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Bennewith C, Bellali J, Watkins L, Tromans S, Bhui K, Shankar R. Sublime and extended reality experiences to enhance emotional wellbeing for autistic people: A state of the art review and narrative synthesis. Int J Soc Psychiatry 2024:207640241261172. [PMID: 39049584 DOI: 10.1177/00207640241261172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND Sublime is a centuries old concept of emergent experience arising from immense and threatening awareness provoked by overwhelming fear and dread when faced with an incomprehensible situation as is common to autistic people. Extended Reality (XR) technologies have been used since the mid-1990s, in regulating emotions, behaviour and supporting social skill development for autistic people. AIMS To understand utility of XR technologies in creating immersive experiences for autistic people to alleviate anxiety and the relationship to the sublime. METHOD A State of the Art literature review and narrative synthesis was conducted. PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with terms Autism AND Technology. In addition, fields of digital technologies and wellbeing, digital art and mental health, generative arts and the sublime were explored through web searches of grey literature, conversations with digital designers and explorations of extended reality platforms. No time limits were placed. Searches were done in English. Papers were screened and shortlisted using the inclusion criteria applied by two reviewers. RESULTS Fifty-eight papers/articles met the preliminary inclusion criteria for in-depth review of which 31 were found suitable for the narrative synthesis related to XR technologies and sublime experiences as related to autistic people. Narrative synthesis lent itself to four themes that is current utility of XR Technologies in autism, the impact of immersive experiences on Behavioural, phenomenological and biological markers of autistic people, the Benefits of increased sensory stimulation using XR on autism and an inquiry into the potential of the sublime for autism. CONCLUSIONS Mixed reality environments that experiment with a broad range of XR technologies including incorporating notions of the sublime, might be beneficial in reducing emotional dysregulation and improving social development in autistic people especially if co-designed with them.
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Affiliation(s)
- Chris Bennewith
- Faculty of Arts, Humanities and Business University of Plymouth, UK
| | - Johara Bellali
- Faculty of Arts, Humanities and Business University of Plymouth, UK
| | - Lance Watkins
- University of South Wales, Pontypridd, UK
- Swansea Bay University Health Board, Port Talbot, UK
- Cornwall Intellectual Disability Equitable Research, University of Plymouth Peninsula School of Medicine, Truro, UK
| | - Samuel Tromans
- Department of Population Health Sciences, University of Leicester, UK
- Leicestershire Partnership NHS Trust, UK
| | | | - Rohit Shankar
- Cornwall Intellectual Disability Equitable Research, University of Plymouth Peninsula School of Medicine, Truro, UK
- Cornwall Intellectual Disability Equitable Research, Cornwall Partnership NHS Foundation Trust, UK
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Aghabozorgi K, van der Jagt A, Bell S, Brown C. Assessing the impact of blue and green spaces on mental health of disabled children: A scoping review. Health Place 2023; 84:103141. [PMID: 37951182 DOI: 10.1016/j.healthplace.2023.103141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/13/2023]
Abstract
During recent decades, there has been a growing consideration of the role of blue and green spaces on mental health of children, but there is insufficient attention in the literature to the mental health of children with disabilities. This paper presents an overview of the evidence on how blue and green spaces affect the mental health of children with various disabilities. A database search found twenty studies eligible for the review, after several consecutive screening stages. Most studies used a cross-sectional design and were carried out in Europe. The results consistently indicate that blue and green space can reduce emotional, behavioral, and social problems in disabled children. A protective association was found between the level of blue or greenness and depressive and anxiety symptoms. Moreover, in most of the studies there were no significant changes in the result after adjusting for socioeconomic confounders. Generally, there is an identified need for more short-term exposure studies in this area, focusing on the impact of landscape design elements on mental health of disabled children. The findings of this scoping review call on urban planners, health care workers and decision makers to consider appropriate measures and interventions providing more blue and green space exposure to disabled children.
