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Landscape architecture and neuroplasticity

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Title:
Landscape architecture and neuroplasticity a role for design in addressing the impact of early childhood trauma
Creator:
McCord, Catharine ( author )
Place of Publication:
Denver, Colo.
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University of Colorado Denver
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English
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1 electronic file (94 pages) : ;

Thesis/Dissertation Information

Degree:
Master's ( Master of landscape architecture)
Degree Grantor:
University of Colorado Denver
Degree Divisions:
College of Architecture and Planning, CU Denver
Degree Disciplines:
Landscape architecture

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Subjects / Keywords:
Gardening -- Therapeutic use ( lcsh )
Gardening -- Therapeutic use ( fast )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

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Review:
This paper will examine the current research on early childhood trauma, and bridge this research with landscape architectural design practices through deliberate, considered application of horticultural therapy. Specifically, current research on brain resiliency outlines the ways in which emotional and behavioral support can be achieved through nature-based therapies. Thus, the spatial and sensory integration practices associated with horticultural therapy connects this research to design practices. In order to effectively support people who have experienced trauma, landscape architects must have a close understanding of how the materials and spatial compositions they select impact users. A designer's ability to thoughtfully construct space to serve the specific needs of those seeking emotional and behavioral support will be strengthened by understanding the ways in which trauma alters the brain, the resiliency of the brain to heal through nature-based interventions and design aspects that will support this healing. To fully understand the potential landscape architects have to positively support treatment services, a cross-disciplinary dialogue that explores the incredible possibilities of trauma-related brain science is critical to developing a shared understanding on how to take the specificity of that information into account in our work.</DISS_para> ( , )
Bibliography:
Includes bibliographical references.
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System requirements: Adobe Reader.
Statement of Responsibility:
by Catharine McCord.

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University of Colorado Denver
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Auraria Library
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All applicable rights reserved by the source institution and holding location.
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on10126 ( NOTIS )
1012612581 ( OCLC )
on1012612581
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LD1193.A77 2017m M33 ( lcc )

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Full Text
LANDSCAPE ARCHITECTURE AND NEUROPLASTICITY: A ROLE FOR DESIGN IN
ADDRESSING THE IMPACT OF EARLY CHILDHOOD TRAUMA
by
CATHARINE MCCORD B.S., University of Central Florida, 2006 M.A., State University of New York at Buffalo, 2009
A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the degree of Master of Landscape Architecture Landscape Architecture Program
2017


2017
CATHARINE MCCORD
ALL RIGHTS RESERVED


This thesis for the Master of Landscape Architecture degree by Catharine McCord has been approved for the Landscape Architecture Program by
Jody Beck, Chair Lois Brink Emmanuel Didier
Date: May 13,2017


McCord, Catharine (MLA, Landscape Architecture Program)
Landscape Architecture and Neuroplasticity: A role for Desing in Addressing the Impact of Early Childhood Trauma
Thesis directed by Assistant Professor Jody Beck
ABSTRACT
This paper will examine the current research on early childhood trauma, and bridge this research with landscape architectural design practices through deliberate, considered application of horticultural therapy. Specifically, current research on brain resiliency outlines the ways in which emotional and behavioral support can be achieved through nature-based therapies. Thus, the spatial and sensory integration practices associated with horticultural therapy connects this research to design practices.
In order to effectively support people who have experienced trauma, landscape architects must have a close understanding of how the materials and spatial compositions they select impact users. A designer's ability to thoughtfully construct space to serve the specific needs of those seeking emotional and behavioral support will be strengthened by understanding the ways in which trauma alters the brain, the resiliency of the brain to heal through nature-based interventions and design aspects that will support this healing. To fully understand the potential landscape architects have to positively support treatment services, a cross-disciplinary dialogue that explores the incredible possibilities of trauma-related brain science is critical to developing a shared understanding on how to take the specificity of that information into account in our work.
The form and content of this abstract are approved. I recommend its publication.
Approved: Jody Beck
IV


This thesis is decicated to my parents, sisters, and husband Matt, this has all be possible with your
love and support.
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ACKNOWLEDGEMENTS
Sewall Child Development Center Colorado Garden Foundation Denver Botanic Garden Mental Health Center of Denver
Congress Park Neighborhood Green Team


TABLE OF CONTENTS
CHAPTER
I. INTRODUCTION...................................................................1
Role of Landscape Architecture in Addressing Trauma...........................1
II. BIBLIOGRAPHIC REVIEW OF THE LITERATURE........................................3
Introduction..................................................................3
Horticultural Therapy.........................................................3
Stress and Trauma.............................................................4
Neuroscience..................................................................5
Nature........................................................................6
Landscape and Plants..........................................................7
Garden Design in Learning Environments........................................8
III. LANDSCAPE ARCHITECTURE AND NEUROPLASTICITY: A ROLE FOR DESIGN IN
ADDRESSING THE IMPACT OF EARLY CHILDHOOD TRAUMA..............................10
Introduction.................................................................10
Current Research on Trauma and how it Affects the Brain......................10
Effect of Trauma on Cognition and Memory and How the Brain is Modified.11
Current Research on Brain Resiliency.........................................14
Sensorimotor Processing................................................14
Resiliency to Rebuild Neural Connections...............................15
Theories and Paradigms.......................................................16
Disconnect to Nature Paradigm..........................................17
Sensory Integration Theory.............................................18
Attachment Theory......................................................19
Attention Restoration Theory...........................................19
vu


Stress Reduction Theory...............................................20
Horticultural Therapy........................................................21
Plant based Therapies Associated with Increased Abilities to
Cope with Stress......................................................24
Landscape Architecture Design Practice.......................................26
Resources for Designing Therapeutic Gardens...........................27
Conclusion...................................................................29
IV. SEWALL CHILD DEVELOPMENT CENTER.............................................30
Introduction.................................................................30
Grant........................................................................30
Design Process...............................................................31
Client Engagement............................................................31
Design Development...........................................................34
Plant Selection..............................................................50
Conclusion...................................................................52
V. CONCLUSION..................................................................53
BIBLIOGRAPHY .......................................................................55
APPENDIX ...........................................................................60
A. Colorado Garden Foundation Grant Application 31 August 2016.................60
B. Colorado Garden Foundation Grant Application 31 October 2016................62
C. Colorado Garden Foundation Interview Materials 18 January 2017..............68
D. Sewall Child Development Center Handouts....................................82
E. Green Team Handouts.........................................................83
F. Feedback Session Board......................................................84
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LIST OF TABLES
TABLE
1. Horticultural Therapy Resources.........................................................4
2. Stress and Trauma Resources.............................................................5
3. Neuroscience Resources..................................................................6
4. Nature References.......................................................................7
5. Landscape and Plant References..........................................................8
6. Garden Design in Learning Environments References.......................................9
7. Plant List.............................................................................50
IX


LIST OF FIGURES
FIGURE
1. Feedback Session....................................................................32
2. Graphical representation of feedback session analysis...............................33
3. Functional Use Diagram..............................................................34
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CHAPTER I
INTRODUCTION
Role of Landscape Architecture in Addressing Trauma
This thesis argues that interacting with plants can help victims of trauma learn to develop healthy coping mechanism for addressing stress and trauma encountered in their lives and the subsequent long term effects trauma has on behavioral outcomes. Landscapes can provide safe and equitable access to nurtuing environments where users can actively engage with the space. As landscape architects there is a potential to act as an agent of change in our communities and across the globe. We design landscapes for public and shared use, to draw people together to share spaces and experiences with those close to us and those we have yet to meet. Landscapes have the ability to promote social change, inclusion, and immersive experiences to promote emotional well-being.
According to the Centers for Disease Control and Prevention suicide is the 10th leading cause of death in the United States (Leading Cause of Death, 2017). The World Health Organization has reported that every 40 seconds someone dies by suicide, and that suicide is the second leading cause of death world wide (Preventing Suicide, 2014). Sucide affects more than the person suffering from a mental health disorder that causes them to commit this action, it also affects the victims family and friends, rendering them victim by proxy and impacting their lives and relationships. In our current politial climate, we are viewing news reports of children afraid to go to school because they are unsure if their immigrant parents will be deported by the time they return home. Suicide, deportation, and losing a parent are examples of traumatic events that have the abililty to mark our genome and affect the way we respond to stress later in life. Examples of trauma that affect the populations that this project is focused on include children who experience emotional trauma resulting from abuse and neglect and who are living in poverty.
This thesis posits that early life interventions which instill positive coping mechanisms through plant based therapies can alleviate long-term suffering and the long term effects trauma can have on
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the brain. This thesis will explore how the brain is functionally affected by trauma and how the brain has been found to be plastic, meaning its able to generate new brain cells, giving us the ability to build new and healthy neural pathways. Three avenues this thesis has used to explore these ideas are to design a sensory garden for a child development center for children with special needs and who have experienced early life stress and trauma, present a paper on epigentic modification of the brain and how design interventions can provide space for plant based therapeutic interventions, and provide a bibliographic reference section.
A large component of this thesis is to put these ideas into practice. A sensory garden will be designed with supporting design development documentation for construction at a child development center in Denver, Colorado. This garden will be designed for children with special needs who learn alongside their typically developing peers. According to the CEO of the organization, 40% of these children suffer from toxic stress resulting from early childhood trauma, living in poverty, and coping with significant daily stressors. It is the belief of the organization that the best treatment for these kids is to provide loving relationships. The sensory garden will be designed with horticultural therapy principals involving nurturing plant actvities to help cultivate a healthy and stable relationships between students and faculty as well as with the land. A paper for presentation was written for the Council of Educators in Landscape Architecture held in Beijing, China in May 2017. This paper digests the literature on brain science related to how the brain is functionally modified in the event of early life trauma. It also explores therapeutic techniqes that are capable of helping the brain to overcome these, and design interventions that landscape architects can incorporate into their design strategies. The bibliographic reference section provides resources to utilize to become more familiar with the process the brain undergoes after experiencing trauma and resources for plant based therapies and design principles.
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CHAPTER II
BIBLIOGRAPHIC REVIEW OF THE LITERATURE
Introduction
The following resources are divided and ordered into categories of relevance to the thesis topic. The different catergories bring together resources relevant to understanding how trauma impacts the brain, what happens in the brain therapies are targeted to ameloriate theses effects, how nature based interventions can play be an effective strategy, and how as landscape architects there is a role to facillitate these effects through design.
Horticultural Therapy
Horticultural therapy principles are referenced in this thesis to generate design interventions that provide engaging and immersive spaces with an understanding of how therapeutic sessions can take place in a constructed landscape. The American Horticultural Therapy Association (AHTA) defines horticultural therapy as the engagement of a client in horticultural activities facilitated by a trained therapist to achieve specific and documented treatment goals. The ATHA also provides a definition of therapeutic horticulture, a process that uses plants and plant-related activities through which participants strive to improve their well-being through active or passive involvement (Definitions and Positions, 2012).
Resources in horticultural therapy range from case study (Airhart, 1988) and pilot studies to scientific studies measuring stress hormones recorded before and after nature based activities (Bratman et al., 2015). Also included in this list of resources are guide books of how to design horticultural therapy sessions (Haller, Kramer, 2016). These resources highlight the effectiveness of engaging participants to cultivate a sense of belonging, identity, ownership, and agency (Adevi, Lieberg, 2012) in stress reduction with horticultural therapy activities. For a select list of resources see Table 1.
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AUTHOR TITLE DATE TYPE
Airhart, D.L. Horticulture Therapy Activities for Exceptional Students 1988 Case Study
Airhart, D.L. Horticultural Training for Adolescent Special Education Students 1987 Case Study
Adevi, A. A., Lieberg, M. Stress rehabilitation through garden therapy: A caregiver perspective on factors considered most essential to the recovery process 2012 Case Study
Adevi, A. A., Martensson, F. Stress rehabilitation through garden therapy: The garden as a place in the recovery from stress 2013 Case Study
Adil, J. R. Accessible gardening for people with physical disabilities: A guide to methods, tools, and plants 1994 Guide Book
Annerstedt, M., Wahrborg, P. Nature-assisted therapy: Systematic review of controlled and observational studies 2011 Review/Report
Bradley, E., Eastman, L., Parsons, A., Relf, P Non-traditional, experimental horticultural programs for at-risk youth: Part 2-Program and case studies 1998 Case Study
Bragg, R., Atkins, G. A review of nature-based interventions for mental health care 2016 Review/Report
Bratman, G. N., et al. The benefits of nature experience: Improved affect and cognition 2015 Study
Brooks, H. D., Oppenheim, C. J. Horticulture as a Therapeutic Aid: By Howard D. Brooks and Charles J. Oppenheim 1973 Guide
Chalquist, C. A look at the ecotherapy research evidence 2009 Review
Haller, R. L., Kramer, C. L. Horticultural therapy methods 2016 Guide
Jiler, J. Doing time in the garden: Life lessons through prison horticulture 2006 Resource
Kamioka, Hiroharu, et al. Effectiveness of horticultural therapy: a systematic review of randomized controlled trials 2014 Review
Keeley, J. Design and Implementation of Horticultural Therapy with Children .Affected by Homelessness and Domestic Violence 1999 Case Study
Lorber, H. Z. The Use of Horticulture in the Treatment of Post-Traumatic Stress Disorder in a Private Practice Setting 2011 Case Study
Milton, M. J., Corbett, L. Ecopsychology: A perspective on trauma. 2011 Report
Simson, S., Straus, M. Horticulture as therapy: Principles and practice 1997 Guide
TABLE 1. Horticultural Therapy Resources
Stress and Trauma
To understand how early life stress and trauma affect the brain and its ability to moderate the stress response, resources on stress and trauma as they realate to brain modification were gathered. Studies include evaluation of brain volume modificatin of the the emotional processing center of the brain as a result of post traumatic stress disorder in children (Carrion et al., 20017) and how this might affect memory recollection and processing during stressful or
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triggering events (Van der Kolk, 2014) and what treatments are appropriate (Ogden et al., 2006).
For a select list of resources see Table 2.
AUTHOR TITLE DATE TYPE
Carrion, V. G., Weems, C. F., Reiss, A. L. Stress predicts brain changes in children: a pilot longitudinal study on youth stress, posttraumatic stress disorder, and the hippocampus 2007 Study
Kahn, G. B., .Aronson, S. Group treatment for traumatized adolescents: Special considerations 2007 Case Study
Ogden, P., Minton, K., Pain, C. Trauma and the body: A sensorimotor approach to psychotherapy (Norton series on interpersonal neurobiology) 2006 Guide
Perry, B. D., Pollard, R. A., Blakley, T. L.. Baker. W. L., Vigilante, D. Childhood trauma, the neurobiology of adaptation, and use-dependent development of the brain: How states become traits 1995 Study
Teicher, M. H., Andersen, S. L., Polcari, A., Anderson, C. M., Navalta, C. P.. Kim. D. M. The neurobiological consequences of early stress and childhood maltreatment 2003 Study
Van der Kolk, B. The body keeps the score: Mind, brain and body in the transformation of trauma 2011 Reference
Van der Kolk, B Traumatic stress: The effects of overwhelming experience on mind, body, and society 2012 Reference
TABLE 2. Stress and r Tauma Resouces
Neuroscience
Literature on how the brain is functionally modified as a result of stress and trauma encountered in life (Ravi, B., Kannan, M., 2013), (Roth, 2012), and how this can affect longitudinal behavioral outcomes Pittenger, C., & Duman, R. S., 2008) was evaluated and compared with literature on how the brain is plastic and able to heal itself by building new neuronal connections (Gomez-Pinilla et al., 2002). These studies were then compared to literature and theories that draw on nature based activities (Koga, K., Iwasaki, Y., 2013), (Kaplan, S., Berman, M., 2010), and theories that identify abilities to form healthy relationships or attachments from a psychology perspective (Bowlby, 1979). This thesis integrates these data and theories with how this information can be used to generate new methods of stress reduction in a constructed landscape (Van Den Berg, A. E.,
Custers, 2010). For a select list of resources see Table 3.
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AUTHOR TITLE DATE TYPE
Bowlby Attachment Theory and its Therapeutic Implications 1979 Theory
Giedd. J. N. The amazing teen brain 2015 Reference
Gomez-Pinilla, F. et al. Voluntary exercise induces a BDNF-mediated mechanism that promotes neuroplasticity 2002 Study
Kaplan, S., Berman, M. Directed attention as a common resource for executive functioning and self-regulation 2010 Study
Koga, K., Iwasaki, Y. Psychological and physiological effect in humans of touching plant foliage-using the semantic differential method and cerebral activity as indicators 2013 Study
Lane, S. J., Schaaf, R. C Examining the neuroscience evidence for sensory-driven neuroplasticity: implications for sensory-based occupational therapy for children and adolescents 2002 Review/Report
Pearce, J. W., Pezzot-Pearce, T. D. Attachment theory and its implications for psychotherapy with maltreated children 1994 Theory
Pittenger, C., Duman, R. S. Stress, depression, and neuroplasticity: a convergence of mechanisms 2008 Review
Ravi, B., Kannan, M. Epigenetics in the nervous system: an overview of its essential role. Indian journal of human genetics 2013 Study
Roth. T. L. Epigenetics of neurobiology and behavior during development and adulthood. 2012 Study
Siegel. D. J. The developing mind: How relationships and the brain interact to shape who we are 2015 Resource
Van Den Berg, A. E., Custers Gardening promotes neuroendocrine and affective restoration from stress 2010 Study
TABLE 3. Neuroscience References
Nature
In order to connect the literature on brain modifications as a result of stress and trauma with therapeutic interventions that take place in a garden setting it is necessary to evaluate wether this environment is optimal for this kind of intervention. Literature was reviewed on theories relating to the innate ability of nature to reduce stress, such as attention restoration theory (Berman et al,. 2008), stress reduction theory (Ulrich R. S., 1991), and the scientific mechanims that demonstrate the effectiveness of nature in reducing stress markers (Bratman, et al., 2015). For a select list of resources see Table 4.
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AUTHOR TITLE DATE TYPE
Berman, M. G., Jonides, J., Kaplan, S. The cognitive benefits of interacting with nature 2008 Study
Bratman, G. N., et al. Nature experience reduces rumination and subgenual prefrontal cortex activation 2015 Study
Chawla, L. Benefits of nature contact for children 2015 Review
Grinde, Bjorn, Patil Biophilia: does visual contact with nature impact on health and wellbeing? 2009 Study
Kalin. P. H.. Jr.. Kellert. S. R. Children and nature: Psychological, sociocultural, and evolutionary investigations 2002 Resource
Kaplan, S. The restorative benefits of nature: Toward an integrative framework 1995 Theory
Louv, R. Last child in the woods: Saving our children from nature-deficit disorder 2008 Resource
Louv, R. The nature principle: Human restoration and the end of nature-deficit disorder 2012 Resource
Louv, R. Vitamin N: The Essential Guide to a Nature-Rich Life 2016 Resource
Selhub, E. M., Logan, A. C Your brain on nature: The science of nature's influence on your health, happiness and vitality 2012 Resource
Sakallaris, B. R., et al. Optimal healing environments 2015 Review
Ulrich. R. S. View through a window may influence recovery 1984 Study
Ulrich, R. S. et al. Stress recovery during exposure to natural and urban environments 1991 Theory
Ulrich. R. S. Visual landscapes and psychological well-being 1979 Study
TABLE 4. Nature References Continued
Landscape and Plants
Effective application and incorporation of design principles relevant to providing enviroments that can actively be used in supporting victims of trauma involves understanding where the curren landscape architecture field is in addresssing this topic. Currently there is a building of healthy communities movement that focuses more closely on social connectivity of marginalized populations and identifying the innate restorative abilities being in a green space and feeling connected or having an identity to it (Anguelovski, 2013). There is little literature on public space and physically using the space as a means of emotional well-being. Resources in the landscape literature are avaiable as guides for how to use plants effectively as design elements in a space (Moore, 1993). There are also resources that advocate for evidence based design for sensitive populations and how to accomodate their safty needs (Marcus, Sachs, 2013). For a select list of resources see Table 5.
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AUTHOR TITLE DATE TYPE
Anguelovski, I. New directions in urban environmental justice rebuilding community, addressing trauma, and remaking place 2013 Review/Report
Chamovitz, D. What a plant knows: A field guide to the senses of your garden-and beyond 2012 Resource
Church. T. D.. Hall. G. M., Laurie M. Gardens are for People 1995 Resource
Cosco, N. G., Moore, R. C.. Islam. M. Z. Behavior mapping: a method for linking preschool physical activity and outdoor design 2010 Study
Eckbo, G. Landscape for living 1950 Resource
Hickman, C. The picturesque at Brislington House, Bristol: The role of landscape in relation to the treatment of mental illness in the early nineteenth-century asylum 2005 Resource
Hirschfeld Theory of garden art 2001 Resource
Hopper, L. J. Landscape architectural graphic standards 2012 Resource/Guide
Jackson, L. E. The relationship of urban design to human health and condition 2008 Study
Jekyll, G. Children and gardens 1908 Resource
Jekyll, G. Colour Scheme in the Flower Garden 1908 Resource
Jekyll. G. Wood and garden: Notes and thoughts, practical and critical, of a working amateur 1904 Resource
Marcus, C. C., Sachs, Therapeutic landscapes: An evidence-based approach to designing healing gardens and restorative outdoor spaces 2013 Resource/Guide
Moore, Robin C. Childhood's domain: play and place in child development 1990 Resource
Moore, Robin C. Plants for Play: A Plant Selection Guide for Children's Outdoor Environments 1993 Resource/Guide
TABLE 5. Landscape and Plant References
Garden Design in Learning Environments
The following resources are applicable to the design of a school yard and address how children learn best in a school environment. The garden design in this thesis is for a child development center and an elemtary school, thus this garden will serve children from birth through 5th grade. The garden will not only provide therapeutic services but will also provide space for educational enrichment and space to enchance classroom curriculum already in place. For a select list of resources see Table 6.
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AUTHOR TITLE DATE TYPE
Alexander, J., North, M. W.. Hendren. D. K. Master gardener classroom garden project: An evaluation of the benefits to children 1995 Case Study
Carey, B. How We Learn: The Surprising Truth about When, Where and Why it Happens 2014 Resource
Framkin, H., Geller, R. J., Nodvin, J Safe and healthy school environments 2006 Resource
Kohlberg, L., Mayer, R. Development as the aim of education 1972 Resource
Moore, R., Cosco, N. Greening Montessori school grounds by design 2007 Resource
Moore, R., Wong, H. Natural Learning: The Life of an Environmental Schoolyard. Creating Environments for Rediscovering Nature's Way of Teaching 1997 Resource
Robinson, C. W., Zajicek, J. M. Growing minds: The effects of a one-year school garden program on six constructs of life skills of elementary school children 2005 Case Study
TABLE 6. Garden Design in Learning Environments References
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CHAPTER III
LANDSCAPE ARCHITECTURE AND NEUROPLASTICITY: A ROLE FOR DESIGN IN ADDRESSING THE IMPACT OF EARLY CHILDHOOD TRAUMA1 Introduction
There is little argument that exposure to nature is restorative and beneficial to human health and that time spent in nature is decreasing as children are granted less time to play at recess during school hours and are spending more time interacting with technology. As landscape architects, we design for human health and wellbeing and understand the importance of mindfulness and being in the present moment within a nature setting. However, we can take the concept of emotional and physical health furtherto acknowledge and humanize both common and uncommon traumas. By applying recent research on brain mechanics, we can better understand the functions of our own brain structure and thus develop tools to cope with all manners of trauma, from minor daily occurrences to life-altering experiences. Landscape architects are familiar with the concept of process; if we expand our vocabulary to include the iterative process of brain formation and modification, we can better understand how the environments we design can contribute to the process of healing. We can accomplish this expansion through open communication with mental health practitioners and therapists and occupational therapists as we generate spaces that suit the needs of trauma victims. Such collaboration will generate engaging spaces that will instill a bond with the site and develop healthy connections within the brain.
Current Research on Trauma and how it Affects the Brain
Adverse childhood experience studies have been conducted over the last 20 years by the Centers for Disease Control and Prevention. These studies indicate that early childhood
i
This chapter was submitted for presentation at the Council for Educators in Lanscape Architecture Conference in Beijing, China, May 2017 and for publication in Landscape Research Record 06 and is expected to be published online December 2017.
10


