Expanding access to neurodiversity-inclusive nature spaces through community partnerships

I partnered with local health and recreation organizations who actively promote children’s access to nature in low-income communities and supported their work with recommendations for making their programs more neurodiversity-inclusive.

Student: Ana Nishioka
Site Mentor: Marika Austin, MS OTR/L
Faculty Mentor: Jessie Bricker, OTD OTR/L
School: Washington University School of Medicine in St. Louis
Site: Bearfoot Occupational Therapy
Setting and location: Nature-based pediatrics in San Francisco, CA
Hybrid work setting

Purpose: The goal of my capstone was to expand children’s access to neurodiversity-inclusive nature spaces.

Method/Design/Approach: Established working relationships between Bearfoot OT and local health and recreation organizations to support free, public access to more neurodiversity-inclusive nature spaces. By working with community partners, I also demonstrated how OT is a key player in the larger national conversation of equitably connecting children to nature.


  • One 15-minute in-service and accompanying discussion about nature-based occupational therapy and neurodiversity-affirming care for the pediatric team at Ravenswood Family Health Network, a federally qualified health center located in East Palo Alto, CA.
  • Two introductory guides to make nature spaces and programming more neurodiversity-inclusive created in collaboration with SF Children & Nature and Zach Pine Create with Nature.


  • Following my in-service presentation, I have received feedback that primary care providers at Ravenswood are considering expanding their nature prescription program, ParkRx, as part of their approach to care for ADHD and Autistic patients.
  • For SF Children & Nature, the guides that we collaborated on are intended for publication to their website and to be shared nationally with other park and recreation agencies.

Ideas for next steps to build on this topic: To my knowledge, there were not other occupational therapists working in the public recreation and parks sector. I think any collaboration with public entities is a great way to expand people’s understanding of what occupational therapy is and how it can contribute to larger issues of equitable access of public spaces.

2-3 tips for students undertaking a similar project:

If you’re interested in working in nature-based therapy, I would join the Therapy in the Great Outdoors free community and follow work from Children & Nature Network and the ParkRxprogram. If you’re interested in working in neurodiversity-affirming care, I would seek information from sources that are created and/or highly informed by neurodivergent advocates. A curated list of introductory resources for these topics can be found on my ePortfolio under “Future Directions” (link below).

Deliverables: Ana Nishioka, OTD

1 Like

@ana7 Is this the ParkRx program you mentioned? (There are a couple sites with this name.) I had no idea there were programs like this here in the US… I knew they were happening in other countries! So cool to see!

Yes! That is one of the websites for ParkRx’s national movement. There are multiple representations of ParkRx locally and nationally. I mostly consulted the SF Bay Area’s regional website here: https://www.parkrx.org
Practitioners can check out this directory to find a ParkRx program near them: Directory of Programs | Parkrx

1 Like

Can you explain it more what is this program. Also, I am from country that do not have OT at all.