Where Wild Things Grow: Immediate and Long-term Impact of Nature- and Activity-based Group Interventions for Neurodivergent Children and Youth in School, Health Care and Leisure Settings in Agder

BACKGROUND Today's children grow up in uncertain times. Global trends include the multicrisis of climate change, pandemic and wars, lack of contact with nature and a life supercharged with technology that offers unprecedented possibilities, but is simultaneously associated with loneliness and distress. Factors such as these may underlie the sharp decline in mental well-being in Norwegian youth during the previous two decades. Indeed, it has been noted that increased screen time is associated with increased depression and anxiety in Norwegian youth and further that replacing free, imaginative outdoor play with more time spent online is an important factor underlying the mental health crisis.

When it comes to neurodivergent population more specifically, numerous intertwined issues are especially pronounced for neurodiverse children and youth, who are at an increased risk of developing mood disorders, planning or committing suicide, becoming delinquent and misusing substances compared to their neurotypical peers.

These complex needs of neurodiverse children combined with the sharp rise in referrals to health services, call for proactive collaboration between schools, healthcare services, community-based services and interest organizations. Clinicians, researchers, politicians and the youth themselves have called for systemic and low-threshold interventions, preferably aimed at strengthening a positive self-image and personal resources, rather than concentrating on reduction of symptoms and deficits. One path forward is to develop tailored group interventions that foster individual inclusion and mastery, while being adaptable for regional implementation across a continuum of services. Over time, this process could ideally lead to systemic societal change by better nurturing the developmental needs of neurodiverse children and youth.

In Where Wild Things Grow, a collaborative continuum across educational, health care and leisure sectors has been established to build systemic competence and to develop, implement and test nature- and activity-based group interventions for neurodivergent children and youth. If effective, the interventions and the collaborative model can be replicated nationally and internationally in a systemic, joint effort to promoting children's overall growth, development and well-being.

The interventions are informed by the global trends outlined above, research on nature-based approaches for children with ADHD and autism, strength-based approaches and the neurodiversity movement. Studies have shown that outdoor education has positive effect on children's biological stress regulation and brain development and function, where children participating in outdoor schooling in a forest exhibited a healthier diurnal rhythm compared to those in a traditional school setting. Similarly, Dettweiler et al. demonstrated that outdoor education fosters better stress regulation and brain development, particularly in those areas of the brain that are associated with stress response and cognitive control. Furthermore, this project builds on a decade of clinical studies by a collective of researchers and practitioners at Sorlandet Hospital that has focused on developing transdiagnostic nature- and activity-based interventions for children, youth, and families.