experiences with trauma adversely affect a person's health later in life (Aces Study, 2016). Separate studies, discussed in the sections following, have shown that adverse physical modifications of the brain can result from early life stress and trauma. Emergent studies in neurobiology illustrate the brains plasticity and its ability to generate new neural pathways, thus promoting the formation of positive brain connections, even later in life. Armed with these studies, therapists can aim specific interventions toward the underlying structural causes of emotional and behavioral disorders, to include interventions that utilize horticultural therapies. These therapies rely on thoughtfully designed spaces created by informed landscape architects. Effect of Trauma on Cognition and Memory and How the Brain is Modified
The examination of epigenetic mechanisms has revealed that early-life traumas have longterm effects on the brain that affect adulthood cognitive processes. These events cause functional changes in gene expression leading to specific behavioral outcomes such as adult learning and memory, drug addiction, and several psychological and neurological illnesses. These developmental changes in neurobiology and behavior can have long-lasting effects, potentially even for the rest of a victims life. In the event of trauma, animal models have indicated that epigenetic modifications of genes in the hippocampus are a direct result of (the quality of) maternal care received in infancy and are associated with the stress response. Put differently, poor maternal care in infancy fundamentally changed the animals genes, leading to depressive behaviors. This study also demonstrated that these resulting depressive behaviors were in turn transferred to the offspring despite not encountering the same stressors in infancy (Roth, 2012). This finding suggests that even though the offspring did not encounter early maltreatment, the neurological markers have been passed on to them and they will have emotional and behavioral outcomes as though they had. It can be fairly extrapolated then, that humans who experience gene-modifying trauma or neglect that manifests in adverse behavioral outcomes can pass these behaviors on to their offspring, even when provided a nurturing and supportive environment. The implications of trauma do not only affect an individual but can
11


