Research

“Outdoor Environments for Children with Autism & Special Needs” in InformeDesign’s ‘Implications’

April Implications 2011 'Outdoor Environments for Children with Autism and Special Needs' by Naomi Sachs and Tara VincentaHot off the press! InformeDesign’s latest issue of Implications (Vol. 9, Issue 1) just went live today, and it features an article by Naomi Sachs and Tara Vincenta, “Outdoor Environments for Children with Autism and Special Needs.” I mentioned this article in my April 13th blog post about Autism Awareness and Landscape Architecture month, but it had not come out yet.

So take a look by linking to the pdf here: http://www.informedesign.org/_news/april_v09-p.pdf.

 

And here is the resource list on autism and related disorders and children and nature mentioned in the article , which will also soon be available for download from the TLN Get Out and Play! page:
PDF of resources on autism and nature-based learning and play for InformeDesign’s ‘Implications’ (Vol. 9, Issue 1)

Tara Vincenta developed the Sequential Outdoor Learning (SOL) Environment and many of the design guidelines in our article are based on SOL Environment principles.

Many thanks to InformeDesign for giving me and Tara this platform to share our work. InformeDesign is an evidence-based design tool that transforms research into an easy-to-read, easy-to-use format for architects, graphic designers, housing specialists, interior designers, landscape architects, and the public. They are, in my humble opinion, one of the best resources out there.

And if you know of people who would benefit from the information in this post, please pass it on!

 

Happy Earth Day, Happy Year of the Forests!

White oak. Photo by Henry Domke http://www.henrydomke.com

White oak. Photo by Henry Domke, www.henrydomke.com

Wow, under the wire here to get this post out before Earth Day ends. But really, every day is Earth Day, right?

2011 is also the Year of the Tree, or the Year of the Forests, another thing I’ve been meaning to blog about since January.

The International Year of the Tree/Year of the Forests was launched at the United Nations Headquarters in New York to heighten awareness of the value of forests in people’s lives and to galvanize action for trees and forests around the world. Here’s the UN website, with lots of great information, pictures, and videos and here’s their Facebook page. And here’s another nice website/blog, The Tree Year, with all sorts of good information and activities to help you celebrate.

Just one of the many reasons that trees are so awesome: One tree can absorb about a ton of carbon dioxide over its lifetime, and produces nearly 260 pounds of oxygen each year – the equivalent of the amount consumed by 18 people annually. For more fun facts about trees and their importance, see Trees Are Good, by the International Society of Arboriculture.

“Shinrin-yoku,” or “forest bathing,” is a practice in Japan in which people visit a forest while breathing in phytoncides – wood essential oils – that are antimicrobial volatile organic compounds derived from trees. According to Wikipedia (yes, I am cutting corners) it has now become a recognized relaxation and/or stress management activity in Japan.

A great article (“Really? The Claim: Exposure to Plants and Parks Can Boost Immunity,” by Anahad O’Connor for The New York Times, July 5, 2010) about this practice was published last year. I’m hoping the intellectual copyright people won’t sue me for posting two paragraphs from the article here:

“One study published in January included data on 280 healthy people in Japan, where visiting nature parks for therapeutic effect has become a popular practice called “Shinrin-yoku,” or “forest bathing.” On one day, some people were instructed to walk through a forest or wooded area for a few hours, while others walked through a city area. On the second day, they traded places. The scientists found that being among plants produced “lower concentrations of cortisol, lower pulse rate, and lower blood pressure,” among other things.

A number of other studies have shown that visiting parks and forests seems to raise levels of white blood cells, including one in 2007 in which men who took two-hour walks in a forest over two days had a 50-percent spike in levels of natural killer cells. And another found an increase in white blood cells that lasted a week in women exposed to phytoncides in forest air.

The main study that O’Connor is referring to is:
Li Q, Morimoto K, Kobayashi M, Inagaki H, Katsumata M, Hirata Y, et al. Visiting a forest, but not a city, increases human natural killer activity and expression of anti-cancer proteins. Int J Immunopathol Pharmacol. 2008;21:117–28. Visit that same Wikipedia page for more.

So, happy Earth Day, and happy Year of the Forests!

It’s in the Dirt! Bacteria in soil may make us happier, smarter

Yum, dirt! Photo by Guy Ambrosino.A big thank you to Horticulture Magazine for featuring this post on their website. We are honored to be chosen as one of their Best Gardening Blogs 2011!

