🌲The Power of Nature: Evidence-Based Interventions for Autistic Children

By Lisa Haverly and Rainbow Tree Therapies, LLC

Why Nature? Why Now?

As professionals working with autistic individuals (identity first language), we’re always seeking interventions that are engaging, effective, and deeply attuned to the child’s whole being. Nature-based approaches check all those boxes—and now, a growing body of research is validating what many of us have long witnessed in the field: children thrive in nature.

A recent systematic review and meta-analysis by Kalubi et al. (2023) adds compelling evidence to this truth. The researchers reviewed 24 studies involving 717 autistic children (ages 5–18), exploring the effects of nature-based interventions (NBIs) on health-related functioning.

Their conclusion? NBIs can significantly improve key developmental areas—especially sensory regulation, social communication, and behavior.

What Are Nature-Based Interventions (NBIs)?

Nature-based interventions are structured, professionally led therapeutic activities that take place in natural outdoor environments such as forests, gardens, farms, or parks. These are not simply “outdoor play.” They are intentional, goal-directed, and therapeutically guided.

Examples may include:

• Animal-assisted activities (e.g., equine therapy, animal-assisted therapy, farm chores)

• Sensory trails or nature walks with embedded social goals

• Gardening and land stewardship

• Adventure-based learning (e.g., hiking, climbing, nature exploration)

• Mindfulness and self-regulation practices in outdoor settings

These interventions are most effective when delivered by trained professionals (OTs, mental health providers, educators) who integrate developmental knowledge, trauma-informed care, and relational strategies into nature-rich settings.

Key Findings from the Review

The meta-analysis revealed moderate, statistically significant benefits in the following domains:

Social Communication

• Children showed improvements in engaging with peers and adults, initiating interaction, and responding more consistently in social contexts.

• These gains were particularly notable in group-based, play-driven NBIs.

Sensory and Attention Regulation

• Enhanced attention and reduced distractibility

• Improvements in sensory seeking and modulation

• Better ability to stay present and participate in goal-directed tasks

Behavior and Emotional Regulation

• Reduced hyperactivity and irritability

• Increased self-control and adaptive behaviors in the moment

• Indirect support for emotional awareness through sensory and motor integration

Gaps and Considerations

• The evidence for emotional well-being and long-term outcomes is still limited.

• Many studies lacked standardized outcome measures or clear descriptions of intervention dosage.

• Research inclusion often skewed toward verbal, school-aged children—future studies should broaden representation.

Implications for Occupational Therapy & Interdisciplinary Practice

This research supports what many OTs and child development professionals observe daily: Children regulate, connect, and grow more easily in nature.

As we integrate NBIs into our therapy frameworks, we can:

• Collaborate with nature as a co-regulatory partner to reduce overwhelm and support sensory needs

• Embed therapeutic goals into real-world, embodied experiences

• Foster meaningful peer interaction in a low-demand, joy-filled context

• Support trauma-informed care by cultivating safety, autonomy, and rhythm in natural settings

Nature doesn’t require perfection. It invites presence. And for many neurodivergent children, that’s where true participation begins.

Final Thoughts

Nature is not just a backdrop—it is an active co-therapist. It calms, inspires, and opens pathways for connection and healing.

For professionals curious about nature-based work, this growing body of evidence should offer encouragement and inspiration. It also highlights the need for more rigorous, inclusive, and long-term research that centers the voices of neurodivergent children and their families.

If you’ve been thinking about starting a garden program, offering outdoor groups, or advocating for more nature access in schools—now is the time.

📚 Reference

Kalubi, J.C., Joosten, A.V., Allison, H., & Memari, A.H. (2023). Nature-Based Interventions for Autistic Children: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 20(23), 6991.

🌲P.S. For professionals: Want to explore a framework that speaks to the intersection of OT skill set and the context of nature? Check out this $99 training that will give you the clarity about taking your OT skills outdoors in nature! Limited time price drop!🌲

🌲 P.S. For caregivers and parents: Explore our website to see all of our services and programming! We provide individual and nature group opportunities! Website here.