NAAEE

This study may be the first of its kind to explicitly examine the relationship between nature exposure and anxiety in youth with autism spectrum disorder (ASD) relative to their peers. While previous research documents anxiety-reducing benefits of exposure to nature, such research did not include children with ASD who tend to be more prone to anxiety than other children. Previous research also suggests that exposure to gray space -- which includes such impervious surfaces as roads and buildings – is associated with increased anxiety in the general population of children. The current study extends the previous research by examining the possible association of both green and gray space proximity and anxiety in youth with autism.

This study used ZIP code level data on children’s health and land cover data from across the United States. The analysis of the data focused on three groups of children all between the ages of 6 and 17:  1501 children with ASD; 15,723 children without ASD who had other special healthcare needs; and 53,650 typically developing children.  The land cover data included measures of both green space and gray space, as both dimensions help define the naturalness of a landscape. For data analysis, the children were split into two anxiety groups (no/low anxiety and moderate/severe anxiety) based on parent/guardian reports.

Results showed that both gray space and green space proximity increased the odds of youth with ASD experiencing moderate to high levels of anxiety problems. Although the association between gray space and anxiety was expected, the association between green space and anxiety was not, based on previous literature suggesting that green space can help alleviate the symptoms of anxiety. These findings did not apply to the typically developing youth or those with other special health care needs in this study.

These results suggest that children with ASD might experience the stress-reducing benefits of nature differently than their typically developing peers. Specifically, the authors suggest that trees, as opposed to grass, may trigger anxiety for children with ASD. More research needs to be conducted to gain a better understanding of the complex relationship between proximity to green space and anxiety in children with ASD.