also genetically affect their childrenand this speaks to the importance of providing therapeutic interventions for all trauma victims.
Early life experiences leave epigenetic markers that determine behavior and have long-lasting effects on brain development and the capacity of individuals to respond to stress later in life. Epigenetic modifications affect synaptic plasticity, which is fundamental for learning and memory. Modifications that disrupt synaptic plasticity lead to depression of memory-related genes, affecting memory formation. Structural plasticity can also be affected. The adult neurogenesis paradigm states that neurogenesis occurs in two areas of the brain, both located in the hippocampus (Ravi & Kannan, 2013). A pilot study was conducted with child participants who had a history of maltreatment and had undergone clinical evaluation for post-traumatic stress disorder (PTSD). PTSD for this study was characterized by intrusive recollections of traumatic events and difficulties with emotional regulation. Hippocampal volumes have been shown to be reduced in size in adults with PTSD. The hippocampus plays a functional role in memory processing and is part of the limbic system, where emotions are registered in the brain. Hippocampal volumes were measured at the start of the study and again 12-18 months later. Cortisol levels were also collected at the start of the study. The study theorized that adult hippocampal volumes were reduced because of prolonged exposure to neurotoxic levels of cortisol secreted during chronic stress. The results showed that the severity of PTSD symptoms and cortisol levels predicted a reduction in hippocampal volumes 12-18 months later (Carrion et al., 2007). This study indicates that stress is associated with a reduction in hippocampal volume, which may be responsible for traumatic memory processing and reccollection.
To process a traumatic event, the prefrontal cortex must be stimulated. The prefrontal cortex is the part of the brain that processes information and imagines scenarios to determine the threat potential of the current environment. Trauma affects the brains imagination and perception of threats. After traumatic experiences, there is a need for the body to learn that the trauma-inducing danger has passed completely and for the brain to live in the present when
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faced with a triggering event. After the experience of a trauma, the body releases stress hormones that affects the brain and its ability to process the event. This results in a living memory and the physical response to being stuck in fight or flight mode. To overcome these experiences, Van der Kolk suggests there is a need for patients to develop a sense of the body and agency; in other words, being in charge of their own life. When traumatic memories are reactivated, imaging studies have shown that the frontal lobe, containing the prefrontal cortex, shuts down and the limbic region remains activated, resulting in the region of the brain that drives emotions taking over. To aid in recovery, the prefrontal cortex must be activated to stimulate the brain to process feelings. Activation of the parasympathetic nervous system slows down the body and the physical response. Body awareness and physical sensations allow the body to organize emotions (Van der Kolk, 2014). This suggests that trauma manifests itself in both the brain and body, and it is necessary to stimulate both for an effective therapeutic intervention. Additionally, cognitive and emotional development in the brains of adolescents does not occur simultaneously. Recent research has found that development of the limbic system intensifies at puberty while the region of the brain that controls impulses and cognitive maturation, the prefrontal cortex, occurs in the mid-twenties (Giedd, 2015). This suggests that finding a way to stimulate the prefrontal cortex along with the limbic brain is especially important in youth.
Therapeutic activities that include moving the body and being aware of sensations in a garden setting are particularly effective components of this therapeutic modality. Many garden activities, such as raking or shoveling, consist of full body movements that can activate proprioception, a sense of where the body is in space, and encourage the participant to become aware of sensations in her body. By providing spaces with ample room for range of motion activities, like jumping and climbing, and for reflection on these activities, landscape architects can design a space to facilitate an entire therapeutic session.
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Current Research on Brain Resiliency
This section will outline the ways in which the brain can be healed through mechanisms of neuroplasticityessentially, rewiring the brain to build healthy connectionswhich will allow therapists to develop more targeted and effective interventions. With somatic (body movement-based therapeutic interventions, therapists can help the client to stimulate the activation of the prefrontal cortex to process the experiences of the trauma encountered. Sensory gardens are ideal settings where these kinds of activities can take place, though it is essential to cultivate an environment that feels safe and secure because the client may be in a vulnerable emotional state when recalling or even reliving these experiences.
Sensorimotor Processing
One avenue for treatment of trauma is to develop somatic resources for processing traumatic memories that combine the awareness of being in the present moment while experiencing physical symptoms of trauma. Sensorimotor processing focuses on maintaining an optimal zone of arousal during the triggering of a traumatic memory or experience. For people who have past experiences with stress and trauma, the zone of arousal is small, and thus it is easy to be in a high or low arousal state and unable to feel calm or secure when triggered. Attachment theories, discussed in section 5.3, explain that these problematic states are related to how the subject was nurtured as a child and subsequently how they learned to cope with stressors. As discussed in section 3, the brains signaling system may be epigenetically altered by stressors and the self-regulating part of the brain, the prefrontal cortex, is unable to function properly. Ogden advocates for sensorimotor interventions that can address these habitual tendencies of activating the fight or flight response. Further, such interventions train the brain with building new patterns of response that can replace the inadequate coping response to stressors. Additionally, interventions can help the brain and the body to be aware of triggering events by recognizing the sensations associated with trauma. With such awareness, the bodys reflexive orienting tendencies can better handle overstimulation and triggering events. The goal
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is to organize experiences and develop skills for working with the body in the present time and promote empowerment, success, and seeing ones own body as an ally (Ogden et al., 2006). Resiliency to Rebuild Neural Connections
Neuroplasticity is the ability of the brain to build new neural connections. In a review article, Pittenger & Duman indicate that stress and depression are observed to negatively affect neuroplasticity. Stress and depression affect the ability of the prefrontal cortex to regulate concentration, attention, and the ability of the hippocampus to process memories. The size and volume of these two brain regions were observed as smaller in those with depression and experience chronic stress. The hippocampus is responsible for dysregulation of the stress response. If this region of the brain is disrupted, the stress response cannot be turned off; residual cortisol is released as a result of stressors and further damages the hippocampus. Damage to this region affects attention and behavioral tasks, altering mechanisms of neuroplasticity that are functionally abnormal in major depression. This review indicates that there are overlapping mechanisms of synaptic plasticity in those who have depression that affects the formation of new neurons (Pittenger & Duman, 2008). Considering these implications, it is reasonable to suggest that trauma could be a factor in the stress and depression response and somatic interventions, such as those available in a garden designed to facilitate this healing process, could be employed in a therapeutic plan.
Siegel discusses how early experiences shape synaptic growth for the regulation of the response to stress (2015). He indicates that a lack of experiences, good or bad, leads to the decrease in synaptic connections in the brain and that a subsequent pruning of connections occurs. This is akin to a use-it-or-lose-it principal for reinforcing experiences. Given this, it is reasonable to assume that as the associated neural pathways are pruned, positive behaviors can be reinforced and repeated to build more neural connections and unfavorable behaviors can therefore be reduced. Animal models indicate that exercise can increase connections within the hippocampus and that experiences increase the creation of new neuron activity and neuron
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development. This can form new linkages and strengthen existing ones. Siegel also suggests that experiences can induce epigenetic modifications. This indicates a cycle in which behavior alters genetic expression and regulation that shapes neuronal connecting and their firing patterns, and such alterations in turn influence a change in behavior (ibid.). Mouse models have indicated that voluntary physical activity upregulates genes associated with neuronal plasticity in the spinal cord and skeletal muscle (Gomez-Pinilla et al., 2002). The requirement that this physical activity be voluntary has deep implications for therapeutic garden design, particularly in the case of children, and suggests that physical activity is a needed activity in healthy brain development.
The ability of the brain to rebuild neural pathways and create new neural pathways to promote desired behaviors and coping skills has clear implications and relevance to horticultural therapy. There are many plant- and garden-based activities that can have repetitive or repeatable actions that reinforce behaviors and neural pathway generation while at the same time processing and integrating a new coping mechanism in response to the memory of atraumatic event. Learning a new skill and practicing it for reinforcement takes significant time and can be a frustrating. Thus, the environment where this activity is taking place matters. The client performing these repetitive exercises must feel safe, secure, and comfortable while in a possible state of vulnerability. It is necessary to allow there to be room to pause and reengage when ready. By understanding the types of activities needed and understanding circulation patterns and materials conducive to this kind of therapeutic healing, the landscape architect can design spaces that can best accommodate a range of activities made with materials to achieve desired activities.
Theories and Paradigms
This section addresses theories and paradigms that affect those who have experienced trauma early in life. This section also addresses theories and paradigms that affect our present conditions and access to nature, and how nature is relevant in emotional health and well-being.
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This section discusses inadequate access to nature, active interaction with green environments, and how that may have adverse effects on physical and emotional wellbeing.
Disconnect to Nature Paradigm
The paradigm that children are spending less time outdoors and instead are spending their time indoors with an increase in time with technology is having adverse effects on health has been covered extensively in recent years (Selhub & Logan, 2012), (Louv, 2008; Louv, 2012; Louv, 2016). In a review of ecotherapeutic applications from nature-based therapies in healthcare settings to animal-assisted therapy to horticultural therapy and outdoor restoration, Chalquist claims that there is a lack of rigorous academic research on these therapies because of the Factor of Imperial Drift. To explain why research on these types of therapies is poorly funded, Chalquist claims research is only funded if it serves to support medical studies rather than challenge them with more cost-effective treatment modalities. The studies that support using nature-based modalities report that people are increasingly disconnected from the natural world; such disconnection increases psychological symptoms of anxiety, frustrations, and depression. Chalquist argues for the need to reconnect to the natural world to alleviate these symptoms and increase the capacity for health, self-esteem, self-relatedness, social connections, and joy. That reconnection works across treatment modalities to replace a pathological sense of alienation of self, others, and world and to rekindle enjoyment of relatedness to self, others, and the world (Chalquist, 2009). Chawla has reviewed relevant literature on providing access to nature to children from the 1970s to the present. Over the years, children have been provided with less time to access nature, particularly in urban environments. Children learn about themselves and develop self-awareness through interactions with their environment, and Chawla argues that playful interactions with natural materials can develop creative intelligence. Chawla reports that in one study from Europe, students that attend schools with quality green spaces showed a decrease in stress and have better outcomes for sleep and higher health rates. Another study in Germany looked at urban 10-year-old children who lived in green areas had lower
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blood pressure measurements that children who did not live in green areas. Similarly, in Austria, students had decreased blood pressure levels than students at other schools after a schoolyard greening. Cognitive functioning was assessed in Chicago through work by Bill Sullivans laboratory. One study indicated that female teenagers performed better on concentration, control of impulsivity, and delay of gratification when their apartment had green views. Chawla argues that this implies that quality green space should be provided where children live, play, and learn. That access to primary health care services should be where people inhabit (Chawla, 2015). Kahn and Kellert discuss the importance of intuitive ways of explaining how children understand living things through animism, distinguishing living things from nonliving things, and understanding themselves as human. Structural constructivist developmental theory discusses how interactions with physical and social environment allows children to construct conceptual understandings and to solve problems and explore (Kahn & Kellert, 2002).
Sensory Integration Theory
Sensory Integration Theory was founded by A.J. Ayres, based on her understanding of neurobiology and her work as an occupational therapist (Roley, 2007). Occupational therapy activities can be achieved in a garden setting while creating sensory experiences with plants and plant-based activities. Children who have experienced trauma have a decreased ability to produce healthy adaptive responses to stress (Perry, 1995) and are likely to have behavioral problems (Teicher, 2003). Lane and Schaaf reviewed the sensory integration literature on neuroplasticity and found it to be an effective application for children with difficulty integrating and processing sensory stimuli through mechanisms of neuroplasticity. Additionally, they found support for neuroplasticitys effectiveness in aiding with sensory integration. Their findings indicated that changes in neuronal function and structure were linked to neural modifications from direct sensory input (Lane & Schaaf, 2010). Because sensory integration and processing is linked to neuroplasticity, it is important that the space where these therapeutic interventions are taking place have adequate sensory support. This can be achieved through thoughtful planning,
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ensuring that, for example, plants have a variety of textures ranging from soft to spikey, and thoughtful consideration of materials in the space that vary in tactile sensations, such as being smooth or cool to the touch.
Attachment Theory
Attachment theory examines the behavior between an individual and a caretaker. In a secure attachment relationship, the individual feels comfortable to explore her environment without becoming frightened because the presence of the attachment figure provides security that the individual can return to. If this relationship is not supportive of exploration and does not provide a secure base point, the individual may develop adverse emotional health affects (Bowlby, 1979). This scenario could be a result of stress or trauma experienced by either the individual herself or the attachment figure projecting her experiences onto the individual, which adversely impacts the relationship. In the case of children who have experienced trauma in the form of abuse, they require multiple positive experiences to disrupt the trajectory of unfavorable experiences (Pearce & Pezzot-Pearce, 1994). This suggests that there is repetition required to create positive experiences and supports the mechanisms of neuroplasticity and building new neural pathways through repetition and active cultivation of new patterns. In a therapeutic session, this can be a somatic activity that looks like the repetitive process of pulling weeds or the repetitive motion of digging.
Attention Restoration Theory
Attention restoration theory separates attention into two components: involuntary attention, attention that is inherently intriguing with stimuli, and voluntary (or directed) attention. The latter is attention that is directed by cognitive control processes and resolves conflicts and suppresses distracting stimulation. Kaplan argues in favor of attention restoration theory and claims that directed attention fatigue occurs when there is mental exhaustion because of intense prolonged directed attention. Kaplan performed studies that hypothesize that restorative experiences or environments are defined by opportunities for reflection which
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Kaplan calls soft fascination. This soft fascination allows for a mental rest from directed attention. Characteristics of restorative environments include a sense of being away (from having to direct ones attention), extent or scale, richness, compatibility between the environment, and the purpose and inclinations for being in the space. Furthermore, restorative environments provide an interest in what the individual is seeking (Kaplan, 1995). It is posited that interactions with nature increase attention and memory in contrast to directed attention and that after spending time in nature, without having to focus ones attention, directed attention can be improved. Two experiments were performed to test this hypothesis. Both experiments measured the levels of stress and cognitive abilities by administering a cognitive performance task and a self-reported mood survey. The participants were divided into groups that took either a walk in nature or in the city then viewed pictures of nature or cityscapes, concurrent with where their walk occurred. Then the same stress task and mood assessment were administered.
In both assessments, the activity involving nature stimuli resulted in a higher performance on the stress task. The completion of tasks were measured, the tasks measured different kinds of attention functioning; alerting, orienting, and executive function after the walk or picture viewing. It was hypothesized that only the executive function would be affected because it requires more cognitive control. This hypothesis was supported by the results of the experiment (Berman et al., 2008). This study has been expanded upon by Bratman, et al., who found similar self-reported affect improved by a walk in a natural environment, though their data did not support an increase in cognitive tasks (Bratman et al., 2015). These data indicate that experiencing nature, by direct experience with nature or simply viewing nature, can lower a persons stress response. This paper posits that in addition to exposure to nature, substantial benefits can be gained from immersive interactions with nature.
Stress Reduction Theory
The architect Roger Ulrich has published numerous studies indicating that viewing nature has positive impacts on health and wellbeing, from reducing lengths in hospital stays to a
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decrease in pain reporting and a reduced duration of healing time (Ulrich, 1984). Ulrich has also written on the stress reduction or psycho-evolutionary theory, producing studies that indicate the stress response is lowered when participants viewed scenes from nature. Ulrich claims that this theory contradicts Kaplans attention restoration theory that suggests restorative effects are achieved by involuntary attention. Ulrich recorded high levels of involuntary attention in participants when they viewed both nature and stressor films. The nature scenes reportedly resulted in participants having a more positive affect, positive physiological markers, and sustained attention (Ulrich, 1991; Ulrich, 1979). This study indicates that while participants watch films that were perceived as stressful or relaxing, they were measured as exerting the same amount of attention while experiencing a decrease in their stress response when viewing a nature scene.
These theories and paradigms indicate a growing need to create environments and experiences for children and adults to interact with nature. For children in developmental years, exposure to nature is vital to cognitive development and learning to cope with life experiences. The mind has an ability to learn and recharge at the same time while being exposed to sensory experiences. As landscape architects, we have a responsibility to create these experiences for people at institutions, at work or school, and in the public realm providing safe and enjoyable commutes and spaces to escape to particularly in urban areas.
Horticultural Therapy
It is important to distinguish between horticultural therapy and therapeutic horticulture. The term horticultural therapy refers to a treatment plan with established goals while therapeutic horticulture utilizes horticultural therapy techniques without necessarily measuring outcomes. The American Horticultural Therapy Association (AHTA) defines horticultural therapy as the engagement of a client in horticultural activities facilitated by a trained therapist to achieve specific and documented treatment goals. Therapeutic horticulture, on the other hand, is defined as a process that uses plants and plant-related activities through which participants
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strive to improve their well-being through active or passive involvement. In a therapeutic horticulture program, goals are not clinically defined and documented, but the leader will have training in the use of horticulture as a medium for human wellbeing (Definitions and Positions, 2012). The AHTA lists characteristics of therapeutic gardens: scheduled and programmed activities, features modified to include accessibility, well-defined perimeters, a profusion of plant and plant activities, benign and supportive conditions, universal design, and recognizable placemaking (Therapeutic Garden Characteristics, 2012). These features can all be expanded upon when designing gardens for horticultural therapy or therapeutic horticulture. For the purposes of this paper and finding design direction in the medical literature described above, we will refer to both horticultural therapy and therapeutic horticulture as horticultural therapy. Further, it is our argument that the following design interventions are also applicable and in fact beneficial to public environments with no organized therapy supervision.
Horticultural therapy is a relatively new field. The first book on horticultural therapy was published in 1960 by Alice Burlingame, who was trained in psychiatric work, occupational therapy, landscape architecture, and greenhouse production. The first undergraduate degree program for horticultural therapy in the United States was in the Horticulture Department at Kansas State University; currently they offer a certificate program in horticultural therapy. The AHTA, a 501(c)3 nonprofit organization, was established in 1988 and currently has approximately 900 members. Only approximately 300 individuals are professionally registered as horticultural therapists (Definitions and Positions, 2012). Examples of populations supported by horticultural therapy services include persons experiencing or who have experienced abuse or neglect, persons with intellectual disabilities, those in assisted living facilities, persons with vision or hearing impairments, and persons undergoing physical rehabilitation. Horticultural therapy programs are also established in prisoner populations that provide vocational training for participants to help reduce the rate of recidivism (Jiler, 2006).
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Utilizing horticultural therapy is a non-threatening way to provide a therapeutic service. The patient and therapist are not meeting in a sterile environment with a series of questions or checklists to review; instead, a rapport is built between the two in a comfortable and interactive environment. This allows the client to build a supportive relationship to develop nurturing skills. Cultivation of horticultural skills as a vocational modality of horticultural therapy can be beneficial to youth who have experienced the kind of stress or traumas that can put them at behavioral risk. Engaging in this modality has been shown to improve behaviors and attitudes, development of job related skills, cultivate a positive attitude about the learning process, and instill a sense of self-worth and self-efficacy (Bradley, 2008). Horticulture therapy has the potential to enhance therapeutic outcomes when combined with traditional talk therapy modalities. In the case of persons who suffer from posttraumatic stress, engaging these two modalities can help a patient work through the trauma physically and emotionally. An example of how to do this includes addressing the trauma with a gardening activity, then visualizing a safe space next, cognitively reframing the safe space and the gardening activity while recalling a traumatic incident, and maintaining imagery of the garden space with the therapist. Combining talk therapy with physical movement can work to empower a patient to deconstruct past experiences and construct new experiences as well as reconstruct the narrative that affected the behavioral sequence (Lorber, 2011). Both the imagery of a safe space and the physical movement within that space have implications for landscape architectural design goals.
When combined with conventional therapies, horticultural therapy can help to increase self-esteem, enhance social skills, and help adolescents to develop physically, emotionally, intellectually, and psychologically (Keeley, 1999). The distinction in development of brain regions as mentioned in section 3.1 can lead to new therapeutic approaches in reaching adolescents who have experienced trauma. There are circumstances where talk therapy alone is unsuccessful because the prefrontal cortex is not developed enough to be fully receptive to that modality of therapy. Traumatic events are not only experienced emotionally but also felt
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physically. For example, children who have witnessed domestic violence often have a decline in their sense of trust in adults because of the unpredictable nature of when these events might occur, as well as a decline in trust in their own body because of the physical symptoms of trauma that manifest. Non-talk therapy modalities can help alleviate emotional and physical trauma by activating the prefrontal cortex along with the limbic system (LaRocque, 2015). As adolescents are reaching puberty, the disconnect in development of the emotional and cognitive regions of the brain is growing. Horticultural therapy can be used to mitigate this disconnect (Farilla, 2015). In children without impairments, typical developmental benchmarks are; an interest in self-development toward an interest in others, developing language and social behavior, developing a sense of will and intentionality, problem solving, and creating solutions. These benchmarks can become skewed in children who have experienced significant trauma or behavioral or developmental disabilities (Fried, 2015).
Plant based Therapies Associated with Increased Abilities to Cope with Stress
Researchers have analyzed physiological effects of touching plants by monitoring change in cerebral blood flow, an indicator of central nervous system activity in the prefrontal cortex. They found that when participants actively touched leaves they experienced an unconscious calming response (Koga & Iwasaki, 2013). This study indicates that the processing region of the brain is activated when touching natural materials. To offer an anecdotal example of a program with the objective to provide exposure to horticulture and plant science, a broad range of group activities were offered throughout the day. Morning sessions consisted a general exposure to horticulture. Afternoon session consisted of activities that offered hands-on activities to teach skills to participants. The goals of the program were to broaden the childrens concepts of what can be learned in school; to offer enrichment activities; and to allow the groups of gifted and talented students and special needs children to be integrated into enrichment activities. Success of the program was indicated by observations of a sparked enthusiasm for training and learning through hands on activities (Airhart, 1988). This example suggests that the program was
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successful because the facilitators were able to observe an interest of the students by their willingness to participate. Often the ability for an activity to entice a child to participate is valuable, especially in children who are under responsive to stimuli.
At a stress rehabilitation center, five horticultural therapists were interviewed to determine what they as caregivers perceived to be most significant factors of stress recovery.
The team consisted of a gardener, a curative teacher, an occupational therapist, a physical therapist, and a psychotherapist. Through individual and group interviews, three main themes emerged in terms of stress rehabilitation: 1) sensory impressions; 2) allowing the participants to be more open and willing to engage while being in natural environments for activities; and 3) identifying with the space. Participants in this program choose places in the garden to cultivate a sense of belonging, identity, ownership, and could choose where in the garden they wanted to engage. Interactions between concrete and symbolic activities created space for the participant to perform cause and effect activities, to perform a task and see a result, which then allowed for applying a symbolic understanding to their personal life (Adevi, & Lieberg 2012). It was hypothesized that a gardening activity that paired exercise with contact with nature would be more effective in promoting stress relief than a control activity of indoor reading. A stress-inducing task was performed by participants with their levels of cortisol measured at multiple points before, during, and after the stress-relieving activity and the control activity. The study found that cortisol levels were significantly increased after the stressful task. The cortisol levels in the participants significantly decreased in both the gardening activity and the control activity, though it was observed that there was a greater reduction of cortisol levels with participants who engaged in the garden activity. Mood was also measured, which showed similar patterns to the cortisol levels. (Van Den Berg et al., 2010). This study provides evidence that integrating physical activity with plant-based activities is a viable method to reduce makers of stress within the body. By incorporating a somatic activity, the body is able to increase its stress relief response.
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Landscape Architecture Design Practice
In order to effectively provide horticultural therapy services, safe and secure spaces are necessary. These spaces need to be thoughtfully constructed so that they do not make people feel enclosed or trapped, provide opportunities for fine motor skill development and practice, and accommodate a wide range of motion. Examples of spatial categories include private and public, active and passive, and challenging and secure. While the specifics of this capacity are largely unstudied, there are conclusions we can draw from anecdotal evidence. Private and public spaces will require delineation of space and programmed activities. Clearly demarcated boundaries that allow forward motion are recommended by horticultural therapist Gwenn Fried. These can include pathways, bridges, climbing trees (with low branches), swings, stepping stones, ladders, and diverse terrain. These spaces can provide therapeutic aspects by allowing users to challenge themselves as they choose how to engage in social activities but also retreat to a space where they can observe what is going on and feel safe and secure until they are ready to reengage as they feel the need.
When designing active and passive spaces, Fried suggests interactive spaces where children can be stimulated through tactile experiences of plant materials and play. These areas should be clear and intuitive, barrier free, and allow direct contact with the plant material. By having active and passive spaces, users can choose or be directed to engage physically with gardening activities or simply be present in the garden and passively obtain therapeutic benefits. Challenging spaces offer potential for risk while secure spaces offer opportunity for repetition of physical motion or directed activities. The repetition of movement has demonstrated therapeutic and rehabilitative benefits. Wildlife, such as bees, offers a living aspect of both challenge and security for many adolescents. There could also be active engagement with the bees. For example, bee often sleep in flowers, and then wake up and crawl out when their backs are rubbed. Simply observing the bees in their habitat offers passive engagement.
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Finally, varying degrees of an individuals control of space and route offer different levels of autonomy. Flexible spaces, where people are, for instance, able turn water on or off, offer graduated amounts of individual oversight. Movable, interactive items offer the opportunity for collective decision-making and compromise. By providing routes that introduce challenges along with alternative paths for those who arent ready for them, designers can allow for a personal choice in personal assessment (Fried, 2015). Designing opportunities for increasing sense of self-efficacy by having the ability to experience risk can be therapeutic and build selfesteem, and this is especially beneficial to populations who have been deprived of control in their lives through their experiences with stress and trauma.
As an example, in a recent project for children who have trouble with sensory integration and sensory processing, the design strategy was to design regions of space according to different sensory needs as indicated by occupational therapists on site. Children who are in a high arousal state and are seeking sensory input benefit from full range of motion activities such as jumping, climbing, and moving objects. Sensory stimulation that entices the children to participate will be the design strategy provided for children who need to arouse their senses or are sensory under responsive. This could include plantings that attract pollinators to observe or plants with aromas or tactile interest. A calming or soothing environment was recommended for children who are over responsive to stimuli. The space should be away from spaces with high activity and allow for a space that feels somewhat enclosed and secure. This space would include materials that are soothing to the touch, soft plantings, and smooth tactile elements.
Resources for Designing Therapeutic Gardens
Marcus and Sachs provide research that informs design decisions and places an emphasis on evidence-based design. They address the fact that the paradigm of randomized control trials that are the standard for scientific research and vetting is not always able to generate productive research when working with sensitive populations as their needs are ever changing. A consistent theme that is discussed in design elements is giving a sense of control and choice to each user.
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Guidelines and case studies are provided in every section for each type of therapeutic space for different populations (Marcus & Sachs, 2013). Moore has developed a guidebook for designing play environments with plants. The functions that plants can have in play environments are categorized by play value, seasonal interests, sensory experiences, and the importance of shade. Guidelines are provided to aid in varying texture, size, seasonal interest, fragrance, craft, and culinary uses of the plant choices. The book also discusses how plants can be design elements to create enclosures and soften transitions between spaces. Moore discusses the roles of plants in creating an identity of the space, directing movement, and programing activities through intimate and touchable spaces for children of all abilities. Plant and other natural materials can serve as landmarks and encourage wildlife to be a part of the garden (Moore, 1993). In a graphic standards text, there is a section for Therapeutic Gardens that provides design guidelines for therapeutic gardens and site elements for restorative and enabling gardens for varying populations (Hopper, 2012). This text breaks down both restorative and enabling site elements for different populations they serve, mentioning horticultural therapy as a mechanism to be used in restorative gardens and touches on theoretical principals of the limbic system and finding comfort in nature. What these texts dont mention is the connection and mechanism of how these elements can functionally heal the brain or address stress and trauma specifically.
To build upon the guidelines from these resources, we can integrate this information with the research on brain modifications from stress and trauma. With the evidenced-based design elements paired with plants as design elements, we can take these ideas further and work with therapists to prescribe activities to integrate their therapeutic services. Focusing on brain science to distinguigh between different theraputic needs based on a response to trauma allows one to tailor the environments to particular population needs with how best to help them achieve their therapeutic goals. This information does not currently exist within the literature.
It is helpful to understand the types of treatment activities planned for horticultural therapy sessions when discussing design programming requirements for therapeutic sessions.
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Session organization and planning should be done together with the designers to fully maximize the potential of the space. Generation of these plans includes documenting horticultural therapy interventions with understanding the rationale for their use. A horticultural therapy methods resource book by Haller and Kramer presents types of programs, settings, and goals for establishing a horticultural therapy program including outlining treatment planning; session development; motivation and behavior management techniques; documentation guidelines; practical approaches for wellness; and resources for activity ideas (Haller & Kramer, 2016). The information from session planning will guide the layout of the space, including establishing lines of sight, placement of activity areas, and optimal circulation.
Conclusion
We are now aware of the longitudinal emotional repercussions of trauma. With the understanding of how brains function and how therapeutic interventions can achieve positive results, landscape architects can push landscapes healing abilities beyond nature's innate healing abilities to generate designs that actively promote healing. Interactions with purposefully designed landscapes stimulate positive brain activities. Rather than recreate nature to elicit passive healing and restorative experiences we can use what weve learned from research on the brain and its ability to heal itself to develop design interventions using natural elements appropriately. In other words, we are not simply recreating nature to provide restorative benefits through passive use, we are providing participants the potential for active engagement with landscapes that will support the development of positive neural connections, providing immersive experiences for individuals on their own or through facilitation by trained therapists. In addition, the authors suggest that these design strategies are capable of moving beyond institutionalized facilities to support populations in the public realm, providing opportunities for self-care and space to practice therapeutic activities on their own. These landscapes also have the ability to support immigrants and refugee populations who may not feel safe or supported when seeking health services; with this in mind, these types of healing environments should be made widely available in the public realm.
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CHAPTER IV
SEWALL CHILD DEVELOPMENT CENTER
Introduction
Sewall Child Development center relocated their headquarters to a new location in the Congress Park neighborhood of Denver, Colorado in January 2016. Sewall serves children who have special needs by creating an inclusive learning environment by having the children learn along side their typically developing peers. According to the CEO of Sewall approximately 40% of the children at Sewall suffer from toxic stress caused by living in poverty and the associated stressors of their daily lives. To alleviate these symptoms and provide developmental services Sewall focuses on providing loving relationships where children can find stability. The site is a former Waldorf school with a 0.3 acre space on the North East comer of the lot, receiving full sun and covered in weeds. The terrain of the site has been elevated on the perimeter creating a bowl shaped. The perimeter of the site was filled with construction materials taken from digging out the basement of the shool with the intentions of the previous occupants to build the grade to make a new parking lot, which was not completed. The garden will be organized around plants designed to stimulate all five senses and encourage hands-on multi-sensory and social learning. The garden will integrated therapeutic horticulture techniques that will pair with Sewalls transdisciplinary intervention model and provide a safe, non-threatening space of respite for children during crisis interventions.
Grant
A grant was co authored with Sewall Child Development Centers Vice President of Development for the Colorado Garden Foundation 2016 Major Grant Award of $75,000. In January 2017 Dr. Jody Beck, the VP of Development, and I presented to the board of directors and were awarded the grant in the full amount on behalf of the center (see Appendices A, B, and C for the grant materials generated as part of this thesis for the award). The grant amount of
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$75,000 will be matched by in-kind donations of plant materials and services from the Congress Park Community including the neighborhood Green Team and the Denver Botanic Garden. Design Process
The sensory garden is designed around addressing the sensory processing and integration needs of both the children with special needs and typically developing children. Occupational therapists at Sewall have identified three zones of arousal that the children typically fall into. Sensory Over Responsive, meaning the children are overly responsive to stimuli and require soothing environments to calm themselves. Sensory Under Resonsive, meaning the children are disengaged or unresponsive to stimuli and require activities that will entice them to participate. Sensory Seeking children are those who are seeking sensory input and require activities that engage their full bodies such as climbing and jumping.
Through designing for three levels of engagment the garden will accomodate the sensory integration needs of all the children served by Sewall. This will be achieved through separate zones of the garden serving primarily one of the three levels of arousal. Within the sensory seeking zone there will be moments of respit where if a child does begin to feel overwhelmed or under responsive they will have an opportunity for self care by moving toward a nearby calming space without feeling like they need to escape or isolate themselves to a calmer zone far from their current space. Understanding that we often move between zones of arousal and will accomodate for that transition.
Client Engagement
Meetings have been held with stakeholders of the garden including the CEO of Sewall Child Development Center and the Principal of REACH Elementary Shool, a charter elementary school from prek to fifth grade, that leases space from Sewall. Teachers, therapists, students, and parents have also attended design development and feedback sessions. Figure 1. represents results from a feedback session where parents, staff, and students were able to vote on elements of a sensory garden that they liked best. The board shows examples of activities for three
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different sensory processing areas that are typically observed in their students. There are spaces left intentionally blank to encourage participation in goal generation for what types of experiences and activities users would like to have in the space. Figure 2. is a graphical analysis of the feedback received by sensory processing categories. A functional use diagram was generated to present to staff at Sewall to engage feedback and assess if the feedback received represented the goals of Sewall (Figure 3).
FIGURE 1. Feedback Session. Dots represent votes.
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SENSORY OVER RESPONSIVE
Calming spaces
S*as
ny*AiL
BIRDS -.v
BATHOUSE
*U
OVvRo
om
SENSORY UNDER RESPONSIVE
Enticing activities
BALANCEPATHWAY.
PAT*4Y
SENSORY SEEKING
High energy activities
WATERING

