Treating ADHD is a Walk in the Park?

So How Helpful is a Walk in the Park on One Single Measure of Attention?

And what’s the difference between the two groups?

The effect of the park exposure on DSB performance was substantial. Expressed in terms of digit span, DSB performance was roughly six-tenths of a digit better after the park exposure than after the downtown exposure. [emphasis added]

That’s about one-half of one digit. This is “significant”? Maybe statistically, but I have serious doubts whether this translates into any actual clinical significance — e.g., made a difference in the child’s or parent’s life. We’d know if it did had the researchers included any parental rating measures in the study, but alas, they chose not to.

By the way, as an interesting aside, out of the 9 studies the researchers note in Table 1 that studied attention with the DBS, 2 of them (22%) found a negative difference in mean scores. Meaning that kids with ADHD actually scored better on the DBS than the non-ADHD control groups. Not exactly a sign of a stable and reliable measure, no? (For reference, I don’t know of any standard ADHD rating scale that has demonstrated a similar kind of effect.)

I guess what I’m saying is that if you’re going to claim a new treatment is better than some other treatment for ADHD, why not use industry-standard measures so we can truly compare apples to apples? We have at least a half-dozen standardized and normed research rating scales for ADHD, including the ADHD SRS, the Connors CPRS-R:S and the ADHD Rating Scale-IV, among others.

If a study has gone badly, the reasonable thing to do is to go back and redo it. I know that takes time, money and resources, but it’s the right thing to do. Or, at the very least, don’t make broad generalizations about your findings based upon such a tiny dataset and weak measures used:

Taken together, the findings from this study and the previous large-scale survey studies suggest that not only does exposure to nature enhance attention in children with ADHD, but also that this effect holds for a wide variety of children, settings, and activities.

Sorry, I don’t agree with that conclusion based upon this study. While it has provided a smidgen more data in this area, it’s not enough to draw any conclusions yet about these issues.

I can’t imagine a walk in the park harming any child, but at the same time, I don’t see that it’s likely to make much of a significant difference in the life of a child with attention deficit disorder.

Read the news article: Walk in the Park May Help Kids with ADHD

Read the Furious Seasons entry: Study: Nature Helps ADHD Kids Concentrate

References:

Hale, J. B., Hoeppner, J. B., & Fiorello, C. A. (2002). Analyzing digit span components for assessment of attention processes. Journal of Psychoeducational Assessment, 20, 128-143.

O’Donnell, L. (2005). Cognitive and memory performance patterns associated with ADHD subtypes. Dissertation Abstracts International: Section B: The Sciences and Engineering, 65(9-B), 4843.

Talor, A.F. & Kuo, F.E. (2008). Children With Attention Deficits Concentrate Better After Walk in the Park. Journal of Attention Disorders 2008, doi:10.1177/1087054708323000.