AND to the National Wildlife Federation for featuring this article as a guest post on their blog!

Many people, including me, talk about the restorative benefits of gardening (see last Tuesday’s post, for example) and the reasons why it makes us feel good. Just being in nature is already therapeutic, but actively connecting with nature through gardening is value-added. And why is that? All sorts of reasons have been posited: It’s a meditative practice; it’s gentle exercise; it’s fun; it allows us to be nurturing and to connect with life on a fundamental level.

And some recent research has added another missing piece to the puzzle: It’s in the dirt. Or to be a little more specific, a strain of bacterium in soil, Mycobacterium vaccae, has been found to trigger the release of seratonin, which in turn elevates mood and decreases anxiety. And on top of that, this little bacterium has been found to improve cognitive function and possibly even treat cancer and other diseases. Which means that contact with soil, through gardening or other means (see Elio, above), is beneficial. How did this discovery come about?

(more…)

Allotment Therapy: More empirical evidence on the salutary benefits of gardening

    Warrenville Lakes Homeowners Community Garden. Photo by Shawna Coronado, www.shawnacoronado.com

Warrenville Lakes Homeowners Community Garden. Photo by Shawna Coronado, www.shawnacoronado.com

Speaking of allotment gardens (see our 1/13 post about Charlie Hopkinson’s photography of allotment gardens), here’s an interesting study:

30 allotment gardeners were assigned to do a stressful task (not related to gardening). Immediately after, half of the gardeners worked in their own allotment plot and half read indoors, both for 30 minutes. With both groups, cortisol (a stress indicator) and self-reported stress levels went down, but they decreased significantly more in the group that gardened. I think I’m going to build me a greenhouse…

And here’s a moving blog by someone who struggles with depression and finds solace in her allotment garden. The blog is Allotment Therapy: A personal view of Ecotherapy, and the post is “The Wisdom of Plants.”

Stay tuned for another article on this topic, coming very soon!

Full abstract (link to the Journal of Health Psychology website to access the abstract and to buy the article): Stress-relieving effects of gardening were hypothesized and tested in a field experiment. Thirty allotment gardeners performed a stressful Stroop task and were then randomly assigned to 30 minutes of outdoor gardening or indoor reading on their own allotment plot. Salivary cortisol levels and self-reported mood were repeatedly measured. Gardening and reading each led to decreases in cortisol during the recovery period, but decreases were significantly stronger in the gardening group. Positive mood was fully restored after gardening, but further deteriorated during reading. These findings provide the first experimental evidence that gardening can promote relief from acute stress.

Full citation: Van Den Berg, Agnes and Custers, Mariëtte H.G. (2011). “Gardening Promotes Neuroendocrine and Affective Restoration from Stress.” Journal of Health Psychology, Vol. 16, No. 1, pp. 3-11.

Research Summary: “Investigating Walking Environments In and Around Assisted Living Facilities.”

Photo courtesy of Susan Rodiek

Walking is the most popular form of exercise for elderly people. Photo courtesy of Susan Rodiek.

Speaking of older adults (see our last post about Environments for Aging), a good article – “Investigating Walking Environments in and Around Assisted Living Facilities: A Facility Visit Study” by Zhipeng Lu – was published in the Summer 2010 issue of Health Environments Research & Design Journal (HERD). I wish I could provide a web link for you to access the free article, but alas, it’s only available to buy. So I’ll summarize the author’s points here.

At issue are the dueling needs of elderly people: The need for safety and the need for exercise and social connection. Lu states that “falls are the most frequent cause of injury-related morbidity and mortality among community-dwelling older people.” Falling is a true risk and needs to be avoided. But as he (and others he cites) argue, exercise and social connection are both critical for maintaining physical and emotional health. Careful consideration of location/neighborhood, as well as design of indoor and outdoor pathways, can both reduce risks and enable elderly people to live active, healthy lives.

Lu first makes a case for the benefits of exercise – in this case, walking – for elderly people (people 65 or older), and asserts that “the physical environment plays a role in promoting physical activity.” Since walking is the most preferred form of exercise among elderly people, it makes good sense to see what types of settings best promote frequent and safe walking.” The design of walkable ALF environments has become more important because frail older people are increasingly averse to nursing homes and seek a higher quality of life and greater independent living in an ALF.” An assisted living facility, or ALF, as defined by the Assisted Living Federation of America is “a long-term care option that combines housing, supportive services, and healthcare for mentally and physically frail individuals.”