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Affiliation(s)
- Koorosh Aghabozorgi
- School of Energy, Geoscience, Infrastructure and Society, Heriot Watt University, Edinburgh, UK.
| | - Alexander van der Jagt
- School of Energy, Geoscience, Infrastructure and Society, Heriot Watt University, Edinburgh, UK
| | - Simon Bell
- Chair of landscape architecture, Estonian University of Life Sciences, Kreutzwaldi 56/1, Tartu, 51009, Estonia
| | - Caroline Brown
- School of Energy, Geoscience, Infrastructure and Society, Heriot Watt University, Edinburgh, UK
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Selanon P, Chuangchai W. Walking activity increases physical abilities and subjective health in people with seven different types of disabilities. Front Public Health 2023; 11:1120926. [PMID: 37397748 PMCID: PMC10313422 DOI: 10.3389/fpubh.2023.1120926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction People with disabilities have a great risk of physical inactivity, which causes several diseases, dependency, and long-term care. Walking helps to increase physical activity, which leads to better overall health and independence. However, less research attention has focused on walking for people with disabilities, and even fewer studies have been considered for different types of disabilities. The present study aimed to demonstrate how walking distance was associated with people with seven different types of disabilities- including visual, hearing, physical/mobility, intellectual, learning, autism, and emotional/behavioral disabilities-in terms of their physical abilities and subjective health. Methods A total of 378 participants (aged 13-65) were gathered from seven national organizations in Thailand. A survey questionnaire on aspects of physical abilities (i.e., walking distance or manually rolling wheelchair distance; body balance; weightlifting; exercise duration and frequency); and subjective health (i.e., health status and satisfaction) was completed online by all participants. Results The walking distance was partially positive and associated with exercise duration, weightlifting, exercise frequency, and health status (all p values < 0.001), as well as body balance and health satisfaction (p = 0.001 and 0.004, respectively), after controlling for age, sex, and types of disability. This demonstrated that increasing the amount of distance walked could well lead to a more positive body and mind. Discussion The present study suggests that the possibility of having a walk and/or encouraging people with disabilities to walk for greater distances can have a significant impact on both their physical and subjective health outcomes.
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Burke HK, Burke LM, Hacker CG, Lane SJ. Nature-Based Pediatric Occupational Therapy: A Scoping Review. Phys Occup Ther Pediatr 2023; 44:96-109. [PMID: 37125675 DOI: 10.1080/01942638.2023.2204924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/14/2023] [Indexed: 05/02/2023]
Abstract
AIMS Our purpose was to explore the scope of nature-based interventions used in pediatric occupational therapy and identify gaps in existing literature. METHODS This scoping review was guided by Arksey and O'Malley's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework. We searched CINAHL, PubMed, PsycINFO, Web of Science, Embase, MEDLine, and gray literature, and we hand-searched included articles' references. We included studies published through June, 2021 that were in English, described a service provided by occupational therapists, with a population with at least 50% of participants ages 0-21 years, with nature as a primary context and treatment modality. Studies were excluded if they only described animal-assisted therapies or human-made structures. RESULTS A total of 12 articles (two reporting quasi-experimental studies; 10 gray literature) met inclusion criteria. Articles described a variety of interventions, but there was a lack of rigor in included articles and no clear conceptualization of nature-based pediatric occupational therapy. CONCLUSIONS Despite practitioner interest in the topic, there are two primary gaps in the literature: lack of a clear conceptualization of nature-based practices for occupational therapy and lack of articulation of the unique contribution of occupational therapy to nature-based practices.
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Affiliation(s)
- Hannah K Burke
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
| | | | | | - Shelly J Lane
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
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Stackhouse TM, Burke HK, Hacker CG, Burke LM, Hui CE, Osten B, Lane SJ. Integrated Occupational Therapy Camp for Children with Regulation/Sensory Processing Differences: Preliminary Evaluation. Can J Occup Ther 2023; 90:25-33. [PMID: 36201004 DOI: 10.1177/00084174221129941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background. Integration of occupational therapy into a camp environment may support participation for children with neurodevelopmental differences, but evidence is limited. Purpose. This study examines the effects of participation of children with regulation/sensory processing differences at one such integrated camp on parent-established functional goals. Method. We used a pre-test/post-test repeated measures cohort design. Individualized goals were established with parents three months before camp using the Canadian Occupational Performance Measure (COPM) (n = 82, child ages 4-13). Parents re-rated goals immediately before, one month after, and three months after camp. Findings. Repeated measures ANOVA revealed improvement in occupational performance over the week of camp significantly exceeded change within the three months prior. Improvements remained stable three months post-camp. Implications. Integrating occupational therapy within a camp setting is beneficial for children with neurodevelopmental differences. The COPM can be integrated into a camp setting to document meaningful change in individualized parent-established goals.