Figure 2. Graphical Representation of feedback session analysis.
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Figure 3. Functional Use Diagram Design Development
To adderss the sesory processing needs of the children through design, we are focusing on three areas of sensory processing. The first, sensory over responsive children who are overstimulated and require a calm and soothing environment, providing a safe space with passive interaction with nature like bird or butterfly watching that creates a sense of autonomy to choose when to rest or engage with their peers. The second, sensory under responsive, those who have a low perception of sensory stimuli and need help activating their senses. These spaces of the garden would include enticing elements to help the children engage with their environment such as interactive musical elements, activities have a cause and effect lesson, or a sensory pathway that challenges their ability to navigate their space. Third, sensory seeking children, or those who have high energy and are seeking an outlet. This space will include
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programming for high energy, full range of movement activities like climbing or moving heavy objects, allowing the children to use their whole bodies. The idea is that once the children have the space to learn how to maintain their optimal zone of arousal they will be able to learn self-soothing techniques, build healthy coping mechanism, and be in a better frame of mind to engage socially and cooperatively.
Parents and students stressed the desire to keep the space feeling like a retreat from the city and rich to explore the perimeter will be buffered by dense plantings. To achieve this, a meadow will add to the wild and less programmed space to encourage explorative and imaginative play. Pathways will range in the challenge that they provide, from safe and stable to challenging with sensory stimulation requiring active concentration to traverse. Some pathways will be undulating to challenge proprioception, or the ability to orient themselves in their space. Active terrain and fort building will be integrated for sensory seeking children who will need to use their whole bodies to climb and navigate through tunnels. Fort building will provide a range of developmental benefits including cooperation, compromise, negotiation, offer room for leadership, vulnerability in asking for help to carry a large log, self efficacy, by being able to carry a smaller log on their own, and help in the development of balance. These spaces are visible from the entrances and draw the sensory seeking children into and through the site. Soothing and quieter moments will be dispersed throughout the site that allow kids to move between these levels of arousal when they need to. They will be near active spaces to allow for a self-determined break that does not take them out and away from their peers but allows them to recharge and choose when to reengage.
For those kids who are overstimulated and not ready to be outside or enter the space there are calm moments at the entrance that allow them to survey the space and choose where they want to go and what to engage with. They can go near the active zones and watch from the side and test themselves with their level of engagement with a safe place to retreat to, or they can stay along the perimeter and explore spaces like the sensory and music walk on their own.
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SEWALL CHILD DEVELOPMENT CENTER SENSORY GARDEN
DESIGN DEVELOPMENT DRAWINGS
SHEET SET
L- 0 COVER SHEET L- 0.1 ENTRANCES L 0.2 ZONE DIAGRAMS L- 0.3 PLAN DIAGRAMS L-1 LAYOUT PAN L- 2 PAVING PAN L- 3 GRADING PAN L-4 PANTING PLAN L-5 SCALED PAN L- 6 SECTIONS L- 7 WASTEWATER MAP L-8 SANITATION MAP
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UNIVERSITY OF CO LORA DO DENVER
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FUNCTIONAL USE
LEVELS OF ENGAGEMENT
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Sensory Plantings and Musical Moments Active Terrain Play Mounded Meadow Plantings Event Space
Dense Plantings for Screening
Bluff with Hardy Medicinal Plants and Grasses
Added Trees
Sensory Garden
Active Areas Calming Moments Enticing Areas Gathering Spaces

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Child Development Center
College of Architecture and Planning
UNIVERSITY OF COLORACO DENVER
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Sensory Garden
01. Outdoor Classroom & Gathering Space
02. Sensory/Music Walk
03. Meadow
04. Climbing Area
05. Fortress Building
06. Medicinal and Culinary Planting
07. Dense Planting
08. Willow Rooms
09. Labryinth
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02. Sensory/Music Walk Plants MarLbjmroiundifdiurri Kniphc'a caulescens 0 03. Meadow Plants Ar idropogor t gorardi i
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Geranun dalmaTdum # Agdepias ruberosa Chesmanthum lertifdum
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Child Development Center
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UNIVERSITY OF COLORACO DENVER
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Herb Garden
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Juniperus 'Woodward' Columnar Juniper 20' 4' Sun Low Could be a good screen
Buddleia Butterfly Bush 12' 12' S/PSH Medium-Low Fall sight/smell attracts butterflies
Philadelphia lewisii Mocko range 7' 5 Sun Low white/spring smell
Viburnum carlesii smell Some are evergreen
Syringa Lilac smell spring flowers
Helianthus Sunflower Sun Medium Yellow sight Could be perennial type or annual
Alcea sp. Hollyhock 5/P5H Medium Variety sight
Symphytum sp. Comfrey 3' 3 5/P5H Medium Low sight Medicinal already on sight
Levisticum officinale Lovage 3' 2.5 5/SH Medium Low sight Medicinal
Artemisia dracunculus Tarragon 3' 1.5 5/PSH Medium Low smell
Salvia officinalis Culinary Sage 2.5' 2.5 5/P5H Medium Low Purple smell Medicinal
Origanum sp. Oregano 2.5' 2.S' 5/P5H Medium Low White smell Medicinal
Melissa officinalis Lemon Balm 2.5' 3' S/PSH Medium Low White smell Medicinal
Hyssopus officinalis Hyssop 2' 1.5' S/PSH Medium Low Purple smell Medicinal
Lavandula sp. Lavender 1.5' 1.5' S/PSH Medium Low Purple smell Medicinal
Matricaria chamomilla Camomile 1.5' 1' S/PSH Medium Low White smell Not technically a perennial, will
Calendula sp. Calendula 1.5' 1.5' S/PSH Medium Low Orange/Yellow sight Not technically a perennial, will
Allium schoenoprasum Chives 1' 1' S/PSH Medium Low Purple smell
Thymus sp. Thyme .5' 1' S/PSH Medium Low Purple smell
Rock Garden
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Picea glauca 'Pendula' Weeping White Spruce 15' 4' Sun Low Fun weeping habit
Muhlenbergia reverchonii Ruby Muhly 3' 2' Sun Low fall sight/texture Great soft seed heads Plant Select variety 'Undaunted'
Buddleia alterniflolia 'Argentea1 Silver Spring Butterfly Bush 12' 12' S/PSH Medium-Low purple/spring sight Spring blooming -atracts insects
Chamaebatiaria millefolium Fernbush 8' 8 Sun Low Summer sight/smell
Fallugia paradoxa Apache Plume 4' 4' Sun Low white/summer sight/texture fluffy seed heads
Geranium dalmaticum Dalmation Geranium 6" 18" Sun Low Pink/Summer Sight Prolific bloomer
Seseli gummiferum Moon Carrot 3' 1.5' Sun Low white/late summer sight Fun flowers and name
Berlandiera lyrata Chocolate Flower 15 2' Sun Low Yellow/Summer Smell Smells just like chocolate!
Festuca glauca Blue Fescue 1' 1.5' Sun Low fall sight/texture
Sedum sediforme Turquoise Tails 5" 12" Sun Low Yellow/Summer Smooth texture
Arenaria 'Wallowa Mountain' Mossy Sandwort 1" 15" S/PSH Low Texture xeric moss grows in the sun!!
Veronica liwanensis Turkish Speedwell 2" 18" Sun Low Blue/Spring Sight
Sedum angolina .25' 1' Sun Low Sight, Texture
Delosperma sp. Ice Plant 2" 18" Sun Low Summer smooth texture
Orrganum libanoticum Hopflower Oregano 18" 18" Sun Low Summer sight Good to plant along a wall
Sempervivum Hens and Chicks
Meadow
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Andropogon gerardii Big Bluestem 5' 3 Sun Law fall sight/texture Native Plant Select variety 'Windwalker'
Bouteloua gracilis 2' 2 Sun Law mid-summer sight/texture Native Plant Select variety Blonde
Schizachyrium scoparium Little Bluestem 4' 2' Sun Law fall sight/texture Native Plant Select variety Standing
Crambe maritima Sea Kale 3' 2.5' Sun Law White/ Spring Smell and Cabbage type leaves
Echinacea purpurea 4' 2' Sun Low Pink/late summer Sight
Phlomis cashmeriana Kashmir Sage 3' 2' Sun Low purple/Summer sight Medicinal
Scrophularia macrantha Birds in a tree 4' 1' Sun Low Pink sight Really fun flowers attracts hummingbirds
Seseli gummiferum Moon Carrot 3 1.5' Sun Low white/late summer sight Fun flowers and name
Salvia sp. Sun Low Tons of options attract insects
Penstemon sp. Tons of options attract insects
Asclepias tuberosa Milkweed 2.5' 1.5' Sun Law Orange/Summer sight Medicinal, attracts monarchs
Achillea Ya rrow Medicinal, _ong Blooms
Monarda fistulosa Bee Balm Medicinal
Herbs for the edge of the meadow and under trees in forest
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Crambe maritima Sea Kale 3' 2.5' Sun Low White/ Spring Smell and Cabbage type leaves
Artimesia versicolor 'Sea Foam' Curlicue Sage 8" 24" Sun Low Texture
Nepeta'Psfike' Little Trudy Catmint 1' 1.5' Sun Low Blue/Summer sight/smell Attracts insects
Stachys byzantina Lambs Ear 2' 2' Sun Low purple/Summer Soft texture
Vines
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Campsis radicans Trumpet vine
Vitis Grape
Clematis Sweet Autumn
Other Grasses
Chasmanthium latifolium Sea Oats 5' 2.5' S/PSH Medium fall sight/texture seed heads that rustle in the wind
Calamagrostis brachytricha 4' 3' Sun Medium fall sight/texture Soft seed heads
Pennisetum alopecurcides 'Little Bunny' 1.5' 2' Sun Medium fall sight/texture Soft seed heads
Pennisetum orientale 'Karly Rose' 3' 3' Sun Medium Low mid-summer sight/texture Soft seed heads
Conifers
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Picea pungens 'Montgomery' Montgomery Spruce 8' 6' Sun Low Dwarf Colorado Blue Spruce
Pinus flexilis Limber Pine 6' 4' Sun Low
Juniperus chinensis 'Blue Point' Blue Point Juniper 12' 8' Sun Low
Pinus edulis Pinyon Pine 33-66'
Decidious
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Amelanchier alnifolia Serviceberry 3-26 201 spring edible berries Medicinal, many branches
Salix matsudana Curly Willow 20-40' 15-20' trunk structure
NOTES:
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SERVICEBERRY
CURLY WILLOW
HERB GARDEN
MEADOW PLANTINGS
SHRUB AREA
FOREST PLANTINGS
COMMUNITY DONATED PLANTS
Sewall TA
Child Development Center
College of Architecture and Planning
UNIVERSITY OF COLORADO DENVER
DRAWN BY: CATHARINE MCCORD
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DENVER BOTANIC
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DATE/ ISSUE:
25 APR 2017
SHEET:
L 4
PLANTING PLAN


MUSIC MOMENT
SCALE 1/4" = 1'-0"


SOFT PLANTS AND SENSORY PATHWAY
SCALE 11T = 1'-0"
MULTIPLE PLANTED POTS
SCALE 1/2" = 1'-0"
DIGGING PIT
SCALE 1/2" = I'-O"
MUSIC MOMENT
SCALE 1/2" = 1'-0"


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SHEET:
SOFT PLANTS AND SENSORY PATHWAY
SCALE 1/2" = r-O"
DIGGING PIT
SCALE 1/2 = 1-0"
L 6.2
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Child Development Center
College of Architecture and Planning
UNIVERSITY OF COLORADO DENVER
DRAWN BY: CATHARINE MCCORD
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Plant Selection
An environmentally responsible plant palette, which requires minimal maintenance in our semi-arid climate, will be carefully selected to provide year round seasonal interest for active engagement. The plant palete maintenance plan will be generated through a collaborative effort between horticultural therapists at Denver Botanic Garden and Mental Health Center of Denver, one of whom is a parent at REACH Elementary School. Plants will be chosen on their ability to provide sensory stimulation for therapeutic horticulture activities and children will be exposed to the plants culinary, medicinal, and spiritual properties.
Plant based activities will play a substantial role in garden programming. Plant material will be used to create barriers and transition space between and with different zones of activity. For example, a sensory seeking activity requiring full range of motion can be shoveling. Students will engage in this activity near sensory calming plants that can provide aromatic stimulation and aid in a calming effect to help release the energy spent while shoveling, or provide that transition space when moving
out of the sensory seeking zone of arousal. The plant selections will be water conscious, manageable, and hardy as these kids will be able to have access to the entire space. See Table 7 for plant list in progress.
Herb Garden
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Juniperus 'Woodward' Columnar Juniper 20' 4' Sun Low Could be a good screen
Buddleia Butterfly Bush 12' 12' S/PSH Medium-Low Fail sight/smell attracts butterflies
Philadelphus lewisii Mockorange 7' 5' Sun Low white/spring smell
Viburnum carlesii smell Some are evergreen
Syringa Lilac smell spring flowers
Helianthus Sunflower Sun Medium Yellow sight Could be perennial type or annual
Alcea sp. Hollyhock S/PSH Medium Variety sight
Symphytum sp, Comfrey 3' 3' S/PSH Medium Low sight Medicinal already on sight
Levisticum officinale Lovage 3' 2.5' S/SH Medium Low sight Medicinal
Artemisia dracunculus Tarra gon 3' 1.5' S/PSH Medium Low smell
Salvia officinalis Culinary Sa ge 2.5' 2.5' S/PSH Medium Low Purple smell Medicinal
Origanum sp. Oregano 2.5' 2.5' S/PSH Medium Low White smell Medicinal
Melissa officinalis Lemon Balm 2.5' 3' S/PSH Medium Low White smell Medicinal
Hyssopus officinalis Hyssop 2' 1.5' S/PSH Medium Low Purple smell Medicinal
Lavandula sp. Lavender 1.5' 1.5' S/PSH Medium Low Purple smell Medicinal
Matricaria chamomilla Camomile 1.5' 1' S/PSH Medium Low White smell Not technically a perennial, will reseed
Calendula sp. Calendula 1.5' 1.5' S/PSH Medium Low Orange/Yellow sight Not technically a perennial, will reseed
Allium schoenoprasum Chives 1' 1' S/PSH Medium Low Purple smell
Thymus sp. Thyme .5' 1' S/PSH Medium Low Purple smell
TABLE 7. Plant List
50


