‘Growing in nature’: evaluating the impact of a nature-based intervention on sensory, emotional, social, and adaptive functioning in children with autism spectrum disorder

Nature-based interventions are increasingly gaining attention as complementary approaches to support children with neurodevelopmental disorders, including Autism Spectrum Disorder (ASD). This pilot study aimed to evaluate the feasibility and preliminary effectiveness of a structured nature-based therapeutic program - “Growing in Nature” - designed to target core functional domains affected in school-aged children with ASD. A single-group, pre–post quasi-experimental design was employed. Sixteen children aged 6–12 years participated in the intervention, which was implemented in outdoor natural settings and incorporated activities aimed at enhancing sensory processing, emotional regulation, social responsiveness, and adaptive functioning. Standardized and psychometrically validated instruments were administered before and after the intervention: the Sensory Processing Measure (SPM), the Child Behavior Checklist 6–18 (CBCL 6–18), the Social Responsiveness Scale–2 (SRS-2), and the Adaptive Behavior Assessment System–II (ABAS-II). Preliminary analyses revealed statistically and clinically significant improvements across multiple domains, including sensory reactivity, emotional–behavioral functioning, social communication, and adaptive skills. Notably, significant associations emerged between changes in sensory processing and improvements in emotional, social, and adaptive functioning, suggesting potential cross-domain effects. Despite methodological limitations—including the small sample size, the lack of a control group, and the short-term follow-up—this study represents one of the first Italian investigations to systematically evaluate the impact of a nature-based intervention in children with ASD using a multidimensional outcome assessment framework. The findings provide initial support for the feasibility, acceptability, and potential clinical utility of nature-based approaches as complementary interventions for ASD.