(more…)

Garden Designers Roundtable: Thoughts and Evidence on Therapy and Healing in the Garden

I go to nature to be soothed and healed, and to have my senses put in order.
~ John Burroughs

Autumn crocus, The High Line, New York City. Photo by Naomi Sachs

This blog post comes courtesy of the Garden Designers Roundtable, who invited me to be their first-ever guest blogger. I’m honored and excited to be participating in today’s roundtable discussion, the theme of which is “Therapy and healing in the garden.” All photos are by Naomi Sachs.

Some Thoughts and Evidence on Therapy and Healing in the Garden

The idea that gardens and landscapes foster good health seems like a no-brainer, especially to gardeners and garden/landscape designers/architects. It’s like telling Newton that apples really do fall down. Sadly, though I’m preaching to the choir here today, many people still haven’t grasped this concept, and we can find all too many examples of landscapes that are anything but healing (picture, if you will, a parking lot at the mall…). At the Therapeutic Landscape Network, we focus a lot of our attention on the design of hospitals and other healthcare environments because – oddly enough – they tend to be so far behind as places that facilitate health and well-being on a holistic level. We’re getting there, but we still have a long way to go.

For today, since a big part of the TLN’s mission is to connect designers and health and human service providers with the research they need to design beautiful, nurturing, successfully restorative spaces, I thought I’d highlight some of the evidence that we’ve blogged about over the years. In this case, research that “proves” that being in and interacting with nature is, indeed, restorative for body and soul. This research is important because it’s positive ammunition. It’s what makes CEOs, and policy makers, and grant funders and our clients sit up and take notice (and change the laws and sign the checks!). I’ve provided a one-sentence summary of the research, with the title of each related blog post that you can link to for more information and full citations.

But first, for background, the seminal ‘View Through a Window’ study:
In 1984, Roger Ulrich studied two sets of patients, both in the same hospital, both recovering from the same surgery. The key difference: One group’s view from their window was of nature – grass, trees and sky; the other’s was of a brick wall. Ulrich found that the patients with the nature view complained less, required less pain medication, and made a faster recovery. Here, finally, was empirical proof of the salutary benefits of nature. Ulrich’s paper, published in the journal Science, got the attention of the medical community and legitimized the field of evidence-based design. Evidence-based design being the use of quantitative, and sometimes qualitative, research to design environments that facilitate health and improve outcomes. Since then, hundreds of studies have been published. Some, like those cited below, continue to demonstrate that contact with nature is good for people; some explore how people benefit, and what conditions are best for specific groups, needs, and situations (e.g., children; seniors with dementia; gardens for people who are immuno-compromised).

Innisfree, Millbrook, NY

The evidence since ‘View Through a Window.’ A few good examples:

Trees, greenery, and other vegetation make neighborhoods safer and more desirable. They even play a role in boosting students’ grades and reducing the risk of domestic violence.
See “Healing the Neighborhood: The Power of Gardens.”

Plants in an office setting improve worker satisfaction, creativity, and productivity.
See “I Demand Satisfaction! The Role of Nature in Job Satisfaction.”

As little as 10 minutes spent outside improves attention in children with ADHD; neighborhoods with more green space improve body mass index of children and youth.
See “Nature Deficit Disorder: Getting Kids Outdoors.” For many more resources on nature-based learning and play for kids, visit our Get Out and Play! page.

Uma, picking serviceberries. Photo by Naomi Sachs

Gardening improves health and happiness, including reducing heart rate and blood pressure.
See “Horticultural Therapy in the Wall Street Journal.” Horticultural Therapy is “a professional practice that uses the cultivation of plants and gardening activities to improve the mental and physical health of its participants,” (definition courtesy of the Horticultural Therapy Institute). Hort therapists often work with occupational and physical therapists in a garden setting; gardens that are designed specifically for this kind of therapy are called rehabilitation gardens. For more information, see the horticultural therapy page on our website and for a really inspiring post about the power of horticultural therapy, see A Life Worth Living: The Garden as Healer.

