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Ramshini M, Hasanzadeh S, Afroz G A, Hashemi Razini H. The Effect of Family-Centered Nature Therapy on Children With Autism Spectrum Disorder. jrehab 2018; 19 (2) :150-159
URL: http://rehabilitationj.uswr.ac.ir/article-1-2294-en.html

Objective The treatment of autism, a long-term developmental neurological disorder, is controversial. Because of the increasing trend and the lack of a known cause in this area, the treatment is complicated; obscure development of the disorder is a fundamental issue for the parents of these children. Due to the nature of the disorder and involvement of long durations of treatment, various therapeutic methods are used. In addition to the present treatments, a cost-effective and effective treatment is nature therapy (Eco therapy). Therefore, we decided to study the effectiveness of family-centered nature therapy on children with autism spectrum disorder.
Materials & Methods A quasi-experimental (pre-test/post-test) study was conducted involving children with autism spectrum disorder (3-7 years old) who were referred to Tehran’s rehabilitation and therapeutic centers. Fourteen children with autism spectrum disorder were selected by an available sampling method and randomly assigned to experimental and control groups. In each group, 7 children (6 boys and 1 girl) were placed. Ten therapeutic sessions were conducted in 3 months in the summer of 2017; each session was held for 3 hours (9 am to 12 pm) in the Nature School of Savan (located in Chitgar Forest Park) with the obligatory presence of parents (parents or at least one of them). To collect data, the Autism Treatment Evaluation Checklist (ATEC) and the Nature Therapy programs (based on the theoretical framework and relevant research findings) were used. The Autism Treatment Evaluation Checklist (ATEC) consisting of four parts, speech / language / communication, socialization, sensory / cognitive awareness, and health / physical / behavior were scrutinized three times, i.e., before the start of the session, 10 days after the last session of education and three months after the last training session. Each family was followed up by the other families. The variables studied in this study were, family-centered nature therapy (independent variable) and autism spectrum disorder syndrome (dependent variable). Data were analyzed using descriptive statistical methods (mean, standard deviation, minimum and maximum scores) and inferential methods (Leven test to assess the assumption of the equation of error variances, Kolmogorov-Smirnov test to examine the normal distribution of covariance analysis and to investigate the effect of test conditions on the dependent variable of the groups).
Results The results showed that the average score of the post-test for Autism Treatment increased in the experimental group (172.3±5.11) compared with the post-test for control (1.151±10.24), which was statistically significant. This showed that the nature therapy program brought an improvement in children with autism spectrum disorder. Also, the average follow-up scores (after 3 months) of the experimental group (173.91±12.02) indicated the efficacy of treatment. The results of covariance analysis indicated that the calculated F value (F=21.91) was highly significant (P<0.001), indicating the effectiveness of the experimental conditions on the dependent variable (improvement in syndrome).
Conclusion The findings of this study showed that family-centered nature therapy improved the syndrome in children with autism spectrum disorder. These children have shown remarkable progress, especially in the field of social and communication skills. Therefore, it is suggested that this type of treatment has positive, simple and accessible effects and can be used as a complementary method along with other treatments for these children.