More Green Space Around Schools is Associated with Lower Rates of ADHD in a Recent Study

By Dr. Mary Rooney, Ph.D.

Spending time in nature is good for your mental health, whether that’s taking a hike in the woods or spending time in a city park. In fact, studies have shown that having access to green space near your home can lower your risk of developing depression, improve cognitive development in children, and reduce neural activity linked to psychiatric disorders. A recent study published in JAMA Network Open1 builds on these studies by examining the connection between the amount of green space in a child’s environment and ADHD symptoms.  

The newly published study was conducted in China, where ADHD occurs in about 6% of the population (slightly lower than what we see here in the US). In China, as in the US, children spend a great deal of their time attending school and after-school programs. In many cases, children have more of an opportunity throughout the week to use green spaces near their school than they do near their home.

In the study, researchers sought to determine whether the amount of green space around a school was associated with the rates of ADHD observed in the students. Researchers collected ADHD symptom ratings from parents of 59,754 children (ages 2-17) attending preschool, elementary school, middle school, and high school in seven provinces in Northern China. Parents rated the frequency of each of 18 ADHD symptoms during the preceding six months on a four-point scale, ranging from “never or rare” to “very often.”

To estimate the amount of green space around the schools, the researchers used measures of vegetation, referred to as vegetation indexes, derived from satellite images taken in August (the greenest month in Northern China). Values ranged from negative one to one, with higher values indicating more green space, negative values representing bodies of water, and values close to 0 indicating areas without water or vegetation.

In the study, 4.3% of the children (2,566) were classified as having ADHD based on parent ratings. The researchers found that a 0.1 unit increase in one of the vegetation indexes within 500 meters of a school or kindergarten was significantly associated with lower odds of ADHD symptoms. Given the large number of participants involved in the study and the wide range of school environments (some with no green space or very little green space, and others with large swaths of green space), the study makes an important contribution to our understanding of how the environment may impact symptoms of ADHD.

The study also highlights important gaps in our knowledge. For example, we do not know why more green space is associated with lower rates of ADHD symptoms. It could be that simply being in nature or viewing nature fosters healthy brain development and helps us regulate our emotions and behaviors. Or, it’s possible that the students with access to more green space are more physically active. Alternatively, the pollutant-lowering effects of vegetation may mean that students in greener environments are exposed to fewer pollutants (which may affect brain functioning).

Despite the unanswered research questions, parents and teachers can help kids with ADHD now by providing as many opportunities as possible for outdoor play and exploration in nature. If your child attends a school with limited green space, work on making visits to local parks part of your regular routine. We already know that kids with ADHD benefit from physical activity, and it’s possible that getting that physical activity in a green environment will give an extra boost to kids with ADHD.  

1 Yang, B.Y. et al. (2019). “Association Between Greenness Surrounding Schools and Kindergartens and Attention-Deficit/Hyperactivity Disorder in Children in China.” JAMA Network Open. 2019;2(12):e1917862.



Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.


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