Rock Garden
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Picea glauca 'Pendula' Weeping White Spruce 15' 4' Sun Low Fun weeping habit
Muhlenbergia reverchonii Ruby Muhly 3' 2' Sun Low fail sight/texture Great soft seed heads Plant Select variety 'Undaunted'
Buddleia aIterniflolia 'Argentea' Silver Spring Butterfly Bush 12' 12' S/PSH Medium-Low purple/spring sight Spring blooming -atracts insects
Chamaebatiaria millefolium Fernbush 8' 8' Sun Low Summer sight/smell
Fallugia paradoxa Apache Plume 4' 4' Sun Low white/summer sight/texture fluffy seed heads
Geranium dalmaticum Dalmation Geranium 6" 18" Sun Low Pink/Summer Sight Prolific bloomer
Seseli gummiferum Moon Carrot 3' 1.5' Sun Low white/late summer sight Fun flowers and name
Berlandiera lyrata Chocolate Flower 15" 2' Sun Low Yellow/Summer Smell Smells just like chocolate!
Festuca glauca Blue Fescue 1' 1.5' Sun Low fail sight/texture
Sedum sediforme Turquoise Tails 6" 12" Sun Low Yellow/Summer Smooth texture
Arenaria 'Wallowa Mountain' Mossy Sandwort 1" 15" S/PSH Low Texture xeric moss grows in the sun!!
Veronica liwanensis Turkish Speedwell 2" 18" Sun Low Blue/Spring Sight
Sedum angolina .25' 1' Sun Low Sight, Texture
Delosperma sp. Ice Plant 2" 18" Sun Low Summer smooth texture
Orrganum libanoticum Hopflower Oregano 18" 18" Sun Low Summer sight Good to plant along a wall
Sempervivum Hens and Chicks
Meadow
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Andropogon gerardii Big Bluestem 6' 3' Sun Low fail sight/texture Native Plant Select variety 'Windwalker'
Bouteloua gracilis 2' 2' Sun Low mid-summer sight/texture Native Plant Select variety 'Blonde Ambition'
Schizachyrium scoparium Little Bluestem 4' 2' Sun Low fail sight/texture Native Plant Select variety 'Standing Ovation'
Crambe maritima Sea Kale 3' 2.5' Sun Low White/ Spring Smell and Texture Cabbage type leaves
Echinacea purpurea 4' 2' Sun Low Pink/late summer Sight
Phlomis cashmeriana Kashmir Sage 3' 2' Sun Low purple/Summer sight Medicinal
Scrophularia macrantha Birds in a tree 4' 1' Sun Low Pink sight Really fun flowers attracts hummingbirds
Seseli gummiferum Moon Carrot 3' 1.5' Sun Low white/late summer sight Fun flowers and name
Salvia sp. Sun Low Tons of options attract insects
Penstemon sp. Tons of options attract insects
Asclepias tube rosa Milkweed 2.5' 1.5' Sun Low Orange/Summer sight Medicinal, attracts monarchs
Achillea Yarrow Medicinal, Long Blooms
Monarda fistulosa Bee Balm Medicinal
Herbs for the edge of the meadow and under trees in forest
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Crambe maritima Sea Kale 3' 2.5' Sun Low White/ Spring Smell and Texture Cabbage type leaves
Artimesia versicolor 'Sea Foam' Curlicue Sage 8" 24" Sun Low Texture
Nepeta'Psfike' Little Trudy Catmint 1' 1.5' Sun Low Blue/Summer sight/smell Attracts insects
Stachys byzantina Lambs Ear 2' 2' Sun Low purple/Summer Soft texture
Vines
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Campsis radicans Trumpet vine
Vitis Gra pe
Clematis Sweet Autumn
Other Grasses
Chasmanthium latifolium Sea Oats 5' 2.5' S/PSH Medium fail sight/texture Great seed heads that rustle in the wind
Calamagrostis brachytricha 4' 3' Sun Medium fail sight/texture Soft seed heads
Pennisetum alopecuroides 'Little Bunny' 1.5' 2' Sun Medium fail sight/texture Soft seed heads
Pennisetum orientale 'Karly Rose' 3' 3' Sun Medium Low mid-summer sight/texture Soft seed heads
Conifers
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Picea pungens'Montgomery' Montgomery Spruce 8' 6' Sun Low Dwarf Colorado Blue Spruce
Pinusflexilis Limber Pine 6' 4' Sun Low
Juniperus chinensis 'Blue Point' Blue Point Juniper 12' 8' Sun Low
Pinus edulis Pinyon Pine 33-66'
Decidious
Botanical Name Common Name Height Spread Light Water Bloom Sensory Notes
Amelanchier alnifolia Serviceberry 3-26' 20' spring edible berries Medicinal, many branches
Salix matsudana Curly Willow 20-40' 15-20' trunk structure
TABLE 7. Plant List Continued
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Conclusion
The goal through design is to translate these data on brain development and resilency, and employ a new way of thinking toward programming activities and moments and to create a balance of enabling activity through support and the introduction of challenges.
Conditions of the grant are that the garden is to be completed by March of 2018. We have received tremendous community support to achieve this timeline. The Congress Park Neighborhood Green Team has offered to provide community outreach to welcome this organization to the neighborhood and coordinate the donation of plant materials from community members of that they divide in their home gardens. The horticulturalists from Denver Botanic Garden, only a few blocks from the site, will coordinate horticultural therapy outreach sessions at Sewall to maximize the potential therapeutic effects of the garden. Horticultural therapy is a therapeutic modality that builds a rapport between the participants and therapists in a garden setting that includes performing nurturing activities while allowing the participants to maintain autonomy with what they are able to do, and choose their level of participation. This aligns well with the CEOs statement that the best treatment is providing loving stable environments.
After completing the design development documents a written plan will be made to hand off this project to Sewall to ensure the completion of the build this summer and planting scheduled for fall 2017. The Auraria Urban Horticulture Club, the Congress Park Neighborhood Green Team, and Denver Botanic Garden have graciously volunteered to help with planting the garden, making this truly a community effort, challenges that create a sense of autonomy or self efficacy.
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CHAPTER V
CONCLUSION
This thesis project has sought to explore the theories and pardigms regarding nature, restoration, and stress reduction and apply them to theories of emotional processing through sensory integration and well-being to generate a discourse on functionally healing the brain to mitgate the longitundinal effects of trauma. Chapter 2 is a bibliographic reference section highlights resources useful to understanding what happens in the brain,what can be done with plants to ameliorate these effects, and how to design to maximize therapeutic processes. Chapter 3 is comprised of a paper that explores the connection between these ideas and principles. This paper was submitted for presentation at the Council for Educators in Lanscape Architecture Conference in Beijing, China, May 2017 and for publication in Landscape Research Record 06 and is expected to be published online December 2017. Finally, chapter four describesthe design which was generated to practically apply what was learned.
How do we create soothing environments beyond receiving passive benefits of being in nature? Through active participation with natural elements we can develop tools such as positive coping mechanisms to apply when we encounter occurences of stress and trauma in our daily lives. Through moving these therapeutic interventions into the public realm and outside of institutionalized care facilities, an identity can be given to communities that reconizes that stress and trauma affect us all and that we do not have to hide that aspect of our lives to protect ourselves or others. Providing an identity to a community, to entice returned visits, to develop and practice these coping skills will cultivate communities that in the face of stress and trauma will better know how to cope, be resilient, and feel empowered.
Further, through understanding and incorporation of the literature on how brains can rebuild themselves with effective theraputic interventions that can take place in gardens, landscape architects can provide resouces for self-care and management of the stress response.
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These design principles can be applied in public spaces that provide equitable access to practice healthy coping mechanisms through interation with plant materials and green environments.
This means that landscape architects help provide environments which give agency to those who need help addressing and coping with trauma in their lives.
Through engaging in conversations about trauma encountered in our lives we begin to generate emphathy and find that we are not as alone as we might have believed. This begins to humanize trauma and make it relatable and understandable rather than something that is seen as necessary to hide. Encountering stress and trauma is a part of all lives, impacted in a variety of ways. As landscape architects, we need to be forward thinking in how we can construct spaces that recognize persons or groups suffering from trauma and how to accomodate them. For example, there is great potential for communities to be devastated by rising waters associated with climage change. How as landscape architects can we best aid in relocation efforts and give those who undoubtedly are experiencing a traumatic event a sense of identity or belonging after being relocated? Can we, through landscape instill healthy coping mechanisms and habits through interacting with landscapes?
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APPENDIX A.
Colorado Garden Foundation Grant Application 31 January 2016
HISTORY
Established in 1944, Sewall Child Development Center has a long-standing reputation for providing services to people with disabilities in the Denver community, starting with services for people with polio and evolving to early childhood education and intervention. Today, Sewall provides education and therapeutic supports for young children (birth-6) of all abilities through a continuum of programs. Sewall fulfills our mission to provide inclusive, joyful learning environments using the power of partnerships, diversity, and belonging to enrich the social and academic growth of every child and family. In 2015, Sewall supported approximately 600 children across our programs.
The last year was a time of tremendous growth at Sewall. In January 2016, Sewall moved its headquarters to a newly renovated building that provides a much-improved learning environment and space to grow. Sewall has experienced a dramatic increase in the number of children being referred through Denver Public Schools and is working in partnership with them to open and maintain several classrooms in high-needs Denver neighborhood, including eleven satellite locations. Sewall operates 12 half-day classrooms, 7 full-day classrooms, and as a result of community need, provides therapeutic supports at two different locations in the metro area; one in southwest Denver and one in the Far Northeast.
The number of Colorado children under 5 with an identified special need rose from 11,000 in 2008 to 19,328 in 2014, the percentage of children living in poverty is 10 percent higher in Denver County than in all of Colorado according to the U.S. Department of Education.
MISSION STATEMENT
Sewalls goal is to help all young children, especially those who leam differently or are at risk for school failure, build a solid foundation for elementary school by meeting the individual educational, therapeutic, and personal needs of every child.
One of the hallmarks of Sewalls high quality programming is inclusion, and Sewall classrooms are living examples of how Sewall encourages diversity on all levels. Over half of the children served by Sewall are identified as having special needs, including autism, a range of physical disabilities, Down Syndrome, ADHD, and fetal alcohol and drug exposure. Roughly sixty percent of them live in poverty and many live with a single parent, in foster care, or with custodial relatives
Sewall offers an array of early education and intervention programs to meet the individual needs of every child through the use of our unique transdisciplinary intervention model. Sewall's transdisciplinary teams, comprised of early childhood educators and special educators, physical and occupational therapists, speech pathologists, and mental health professionals, staff every program collaboratively and work together to support each child.
Sewalls mission is to provide inclusive, joyful learning environments using the power of partnerships, diversity, and belonging to enrich the social and academic growth of every child and family.
PROJECT PURPOSE
Sewall is requesting funding for the installation of a sensory and therapeutic garden that will foster the intellectual, emotional, and physical development for the 300 children from Sewall and their
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partner, REACH Charter Elementary School. The one-third acre space will be a specialized learning environment focused on children ages 3-9 with and without alternative learning needs. By simultaneously supporting and nurturing all children while they use the space side-by-side, the garden will directly support Sewalls mission of inclusivity for all children.
This outdoor educational garden, adjacent to an existing playground environment, will be organized around plants designed to stimulate all five senses and encourage hands-on multi-sensory and social learning. An environmentally responsible plant palette, which requires minimal maintenance in our semi-arid climate, will be carefully selected to provide year round seasonal interest for active engagement. The garden will allow therapeutic horticulture techniques to be integrated into SewalTs transdisciplinary intervention model and provide a safe, non-threatening space of respite during crisis interventions.
This garden will provide more benefit to students and community than the typical schoolyard.
Because Sewall is open year round, the garden will be more fully occupied than most school landscapes. In addition, the grounds will be available to the broader community as a therapeutic space and offer summer camp programs.
Sewall has the commitment of an in-kind match of plant material from the Congress Park Neighbors Green Team who will liaise with community members to facilitate the donation of hardy perennials and volunteer hours for installation.
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APPENDIX B.
Colorado Garden Foundation Grant Application 31 October 2016
31 October 2016
Colorado Garden Foundation 959 S Kipling Pkwy #100 Lakewood, CO 80226
Dear Colorado Garden Foundation Grant Selection Committee,
Sewall Child Development Center is pleased to present this proposal for your review. The last year was a time of tremendous growth at Sewall. In January 2016, Sewall achieved a long-awaited goal and moved its headquarters to a newly renovated building at 940 Fillmore St. in the Congress Park neighborhood of Denver. This renovated space provides a much-improved learning environment and space to grow. Our new campus offers outdoor space for a sensory garden that will enhance the development of each and every child.
Over half of the children served by Sewall have special needs; including autism, physical disabilities, Down Syndrome, ADHD, fetal alcohol and drug exposure. Roughly sixty percent of them live in poverty and many live with a single parent, in foster care, or with custodial relatives. Our proposal requests $75,000 in funding to build an outdoor sensory garden that can serve as an educational environment. Adjacent to the more formalized play environment, the garden will be organized around natural materials designed to stimulate all five senses and encourage hands-on multi-sensory, and social learning. It will allow therapeutic horticulture techniques to be integrated into Sewalls transdisciplinary intervention model, providing a safe, non-threatening space that serves as an opportunity for needed respite during crisis interventions. A predominantly xeric and native plant palette will be selected to provide year round seasonal interest. Students from both the Fillmore St. headquarters and the nine satellite locations will have year-round access to the garden. The garden will also be used by REACH Charter School, Sewalls partner elementary school that shares the building and outdoor spaces.
As a community-focused organization, the grounds will also be available to the surrounding neighbors as a therapeutic space when the academic schedule allows. This garden project is strongly supported by members of the local community. The Congress Park Neighborhood Green Team has committed to cultivating community relationships between Sewall and its new neighborhood home. Sewall currently operates a community garden with strong participation from parents, staff, and the local community.
We believe our project aligns with the purpose of the Colorado Garden Foundations grant program; it is a horticulturally related community improvement project that emphasizes education and therapy. Furthermore, it connects neighboring home gardeners and plant material sourced from their home gardens with a school landscape with focus on community benefit. We appreciate the Colorado Garden Foundation taking an interest in supporting our sensory and therapeutic garden and would be more than willing to provide additional information or answer any questions regarding our project.
Sincerely,
Heidi Heissenbuttel, MA ECSE President and CEO Sewall Child Development Center 940 Fillmore St.
Denver, CO 80206
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AGENCY INFORMATION
Sewall has a rich history of providing services to the Denver Community for 72 years. Sewall has one goal: to help all young children, especially those who leam differently or are at risk for school failure, build a solid foundation for elementary school by meeting the individual educational, therapeutic, and personal needs of every child. To help each child build a solid foundation for school success, Sewall provides high quality, inclusive education in responsive classroom communities in partnership with families.
Sewall offers an array of early education and intervention programs to meet the individual needs of every child through the use of our unique transdisciplinary intervention model. Sewall's transdisciplinary teams comprised of early childhood educators and special educators, physical and occupational therapists, speech pathologists, and mental health professionals, staff every program collaboratively and work together to support each child.
One of the hallmarks of Sewall's high quality programming is inclusion, and Sewall classrooms are living examples of how Sewall encourages diversity on all levels. Research shows all children benefit from individualized learning within supportive communities. Our mixed-age classrooms include three and four-year olds. Between one third and one half of the children in each class have identified special needs. Children with and without special needs leam side-by-side, with all therapies occurring within the natural setting of the classroom and outdoor playground. Each classroom represents a wide range of cultural, ethnic, and socio-economic backgrounds.
Sewall is routinely evaluated by outside organizations including the Department of Human Services licensing and Colorado Shines (formerly Qualistar). Our high-quality programming, combined with our consistent success in preparing young children with and without special needs for ongoing academic and personal success, has earned us the following:
The National Association for the Education of Young Children (NAEYC) accredits Sewall, a distinction awarded to only 7 percent of early childhood education organizations in Colorado. Accreditation was renewed in July 2012 for five years.
Sewall was the first early childhood program to receive Qualistar's highest four-star rating. Today, all Sewall classrooms maintain a three or four-star rating. Sewall will continue to work with Qualistar as it transitions to Colorado Shines.
The federal Division of Early Childhood (DEC) named Sewall as one of 20 national replication sites that demonstrate recommended practices for inclusion of young children.
ORGANIZATION HISTORY
Established in 1944, Sewall Child Development Center has a long-standing reputation for providing services to people with disabilities in the Denver community, starting with services for people with polio and evolving to early childhood education and intervention. Today, Sewall provides education and therapeutic supports for young children (birth-6) of all abilities through a continuum of programs. Sewall fulfills our mission to provide inclusive, joyful learning environments using the power of partnerships, diversity, and belonging to enrich the social and academic growth of every child and family. In 2015, Sewall supported approximately 600 children across our programs.
CURRENT PROGRAMS
Inclusive Preschool Program Sewall's NAEYC accredited program provides educational and therapeutic intervention and an opportunity for children of all abilities and learning styles to leam side-by-side. In order to meet growing community need, Sewall increased its inclusive satellite program from 3 classrooms in the fall of 2012 to 10 in fall of 2015, increasing our total preschool classrooms to twenty. Roughly 300 children are served in the preschool programs; approximately 60% are low-income.
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Early Childhood Care Program- Sewall provides 9 full-day preschool and toddler programs at 3 sites: 940 Fillmore, Strive, and Dahlia. This program offers one of the few inclusive options in Denver for families with children who have complex developmental or medical concerns serving 118 children annually. Approximately 60% are low income.
Infant/Toddler Program Sewall's transdisciplinary team provides family based educational and therapeutic supports to young children with special needs in their homes. Therapists and specialists partner with parents and care givers, helping them to support their child's developmental needs. Program serves up to 40 children annually; approximately 60% are low income.
Head Start Disability Services Program Sewall's therapeutic teams provide direct and indirect services to children with special needs in 47 Denver Head Start classrooms, while simultaneously providing training and consultation to Head Start classroom teachers. Sewall provides service to 150 children this year; approximately 95% are low-income.
Diagnostic and Evaluation Clinic The assessment team, which includes a clinical psychologist, speech pathologist, physical therapist, and a developmental pediatrician, provides comprehensive evaluations and reports for children with developmental concerns. In 2015, the team conducted 72 evaluations; 95% of those children were Medicaid eligible.
Familv/Parent Engagement Program Sewall partners with parents to support the individual needs of each child and family, particularly our families in clinic. This includes home visits, ongoing family support, advocacy, and resource management to promote parenting skills, and facilitating and fostering a peer network between families. Approximately 80% of families supported are low-income.
PURPOSE OF GRANT
Sewall is requesting funding from the Colorado Garden Foundation for the installation of a sensory and therapeutic garden that will foster the intellectual, emotional, and physical development for the expected 300 children and students who will regularly use this garden from Sewall and our partnership with REACH Charter School. The one-third acre space will be a specialized learning environment for both Sewall and REACH, focused on children with alternative learning needs while at the same time providing benefit to their typically developing peers. Installation of this garden will offer a safe and inviting outdoor space that will serve to reduce the amount of time children spend in crisis. By simultaneously supporting and nurturing all children while they use the space side-by-side, the garden will directly support Sewall's mission of inclusivity for all children. The project is supported by a wide range of community partners, all of whom are committed to its completion.
To achieve these goals, curricula will be developed that incorporate students' individual education plan. As students are in need of a crisis intervention, access to the space will provide a place for these interventions. A subsidiary goal is to increase the level of community engagement with the school. In addition to facilitating donation of plants, materials and other donations, the Congress Park Neighborhood Green Team has committed to cultivating a relationship between Sewall and the neighborhood to assist in community outreach and engagement, specifically focused on ongoing volunteer commitments to maintain the garden-Involving the neighbors of Congress Park through volunteer activities will aid in building the relationship between Sewall and it's new neighborhood, and will continue helping the organization meet its sustainability goals.
A combination of new and ongoing activities will be performed in the sensory and therapeutic garden. A digging area located in the current playground will be relocated in the sensory garden to provide a physical outlet for emotional release as the activity can provide a sensory motor relief response with whole body movement and interaction with soil. New activities will include introducing therapeutic horticultural techniques into Sewall's suite of therapies available to help our students. Planting and harvesting activities will serve to aid in the development of fine and gross motor skills. To that end, plants such as lemon balm that can be picked and made into a tea will be
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featured in the landscape. Tactile activities including touching plants and navigation over sensory pathways will stimulate ambulatory development, balance, and navigation development.
The land for the garden is an unused part of the existing school site and does not need to be acquired. We are requesting $75,000 from the Colorado Garden Foundation for expenses including site work, grading, utilities, draining, and erosion control. We expect the sum of our in-kind donation and matches to equal the sum of the funds requested from the Colorado Garden Foundation. These in-kind donations will include design and construction services, donations of plant and other materials, and community volunteer workshops for installation of plants and site furnishings.
This project is expected to be completed in the fall of 2017 in three phases. Phase 1 will occur in spring 2017 and will included construction drawing completion and permit acquisition. Phase 2 will occur in summer of 2017 and will comprise the hard installation including site work, demo, grading, utility installation, drainage, erosion control, and ground remediation. Phase 3 will begin in the fall of 2017 and be comprised of community engagement workshops to build site furnishings and install plant material.
COLLABORATION
Collaboration is a cornerstone of Sewall's efforts to assist children in our community. We partner with Denver Public Schools to provide our inclusive preschool program, not only at our 940 Fillmore St. headquarters, but also in nine satellite locations. We opened new classrooms at the Dahlia Campus for Health and Well-being in partnership with the Mental Health Center of Denver in fall 2015.
Sewall will continue working with Denver Public Schools and community partners to expand into more neighborhoods in the coming years.
Sewall also collaborates with the 47 Denver's Great Kids Head Start classrooms by providing disability services for all children with identified special needs. We provide consultation and training to all Head Start teachers in delegate agencies throughout Denver. Collegiate partnerships include University of Colorado Denver, University of Denver, Community College of Denver, and Arapahoe Community College.
VOLUNTEER INVOLVEMENT AND IN-KIND CONTRIBUTIONS
Volunteer support is integral to Sewall's success. Approximately 117 people lend their assistance to Sewall each year. Volunteers help in a variety of ways, from volunteering in classrooms to participating on committees for fundraising events. We estimate that volunteers spend a total of 5,335 hours donating their time and energy to assisting Sewall each year. Volunteers participate in activities throughout the school year, including annual seasonal festivals and fundraising events and assist with projects like playground installations, building maintenance, and painting everything from classroom murals to stripes in the parking lot.
Graduate student Catharine McCord a Master of Landscape Architecture candidate at the University of Colorado Denver and horticultural therapist is working with Sewall for her thesis project and will provide design development services as an in-kind contribution. Jody Beck an assistant professor who lives in the neighborhood is chairing the thesis. He and Emmanuel Didier, Landscape Architect and Professor in Practice will be providing in-kind support as they guide the design component of Catharine's thesis. Lee McCoy, horticulturalist and horticultural therapist at the Denver Botanic Garden located in the neighborhood with Sewall will provide an in-kind contribution of plant selection expertise. Neighborhood community members of the Congress Park Neighborhood Green Team are committing in- kind expertise in many areas. Members include Landscape Architect Melanie Reber who will provide assistance with construction document drawings for permitting and construction and landscape designer Susan Bardwell who will develop a maintenance plan and provide onsite community build supervision. Emily Hunter is the point of contact for the Green Team which will coordinate member volunteer activities including: administrative services, landscape architecture expertise, construction expertise, bulb and plant donations from neighbor's gardens,
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purchased plant donations, installation labor, ongoing maintenance, facilitation of landscape architectural donated services, and donation of other supplies.
EVALUATION
Expected results are to complete construction of the garden and engage with the community through relationship building and community contributions. This would be evident though the completion of the design, acquisition of plants and materials, preparation and planting of the garden, participation of the Congress Park neighbors and integration of the garden in Sewall's interdisciplinary team approach.
At Sewall, we measure success through the children we serve. Sewall deploys thorough, ongoing evaluation across all programs, and rigorously monitors the progress of each child. To monitor the progress of all children, Sewall began using Teaching Strategies GOLD (TS Gold) during the fall of 2011. These include social-emotional, physical, language, and cognitive development, as well as academic areas of growth such as literacy, math, and art.
Every preschooler served by Sewall who has identified special needs has an Individual Education Plan (IEP) that is developed by Sewall's transdisciplinary teams in partnership with each child's family. These IEPs outline specific categorical goals for each child and strategies for achieving those goals.
This garden project is intended to enhance these educational practices and build upon the already strong record of success in serving our target population. In particular, we would define the success of this garden project in three areas; its integration into curricular activities, its use as a component in IEPs, and its value as a space of respite during crisis interventions. Success will be measured by the degree to which this takes place. The role of the garden in our program delivery will be included in all of the above assessment and evaluation programs as appropriate.
Reflective observations about the use of the sensory garden and outdoor learning environment will be used to enhance learning and therapeutic interventions. Graduate student Catharine McCord will apply to present the outcome of the project at conferences such as the American Society for Landscape Architects (ASLA) and the American Horticultural Therapy Association (AHTA). Sewall will allow future researchers at the University of Colorado Denver to access available and non-confidential documentation of both educational and therapeutic uses of the garden for continued research.
Sewall has not previously been awarded funding through the Colorado Garden Foundation. If our project is awarded this grant, a commemorative plaque will be placed in a high visibility area of the garden showcasing the generosity of the Colorado Garden Foundation. The Congress Park Neighborhood Green Team plans to announce the project and project updates in their monthly newsletter. This neighborhood organization partners closely with community businesses to foster neighborhood relationships. Sewall can partner with its satellite locations and provide outreach through these organizations as well as local media and news outlets. The University of Colorado Denver press and communications offices will be contacted and given information necessary to issue a press release and generate internal publications disseminated to thousands of students and alumni.
BOARD OF DIRECTORS
Our 17 member Board of Directors is charged with providing strategic direction and oversight for programmatic, fundraising, financial, and administrative activities at Sewall. Working in collaboration with Leadership Team, members serves a minimum term of three years and is on at least one standing committee. Board members also solicit supporters and participants for special events and bring potential new supporters into Sewall. We are proud of the fact that 100 percent of our board members make personal gifts to Sewall annually.
Board of directors include; Sarah R. Allen (Board Development and Capital Campaign), Barbara Bieber (Development), John Chahbandour (Program), Charon Earnest (Program and Marketing), Chuck Fish (Executive and Finance), William C. Holland (Executive and Board Development), Linda
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M. Kanan, Ph.D. (Program), Marc Kleiner (Executive and Development), Gene Koelbel (Program and Development), Randall Sylvan (Parent Seat), Jason Waldron (Finance), Ashley Walker (Development).
REACH 2016 Budget Summary Revenue
subtotal program revenue $ 3,508,221.00
subtotal G&A $ 295,000.00
940 Fillmore development_______$_____918,500,00
Total Revenue $ 4,721,721.00
Expense
subtotal program expense $ 3,895,696.00
G&A $ 635,481.00
940 Fillmore Development $ 181,440.00
Total Expense $ 4,712,617.00
Net Income (Loss)
subtotal program income $ (387,475.00)
G&A $ (340,481.00)
940 Fillmore Development $ 737,060.00
Net Cash Flow $ 9,104.00
Depreciation Expense $ 105,975.00
Net Income (Loss) $ (96,871.00)
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APPENDIX C.
Colorado Garden Foundation Interview Materials 18 January 2017
What is a Sensory Garden and how can it Benefit Sewall Child Development Center?
A sensory garden can be very therapeutic for people who suffer from sensory problems. It may be used as a calming place and as a gentle way to stimulate the senses. This type of environment can become a place where children with autism and other sensory processing disorders feel safe and comfortable in exploring their senses without feeling overwhelmed by them.
For children who are hyper-reactive to stimuli, the sensory garden should provide a relaxing environment, and for children who tend to be under-reactive to stimuli, the garden is a great way to stimulate the senses.
For children who do not suffer from a disability, a sensory garden is beneficial in that it is a fun educational tool that allows them to explore and learn about their senses and nature. While in the garden, they are encouraged to touch, smell, taste, and generally interact with the environment around them.
- Planet Natural https://www. planetnatural .com
Universal design refers to products, services, and environments usable by the widest range of people possible, despite ability, age, or preference.
Inclusive design is design that considers the full range of human diversity with respect to ability, language, culture, gender, age and other forms of human difference. Unlike accessible design, which is often stigmatizing, institutional looking, and possibly embarrassing for users, universal and inclusive design is sensitive to users physical, cognitive, and emotional needs, and is aesthetically pleasing. Universal and inclusive design is about equity and parity.
If we step back and look at the whole child, there is more to universal and inclusive design than, say, addressing physical challenges. In an ideal design scenario, universal and inclusive children's outdoor environments nurture the childs intellect, emotions, sensory systems, and yes, physical skills.
- The Field
https://thefield.asla.org/2016/07/21/designing-for-all-children/
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SENSORY PATHWAYS
Sensory pathways can be used therapeutically by taking off shoes and feeling the textures beneath the feet
Sensory pathways are abb to introduce challenges to children in wheefchairs.
Sensory pathways may also provide a signal of changing direct bn.
Krakucbthing
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MUSICAL WALLS
A musical walls can provide tactile exploration and interaction with non-traditional musical elements.
A musical wall allow children to create and explore sounds that they generate.
Melody Pole Timotey Playscapes
miss ol uci ones -pangala
Music wall
Sensory musical wall
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SENSORY WALLS
Top:
Beiiensen Park Sensory Wall
Back row from left, Tiffany Harris, co-founder and CEO of Stone's inspiration; Richard Bencwengo, president and CEO of Lari noton Design + Fabrication; Catherine Curry-Williams, co-founderof Shane's inspiration; and Frank Bene rue ngo, C.OO. of Lexington Design + FaPrication, stand at the sensory wall with children at AnthonyC. Beilenson Parkat Late Balboa, Monday, March22,
2010. The sensory wall *as built by Lexington Design + Fabrication, of Pacoima, and Shane's insp iration, a \an Nuys whose mission is to create universally accessible playgrounds and programs that socially integrate children of all abilities. (Michael Owen Bater/Staff Photographer)
Left:
Beilensen Park Sensory Wall
Cole Massie, 12, feois the texture on the sensory wall at tto universal access playground at Anthony C. Be'ilenson Park at Late Balboa, Monday, March 22, 2010. The sensory wall was built by Lexington Design + Fabrication, of Pacoima, and Stones inspiration, a Nuys whose mission isto create unruentolly accessible playgrounds and programs that soc ally in teg rate childrenofaliabi lities. (Michae I Owe n Eaker,Staff pnotographer)
4
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ENCLOSED SPACES FOR PRIVACY
Children may need time for privacy or respite from an overstimulating environment.
Allowing children to choose to take a break while still being able to see the group allows them to choose to reengage in activities when they are ready.
Enclosed spaces can also reduce noise for a less visually and distracting space while being outside.
Semi -p ri vate s pac e Willowpool
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TERRAIN PLAY
Terrain can be utilized to create natural play features which encourage children to use their whole bodies and generate play based on their imaginations.
These play features can stimulate and encourage cooperative play
Natural features can help to keep costs low.
Culvert tunnels to climb under, through, and above
Aspen Elementary
Image Source: Connect One Design
Aspen Elementary
Image Source: Connect One Design
6
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fL
SNoiido wooassvio aooaino


