Presentation Information
[P-21-05]The Effectiveness of a Clinical Nature-Based Intervention for ASD Children from a Biopsychosocial Perspective
*John Wong1,2, Tammy Neo1, Lina Lim2, Angelia Sia3, Esther Tai1, Sze-Yin Seow1, Michelle Lee, Maria Paula Leon Mora2, Chris Loo2, Christel Chang, Natalie Lei1, Tiffany Ho1, Kenneth Khoo3, Kian Seng Ding, Maria Koh, Kee Juan Yeo2 (1.National University Hospital Singapore(Singapore), 2.National University of Singapore(Singapore), 3.National Parks Board, Singapore(Singapore))
Keywords:
Child Psychiatry/Psychology,Autism Spectrum Disorder,Nature-Based Intervention
Nature has been proven to be useful in improving the mental well-being of neurotypical children. Adopting a biopsychosocial perspective, this study aimed to prove the usefulness of a nature-based clinical therapeutic intervention in improving the emotional-behavioural difficulties of ASD children.
A 6-week 90-minute intervention program curated based on DIRFloortime® principles was carried out in specially designed Nature Playgardens. Participant dyads (n=28) were ASD boys aged 5-9 and their caregivers aged 21-80. Study consisted of 4 time-points, pre (T0), mid (T1), post (T2), post 4-weeks (T3) intervention.
Child’s psychosocial quality of life was measured using the Pediatric Quality of Life Inventory (PEDsQL) at T0, T2, and T3, while Emotional Regulation Checklist (ERC) – completed at T0 and T2 – tested for a child’s negative emotional reactivity.
Salivary analyses were completed at T0, T2 and T3 for: Annexin-A1– an immunomodulatory, glucocorticoid inducible protein with inflammation resolution properties – and IL6 – a pleiotropic cytokine which mediates autism-like behaviour through neuronal circuitry imbalances.
Linear Mixed Model Analysis controlling for age revealed at 95% CI: Child participants’ negative emotional reactivity (ERC) significantly decreased from T0 to T2, mean difference = -4.71, p<.001, CI (-6.31, -3.11). Child's psychosocial quality of life (PEDsQL) significantly increased from T0 to T2 and T3. Mean difference (T2) = 5.96, p = .004, CI (1.98, 9.95). Mean difference (T3) = 6.82, p = .001, CI (2.84, 10.81).
Paired t-test revealed a significant decrease in Annexin-A1 from T0 to T2 (mean difference = -38.47ng/ml, p=0.0074, 95% CI [64.84 to -12.09]). Paired Wilcoxon test showed a significant decrease in IL6 (square rooted transformation to reduce variation) from T0 to T3 (median difference = -40.3 [sqrt(ng/ml)], p=0.03).
Hence, this clinical nature-based intervention helped to reduce ASD children’s emotional reactivity and improve psychosocial quality of life as well as modulate inflammation.
A 6-week 90-minute intervention program curated based on DIRFloortime® principles was carried out in specially designed Nature Playgardens. Participant dyads (n=28) were ASD boys aged 5-9 and their caregivers aged 21-80. Study consisted of 4 time-points, pre (T0), mid (T1), post (T2), post 4-weeks (T3) intervention.
Child’s psychosocial quality of life was measured using the Pediatric Quality of Life Inventory (PEDsQL) at T0, T2, and T3, while Emotional Regulation Checklist (ERC) – completed at T0 and T2 – tested for a child’s negative emotional reactivity.
Salivary analyses were completed at T0, T2 and T3 for: Annexin-A1– an immunomodulatory, glucocorticoid inducible protein with inflammation resolution properties – and IL6 – a pleiotropic cytokine which mediates autism-like behaviour through neuronal circuitry imbalances.
Linear Mixed Model Analysis controlling for age revealed at 95% CI: Child participants’ negative emotional reactivity (ERC) significantly decreased from T0 to T2, mean difference = -4.71, p<.001, CI (-6.31, -3.11). Child's psychosocial quality of life (PEDsQL) significantly increased from T0 to T2 and T3. Mean difference (T2) = 5.96, p = .004, CI (1.98, 9.95). Mean difference (T3) = 6.82, p = .001, CI (2.84, 10.81).
Paired t-test revealed a significant decrease in Annexin-A1 from T0 to T2 (mean difference = -38.47ng/ml, p=0.0074, 95% CI [64.84 to -12.09]). Paired Wilcoxon test showed a significant decrease in IL6 (square rooted transformation to reduce variation) from T0 to T3 (median difference = -40.3 [sqrt(ng/ml)], p=0.03).
Hence, this clinical nature-based intervention helped to reduce ASD children’s emotional reactivity and improve psychosocial quality of life as well as modulate inflammation.