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Objectives. We examined the impact of relatively "green" or natural settings on attention-deficit/hyperactivity disorder (ADHD) symptoms across diverse subpopulations of children.
Methods. Parents nationwide rated the aftereffects of 49 common after-school and weekend activities on children's symptoms. Aftereffects were compared for activities conducted in green outdoor settings versus those conducted in both built outdoor and indoor settings.
Results. In this national, nonprobability sample, green outdoor activities reduced symptoms significantly more than did activities conducted in other settings, even when activities were matched across settings. Findings were consistent across age, gender, and income groups; community types; geographic regions; and diagnoses.
Conclusions. Green outdoor settings appear to reduce ADHD symptoms in children across a wide range of individual, residential, and case characteristics. (Am J Public Health. 2004;94:1580-1586)
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood.1 It manifests as an unusually high and chronic level of inattention, impulsivity/hyperactivity, or both, and it may affect more than 2 million school-aged children.2 Recent statistics indicate that, among children aged 6 to 11 years, the incidence of ADHD is approximately 7%.3 ADHD exacts a substantial toll on afflicted individuals and often persists into adulthood. According to the Centers for Disease Control and Prevention: "if untreated, a person with ADHD will struggle with impairments in crucial areas of life, including relationships with peers and family members, and performance at school or work."2(p1)
Unfortunately, current ADHD treatments fall far short of ideal, offering only limited relief from symptoms and often involving serious side effects.4-7 The Centers for Disease Control and Prevention has labeled ADHD "a serious public health problem,"8 citing "the large estimated prevalence of the disorder; the significant impairment in the areas of school performance and socialization; the chmnidty of the disorder; the limited effectiveness of current interventions to attend to all the impairments associated with ADHD; and the inability to demonstrate that intervention provides substantial benefits for long-term outcomes."8(p1)
In this article, we report the results of 1 in a series of studies exploring a possible new treatment for ADHD. The findings outlined here, taken in the context of previous research, suggest that common after-school and weekend activities conducted in relatively natural outdoor environments may be widely effective in reducing ADHD symptoms. If controlled experiments and clinical...