ACTIVITY IDEAS
Karas Creative Place
Sensory Ice Play Crafts on Sea
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PRECEDENT SPACES
Designed to for vision m pa red visitors. This garden has a range of tactile stmukation and interact^ elements.
9


PRECEDENT SPACES
The Anchor Center for Blind Children
Sensory garden used for horticultural therapy. Tall grasses provide auditory stimulation when blown in the breeze and tactile stimulation when touched. Changing pathway textures provide challenge to not transitions between space and the sensation of walking on different surfaces. A hilly terrain provides a challenge in
navigation, stimulates curiosity and instills a sense of independence. 1 0
Denver, CO
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Sensory Gardens for Special Education Students
Sensory garden benefits may include:
-Improves fine and gross motor skills -Encourages communication and social skills -Increases self-esteem -Promotes responsibility -Stimulates sensory awareness -Enhances creativity
-Promotes hands-on and multi-sensory learning -Helps reduce stress, anxiety, and frustration -Helps reduce aggressive behaviors
-Can help enhance and support concepts taught in the classroom -Adapts to many types of curriculum -Provides opportunities for investigative learning -Provides a non-threatening environment -Creates common ground between students
Tips for your sensory garden:
-Make safety your top priority
-Make sure the garden is accessible and inclusive to all students
-Use tools suited to children or specially adapted tools for children with special needs
-Plan garden related activities often, but for short time periods
-Use plants that are durable and easy to grow
-Let your students participate as much as possible
-Design your garden to meet your students needs.
-Keep safety in mind
-Provide plenty of adult helpers
-Have plenty of fluids and sun protection available
-Partner special education students with mainstream students
-Allow time for children to adjust to the sights and smells of the garden
-Balance jobs that have instant results, such as weeding and harvesting; with jobs that have longer term results, such as transplanting or sowing seeds.
-Demonstrate gardening tasks for the students before they leave the classroom and once they are in the garden
Curriculum connections:
MATH
*How fast does dill grow? Measure and graph the growth rates of dill plants, make size comparisons "When will a seed germinate? Use seed catalog/seed packet information and math to predict when a seed will germinate and how long it will take to mature, predict when a seed would need to be planted in order to be ready for a chosen holiday.
"Compare the sizes of herb seeds?
"Observe and record the air and soil temperatures in your class herb garden?
"Calculate the weight and volume of soil when it is wet and when it is dry.
"Calculate how many sage plants will fit into a 6 ft. x 6 ft. garden "Use plants to help you learn about taking measurements "Learn about fractions by using herbs for cooking
The Herb Society of America2009 -| -|
The Herb Society of America2009/www.herbsociety.org
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Sensory Gardens for Special Education Students
Curriculum connections:
SCIENCE
Dead or alive? use basil plants to compare the difference between living and non-living things
What is pH? How does pH affect the smell and taste of basil, sage, and oregano *What happens if I water thyme plants with soda or tomato juice?
*Why do herbs smell? investigate what parts of herb plants cause them to smell Plant identification press and label various herb plants, draw and diagram the parts of a leaf Plant life cycles plant seeds and learn about reproductive life cycles as they grow WRITING/LANGUAGE ARTS
What role have herbs played in the development of modern day medicine? have the students interview a pharmacist or doctor about the role herbs have played in the developing of medicine, have them write a written report or give an oral report to share what they have learned.
Compare and contrast the facts and fiction about various herb plants.
Write a description of the plants growing in your garden
Write a letter to your local extension service or botanic garden asking a plant-related question?
Learn to use the library or internet by researching a certain type of herb or plant
HEALTH
What role can herbs play in healthy eating?
Can herbs be used to spice up vegetable dishes?
Use herbs to learn about how to harvest and preserve food?
Learn about cooking with herbs
Learn about the role herbs have played in the development of medicine?
SOCIAL STUDIES
What role have herbs played in different cultures?
How are herbs used around the world?
What role have spices played in ancient civilizations?
Do herbs have economic uses? examine the ingredient labels of various household products to determine if herbs are listed in the ingredients, visit the grocery store and look for products that use herbs CULTURAL ARTS music, art, drama Paint or draw various herbs and plants
Perform a play that depicts the life cycle of a sunflower or other plants Does Basil like Beethoven? learn how music affects plant behavior and growth Make or decorate clay pots for a school plant sale
Develop advertising skills by designing marketing materials and plant labels for a school plant sale.
Write the lyrics for songs that teach about the parts of a plant or the life cycle of a plant. Perform the songs for your school.
Decorate rain barrels for a school plant sale or for use by your school.
Contact Information
The Herb Society of America 9019 Kirtland Chardon Road Kirtland, OH 44094 Office hours: M-Th, (9 am 5 pm, EST) Phone: 440.256.0514 www.herbsociety.org
The Herb Society of America2009
The Herb Society of America2009/www.herbsociety.org
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Sewall
Child Development Center
Collaboration fa Equality fa Community
Sewall Child Development Center is a nonprofit organization serving the Denver community for over 70 years.
Sewall is committed to inclusive, high-quality early childhood education.
At Sewall, children of all abilities, including those with special needs, learn and grow together. Every classroom has a team of professionals who work together to ensure every individual students academic, social, emotional and cognitive needs are met.
Our mission ensures that each child and family reaches their highest potential.
Sewall Child Development Center
19 Classrooms across Denver
Over 600 Children Served each year
Fully inclusive programs
All children, of all abilities, welcome to learn and thrive
Sewall Child Development Center
940 Fillmore Street, Denver, CO 80206 | 303-399-1800 | www.sewall.org
Where all children are welcome to learn and thrive
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SENSORY and THERAPEUTIC GARDEN
The sensory and therapeutic garden will support Sewalls mission of inclusivity for children of all abilities by providing an outdoor space for the transdisciplinary team to foster the intellectual, emotional and physical development of the children they serve as they use the space side-by-side.
300 children and students from Sewall and our partner organization, REACH Charter School, will regularly use this garden.
A safe and inviting outdoor space will serve to reduce the amount of time children spend in crisis.
The garden will increase the connections between Sewall and its neighbors through relying on the Congress Park Green Team to facilitate the sourcing of plant material from home gardens and other direct donations. The garden will also be open for community use after school hours.
This garden is expected to be completed in the fall of 2017.
SEWALL FACTS
Sewall directly serves 670 children annually, and an additional 600 children as the disability service provider for Denver Great Kids Head Start
2016 Budget: $4,721,721
Sewall has 71 full-time and 24 part-time staff
Sewall does not deny service to any child based on the familys ability to pay
For every $1 invested in high-quality early childhood education, society is repaid as much as $17
GET INVOLVED
Donate | Volunteer | Attend Events | Host a Tour | Make a Planned Gift | Corporate Gifts
Sewall Child Development Center
940 Fillmore Street, Denver, CO 80206 | 303-399-1800 | www.sewall.org
Where all children are welcome to learn and thrive
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APPENDIX D.
Sewall Child Development Center Handouts
If*
Please join us to help shape the GOALS for a Sensory Garden at Sewall and REACH
J _-i _ .____. X 'V ,
The Colorado Garden Foundation has awarded Sewall $75,000 to build a new garden!
We want to hear what experiences you and your children would like to have in this redesigned space next to our playground.
The Denver Botanic Garden and Congress Park Neighborhood Green Team are working with the design team to help make this space an exciting addition the school and the neighborhood!
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APPENDIX E.
Catharine McCord
Landscape Architecture Student Certificate in Horticultural Therapy Certificate in Healthcare Garden Design
Green Team Handouts
SENSORY GARDEN AT SEWALL CHILD DEVELOPMENT CENTER
$75,000 Grant from Colorado Garden Foundation
Accepted through first round of grant process 2nd round due October 31, 2016
HOW THE GREEN TEAM CAN HELP
Facilitate the donation of perennials divided from home gardens
Volunteer to plant garden (estimated Summer/Fall 2017)
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APPENDIX F
Feedback Session Board
SEWALL CHILD DEVELOPMENT
SENSORY GARDEN
SENSORY INTEGRATION
SENSORY SEEKING/ CRAVING SENSORY UNDER-RESPONSIVE (SUR)
SENSORY OVER-RESPONSIVE (SOR)
otirri.tet on.Constant movc-picit. at a tyc cal irtonsiry.
CMo typically ox or-i>-
NOTES & COMMENTS
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Full Text

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LANDSCAPE ARCHITECTURE AND NEUROPLASTICITY: A ROLE FOR DESIGN IN ADDRESSING THE IMPACT OF EARLY CHILDHOOD TRAUMA b y CATHARINE MCCORD B.S., University of Central Florida 2006 M.A., State University of New York at Buffalo 2009 A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the degree of Master of Landscape Architecture Landscape Architecture Program 2017

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ii 2017 CATHARINE MCCORD ALL RI GHTS RESERVED

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iii This thesis for the Master of Landscape Architecture degree by Catharine McCord h as been approved for the Landscape Architecture Program by Jody Beck Chair Lois Brink Emmanuel Didier Date: May 13 2017

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iv McCord, Catharine (MLA, Landscape Architecture Program ) Landscape Architecture and Neuroplasticity: A role for Desing in Addressing the Impact of Early Childhood Trauma Thesis directed by Assistant Professor Jody Beck ABSTRACT This paper will examine t he current research on early childhood trauma, and bridge this research with landscape architectural design practices through deliberate, considered application of horticultural therapy. Specifically, current research on brain resiliency outlines the ways in which emotional and behavioral support can be achieved through nature based therapies. Thus, the spatial and sensory integration practices associated with horticultural therapy connects this research to design practices. In order to effectively suppo rt people who have experienced trauma, landscape architects must have a close understanding of how the materials and spatial compositions they select impact eking emotional and behavioral support will be strengthened by understanding the ways in which trauma alters the brain, the resiliency of the brain to heal through nature based interventions and design aspects that will support this healing. To fully under stand the potential landscape architects have to positively support treatment services, a cross disciplinary dialogue that explores the incredible possibilities of trauma related brain science is critical to developing a shared understanding on how to take the specificity of that information into account in our work The form and content of this abstract are approved. I recommend its publication. Approved: Jody Beck

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v This thesis is decicated to my parents, sisters and husband Matt, this ha s all be possible with your love and support

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vi A CKNOWLEDGEMENTS Sewall Child Development Center Colorado Garden Foundation Denver Botanic Garden Mental Health Center of Denver Congress Park Neighborhood Green Team

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vii TABLE OF CONTENT S CHAPTER I. INTRODUCTION ................................ ................................ ................................ ........................ 1 Role of Landscape Architecture in Addressing Trauma ................................ ........................... 1 II. BIBLIOGRAPHIC REVIEW OF THE LITERATURE ................................ .............................. 3 Introduction ................................ ................................ ................................ ............................... 3 Horticultural Therapy ................................ ................................ ................................ ................ 3 Stress and Trauma ................................ ................................ ................................ ..................... 4 Neuroscience ................................ ................................ ................................ ............................. 5 Nature ................................ ................................ ................................ ................................ ........ 6 Landscape and Plants ................................ ................................ ................................ ................ 7 Garden Design in Learning Environments ................................ ................................ ................ 8 III. LANDSCAPE ARCHITECTURE AND NEUROPLASTICITY: A ROLE FOR DESIGN IN ADDRESSING THE IMPACT OF EARLY CHILDHOOD TRAUMA ............................... 10 Introduction ................................ ................................ ................................ ............................. 10 Current Research on Trauma and how it Affects the Brain ................................ .................... 10 Effect of Trauma on Cognition and Memory and How the Brain is Modified .......... 11 Current Research on Brain Resiliency ................................ ................................ .................... 14 Sensorimotor Processing ................................ ................................ ............................ 14 Resiliency to Rebuild Neural Connections ................................ ................................ 1 5 Theories and Paradigms ................................ ................................ ................................ .......... 16 Disconnect to Nature Paradigm ................................ ................................ .................. 17 Sensory Integration Theory ................................ ................................ ........................ 18 At tachment Theory ................................ ................................ ................................ ..... 19 Attention Restoration Theory ................................ ................................ ..................... 19

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viii Stress Reduction Theory ................................ ................................ ............................ 2 0 Horticultural Therapy ................................ ................................ ................................ .............. 2 1 Plant based Therapies Associated with Increase d Abilities to Cope with Stress ................................ ................................ ................................ ......... 2 4 Landscape Architecture Design Practice ................................ ................................ ................. 2 6 Resources for Designing Therapeutic Gardens ................................ .......................... 2 7 Conclusion ................................ ................................ ................................ ............................... 29 IV. SEWALL CHILD DEVELOPMENT CENTER ................................ ................................ ..... 30 Introduction ................................ ................................ ................................ ............................. 30 Grant ................................ ................................ ................................ ................................ ........ 3 0 Design Process ................................ ................................ ................................ ........................ 31 Client Engagement ................................ ................................ ................................ .................. 3 1 Design Development ................................ ................................ ................................ ............... 3 4 Plant Selection ................................ ................................ ................................ ......................... 50 Conclusion ................................ ................................ ................................ ............................... 52 V. CONCLUSION ................................ ................................ ................................ ....................... 53 BIBLIOGRAPHY ................................ ................................ ................................ ............................... 55 APPENDIX ................................ ................................ ................................ ................................ ......... 60 A. Colorado Garden Foundation Grant Application 31 August 2016 ................................ ......... 60 B. Colorado Garden Foundation Grant Application 31 October 2016 ................................ ....... 62 C. Colorado Garden Foundation Interview Materials 18 January 2017 ................................ ...... 68 D. Sewall Child Development Center Handouts ................................ ................................ ......... 82 E. Green Team Handouts ................................ ................................ ................................ ............ 83 F Feedback Session Board ................................ ................................ ................................ ......... 84

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ix LIST OF TABLES TABLE 1. Horticultural Therapy Resources ................................ ................................ ................................ ............. 4 2. Stress and Trauma Resources ................................ ................................ ................................ ................... 5 3. Neuroscience Resources ................................ ................................ ................................ ............................ 6 4. Nature References ................................ ................................ ................................ ................................ ....... 7 5. Landscape and Plant References ................................ ................................ ................................ .............. 8 6. Garden Desi g n in Learning Environments References ................................ ................................ ......... 9 7. Plan t L ist ................................ ................................ ................................ ................................ ...................... 50

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x LIST OF FIGURES FIGURE 1. Feedback Session ................................ ................................ ................................ ................................ ..... 32 2. Graphical representation of feedback session analysis ................................ ................................ ....... 33 3. Functional Use Diagram ................................ ................................ ................................ .......................... 34

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1 CHAPTER I INTRODUCTION Role of Landscape Architecture in Addressing Trauma This thesis argues that intera cting with plants can help victims of trauma learn to develop healthy coping mechanism for addressing stress and trauma encountered in their lives and the subsequent long term effects trauma has on behavioral outcomes. Landscapes can provide safe and equit able access to nurtuing environments where users can actively engage with the space. As landscape architects there is a potential to act as an agent of change in our communities and across the globe. We design landscapes for public and shared use, to draw people together to share spaces and experiences with those close to us and those we have yet to meet. Landscapes have the ability to promote social change, inclusion, and immersive experiences to promote emotional well being. According to the Centers for Disease Control and Prevention suicide is the 10th leading cause of death in the United States (Leading Cause of Death, 2017). The World Health Organization has reported that every 40 seconds someone dies by suicide, and that suicide is the second leading cause of death world wide (Preventing Suicide, 2014). Sucide affects more than the person suffering from a friends, rendering them victim by proxy and i mpacting their lives and relationships. In our current politial climate, we are viewing news reports of children afraid to go to school because they are unsure if their immigrant parents will be deported by the time they return home. Suicide, deportation and losing a parent are examples of traumatic events that have the abililty to mark our genome and affect the way we respond to stress later in life. Examples of trauma that affect the populations that this project is focused on include children who expe rience emotional trauma resulting from abuse and neglect and who are living in poverty. This thesis posits that early life interventions which instill positive coping mechanisms through plant based therapies can alleviate long term suffering and the l ong term effects trauma can have on

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2 the brain. This thesis will explore how the brain is functionally affected by trauma and how the brain giving us the ability to build new and heal thy neural pathways. Three avenues this thesis has used to explore these ideas are to design a sensory garden for a child development center for children with special needs and who have experienced early life stress and trauma present a paper on epigentic modifi cation of the brain and how design interventions can provide space for plant based therapeutic interventions, and provide a bibliographic reference section. A large component of this thesis is to put these ideas into practice. A sensory garden will be designed with supporting design development documentation for construction at a child development center in Denver, Colorado. This garden will be designed for children with special needs who learn alongside their typically developing peers. According t o the CEO of the organization, 40% of these children suffer from toxic stress resulting from early childhood trauma, living in poverty, and coping with significant daily stressors. It is the belief of the organization that the best treatment for these kids is to provide loving relationships. The sensory garden will be designed with horticultural therapy principals involving nurturing plant actvities to help cultivate a healthy and stable relationships between students and fac ulty as well as with the land. A paper for presentation was written for the Council of Educators in Landscape Architecture held in Beijing, China in May 2017. This paper digests the literature on brain sci ence related to how the brain is functionally modified in the event of early life t rauma. It also explores therapeutic techniqes that are capable of helping the brain to overcome these, and design interventions that landscape architects can incorporat e into their design strategies. The bibliographic reference section provides resources t o utilize to become more familiar with the process the brain undergoes after experiencing trauma and resources for plant based therapies and design principles.

