The Effect of an Outdoor Adventure Program on Functioning of Children with Autism Spectrum Disorder

Background:  

Challenge in the outdoors is important for people with and without disabilities. The outdoor environment intensifies group interaction and development. Individuals with cognitive and/or motor disabilities benefit from participation in outdoor adventure programs and show increased outdoor recreation skills, enhanced self-concept, self-esteem, social adjustment, positive behavior changes, increased interpersonal relationships, and sensitivity to the needs of others. The effect of outdoor adventure programs (OAP) on the functioning of children with autism spectrum disorder (ASD) has not yet been examined.

Objectives:  

The aim of the current study was to examine the effect of OAP for children with ASD on autism severity, adaptive skills, and the kindergarten (KG) teacher's perception of the child's ‘future competence’.

Methods:  

Fifty-one participants recruited from seven special education KGs for ASD using the same educational curriculum in Tel Aviv, with an age range of 3:4-7:4 years (M=5:4, SD=.9) were enrolled in this study. Four KGs including 31 participants were randomly selected to participate in an OAP (research group). The other three KGs included 20 participants who did not participate in this program (the control group). The groups did not differ in age and sex. The OAP included 13 weekly sessions of 30 minutes each provided by professional recreation specialists from "ETGARIM", a non-profit organization. Activities included: climbing and descending a ladder; a rope elevator requiring group collaboration by pulling a child tied to a harness; walking on ropes tied to trees requiring a request for the instructors’ help, and swinging on a hanging hammock. Pre-and post-evaluation of autism severity (Social Responsiveness Scale-SRS), adaptive skills (Vineland Adaptive Behavior Scales- VABS) and perception of the KG teacher on ‘future competence’ (a questionnaire based on several sources and modified by the authors) were conducted.

Results:

Outcome in autism severity revealed a significant TimeXGroup interaction. At post-intervention time, the research group showed a significant reduction in autism severity on the SRS composite and specific subdomains (cognition, motivation and repetitive behaviors scores), while the control group showed an increase in autism severity in these measures. Further analyzing the differences between the groups using T tests revealed that only the research group showed significant improvements in SRS communication, p<0.05) and motivation (p<0.05) subdomains. At post-intervention time, only the control group had more severe SRS composite, p<0.05) and repetitive behaviors (p<0.05) scores. The two groups showed significant improvements over time in VABS communication and daily living skills scores. No significant TimeXGroup interaction was found for VABS scores nor for the ‘future competence’ questionnaire scores. Dividing the groups at baseline into two autism severity subgroups based on the SRS scores revealed that only the low autism severity subgroup that received intervention showed significant improvements on the VABS DLS scores (p<0.05) and on ‘future competence’ questionnaire scores (p<0.05).

Conclusions:  

Outdoor adventure programs for children with ASD improve measures of autism severity and prevent deterioration in socio-communication skills and repetitive behaviors. Children with less severe autism symptoms benefit from this program and improve in adaptive skills. Including an outdoor adventure program in the intervention plan in ASD is recommended.