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Baird A, Candy B, Flouri E, Tyler N, Hassiotis A. The Association between Physical Environment and Externalising Problems in Typically Developing and Neurodiverse Children and Young People: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2549. [PMID: 36767909 PMCID: PMC9916018 DOI: 10.3390/ijerph20032549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/28/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
The physical environment is of critical importance to child development. Understanding how exposure to physical environmental domains such as greenspace, urbanicity, air pollution or noise affects aggressive behaviours in typical and neurodiverse children is of particular importance given the significant long-term impact of those problems. In this narrative review, we investigated the evidence for domains of the physical environment that may ameliorate or contribute to the display of aggressive behaviours. We have considered a broad range of study designs that include typically developing and neurodiverse children and young people aged 0-18 years. We used the GRADE system to appraise the evidence. Searches were performed in eight databases in July 2020 and updated in June 2022. Additional articles were further identified by hand-searching reference lists of included papers. The protocol for the review was preregistered with PROSPERO. Results: We retrieved 7174 studies of which 67 are included in this review. The studies reported on green space, environmental noise and music, air pollution, meteorological effects, spatial density, urban or rural setting, and interior home elements (e.g., damp/sensory aspects/colour). They all used well validated parent and child reported measures of aggressive behaviour. Most of the studies were rated as having low or unclear risk of bias. As expected, noise, air pollution, urbanicity, spatial density, colour and humidity appeared to increase the display of aggressive behaviours. There was a dearth of studies on the role of the physical environment in neurodiverse children. The studies were heterogeneous and measured a range of aggressive behaviours from symptoms to full syndromes. Greenspace exposure was the most common domain studied but certainty of evidence for the association between environmental exposures and aggression problems in the child or young person was low across all domains. We found a large knowledge gap in the literature concerning neurodiverse children, which suggests that future studies should focus on these children, who are also more likely to experience adverse early life experiences including living in more deprived environments as well as being highly vulnerable to the onset of mental ill health. Such research should also aim to dis-aggregate the underlying aetiological mechanisms for environmental influences on aggression, the results of which may point to pathways for public health interventions and policy development to address inequities that can be relevant to ill health in neurodiverse young people.
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Affiliation(s)
- Alister Baird
- Division of Psychiatry, University College London, London W1T 7BN, UK
| | - Bridget Candy
- Division of Psychiatry, University College London, London W1T 7BN, UK
| | - Eirini Flouri
- Institute of Education, Psychology and Human Development, University College London, London WC1H 0AL, UK
| | - Nick Tyler
- Department of Civil, Environmental and Geomatic Engineering, Faculty of Engineering Science, University College London, London WC1E 6DE, UK
| | - Angela Hassiotis
- Division of Psychiatry, University College London, London W1T 7BN, UK
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Byström K, Wrangsjö B, Grahn P. COMSI ®-A Form of Treatment That Offers an Opportunity to Play, Communicate and Become Socially Engaged through the Lens of Nature-A Single Case Study about an 8-Year-Old Boy with Autism and Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16399. [PMID: 36554277 PMCID: PMC9779248 DOI: 10.3390/ijerph192416399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
This case study shows how an 8-year-old boy with autism and mild intellectual disability underwent positive psychological development in terms of play, social communication, and mentalization during a year and a half of group-based therapy using COMSI®-(COMmunication and Social Interaction). This eclectic treatment has a relational approach and is based on developmental psychology, knowledge of autism, and the impact of nature and animals on human health. The change in the child was been studied using both quantitative and qualitative methods. His general intellectual capacity was measured using the Wechler Preschool and Primary Scale of Intelligence, and his Mentalization Ability/Theory of Mind was assessed using three tests: Eva and Anna, Hiding the fruit and Kiki and the cat. Throughout the study period, change was documented with the help of the therapists' process notes and the parents' descriptions. The results show that support for the child comes from three different sources: nature, animals, and the therapists. Animals and nature form the basis for episodes of coordinated attention in conversation and play with therapists. The therapists' approach used sensitivity and compliance with the child's needs and focus of interest.
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Affiliation(s)
- Kristina Byström
- Department of People and Society, Swedish University of Agricultural Sciences, Alnarp, SE-230 44 Lomma, Sweden
- Region Västra Götaland, Habilitation & Health, Children and Youth Habilitation, SE-541 50 Skövde, Sweden
| | - Björn Wrangsjö
- Department of Children’s and Woman’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Patrik Grahn
- Department of People and Society, Swedish University of Agricultural Sciences, Alnarp, SE-230 44 Lomma, Sweden
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Harris K, Rosinski P, Wood-Nartker J, Hill Renirie R. Developing Inclusive Playgrounds That Welcome All Children—Including Those with Autism. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives. The focus on functional deficits in conventional autism research constrains understanding of autistic lives. In this Review, Pellicano et al. appraise research on autistic adulthood through a capabilities lens to identify areas where autistic adults thrive, and where more research and services are needed to enhance their quality of life.