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3 CHAPTER II BIBLIOGRAPHIC REVIEW OF THE LITERATURE Introduction The following resources are d ivided and ordered into categories of relevance to the thesis topic. The different catergories bring together resources relevant to understanding how trauma impacts the brain, what happens in the brain therapies are targeted to ameloriate theses effects, h ow nature based interventions can play be an effective strategy, and how as landscape architects there is a role to facillitate these effects through design. Horticultural Therapy Horticultural therapy principles are referenced in this thesis to generate d esign interventions that provide engaging and immersive spaces with an understanding of how therapeutic sessions can take place in a constructed landscape The American Horticultural nt of a client in horticultural activities facilitated by a trained therapist to achieve specific and documented The ATHA also provides a definition of therapeutic horticulture, that uses plants and plant related activities thr ough which participants strive to improve their well Resources in horticultural therap y range from case study (Airhart 1988) and pilot studies to scientific studies measuring stress hormones recorded before and after nature based activities (Bratman et al. 2015). Also included in this list of resources are guide books of how to design horticultural therapy sessions (Haller Kramer, 2016). These resources highlight the effecti veness of engaging participant s to cultivate a sense of belonging, identity, ownership, and agency ( Adevi, Lieberg 2012) in stress reduction with horticultural therapy activities. For a select list of resources see Table 1.

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4 AUTHOR TITLE DATE TYPE Airhar t, D.L. Horticulture Therapy Acti vities for Exceptional Students 1988 Case Study Airhart, D.L. Horticultural Training for Adolescent Special Education Students 1987 Case Study Adevi, A. A., Lieberg, M. Stress rehabilitation through garden therapy: A care giver perspective on factors considered most essential to the recovery process 2012 Case Study Adevi, A. A., Mrtensson, F. Stress rehabilitation through garden therapy: The garden as a place in the recovery from stress 2013 Case Study Adil, J. R. Access ible gardening for people with physical disabilities: A guide to methods, tools, and plants 1994 Guide Book Annerstedt, M., Whrborg, P. Nature assisted therapy: Systematic review of controlled and observ ational studies 2011 Review /Report Bradley, E., Ea stman, L., Parsons, A., Relf, P Non traditional, experimental horticultural programs for at risk youth: Part 2 Program and case studies 1998 Case Study Bragg, R., Atkins, G. A review of nature based inter ventions for mental health care 2016 Review/Repo rt Bratman, G N., et al. The benefits of nature experience : Improved affect and cognition 2015 Study Brooks, H. D., Oppenheim, C. J. Horticulture as a Therapeutic Aid: By Howard D. Brooks and Charles J. Oppenheim 1973 Guide Chalquist, C. A look at the ecotherapy research evidence 2009 Review Haller, R. L., Kramer, C. L. Horticultural therapy methods 2016 Guide Jiler, J. Doing time in the garden: Life lessons through prison horticulture 2006 Resource Kamioka, Hiroharu, et al. Effectiveness of horticu ltural therapy: a systematic review of randomized controlled trials 2014 Review Keeley, J. Design and Implementation of Horticultural Therapy with Children Affected by Homelessness and Domestic Violence 1999 Case Study Lorber, H. Z. The Use of Horticultu re in the Treatment of Post Traumatic Stress Disorder in a Private Practice Setting 2011 Case Study Milton, M. J., Corbett, L. Ecopsychology: A perspective on trauma. 2011 Report Simson, S., Straus, M. Horticulture as therapy: Principles and practice 19 97 Guide T ABLE 1. Horticultural Therapy Re sources Stress and Trauma To understand how early life stress and trauma affect the brain and it s ability to moderate the stress response, resources on stress and trauma as they realate to brain modification wer e gathered. Studies include evaluation of brain volume modificatin of the the emotional processing center of the brain as a result of post traumatic stress disorder in children (Carrion et al., 20017) and how this might affect memory recollection and proce ssing during stressful or

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5 triggering events (Van der Kolk, 2014) and what treatments are ap propriate (Ogden et al., 2 006). For a select list of resourc es see Table 2. AUTHOR TITLE DATE TYPE Carrion, V. G., Weems, C. F., Reiss, A. L. Stress predicts brain changes in children: a pilot longitudinal study on youth stress, posttraumatic stress disorder, and the hippocampus 2007 Study Kahn, G. B., Aronson, S. Group treatment for traumatized adolescents: Special considerations 2007 Case Study Ogden, P., Minto n, K., Pain, C. Trauma and the body: A sensorimotor approach to psychotherapy ( Norton series on interpersonal neurobiology) 2006 Guide Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., Vigilante, D. Childhood trauma, the neurobiology of adaptati 1995 Study Teicher, M. H., Andersen, S. L., Polcari, A., An derson, C. M., Navalta, C. P., Kim, D. M. The neurobiological consequences of early stress and childhood maltreatment 2003 Study Van der Kolk, B. The body keeps the score: Mind, brain and body in the transformation of trauma 2011 Reference Van der Kolk, B Traumatic stress: The effects of overwhelming experience on mind, body, and society 2012 Reference TABLE 2. Stre ss and Trauma Resouces N euroscience Literature on how the brain is functionally modified as a result of stress and trauma encountered in life ( Ravi, B., Kannan, M., 2013) (Roth, 2012), and how this can affect longitudinal behavioral outcomes Pittenger, C ., & Duman, R. S., 2008) was evaluated and compared with literature on how the brain is plastic and able to heal itself by building new neuronal connections (Gomez Pinilla et al., 2002) These studies were then compared to literature and theories that draw on nature based activities ( Koga, K., Iwasaki, Y., 2013), ( Kaplan, S., Berman, M., 2010), and theories that identify abilities to form healthy relationships or attachments from a psychology perspective (Bowlby, 1979) This thesis integrates these data and theories with how this information can be used to generate new methods of stress reduction in a constructed landscape ( Van Den Berg, A. E., Custers, 2010) For a select list of resour ces see Table 3

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6 AUTHOR TITLE DATE TYPE Bowlby Attachment Theory and i ts Therapeutic Implications 19 79 Theory Giedd, J. N. The amazing teen brain 2015 Reference Gmez Pinilla, F. et al. Voluntary exercise induces a BDNF mediated mechanism that promotes neuroplasticity 2002 Study Kaplan, S., Berman, M. Directed attention as a common resource for executive functioning and self regulation 2010 Study Koga, K., Iwasaki, Y. Psychological and physiological effect in humans of touching plant foliage using the semantic differential method and cerebral activity as indicators 2013 Study Lane, S. J., Schaaf, R. C Examining the neuroscience evidence for sensory driven neuroplasticity: implications for sensory based occupational therapy for children and adolescents 20 02 Review/Report Pearce, J. W., Pezzot Pearce, T. D. Attachment theory and its implications for psychotherapy with maltreated children 1994 Theory Pittenger, C., Duman, R. S. Stress, depression, and neuroplasticity: a convergence of mechanisms 2008 Review Ravi, B., Kannan, M. Epigenetics in the nervous system: an ov erview of its essential role. Indian journal of human genetics 2013 Study Roth, T. L. Epigenetics of neurobiology and behavior during development and adulthood. 2012 Study Siegel, D. J. The developing mind: How relationships and the brain interact to sha pe who we are 2015 Resource Van Den Berg, A. E., Custers Gardening promotes neuroendocrine and affective restoration from stress 2010 Study T ABLE 3. Neuroscience References N ature In order to connect the literature on brain modifications as a result of stress and trauma with therapeutic interventions that take place in a garden setting it is necessary to evaluate wether this environment is optimal for this kind of intervention. Literature was reviewed on theories relating to the innate ability of natu re to reduce stress, such as attention restoration theory (Berman et al,. 2008), stress reduction theory (Ulrich R. S., 1991), and the scientific mechanims that demonstrate the effectiveness of nature in reducing stress markers (Bratman, et al., 2015). For a select list of resour ces see Table 4.

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7 AUTHOR TITLE DATE TYPE Berman, M. G., Jonides, J., Kaplan, S. The cognitive benefits of interacting with nature 2008 Study Bratman, G. N., et al. Nature experience reduces rumination and subgenual prefrontal c ortex activation 2015 Study Chawla, L. Benefits of nature contact for children 2015 Review Grinde, Bjrn, Patil Biophilia: does visual contact with nature impact on health and well being? 2009 Study Kahn, P. H., Jr., Kellert, S. R. Children and nature: Psychological, sociocultural, and evolutionary investigations 2002 Resource Kaplan, S. The restorative benefits of nature: Toward an integrative framework 1995 Theory Louv, R. Last child in the woods: Saving our children from nature deficit disorder 2008 Resource Louv, R. The nature principle: Human restoration and the end of nature deficit disorder 2012 Resource Louv, R. Vitamin N: The Essential Guide to a Nature Rich Life 2016 Resource Selhub, E. M., Logan, A. C Your brain on nature: The science of n ature's influence on your health, happiness and vitality 2012 Resource Sakallaris, B. R., et al. Optimal healing environments 2015 Review Ulrich, R. S. View through a window may influence recovery 1984 Study Ulrich, R. S. et al. Stress recovery during e xposure to natural and urban environments 1991 Theory Ulrich, R. S. 1979 Study TABLE 4. Nature References Continued Landscape and Plants Effective application and incorporation of design principle s relevant to providing enviroments that can actively be used in supporting vi ctims of trauma involves understanding where the curren landscape architecture field is in addres ssing this topic. Currently there is a building of healthy communities mov e ment that focuses more closely on social connectivity of marginalized populations an d identifying the innate restorative abilities being in a green space and feeling connected or having an identity to it (Anguelovski, 2013) T here is little literature on public space and physically using the space as a means of emotional well being. Resou rces in the landscape literature are avaiable as guides for how to use plants effectively as design elements in a space (Moore, 1993). There are also resources that advocate for evidence based design for sensitive populations and how to accomodate their sa fty needs ( Marcus, Sachs, 2013). For a select list of resour ces see Table 5.

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8 T ABLE 5 Landscape and Plant References G arden Design in Learning Environments The following resources are applicable to the design of a school yard and address how children learn best in a school environment. The g arden design in this thesis is for a child development center and an elemtary school, thus this garden will serve children from birth through 5th grade. The garden will not only provide therapeutic services but will also provide space for educational enric hment and space to enchance classroom curriculum already in place. For a select list of resour ces see Table 6. AUTHOR TITLE DATE TYPE Anguelovski, I. New directions in urban environmental justice rebuilding community, addressing trauma, and remaking place 2013 Review/Report Chamovitz, D. What a plant knows: A field guide to the senses of your garden and beyond 2012 Resource Church, T. D., Hall, G. M., Laurie M. Gardens are for People 1995 Resource Cosco, N. G., Moore, R. C., Islam, M. Z. Behavior mapping: a method for linking preschool physical activity and outdoor design 2010 Study Eckbo, G. Landscape for living 1950 Resource Hickman, C. The picturesque at Brislington House, Bristol: The role of landscape in relation to the treatment of mental illness in the early nineteenth century a sylum 2005 Resource Hirschfeld Theory of garden art 2001 Resource Hopper, L. J. Landscape architectural graphic standards 2012 Resource/Guide Jackson, L. E. The relationship of urban design to human health and condition 2008 Study Jekyll, G. Children a nd gardens 1908 Resource Jekyll, G. Colour Scheme in the Flower Garden 1908 Resource Jekyll, G. Wood and garden: Notes and thoughts, practical and critical, of a working amateur 1904 Resource Marcus, C. C., Sachs, Therapeutic landscapes: An evidence bas ed approach to designing healing gardens and restorative outdoor spaces 2013 Resource/Guide Moore, Robin C. Childhood's domain: play and place in child development 1990 Resource Moore, Robin C. Plants for Play: A Plant Selection Guide for Children's Outd oor Environments 1993 Resource/Guide

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9 AUTHOR TITLE DATE TYPE Alexander, J., North, M. W., Hendren, D. K. Master gardener classroom garden project: An evaluation of the benefits t o children 1995 Case Study Carey, B. How We Learn: The Surprising Truth about When, Where and Why it Happens 2014 Resource Frumkin, H., Geller, R. J., Nodvin, J Safe and healthy school environments 2006 Resource Kohlberg, L., Mayer, R. Development as th e aim of education 1972 Resource Moore, R., Cosco, N. Greening Montessori school grounds by design 2007 Resource Moore, R., Wong, H. Natural Learning: The Life of an Environmental Schoolyard. Creating Environments for Rediscovering Nature's Way of Teach ing 1997 Resource Robinson, C. W., Zajicek, J. M. Growing minds: The effects of a one year school garden program on six constructs of life skills of elementary school children 2005 Case Study T ABLE 6 Garden Design in Learning Environments References

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10 CHAPTER I I I LANDSCAPE ARCHITECTURE AND NEUROPLASTICITY: A ROLE FOR DESIGN IN ADDRESSING THE IMPACT OF EARLY CHILDHOOD TRAUMA 1 Introduction There is little argument that exposure to nature is restorative and beneficial to human health and that time spent in nature is decreasing as children are granted less time to play at recess during school ho urs and are spending more time interacting with technology. As landscape architects, we design for human health and wellbeing and understand the importance of mindfulness and being in the present moment within a nature setting. However, we can take the con cept of emotional and physical health further to acknowledge and humanize both common and uncommon traumas. By applying recent research on brain mechanics, we can better understand the functions of our own brain structure and thus develop tools to cope wit h all manners of trauma, from minor daily occurrences to life altering experiences. Landscape architects are familiar with the concept of process; if we expand our vocabulary to include the iterative process of brain formation and modification, we can bett er understand how the environments we design can contribute to the process of healing. We can accomplish this expansion through open communication with mental health practitioners and therapists and occupational therapists as we generate spaces that suit t he needs of trauma victims. Such collaboration will generate engaging spaces that will instill a bond with the site and develop healthy connections within the brain. Current Research on Trauma and how it Affects the Brain Adverse childhood experience stud ies have been conducted over the last 20 years by the Centers for Disease Control and Prevention. These studies indicate that early childhood 1 T his c h a p t e r w as submitted f o r p r e s e n t a t i o n a t t h e C o u n c i l f o r E d u c a t o r s i n L a n s c a p e A r c h i t e c t u r e C o n f e r e n c e i n B e i j i n g C h i n a M a y 2 0 1 7 a n d f o r p u b l i c a t i o n i n Landscape Research Record 06 a n d i s ex pected to be p ublished online December 2017

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11 experiences with trauma adversely affect a person's health later in life (Aces Study, 2016). Separate studies, dis cussed in the sections following, have shown that adverse physical modifications of the brain can result from early life stress and trauma. Emergent studies in thus promoting the formation of positive brain connections, even later in life. Armed with these studies, therapists can aim specific interventions toward the underlying structural causes of emotional and behavioral disorders, to include interventions that utilize horticultural therapies. These therapies rely on thoughtfully designed spaces created by informed landscape architects. Effect of Trauma on Cognition and Memory and How the Brain is Modified The examination of epigenetic mechanisms has revealed that early life traumas have long term effects on the brain that affect adulthood cognitive processes. These events cause functional changes in gene expression leading to specific behavioral outcomes such as adult learning and memory, drug addiction, and s everal psychological and neurological illnesses. These developmental changes in neurobiology and behavior can have long lasting effects, indicated that epigenetic modifications of genes in the hippocampus are a direct result of (the quality of) maternal care received in infancy and are associated with the stress response. Put g to depressive behaviors. This study also demonstrated that these resulting depressive behaviors were in turn transferred to the offspring despite not encountering the same stressors in infancy (Roth, 2012). This finding suggests that even though the offs pring did not encounter early maltreatment, the neurological markers have been passed on to them and they will have emotional and behavioral outcomes as though they had. It can be fairly extrapolated then, that humans who experience gene modifying trauma o r neglect that manifests in adverse behavioral outcomes can pass these behaviors on to their offspring, even when provided a nurturing and supportive environment. The implications of trauma do not only affect an individual but can

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12 also genetically affect t heir children and this speaks to the importance of providing therapeutic interventions for all trauma victims. Early life experiences leave epigenetic markers that determine behavior and have long lasting effects on brain development and the capacity of i ndividuals to respond to stress later in life. Epigenetic modifications affect synaptic plasticity, which is fundamental for learning and memory. Modifications that disrupt synaptic plasticity lead to depression of memory related genes, affecting memory fo rmation. Structural plasticity can also be affected. The adult neurogenesis paradigm states that neurogenesis occurs in two areas of the brain, both located in the hippocampus (Ravi & Kannan, 2013). A pilot study was conducted with child participants who h ad a history of maltreatment and had undergone clinical evaluation for post traumatic stress disorder (PTSD). PTSD for this study was characterized by intrusive recollections of traumatic events and difficulties with emotional regulation. Hippocampal volum es have been shown to be reduced in size in adults with PTSD. The hippocampus plays a functional role in memory processing and is part of the limbic system, where emotions are registered in the brain. Hippocampal volumes were measured at the start of the study and again 12 18 months later. Cortisol levels were also collected at the start of the study. The study theorized that adult hippocampal volumes were reduced because of prolonged exposure to neurotoxic levels of cortisol secreted during chronic stress The results showed that the severity of PTSD symptoms and cortisol levels predicted a reduction in hippocampal volumes 12 18 months later (Carrion et al., 2007). This study indicates that stress is associated with a reduction in hippocampal volume, which may be responsible for traumatic memory processing and reccollection. To process a traumatic event, the prefrontal cortex must be stimulated. The prefrontal cortex is the part of the brain that processes information and imagines scenarios to determine th e perception of threats. After traumatic experiences, there is a need for the body to learn that the trauma inducing danger has passed completely and for the brain to l ive in the present when

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13 faced with a triggering event. After the experience of a trauma, the body releases stress hormones that affects the brain and its ability to process the event. This results in a living memory and the physical response to being stuck in fight or flight mode. To overcome these experiences, Van der Kolk suggests there is a need for patients to develop a sense of the body and agency; in other words, being in charge of their own life. When traumatic memories are reactivated, imaging studi es have shown that the frontal lobe, containing the prefrontal cortex, shuts down and the limbic region remains activated, resulting in the region of the brain that drives emotions taking over. To aid in recovery, the prefrontal cortex must be activated to stimulate the brain to process feelings. Activation of the parasympathetic nervous system slows down the body and the physical response. Body awareness and physical sensations allow the body to organize emotions (Van der Kolk, 2014). This suggests that tr auma manifests itself in both the brain and body, and it is necessary to stimulate both for an effective therapeutic intervention. Additionally, cognitive and emotional development in the brains of adolescents does not occur simultaneously. Recent research has found that development of the limbic system intensifies at puberty while the region of the brain that controls impulses and cognitive maturation, the prefrontal cortex, occurs in the mid twenties (Giedd, 2015). This suggests that finding a way to stim ulate the prefrontal cortex along with the limbic brain is especially important in youth. Therapeutic activities that include moving the body and being aware of sensations in a garden setting are particularly effective components of this therapeutic modal ity. Many garden activities, such as raking or shoveling, consist of full body movements that can activate proprioception, a sense of where the body is in space, and encourage the participant to become aware of sensations in her body. By providing spaces w ith ample room for range of motion activities, like jumping and climbing, and for reflection on these activities, landscape architects can design a space to facilitate an entire therapeutic session.