Exposure to nature makes people more altruistic and generous.
It’s true, Nature Makes Us Nicer!

Autumn leaves. Photo by Naomi Sachs

I hope that now that you’ve been introduced to the Therapeutic Landscapes Network Blog, you’ll stay awhile and read some of our older posts, and that you’ll visit us again for new ones (you can also sign up to have posts emailed to you). I welcome your comments, which can often lead to great dialog on the TLN Blog.

Many thanks again to the Garden Designers Roundtable for the invitation and warm welcome as a guest blogger. Visit the GDRT website (gdrt.wordpress.com), or click on the links below, to read other bloggers’ posts (and to see some great pictures) – it’s an excellent group, and each blogger has something interesting to say on the topic.

Genevieve Schmidt, North Coast Gardening: Designing a Landscape for Colorblind People
Ivette Soler, The Germinatrix: Plant a Garden, The Life You Save Might Be Your Own
Jenny Petersen, J Petersen Garden Design: Therapeutic Spaces
Lesley Hegarty & Robert Webber, Hegarty Webber Partnership: Homage to Ariadne: Labyrinthine Therapy
Rochelle Greayer, Studio “G”: A Tale About What Makes a Garden Healing

An Amazing Opportunity – TKF Foundation Capstone Awards

Summer Sky by Henry Domke

Photo by Henry Domke, www.HenryDomke.com

The TKF Foundation‘s mission is “to provide the opportunity for a deeper human experience by inspiring and supporting the creation of public greenspace that offers a temporary place of sanctuary, encourages reflection, provides solace, and engenders peace and well being.” TKF does amazing work. They have funded over 120 projects in the Maryland and Washington, D.C. area, and now they are embarking on a new project, the National Demonstration Site and Research Challenge Awards Initiative. I hope that some of you will apply, and please also help spread the word. This really is an amazing opportunity, from which all of us will benefit.

TKF Announces New Capstone Awards

National Demonstration Site and Research Challenge Awards Initiative
We are living in a time of crisis when the press of urban congestion and technology threaten our human wellbeing.  In the 21st century, as the pace of life has accelerated, our relationship with the land, with each other and with our inner selves has diminished. TKF believes that a critical part of what today’s communities cry out for is the peace of a Walden Pond in every neighborhood and the awe-inspiring power of trees outside our windows. Through many years of involvement in environmental and public greening advocacy, we have found that the language of the spirit has been silenced. We seek to restore that voice to the public discourse.

While we know intuitively and anecdotally that nature heals, unifies and uplifts the human spirit, TKF believes there is a growing need to complement these insights with empirical evidence in order to gain wider acceptance, advance understanding, influence policy, and effect systems change.

Beginning in 2012, TKF will begin awarding challenge grants of up to $1 million to applicants who seek to create a new Open Space Sacred Place and to study aspects of the impact on the human spirit of the opportunity to be in nature.  Open to qualified applicants from across the United States, this program is designed to inspire non-profit organizations, professional associations, educational institutions, municipalities and community-based groups from a range of perspectives to come together in interdisciplinary teams to create new public green spaces and to implement a significant research or evaluation component. Through these awards and the ensuing research and communication of findings, we seek to build a body of useful information and evidence about the impact of Open Spaces Sacred Places on the human spirit that can be shared to create greater public understanding and support of the benefits of  nature to individual and community wellbeing. Our goal is to encourage all types of practitioners, policy makers and opinion leaders — from community activists to environmental advocates to city planners and including doctors, philosophers, journalists, social scientists and theologians among many others — to think broadly about the role and importance of nature in every life and to take concrete steps to make access to nature.

As a first step, later this year we will convene a National Advisory Panel, to help us better understand the kinds of questions from the field that need study and the ways that research could be most helpful in advancing a variety of missions that intersect in the realm of nature, spirit and individual and community wellbeing. We anticipate that the output of the panel’s work will provide important context and inspiration for the Demonstration Site and Research projects and for many others already working in related fields. For more information, click here.