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Weyland M, Maes P, Kissine M, Defresne P. Impact of Belgian COVID-19 lockdown restrictions on autistic individuals’ socio-communicative behaviors and their parents’ quality of life. PLoS One 2022; 17:e0273932. [PMID: 36044732 PMCID: PMC9433112 DOI: 10.1371/journal.pone.0273932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background In the spring of 2020, Belgian authorities enforced a full lockdown period to contain the spread of the SARS-CoV-2 virus. This lockdown drastically disrupted the daily life of autistic individuals’ and that of their families. In the midst of these extraordinary circumstances, we assessed the impact of social restrictions on autistic individuals’ behavior and their parents’ or caregivers’ quality of life; we also sought to identify individual characteristics that may influence such changes. Methods We designed an online survey targeting caregivers living with an autistic child or adult. The questionnaire included 125 five-point Likert questions which targeted changes in families’ quality of life and in autistic individuals’ behavior, as well as factors likely to influence the extent and direction of these changes. Results We collected data from 209 French-speaking Belgian respondents. Respondents reported that the lockdown brought about a higher frequency of nonfunctional socio-communicative behaviors, as well as a decrease in families’ quality of life. Parents who had less access to respite care experienced a steeper decrease in their quality of life. Autistic individuals with comorbidities, and whose parents had less access to respite care and implemented fewer rules at home during lockdown were more likely to display nonfunctional socio-communicative behaviors. Conclusion COVID-19 lockdown restrictions had a negative impact on both autistic individuals and their parents.
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Affiliation(s)
- Marielle Weyland
- Service Métrologie et Sciences du Langage, Université de Mons, Mons, Belgium
- ACTE at LaDisco and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
- * E-mail:
| | - Pauline Maes
- ACTE at LaDisco and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Mikhail Kissine
- ACTE at LaDisco and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
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Yoo EH, Roberts JE, Eum Y, Li X, Konty K. Exposure to urban green space may both promote and harm mental health in socially vulnerable neighborhoods: A neighborhood-scale analysis in New York City. ENVIRONMENTAL RESEARCH 2022; 204:112292. [PMID: 34728238 DOI: 10.1016/j.envres.2021.112292] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/16/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND There is growing evidence that exposure to green space can impact mental health, but these effects may be context dependent. We hypothesized that associations between residential green space and mental health can be modified by social vulnerability. METHOD We conducted an ecological cross-sectional analysis to evaluate the effects of green space exposure on mental disorder related emergency room (ER) visits in New York City at the level of census tract. To objectively represent green space exposure at the neighborhood scale, we calculated three green space exposure metrics, namely proximity to the nearest park, percentage of green space, and visibility of greenness. Using Bayesian hierarchical spatial Poisson regression models, we evaluated neighborhood social vulnerability as a potential modifier of greenness-mental disorder associations, while accounting for the spatially correlated structures. RESULTS We found significant associations between green space exposure (involving both proximity and visibility) and total ER visits for mental disorders in neighborhoods with high social vulnerability, but no significant associations in neighborhoods with low social vulnerability. We also identified specific neighborhoods with particularly high ER utilization for mental disorders. CONCLUSIONS Our findings suggest that exposure to green space is associated with ER visits for mental disorders, but that neighborhood social vulnerability can modify this association. Future research is needed to confirm our finding with longitudinal designs at the level of individuals.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
| | - John E Roberts
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA
| | - Xiaojiang Li
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA, USA
| | - Kevin Konty
- New York City Department of Health & Mental Hygiene, NYC, NY, USA
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Shannon CA, Olsen LL, Hole R, Rush KL. "There's nothing here": Perspectives from rural parents promoting safe active recreation for children living with autism spectrum disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 115:103998. [PMID: 34111755 DOI: 10.1016/j.ridd.2021.103998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/02/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) and their families experience challenges and barriers at multiple levels that influence their activity participation. The purpose of this study was to develop understanding about factors influencing how families can promote safe, active recreation for their children 3-12 years living with ASD across rural settings and how supports for these families can be enhanced. METHODS This qualitative study used an interpretive descriptive approach. Twelve in-depth, semi-structured interviews with parents of children with ASD were conducted. Data was analyzed thematically. RESULTS Four main themes emerged: 1) ASD specific child vulnerabilities impeding safe recreation. 2) Importance of safe outdoor spaces in rural settings for children with ASD. 3) Diverse parent strategies to address risks and needs. 4) Perceived needs for training of recreation providers. CONCLUSION Findings highlight family-centred priority issues including parental safety concerns related to elopement and risk of injury linked to environmental and outdoor hazards prominent in rural settings. Autism awareness and recreational training is needed and could incorporate collaborative development of child specific safety plans to foster inclusive opportunities. Program planners can use this information to encourage policy making to aid families' safe activity participation.
