Graduation Year


Document Type

Capstone Project

Project Type

Quantitative Study

Degree Name

Master of Science in Occupational Therapy


Occupational Therapy

Program Chair

Gina Tucker-Roghi, OTD, OTR/L, BCG

Faculty Advisor

Julia Wilbarger, PhD, OTR/L


To date, there is limited evidence to support the effectiveness of Occupational Therapy (OT) services delivered outside in nature. This study explored the benefits of OT intervention in Natural Settings (NS) for children by examining development in the areas of self-regulation, social skills, sensory processing, confidence, and motor skills. A quantitative, quasi-experimental pre-test/post-test design was used in this study. Researchers partnered with a local outpatient OT clinic that offers an 8-week outdoor program. Seven children and their parents were recruited and participated in the study. A modified version of the COPM and two BOT-2 subtests, along with a novel log climb measure were used to track changes among participants. Group results are presented, as well as two case vignettes that capture individual progress of two participants. Results showed that performance and satisfaction ratings, as well as scores from the balance and catching subtests from the BOT-2 generally improved from pre-test to post-test after the eight weeks. Additionally, the speed, efficiency, and quality of movement data gathered from the novel log climb generally improved by the end of the 8-week period. Overall, though there are several limitations to the study, the data showed improvement in key areas across parent reports and motor skill measures.