Make it Pretty and They Will Come: The Role of Aesthetics in Patient Satisfaction

Woodwinds Health Campus

Garden bench at Woodwinds Health Campus, photo courtesy of Woodwinds Health Campus

Like most people, I’ve had my fair share of unpleasant experiences in doctors offices and hospitals. And looking back, I realize that many of my most worst memories had to do with the way the place looked. The one that took the cake was a doctor’s office in a windowless clinic with one potted plant in the waiting room. And that plant, a Poinsettia from Christmas-time (this was in February) was dead. Even if only on a subliminal level, we perceive that something is wrong with this picture: “If they can’t even take care of one houseplant, how the heck are they going to take care of me?” I have heard many people, when talking about the gardens in a hospital, clinic, or nursing home or other place of healing, express the opposite sentiment: “They take such good care of the gardens, and that reassures me that they will take good care of me, too.”

I’m reading an article from an old (2008) issue of Healthcare Environments Research & Design Journal (HERD), titled “Ambulatory Facility Design and Patients’ Perceptions of Healthcare Quality,” which completely reinforces what we all know in our hearts to be true: That places of healing work better when they look and feel like…places of healing. And I’m talking, of course, about a more holistic idea of healing than just “isolate, sterilize, and medicate.” Squeaky white linoleum floors that reflect buzzing fluorescent lights attached to low ceilings in long, windowless corridors is an old model that has been proven to be anything but good for our health.

So, let me just share a few nuggets from this article. First, its conclusion, as stated in the abstract: “This study is consistent with other studies that examined the relationship among the physical attractiveness of healthcare settings, patient satisfaction, and quality of care.” Patients reported better care, service, and staff and doctor interactions in the more attractive waiting rooms. The authors cite several other related studies about patient satisfaction: Leitner and colleagues (1998) found that “patients in hospital units where nurses felt that their work was meaningful were more satisfied with their hospital stay” and that “…patients on units where nurses felt more tired and more frequently expressed their intention to quit were less satisfied with their care.” Mallak, Lyth, Olsen, Ulshafer, and Sardone (2003) found that “…job satisfaction [among healthcare providers] and patient satisfaction were significantly and positively correlated with culture strength and ratings of the built environment.” They also cite interviews with patients and families about what they want. Douglas and Douglas (2004) “found that patients reported the need for personal space, a homey welcoming atmosphere, areas for visitors, access to external areas, and provision of facilities for recreation and leisure.” Gardens in places of healing can fulfill many of these criteria, and a well-designed garden should address all of them.

I once got an email from someone recommending that his local hospital’s healing gardens (Woodwinds Health Campus, pictured above) be added to the TLN’s list of exemplary gardens in healthcare facilities. The gardens made a strong positive impression on him, and influenced how he felt about the entire hospital. And it probably provided a great incentive for him to visit for regular check-ups rather than waiting for emergencies. Think about how much people’s health would improve if they adhered to the preventative care model!

The article mentioned above explores the role of the built environment in influencing patient (consumer) satisfaction. Another article, which I’ll blog about soon, discusses the role of the built environment in influencing patient health and safety. There are so many reasons for healthcare providers to focus not just on the medicines and the machines, but on the places that house what all that stuff is there for: The patients and their families. All of those places have outdoor space – be it a parking lot and drop-off area or a designed “healing garden,” and all of those outdoor spaces could and should be considered as part of the aesthetic package that influences patient satisfaction, health, and well-being.

Full citations:

Becker, Franklin, Bridget Sweeney, and Kelley Parsons (2008). “Ambulatory Facility Design and Patients’ Perceptions of Healthcare Quality.” Healthcare Environments Research & Design Journal (HERD), Vol. 1, No. 4, pp. 35-54.

Douglas, C. H., and M. R. Douglas (2004). “Patient-friendly Hospital Environments: Exploring the Patient’s Perspective.” Health Expectations, Vol. 7, No. 1, pp. 61-73.

Leiter, M. P., P. Harvey, and C. Frizzell (1998). “The Correspondence of Patient Satisfaction and Nurse Burnout,” Social Science Medicine, Vol. 47, No. 10, pp. 1611-1617.

Mallak, L. A., D. M. Lyth, S. D. Olsen, S. M. Ulshafer, and F. F. Sardone (2003). “Culture, the Built Environment and Healthcare Organizational Performance.” Managing Service Quality, Vol. 13, No. 1, pp. 27-38.

