Planting Possibilities: Sensory Gardens in Pediatric Occupational Therapy

 Marissa Casamento OTD-S

Jennifer Martinc OTR/L 

Planting Possibilities: Sensory Gardens in Pediatric Occupational Therapy

In an increasingly digital world, children’s opportunities for rich, hands-on experiences are limited by the domination of screen use. The natural environment provides endless sensory exploration, a significant component of a child’s development. In addition to traditional outpatient occupational therapy, my goal as an occupational therapy doctoral student was to create immersive sensory opportunities for the pediatric population to support their exploration, engagement, and therapeutic goals. I partnered with the TampaWell Garden and the Food Pharmacy, which are community wellness initiatives at Tampa General Hospital. These two initiatives aim to connect health, nutrition, and occupation through holistic-based care. 

According to the Centers for Disease Control’s (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network in 2025, 1 in 31 children were diagnosed with autism. Children with autism spectrum disorder (ASD) and sensory processing disorder (SPD) often have difficulty organizing and responding to sensory input, impacting their emotional regulation, attention, and engagement in daily activities (Lane, 2020). Engagement with nature can significantly enhance physical, emotional, and sensory well-being. Wajchman-Świtalska (2021) stated that a sensory garden is an area that encourages individuals to explore experiences through their five senses and emphasized the need to create a barrier-free and stimulating sensory experience for children with neurodivergent conditions. Nieberler-Walker et al. (2023) highlighted five positive outcomes of nature on human development, including (a) improved mental health, (b) increased cognitive and creative function, (c) enhanced motor development, (d) better social interaction, and (e) encouraging emotional regulation. Although Nieberler-Walker et al. (2023) studied the benefits of sensory gardens in hospital settings, González-Fernández et al. (2020) studied their benefits in homes and community settings, concluding that sensory gardens can help reduce food insecurity and decrease the risk of language delays in children by 60%. The integration of the Food Pharmacy at Tampa General Hospital connected families to fresh produce, promoting healthy eating and encouraging continued sensory exploration at home. Despite these positive outcomes, few healthcare organizations have integrated sensory gardens into outpatient care, emphasizing the need to develop an inclusive sensory garden that provides multisensory experiences through foundational occupational therapy principles. 

TampaWell had previously developed the community garden, which consists of multiple raised gardening beds filled with herbs, fruits, vegetables, and flowers, as well as an outdoor classroom and a small playground. Our role in the partnership was to implement occupational therapy services in the garden during treatment sessions to create a dynamic environment supporting structured therapy and explorative play. Children were able to participate in outdoor activities such as harvesting, watering, mindfulness yoga, painting, meal planning, and food exploration. These activities addressed traditional occupational therapy (OT) skills, including fine motor, gross motor, bilateral coordination, sensory processing, and executive functioning, through a nature-based approach. The children were encouraged to interact with the environmental stimuli, utilizing all their senses. For example, children had the opportunity to smell the flowers, touch the grass, taste the produce, listen to the birds, and ambulate around the playground. Before these sessions, many children had minimal exposure to gardening and other nature-based interventions. The use of social stories was a helpful tool for providing the children with some predictability and comfort before entering an unfamiliar environment. 

The caregivers of the children exposed to the garden reported positive experiences following OT treatment sessions. For instance, one parent stated, “The growth in my child’s self-confidence has been amazing to witness.” Another child typically presented with hesitation when participating in traditional OT; however, after her second session in the garden, she progressively engaged in non-preferred activities (ex. messy sensory media). Her father shared, “My daughter has never intentionally stuck her hands in dirt and played with it until now.” These children are demonstrating increased willingness to explore, improved sensory tolerance, and enhanced engagement in therapeutic activities. One caregiver also noted, “I’ve noticed my child is more curious and less fearful when trying new things, even outside of therapy.” Overall, an open, sensory-rich, and exploratory environment offers far more opportunities than a four-walled room. 

To conclude, community-based sensory garden initiatives provide occupational therapists with a valuable opportunity to broaden therapeutic interventions beyond traditional settings. Programs like those implemented through TampaWell demonstrate the positive impact of collaborative, nature-based approaches on patients and their families. The combination of sensory experiences, social participation, and meaningful outdoor engagement can promote a holistic, client-centered approach in occupational therapy. Not only do sensory gardens encourage inclusivity, but they also foster confidence, exploration, and overall well-being for children of diverse backgrounds and abilities. As OT continues to grow and evolve, sensory gardens may serve as an innovative and sustainable approach to enhancing lives within the community. 

References

Centers for Disease Control and Prevention. (2025). Data and statistics on autism spectrum disorder. https://www.cdc.gov/autism/data-research/index.html

González-Fernández, D., Mazzini Salom, A. S., Herrera Bendezu, F., Huamán, S., Rojas Hernández, B., Pevec, I., Galarza Izquierdo, E. M., Armstrong, N., Thomas, V., Vela Gonzáles, S., Gonzáles Saravia, C., Scott, M. E., & Koski, K. G. (2020). A multi-sectoral approach improves early child development in a disadvantaged community in Peru: Role of community gardens, nutrition workshops and enhanced caregiver-child interaction: Project "Wawa Illari." Frontiers in Public Health, 8, Article 567900. https://doi.org/10.3389/fpubh.2020.567900

Lane, S. J. (2020). Structure and function of the sensory systems. In A. C. Bundy & S. J. Lane (Eds.), Sensory integration: Theory and practice (3rd ed., pp. 58–114). F. A. Davis Company.

Nieberler-Walker, K., Desha, C., Bosman, C., Roiko, A., & Caldera, S. (2023). Therapeutic hospital gardens: Literature review and working definition. Health Environments Research & Design Journal, 16(4), 260–295. https://doi.org/10.1177/19375867231187154

Wajchman-Świtalska, S., Zajadacz, A., & Lubarska, A. (2021). Recreation and therapy in urban forests: The potential use of sensory garden solutions. Forests, 12(10), Article 1402. https://doi.org/10.3390/f12101402