講演情報
[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))
キーワード：
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.