Hurrah! ‘Access to Nature for Older Adults’ Wins ASLA Award

Access to Nature for Older Adults

Photo by Susan Rodiek

The 2010 ASLA (American Society of Landscape Architects) Awards have been announced, and one of the winners is the excellent new DVD series, “Access to Nature for Older Adults: Promoting Health Through Landscape Design.” Yea! We’ve blogged about this DVD series before, and we’re so pleased that ASLA agrees that it’s a valuable educational and design tool. Here’s what the jury had to say:

“Many of the features that were found beneficial, if included in all landscape design activity, would result in superior design and experience for us all. Improving our interactions with our world and better mental health all around! Talks about landscape design specific to an older population, proving a point of the importance of landscape architects. It sets up a design hypothesis that is in need of proving. Everything it applies to older population also applies to everyone. The research has a much broader application than just the elderly population.”
—2010 Professional Awards Jury

And to celebrate, TLN members get a 15% discount off any or all three Access to Nature DVDs. You don’t even need to be an official TLN member (though we’d love it if you were: Join online – it’s free!). If you are a designer, or an administrator, or a health and human service provider, or an educator, or a student, or someone with parents or grandparents (hm, that would be everybody), you should buy this award-winning DVD series.

To order your Access to Nature DVDs with the 15% discount, visit the Access to Nature website, (www.accesstonature.org) and at the checkout, enter the promotional code TLNA2N. If for some reason that code doesn’t work, try TLNA2Na (same code but with a lower-case “a” at the end). The website is also chock-full of good information, so it’s a good one to bookmark.

Access to Nature DVDs

This is actually the fourth award for Access to Nature series: It received the 2009 Environment + Design Award from CEAL – The Center for Excellence in Assisted Living, and an early prototype of the Access to Nature program also won the Active Place Design Competition award in product design from EDRA, the Environmental Design Research Association, and a Viewer’s choice award from the Harvard School of Public Health.

Congratulations again to Susan Rodiek and her team at Texas A & M University; keep up the good work, and thanks for extending the discount to the Therapeutic Landscapes Network!

Now online! Nature-Based Learning and Play for Children with Autism and Special Needs

Since Richard Louv began his No Child Left Inside campaign, we have seen a wonderful groundswell around the importance of children experiencing the natural world. And at the same time, sadly, we continue to see an alarming rise in children with autism and other related disorders. According to the Centers for Disease Control, autism now affects 1 in every 110 American children. This new number is a staggering 57% increase from 2002-2006. Clearly, we need more research on prevention and treatment options, but we also need more ways to help those children (and their families) on the “autism spectrum” who are coping on a daily basis.

One way that we can help is by designing environments that support children on the spectrum, including outdoor play and learning spaces. That’s why Tara Vincenta – Principal at Artemis Landscape Architects and creator of the SOL (Sequential Outdoor Learning) Environment –  and I were thrilled when KaBOOM! approached us about doing an online training on this very subject. We’ve had a great time collaborating and are happy to announce that the training is now available on the KaBOOM! website, and will soon be up on the SOL Environment and Therapeutic Landscapes Network websites as well.

The free online training is called “Prescription for Play: Nature-based Play and Learning for Autistic and Special Needs Children.” Here’s the description:

Join landscape architects Naomi Sachs, Director of the Therapeutic Landscapes Network and Tara Vincenta, creator of SOL (Sequential Outdoor Learning) Environment as they explore research and design considerations for creating outdoor, nature-based play and learning environments for autistic and special needs children. Many of the challenges faced by autistic children are shared with a broader community of special needs children, including motor, neuromuscular, cognitive, sensory and communication issues, and visual and auditory impairment. Sachs and Vincenta will share ideas for creating outdoor spaces that allow children to play at their own comfort level, overcoming common challenges in a safe, FUN, nature-based environment that is equally engaging for any child.

Go to KaBOOM’s Hot Topics in Play page to access the training, and if ours is not the first training, just scroll down until you see it. You’ll find other great topics there as well, and once you join KaBOOM (free, of course), you can access any and all. KaBOOM! is a wonderful non-profit organization whose mission is to create great playspaces through the participation and leadership of communities, and whose vision is “a great place to play within walking distance of every child in America.”

You can also download a pdf of the supplemental materials – a list resources in print and online about this topic – from the KaBOOM website, and we’ll have those on our respective websites soon, too.

Many, many thanks to KaBOOM! (and especially to Kiva) for this wonderful opportunity, and to you, dear reader, for spreading the word (yes, that’s a hint).