Coping with AD/HD

A study conducted by

Andrea Faber Taylor, Frances E. Kuo,

and William C. Sullivan

Natural Resources & Environmental Sciences

University of Illinois at Urbana-Champaign
 With funding from
• The Cooperative State Research, Education
and Extension Service, U.S. Department of
Agriculture

• The USDA Forest Service

Urban and Community Forestry Program
on the recommendation of the National Urban
and Community Forestry Advisory Council

• The University of Illinois at Urbana-Champaign

Take home message
 Take home message

Children’s AD/HD symptoms

are better after activities in
green settings.
 Presentation outline

• What is AD/HD?
• Why Study Coping with AD/HD?
• The Approach
• The Findings
• So What?
What is AD/HD?
Attention Deficit
Hyperactivity Disorder
(AD/HD) is characterized by
severe difficulties with
inattention and impulsivity.
AD/HD symptoms include
• restlessness
• outbursts
• trouble listening
• difficulty following directions
• problems focusing on tasks
Why Study Coping with
AD/HD?
Why should we focus on AD/HD?
• AD/HD is relatively common,
occurring in roughly 7% of
school-age children.
Why should we focus on AD/HD?
• AD/HD is relatively common,
occurring in roughly 7% of
school-age children.
• AD/HD is linked to poor
academic performance.
Why should we focus on AD/HD?
• AD/HD is relatively common,
occurring in roughly 7% of
school-age children.
• AD/HD is linked to poor
academic performance.
• AD/HD can have long-lasting
effects on social development.
New treatment options are needed for
AD/HD because
• behavioral therapies help, but
not much.
New treatment options are needed for
AD/HD because
• behavioral therapies help, but
not much.
• stimulant medications are
better, but have several
problems.
Problems with stimulant medication:
• They often have serious side
effects.
Problems with stimulant medication:
• They often have serious side
effects.
• They help only 9 out of 10
children with AD/HD.
Problems with stimulant medication:
• They often have serious side
effects.
• They help only 9 out of 10
children with AD/HD.
• There is no evidence they
improve long-term social and
academic outcomes.
Cost is a further problem with
all current treatments.
But are there any other
treatment options?
Contact with nature
restores attention in the
general population.
One explanation comes from
Attention Restoration Theory.
(Kaplan, S. 1995)
According to Attention Restoration
Theory
• Nature is engaging, so
attracts our attention
effortlessly.
• This allows deliberate
attention to rest.
• Restored deliberate
attention is then available
when needed.
Since the underlying problem
in AD/HD seems to be one of
attention…
Perhaps exposure to
nature can improve
AD/HD symptoms?
The Approach
Parents of children with
AD/HD were asked to
complete a survey.
The participants:
• 96 parents or guardians of
children with AD/HD aged 7-12
The participants:
• 96 parents or guardians of
children with AD/HD aged 7-12
• recruited through ads and
flyers in the Midwest
The participants:
• 96 parents or guardians of
children with AD/HD aged 7-12
• recruited through ads and
flyers in the Midwest
• ratio of boys to girls in
sample same as in AD/HD
populations in general (3:1)
The survey asked parents to
• nominate activities that
especially affected
functioning – “best
activities” and “worst
activities”
The survey asked parents to
• nominate activities that
especially affected
functioning – “best
activities” and “worst
activities”
• rate the aftereffects of
activities, grouped by
setting, on symptoms
The relationship between
greenness of activity settings
and symptom severity was
examined.
The Findings
Was there a relationship
between activities that most
affect functioning and the
greenness of their setting?
 Likely settings of activities
nominated as “Best” and “Worst”
for AD/HD symptoms
Likely Setting Best Worst
Green 85% (17) 15% (3)
(e.g., fishing,
soccer)
Ambiguous 56% (43) 44% (34)
(rollerblading,
playing outside)
Not Green 43% (53) 57% (69)
(video games,
TV)
Was there a relationship
between greenness of
activity setting and ratings of
post-activity symptoms?
 Mean symptom ratings for
activities in different greenness
settings
Better 4

3.8
Mean
rating of 3.6
AD/HD 3.4
symptoms
3.2
after
activitie
Same 3
s worse
Much 1
Indoors Built outdoor Green outdoor
Activity Setting
So What?
Activities in green
settings were more likely
to lead to improved
AD/HD symptoms.
Activities that led to
worsened AD/HD
symptoms were more
likely to occur indoors
or in barren outdoor
settings.
Outdoor play in green
settings should help
children with AD/HD
function better.
Green play settings
are widely accessible,
inexpensive to use,
and free of side
effects.
Tips for parents, teachers, and
caregivers:
• Encourage children to play
outside in green yards or
parks and advocate recess in
green schoolyards.
Tips for parents, teachers, and
caregivers:
• Encourage children to play
outside in green yards or
parks and advocate recess in
green schoolyards.
• Observe which activities and
settings improve children’s
symptoms.
Tips for parents, teachers, and
caregivers:
• Encourage children to play
outside in green yards or
parks and advocate recess in
green schoolyards.
• Observe which activities and
settings improve children’s
symptoms.
• Value and care for trees.
Caring for trees means caring
for people!
 To share this information
with others
• Copies of this presentation and
other, written materials for
nonscientific audiences may be
obtained at <www.lhhl.uiuc.edu>

• To quote this information in print,

please consult the original
scientific journal article:
Faber Taylor, A., Kuo, F.E., & Sullivan,
W.C. (2001). Coping with ADD: The
surprising connection to green play
settings. Environment & Behavior, 33(1),
 To learn more:
On AD/HD incidence, symptoms, and
treatments
Barkley, R.A. (1997). Behavioral inhibition, sustained attention, and executive
functions: Constructing a unifying theory of ADHD. Psych Bulletin, 12, 65-94.
Bender, W.N. (1997). Understanding ADHD: A practical guide for teachers
and parents. Upper Saddle River, NJ: Prentice Hall.
Fiore, T.A., Becker, E.A., Nero, R.C. (1993). Interventions for students with
attention deficits. Exceptional Children, 60, 163-173.
Hinshaw, S.P. (1994). Attention deficits and hyperactivity in children (Vol. 29).
Thousand Oaks, CA: Sage.
National Institute of Mental Health. (1994). Attention Deficit Hyperactivity
Disorder (No. 94-3572). Washington, DC: NIMH.
 To learn more:
On nature and attention
Hartig, T., Mang, M., Evans, G.W. (1991). Restorative effects of natural
environment experiences. Environment & Behavior, 23, 3-26.
Miles, I., Sullivan, W., Kuo, F. (1998). Ecological restoration volunteers: The
benefits of participation. Urban Ecosystems, 2, 27-41.
Tennessen, C.M., Cimprich, B. (1995). Views to nature: Effects on attention.
Journal of Environmental Psychology, 15, 77-85.

On Attention Restoration Theory

Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative
framework. Journal of Environmental Psychology, 15, 169-182.
 Other questions?
Contact Andrea Faber Taylor, Ph.D.
(afabrtay@uiuc.edu)
The University of Illinois at Urbana-Champaign
Landscape and Human Health Laboratory
1103 S. Dorner Drive, MC-636
Urbana IL 61801