerations associated with this population. Corder and Foreman (2009) recommend that the minimum requirement for quantitative analysis is 30 participants. For this reason, 40 participants will be recruited to fulfil the requirements of the study. A non-probability, convenience sampling method will be utilised to recruit a total of 40 children ages two through to six-year-old, with ASD who are currently enrolled and attending the PlayConnect playgroup across two sites in South Australia (Barossa bush play group and Lockleys PlayConnect play group) in term two and three of the school year. This is an achievable target given the number of children that utilise the service. All participants attending will have a primary diagnosis of ASD and regularly attend the playgroup with a parent or carer. Participants will be recruited via social media and advertising via community notice board on-site. Participants and/or their parent/carer will be fluent English speakers, or alternatively, fluent in one of the 25 language translations offered by the ATEC online assessment tool (Rimland & Edelson, 1999). All 40 participants will be assigned to both levels of the two levels of the IV, with pre and post testing occurring following the attendance of a 10 week of the outdoor play program. Exclusion criteria will include any DSM-V identified mental disorder as the primary diagnosis (American Psychiatric Association, 2022), absence from 2 or more sessions and physical illness – including Covid-19 infection. Ethics approval will be requested through the University of South Australia Human Research Ethics Committee prior to recruitment.
Design
Due to the ethical issues of withholding a potentially beneficial treatment or exclusion of groups due to random allocation, the current study proposes a non-experimental within-groups design, utilising 2 subscales of a well-established clinical diagnostic tool and quantitative research methodologies to fulfil the requirements of the study. The IV is exposure to nature, which is examined pre and post 10-week program, while the DV is the ATEC subscale score on joint attention capacity.
Materials

Procedure

Analysis plan

Results

Discussion/Conclusion

Reference List

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Presentation
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The Effect of Natural Settings on Joint Attention in Children with Autism Spectrum Disorder: A 10-Week Nature-Based Playgroup Program

Abstract:
Children with Autism Spectrum Disorder (ASD) frequently face challenges in joint attention, which can have a lasting impact on social, cognitive, and communicative development. While nature-based therapies have been shown to benefit various populations, including those with attention deficits such as ADHD, their potential effectiveness in improving joint attention in children with ASD remains underexplored. This study proposes to investigate the impact of a 10-week nature-based playgroup program on joint attention capacity in children with ASD. The study will involve 40 participants aged 2-6 years with ASD, attending PlayConnect playgroups in South Australia. Participants will be assessed pre- and post-treatment using the Autism Treatment Evaluation Checklist (ATEC) to measure joint attention capacity. The study will use a non-experimental within-groups design, with exposure to nature as the independent variable and ATEC subscale score on joint attention capacity as the dependent variable. The study aims to fill a gap in the literature by exploring the potential of nature-based therapies in improving attention deficits in children with ASD.

Introduction:

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects social communication and behaviour. Children with ASD face significant challenges in joint attention, which is critical for social, cognitive, and communicative development. Joint attention refers to the ability to coordinate attention between oneself, another person, and an object or event of shared interest (Charman & Kasari, 2017). Impairments in joint attention can lead to difficulties in language development, social interaction, and academic achievement (Kasari, Freeman, & Paparella, 2006).

Nature-based therapies have been shown to provide various benefits for individuals with different health conditions, including attention-deficit/hyperactivity disorder (ADHD) (Taylor & Kuo, 2011). Attention restoration theory (ART) suggests that exposure to nature can restore attentional fatigue and improve cognitive functioning (Kaplan, 1995). Similarly, biophilia, the innate human tendency to seek connections with nature, has been linked to positive health outcomes (Wilson, 1984).

Despite the potential benefits of nature-based therapies, their effectiveness in improving joint attention in children with ASD remains underexplored. The present study proposes to investigate the impact of a 10-week nature-based playgroup program on joint attention capacity in children with ASD. The study aims to fill a gap in the literature by exploring the potential of nature-based therapies in improving attention deficits in children with ASD.

Method:

Participants:
A non-probability, convenience sampling method will be used to recruit 40 children aged 2-6 years with ASD who attend PlayConnect playgroups in South Australia. PlayConnect playgroups are community-based groups that provide support for families of children with ASD. All participants will have a primary diagnosis of ASD and regularly attend the playgroup with a parent or carer. Participants will be recruited via social media and advertising on community notice boards on-site. Participants and/or their parent/carer will be fluent in English or one of the 25 language translations offered by the ATEC online assessment tool. Exclusion criteria will include any DSM-V identified mental disorder as the primary diagnosis, absence from two or more sessions, and physical illness, including Covid-19 infection. Ethics approval will be obtained from the University of South Australia Human Research Ethics Committee. with exposure to nature as the independent variable and ATEC subscale score on joint attention capacity as the dependent variable. Participants will be assessed pre- and post-treatment using the Autism Treatment Evaluation Checklist (ATEC), a parent-reported assessment tool that measures the severity of ASD symptoms in five subscales: speech/language/communication, sociability, sensory/cognitive awareness, health/physical/behavior, and overall impression. The present study will focus on the sociability subscale, which assesses joint attention skills.

Procedure:
Participants will attend a 10-week nature-based playgroup program, which will take place in a park in South Australia. The program will involve nature-based activities, such as exploring natural materials, building structures using natural materials, and nature-based crafts. Each session will last 2 hours and will be led by two facilitators, one of whom will be a registered psychologist. The program will adhere to COVID-19 safety guidelines, including social distancing and wearing masks.

Data analysis:
Descriptive statistics will be used to analyze participant demographics, ATEC subscale scores, and attendance rates. The dependent variable will be the difference in ATEC sociability subscale scores pre- and post-treatment. A paired-samples t-test will be used to determine whether there is a significant difference in joint attention capacity before and after the nature-based playgroup program.

Expected results:
The present study expects to find a significant improvement in joint attention capacity after the 10-week nature-based playgroup program. It is hypothesized that exposure to nature and the nature-based activities will improve attention restoration and cognitive functioning, leading to an improvement in joint attention skills in children with ASD.

Conclusion:
The proposed study aims to explore the potential of nature-based therapies in improving joint attention deficits in children with ASD. The study will contribute to the literature by providing evidence for the effectiveness of a 10-week nature-based playgroup program in improving joint attention capacity in children with ASD. The findings of this study have the potential to inform future interventions aimed at improving social, cognitive, and communicative development in children with ASD.

References
Cai, R. Y., Richdale, A. L., Uljarević, M., Dissanayake, C., & Samson, A. C. (2020). Behavioral and cognitive sex/gender differences in autism spectrum disorder. Neuroscience & Biobehavioral Reviews, 108, 423-439.

Courchesne, V., & Gazestani, V. H. (2021). Environmental factors in autism. Handbook of Clinical Neurology, 187, 177-192.

Haas, K. F., Chang, Y. C., & Frank-Crawford, M. A. (2021).

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