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Affiliation(s)
- Crystal A Shannon
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; School of Nursing, University of British Columbia, Okanagan, Canada.
| | - Lise L Olsen
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; Canadian Institute for Inclusion and Citizenship, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada; School of Nursing, University of British Columbia, Okanagan, Canada
| | - Rachelle Hole
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; Canadian Institute for Inclusion and Citizenship, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada; School of Social Work, University of British Columbia, Okanagan, Canada
| | - Kathy L Rush
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; School of Nursing, University of British Columbia, Okanagan, Canada
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Li D, Newman G, Zhang T, Zhu R, Horney J. Coping with post-hurricane mental distress: The role of neighborhood green space. Soc Sci Med 2021; 281:114084. [PMID: 34107388 DOI: 10.1016/j.socscimed.2021.114084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/08/2021] [Accepted: 05/24/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although increases in the prevalence of mental distress have been reported after natural disasters, less is known about the role the environment may play in mitigating posttraumatic stress disorder (PTSD) in hurricane-impacted communities. AIM This study aims to investigate the extent to which concentration and perceived quality of neighborhood greenness are associated with lower levels of PTSD, along with potential mechanisms through which these effects occur. METHODS We conducted a cross-sectional survey of individuals (N=272) from 30 Houston neighborhoods that were affected during Hurricane Harvey. Perceived quality of neighborhood green space was measured using a scale adapted from the Neighborhood Open Space (NOS) scale, and concentration of greenness was measured objectively using the normalized difference vegetation index (NDVI). Probable PTSD was measured using the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and hurricane-related distress using the Impact of Event Scale (IES-R). Generalized linear mixed models were used to fit individual models. Based on the results, structural equation models were employed to test direct and indirect pathways simultaneously. Models were adjusted for neighborhood- and individual-level confounders. RESULTS Greater perceived quality of neighborhood green space was significantly associated with lower likelihoods of probable PTSD and hurricane-related distress. The effects of perceived green space quality on hurricane-related distress were mediated by higher levels of emotional resilience. Social cohesion, although significantly correlated with PTSD and distress, did not mediate the effect of perceived green space quality on either. Neighborhood NDVI was significantly associated with hurricane-related distress, but not with PTSD. CONCLUSION We conclude that living in neighborhoods with greater perceived quality of green space was associated with lower levels of post-hurricane distress, with mediation especially through the emotional resilience pathway. These findings suggest that in disaster recovery policy frameworks, more attention should be paid to the benefits of high-quality neighborhood green infrastructure.
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Affiliation(s)
- Dongying Li
- Department of Landscape Architecture and Urban Planning, Texas A&M University, Langford A 337, TAMU 3137, TX, 77843, USA.
| | - Galen Newman
- Department of Landscape Architecture and Urban Planning, Texas A&M University, Langford A 337, TAMU 3137, TX, 77843, USA
| | - Tiantian Zhang
- Department of Landscape Architecture, School of Architecture, Soochow University, No.1 Shizi Street, Suzhou, 215006, China
| | - Rui Zhu
- Department of Landscape Architecture and Urban Planning, Texas A&M University, Langford A 337, TAMU 3137, TX, 77843, USA
| | - Jennifer Horney
- Epidemiology Program, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, USA
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Nawrath M, Guenat S, Elsey H, Dallimer M. Exploring uncharted territory: Do urban greenspaces support mental health in low- and middle-income countries? ENVIRONMENTAL RESEARCH 2021; 194:110625. [PMID: 33338487 DOI: 10.1016/j.envres.2020.110625] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/29/2020] [Accepted: 12/11/2020] [Indexed: 05/27/2023]
Abstract
Exposure to urban greenspaces promotes an array of mental health benefits. Understanding these benefits is of paramount importance, particularly in low- and middle-income countries (LMICs), where cities are expanding at an unprecedented rate. However, the existing evidence-base for the health benefits of greenspaces has a strong bias towards high-income countries. Here we systematically assess the emerging evidence regarding the mental health benefits provided by urban greenspaces in LMICs. We carried out a scoping review to assess the extent, type and quality of evidence investigating the relationship between greenspaces and mental health in LMICs. We systematically searched the literature databases Web of Science, Medline, Embase and CAB Abstracts using key terms related to greenspaces and mental health in LMICs. We analysed the resulting studies using a narrative synthesis approach, taking into account study quality, to assess the overall effects on mental health. 36 studies met the inclusion criteria and were included in the narrative synthesis. Studies were heterogeneous in design, study population, greenspace and mental health assessment. While more than 90% of LMICs remain unstudied, we found that eight out of ten studies using validated mental health screening tools detected positive associations between greenspaces and one or more mental health outcomes. These studies mostly took place in upper-middle-income countries. However, there still is a lack of evidence from regions with the highest levels of urbanisation, and only four studies assessed lower-middle and low-income countries. Furthermore, the analysis of mediating and moderating factors indicates that the relationship between greenspaces and mental health in LMICs is context dependent and needs to be assessed in relation to locally relevant environmental and cultural settings. Based on the evidence reviewed here, exposure to urban greenspaces can support multiple mental health outcomes in upper-middle-income countries. However, we still know little about poorer, rapidly urbanising countries. Our findings highlight the need for high-quality, context specific research in those urban areas with the highest levels of urbanisation, and the need to address specific challenges regarding mediating and moderating factors. Future studies should combine robust ecological assessments of greenspaces with validated mental health screening tools.
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Affiliation(s)
- Maximilian Nawrath
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK.
| | - Solène Guenat
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK.
| | - Helen Elsey
- Department of Health Sciences, University of York, York, YO10 5NG, UK.
| | - Martin Dallimer
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK.
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Deng L, Rattadilok P. The need for and barriers to using assistive technologies among individuals with Autism Spectrum Disorders in China. Assist Technol 2020; 34:242-253. [PMID: 32310026 DOI: 10.1080/10400435.2020.1757787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
A large number of people in China have been affected by Autism Spectrum Disorders (ASDs). However, different factors associated with current barriers to accessing external support by ASD individuals in China have been identified. Assistive technologies are believed to help address the barriers. To obtain an in-depth understanding of the need and barriers of Chinese individuals with ASD in using assistive technologies, this study surveyed parents of ASD children, ASD professionals, as well as technology developers in the field. This study found that people in China have lower awareness and utilization of assistive technologies but similar demands for technologies when compared to those in the United Kingdom. Monitoring and informing systems, therapeutic recommendation systems and social skill training applications are major forms of assistive technologies desired by the participants in the interviews. Concerns about affordability, public exposure, confidentiality breaches and possible side-effects are considered as barriers that may prevent ASD individuals in China from using assistive technologies. The paper further discussed potential orientations of assistive technology development in China. Considering Chinese individuals may suffer intense stigma and heavy financial burden on mental disabilities, affordable mobile applications that help reduce the stigma would be more acceptable by Chinese ASD individuals.
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Affiliation(s)
- Lingling Deng
- School of Computer Science, University of Nottingham Ningbo China, Ningbo, China
| | - Prapa Rattadilok
- School of Computer Science, University of Nottingham Ningbo China, Ningbo, China
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16
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Birch J, Rishbeth C, Payne SR. Nature doesn't judge you - how urban nature supports young people's mental health and wellbeing in a diverse UK city. Health Place 2020; 62:102296. [PMID: 32479372 DOI: 10.1016/j.healthplace.2020.102296] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/29/2020] [Accepted: 02/06/2020] [Indexed: 12/23/2022]
Abstract
Reviewed research reveals a lack of young people's voices articulating if and how urban nature supports their mental health and wellbeing. This paper presents qualitative research with young multi-ethnic urban residents living in a northern UK city and offers an important counter-narrative to the pervasive notion of childhood nature-deficit disorder. Using interviews and creative arts workshops, we explored the value of urban nature for the mental health and wellbeing of 24 young people aged 17-27 years, 9 of whom had lived experience of mental health difficulties. Trees, water, open spaces and views were frequently experienced nature typologies offering benefits. Deteriorating landscapes, young people's shifting identities and perceived time pressures disrupted support. Young people expressed how urban nature encounters were experienced as accepting and relational, offering a: stronger sense of self; feelings of escape; connection and care with the human and non-human world.
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Affiliation(s)
- Jo Birch
- Department of Landscape Architecture, University of Sheffield, UK.
| | - Clare Rishbeth
- Department of Landscape Architecture, University of Sheffield, UK.
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