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14 Current Research on Brain Resiliency This section will outline the ways in which the brain can be healed through mechanisms of neuroplasticity essentially, rewiring the brain to build healthy connections which will allow therapists to develop more targeted and effective interventions. With somatic (body moveme nt) based therapeutic interventions, therapists can help the client to stimulate the activation of the prefrontal cortex to process the experiences of the trauma encountered. Sensory gardens are ideal settings where these kinds of activities can take place though it is essential to cultivate an environment that feels safe and secure because the client may be in a vulnerable emotional state when recalling or even reliving these experiences. Sensorimotor Processing One avenue for treatment of trauma is to develop somatic resources for processing traumatic memories that combine the awareness of being in the present moment while experiencing physical symptoms of trauma. Sensorimotor processing focuses on maintaining an optimal zone of arousal during the trig gering of a traumatic memory or experience. For people who have past experiences with stress and trauma, the zone of arousal is small, and thus it is easy to be in a high or low arousal state and unable to feel calm or secure when triggered. Attachment the ories, discussed in section 5.3, explain that these problematic states are related to how the subject was nurtured as a child and subsequently how they learned to cope with cally altered by stressors and the self regulating part of the brain, the prefrontal cortex, is unable to function properly. Ogden advocates for sensorimotor interventions that can address these habitual tendencies of activating the fight or flight respons e. Further, such interventions train the brain with building new patterns of response that can replace the inadequate coping response to stressors. Additionally, interventions can help the brain and the body to be aware of triggering events by recognizing reflexive orienting tendencies can better handle overstimulation and triggering events. The goal

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15 is to organize experiences and develop skills for working with the body in the present t ime and Resiliency to Rebuild Neural Connections Neuroplasticity is the ability of the brain to build new neural connections. In a review article, Pittenger & Duman indicate that stress and depression are observed to negatively affect neuroplasticity. Stress and depression affect the ability of the prefrontal cortex to regulate concentration, attention, and the ability of the hippocampus to process memories. The size and volume of these two brain regions were observed as smaller in those with depression and experience chronic stress. The hippocampus is responsible for dysregulation of the stress response. If this region of the brain is disrupted, the stress response ca nnot be turned off; residual cortisol is released as a result of stressors and further damages the hippocampus. Damage to this region affects attention and behavioral tasks, altering mechanisms of neuroplasticity that are functionally abnormal in major dep ression. This review indicates that there are overlapping mechanisms of synaptic plasticity in those who have depression that affects the formation of new neurons (Pittenger & Duman, 2008). Considering these implications, it is reasonable to suggest that t rauma could be a factor in the stress and depression response and somatic interventions, such as those available in a garden designed to facilitate this healing process, could be employed in a therapeutic plan. Siegel discusses how early experiences shape synaptic growth for the regulation of the response to stress (2015). He indicates that a lack of experiences, good or bad, leads to the decrease in synaptic connections in the brain and that a subsequent pruning of connections occurs. This is akin to a us e it or lose it principal for reinforcing experiences. Given this, it is reasonable to assume that as the associated neural pathways are pruned, positive behaviors can be reinforced and repeated to build more neural connections and unfavorable behaviors ca n therefore be reduced. Animal models indicate that exercise can increase connections within the hippocampus and that experiences increase the creation of new neuron activity and neuron

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16 development. This can form new linkages and strengthen existing ones. Siegel also suggests that experiences can induce epigenetic modifications. This indicates a cycle in which behavior alters genetic expression and regulation that shapes neuronal connecting and their firing patterns, and such alterations in turn influence a change in behavior (ibid.). Mouse models have indicated that voluntary physical activity upregulates genes associated with neuronal plasticity in the spinal cord and skeletal muscle (Gomez Pinilla et al., 2002). The requirement that this physical activity be voluntary has deep implications for therapeutic garden design, particularly in the case of children, and suggests that physical activity is a needed activity in healthy brain development. The ability of the brain to rebuild neural pathways and create new neural pathways to promote desired behaviors and coping skills has clear implications and relevance to horticultural therapy. There are many plant and garden based activities that can have repetitive or repeatable actions that reinforce behaviors and neural pathway generation while at the same time processing and integrating a new coping mechanism in response to the memory of a traumatic event. Learning a new skill and practicing it for reinforcement takes significant time and can be a frustrating. Thu s, the environment where this activity is taking place matters. The client performing these repetitive exercises must feel safe, secure, and comfortable while in a possible state of vulnerability. It is necessary to allow there to be room to pause and reen gage when ready. By understanding the types of activities needed and understanding circulation patterns and materials conducive to this kind of therapeutic healing, the landscape architect can design spaces that can best accommodate a range of activities m ade with materials to achieve desired activities. Theories and Paradigms This section addresses theories and paradigms that affect those who have experienced trauma early in life. This section also addresses theories and paradigms that affect our present conditions and access to nature, and how nature is relevant in emotional health and well being.

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17 This section discusses inadequate access to nature, active interaction with green environments, and how that may have adverse effects on physical and emotional wellbeing. Disconnect to Nature Paradigm The paradigm that children are spending less time outdoors and instead are spending their time indoors with an increase in time with technology is having adverse effects on health has been covered extensively in re cent years (Selhub & Logan, 2012), (Louv, 2008; Louv, 2012; Louv, 2016). In a review of ecotherapeutic applications from nature based therapies in healthcare settings to animal assisted therapy to horticultural therapy and outdoor restoration, Chalquist cl aims that there is a lack of rigorous academic research on these therapies because of funded, Chalquist claims research is only funded if it serves to support med ical studies rather than challenge them with more cost effective treatment modalities. The studies that support using nature based modalities report that people are increasingly disconnected from the natural world; such disconnection increases psychologica l symptoms of anxiety, frustrations, and depression. Chalquist argues for the need to reconnect to the natural world to alleviate these symptoms and increase the capacity for health, self esteem, self relatedness, social connections, and joy. That reconnec tion works across treatment modalities to replace a pathological sense of alienation of self, others, and world and to rekindle enjoyment of relatedness to self, others, and the world (Chalquist, 2009). Chawla has reviewed relevant literature on providing access to nature to children from the 1970s to the present. Over the years, children have been provided with less time to access nature, particularly in urban environments. Children learn about themselves and develop self awareness through interactions wit h their environment, and Chawla argues that playful interactions with natural materials can develop creative intelligence. Chawla reports that in one study from Europe, students that attend schools with quality green spaces showed a decrease in stress and have better outcomes for sleep and higher health rates. Another study in Germany looked at urban 10 year old children who lived in green areas had lower

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18 blood pressure measurements that children who did not live in green areas. Similarly, in Austria, stude nts had decreased blood pressure levels than students at other schools after a schoolyard laboratory. One study indicated that female teenagers performed better on conc entration, control of impulsivity, and delay of gratification when their apartment had green views. Chawla argues that this implies that quality green space should be provided where children live, play, and learn. That access to primary health care service s should be where people inhabit (Chawla, 2015). Kahn and Kellert discuss the importance of intuitive ways of explaining how children understand living things through animism, distinguishing living things from nonliving things, and understanding themselves as human. Structural constructivist developmental theory discusses how interactions with physical and social environment allows children to construct conceptual understandings and to solve problems and explore (Kahn & Kellert, 2002). Sensory Integration T heory Sensory Integration Theory was founded by A.J. Ayres, based on her understanding of neurobiology and her work as an occupational therapist (Roley, 2007). Occupational therapy activities can be achieved in a garden setting while creating sensory exp eriences with plants and plant based activities. Children who have experienced trauma have a decreased ability to produce healthy adaptive responses to stress (Perry, 1995) and are likely to have behavioral problems (Teicher, 2003). Lane and Schaaf reviewe d the sensory integration literature on neuroplasticity and found it to be an effective application for children with difficulty integrating and processing sensory stimuli through mechanisms of neuroplasticity. Additionally, they found support for neuropla indicated that changes in neuronal function and structure were linked to neural modifications from direct sensory input (Lane & Schaaf, 2010). Because sensory integration and proces sing is linked to neuroplasticity, it is important that the space where these therapeutic interventions are taking place have adequate sensory support. This can be achieved through thoughtful planning,

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19 ensuring that, for example, plants have a variety of t extures ranging from soft to spikey, and thoughtful consideration of materials in the space that vary in tactile sensations, such as being smooth or cool to the touch. Attachment Theory Attachment theory examines the behavior between an individual and a caretaker. In a secure attachment relationship, the individual feels comfortable to explore her environment without becoming frightened because the presence of the attachment figure provides security that the individual can return to. If this relationship is not supportive of exploration and does not provide a secure base point, the individual may develop adverse emotional health affects (Bowlby, 1979). This scenario could be a result of stress or trauma experienced by either the individual herself or the a ttachment figure projecting her experiences onto the individual, which adversely impacts the relationship. In the case of children who have experienced trauma in the form of abuse, they require multiple positive experiences to disrupt the trajectory of unf avorable experiences (Pearce & Pezzot Pearce, 1994). This suggests that there is repetition required to create positive experiences and supports the mechanisms of neuroplasticity and building new neural pathways through repetition and active cultivation of new patterns. In a therapeutic session, this can be a somatic activity that looks like the repetitive process of pulling weeds or the repetitive motion of digging. Attention Restoration Theory Attention restoration theory separates attention into two com ponents: involuntary attention, attention that is inherently intriguing with stimuli, and voluntary (or directed) attention. The latter is attention that is directed by cognitive control processes and resolves conflicts and suppresses distracting stimulati on. Kaplan argues in favor of attention restoration theory and claims that directed attention fatigue occurs when there is mental exhaustion because of intense prolonged directed attention. Kaplan performed studies that hypothesize that restorative experie nces or environments are defined by opportunities for reflection which

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20 Kaplan calls soft fascination. This soft fascination allows for a mental rest from directed attention. Characteristics of restorative environments include a sense of being away (from ha environment, and the purpose and inclinations for being in the space. Furthermore, restorative environments provide an interest in what the individual is seeking (Kaplan, 1995). It is posited that interactions with nature increase attention and memory in contrast to directed attention and be improved. Two experiments were pe rformed to test this hypothesis. Both experiments measured the levels of stress and cognitive abilities by administering a cognitive performance task and a self reported mood survey. The participants were divided into groups that took either a walk in natu re or in the city then viewed pictures of nature or cityscapes, concurrent with where their walk occurred. Then the same stress task and mood assessment were administered. In both assessments, the activity involving nature stimuli resulted in a higher perf ormance on the stress task. The completion of tasks were measured, the tasks measured different kinds of attention functioning; alerting, orienting, and executive function after the walk or picture viewing. It was hypothesized that only the executive funct ion would be affected because it requires more cognitive control. This hypothesis was supported by the results of the experiment (Berman et al., 2008). This study has been expanded upon by Bratman, et al., who found similar self reported affect improved by a walk in a natural environment, though their data did not support an increase in cognitive tasks (Bratman et al., 2015). These data indicate that experiencing nature, by direct experience with nature or simply viewing nature, can lower a response. This paper posits that in addition to exposure to nature, substantial benefits can be gained from immersive interactions with nature. Stress Reduction Theory The architect Roger Ulrich has published numerous studies indicating that viewing natur e has positive impacts on health and wellbeing, from reducing lengths in hospital stays to a

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21 decrease in pain reporting and a reduced duration of healing time (Ulrich, 1984). Ulrich has also written on the stress reduction or psycho evolutionary theory, pr oducing studies that indicate the stress response is lowered when participants viewed scenes from nature. Ulrich claims that this achieved by involuntary attenti on. Ulrich recorded high levels of involuntary attention in participants when they viewed both nature and stressor films. The nature scenes reportedly resulted in participants having a more positive affect, positive physiological markers, and sustained att ention (Ulrich, 1991; Ulrich, 1979). This study indicates that while participants watch films that were perceived as stressful or relaxing, they were measured as exerting the same amount of attention while experiencing a decrease in their stress response w hen viewing a nature scene. These theories and paradigms indicate a growing need to create environments and experiences for children and adults to interact with nature. For children in developmental years, exposure to nature is vital to cognitive developm ent and learning to cope with life experiences. The mind has an ability to learn and recharge at the same time while being exposed to sensory experiences. As landscape architects, we have a responsibility to create these experiences for people at instituti ons, at work or school, and in the public realm providing safe and enjoyable commutes and spaces to escape to particularly in urban areas. Horticultural Therapy It is important to distinguish between horticultural therapy and therapeutic horticulture. The term horticultural therapy refers to a treatment plan with established goals while therapeutic horticulture utilizes horticultural therapy techniques without necessarily measuring outcomes. The American Horticultural Therapy Association (AHTA) defines hor engagement of a client in horticultural activities facilitated by a trained therapist to achieve plant related activities through which participants

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22 strive to improve their well horticulture program, goals are not clinically defined and documented, but the leader will have training in the programmed activities, features modified to include accessibility, well defined perimeters, a pro fusion of plant and plant activities, benign and supportive conditions, universal design, and be expanded upon when designing gardens for horticultural therapy or therapeutic horticulture. For the purposes of this paper and finding design direction in the medical literature described above, we will refer to both horticultural therapy and therapeutic horticulture as horticultural therapy. Further, it is our argument that the following design interventions are also applicable and in fact beneficial to public environments with no organized therapy supervision. Horticultural therapy is a relatively new field. The first book on horticultural therapy was published in 1 960 by Alice Burlingame, who was trained in psychiatric work, occupational therapy, landscape architecture, and greenhouse production. The first undergraduate degree program for horticultural therapy in the United States was in the Horticulture Department at Kansas State University; currently they offer a certificate program in horticultural therapy. The AHTA, a 501(c)3 nonprofit organization, was established in 1988 and currently has approximately 900 members. Only approximately 300 individuals are profess ionally registered supported by horticultural therapy services include persons experiencing or who have experienced abuse or neglect, persons with intellectual disabil ities, those in assisted living facilities, persons with vision or hearing impairments, and persons undergoing physical rehabilitation. Horticultural therapy programs are also established in prisoner populations that provide vocational training for partici pants to help red uce the rate of recidivism (Jil er, 2006).

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23 Utilizing horticultural therapy is a non threatening way to provide a therapeutic service. The patient and therapist are not meeting in a sterile environment with a series of questions or checklis ts to review; instead, a rapport is built between the two in a comfortable and interactive environment. This allows the client to build a supportive relationship to develop nurturing skills. Cultivation of horticultural skills as a vocational modality of h orticultural therapy can be beneficial to youth who have experienced the kind of stress or traumas that can put them at behavioral risk. Engaging in this modality has been shown to improve behaviors and attitudes, development of job related skills, cultiva te a positive attitude about the learning process, and instill a sense of self worth and self efficacy (Bradley, 2008). Horticulture therapy has the potential to enhance therapeutic outcomes when combined with traditional talk therapy modalities. In the ca se of persons who suffer from posttraumatic stress, engaging these two modalities can help a patient work through the trauma physically and emotionally. An example of how to do this includes addressing the trauma with a gardening activity, then visualizing a safe space next, cognitively reframing the safe space and the gardening activity while recalling a traumatic incident, and maintaining imagery of the garden space with the therapist. Combining talk therapy with physical movement can work to empower a pa tient to deconstruct past experiences and construct new experiences as well as reconstruct the narrative that affected the behavioral sequence (Lorber, 2011). Both the imagery of a safe space and the physical movement within that space have implications f or landscape architectural design goals. When combined with conventional therapies, horticultural therapy can help to increase self esteem, enhance social skills, and help adolescents to develop physically, emotionally, intellectually, and psychologically (Keeley, 1999). The distinction in development of brain regions as mentioned in section 3.1 can lead to new therapeutic approaches in reaching adolescents who have experienced trauma. There are circumstances where talk therapy alone is unsuccessful becaus e the prefrontal cortex is not developed enough to be fully receptive to that modality of therapy. Traumatic events are not only experienced emotionally but also felt

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24 physically. For example, children who have witnessed domestic violence often have a decli ne in their sense of trust in adults because of the unpredictable nature of when these events might occur, as well as a decline in trust in their own body because of the physical symptoms of trauma that manifest. Non talk therapy modalities can help allevi ate emotional and physical trauma by activating the prefrontal cortex along with the limbic system (LaRocque, 2015). As adolescents are reaching puberty, the disconnect in development of the emotional and cognitive regions of the brain is growing. Horticul tural therapy can be used to mitigate this disconnect (Farilla, 2015). In children without impairments, typical developmental benchmarks are; an interest in self development toward an interest in others, developing language and social behavior, developing a sense of will and intentionality, problem solving, and creating solutions. These benchmarks can become skewed in children who have experienced significant trauma or behavioral or developmental disabilities (Fried, 2015). Plant base d T herapies Associated with Increased A bilities to Cope with S tress Researchers have analyzed physiological effects of touching plants by monitoring change in cerebral blood flow, an indicator of central nervous system activity in the prefrontal cortex. They found that when par ticipants actively touched leaves they experienced an unconscious calming response (Koga & Iwasaki, 2013). This study indicates that the processing region of the brain is activated when touching natural materials. To offer an anecdotal example of a program with the objective to provide exposure to horticulture and plant science, a broad range of group activities were offered throughout the day. Morning sessions consisted a general exposure to horticulture. Afternoon session consisted of activities that offe red hands on activities to teach can be learned in school; to offer enrichment activities; and to allow the groups of gifted and talented students and special needs children to be integrated into enrichment activities. Success of the program was indicated by observations of a sparked enthusiasm for training and learning through hands on activities (Airhart, 1988). This example suggests that the program was

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25 succe ssful because the facilitators were able to observe an interest of the students by their willingness to participate. Often the ability for an activity to entice a child to participate is valuable, especially in children who are under responsive to stimuli. At a stress rehabilitation center, five horticultural therapists were interviewed to determine what they as caregivers perceived to be most significant factors of stress recovery. The team consisted of a gardener, a curative teacher, an occupational the rapist, a physical therapist, and a psychotherapist. Through individual and group interviews, three main themes emerged in terms of stress rehabilitation: 1) sensory impressions; 2) allowing the participants to be more open and willing to engage while bein g in natural environments for activities; and 3) identifying with the space. Participants in this program choose places in the garden to cultivate a sense of belonging, identity, ownership, and could choose where in the garden they wanted to engage. Intera ctions between concrete and symbolic activities created space for the participant to perform cause and effect activities, to perform a task and see a result, which then allowed for applying a symbolic understanding to their personal life (Adevi, & Lieberg 2012). It was hypothesized that a gardening activity that paired exercise with contact with nature would be more effective in promoting stress relief than a control activity of indoor reading. A stress inducing task was performed by participants with their levels of cortisol measured at multiple points before, during, and after the stress relieving activity and the control activity. The study found that cortisol levels were significantly increased after the stressful task. The cortisol levels in the partici pants significantly decreased in both the gardening activity and the control activity, though it was observed that there was a greater reduction of cortisol levels with participants who engaged in the garden activity. Mood was also measured, which showed s imilar patterns to the cortisol levels. (Van Den Berg et al., 2010). This study provides evidence that integrating physical activity with plant based activities is a viable method to reduce makers of stress within the body. By incorporating a somatic activ ity, the body is able to increase its stress relief response.

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26 Landscape Architecture Design Practice In order to effectively provide horticultural therapy services, safe and secure spaces are necessary. These spaces need to be thoughtfully constructed so that they do not make people feel enclosed or trapped, provide opportunities for fine motor skill development and practice, and accommodate a wide range of motion. Examples of spatial categories include private and public, active and passive, and challeng ing and secure. While the specifics of this capacity are largely unstudied, there are conclusions we can draw from anecdotal evidence. Private and public spaces will require delineation of space and programmed activities. Clearly demarcated boundaries that allow forward motion are recommended by horticultural therapist Gwenn Fried. These can include pathways, bridges, climbing trees (with low branches), swings, stepping stones, ladders, and diverse terrain. These spaces can provide therapeutic aspects by al lowing users to challenge themselves as they choose how to engage in social activities but also retreat to a space where they can observe what is going on and feel safe and secure until they are ready to reengage as they feel the need. When designing act ive and passive spaces, Fried suggests interactive spaces where children can be stimulated through tactile experiences of plant materials and play. These areas should be clear and intuitive, barrier free, and allow direct contact with the plant material. B y having active and passive spaces, users can choose or be directed to engage physically with gardening activities or simply be present in the garden and passively obtain therapeutic benefits. Challenging spaces offer potential for risk while secure spaces offer opportunity for repetition of physical motion or directed activities. The repetition of movement has demonstrated therapeutic and rehabilitative benefits. Wildlife, such as bees, offers a living aspect of both challenge and security for many adolesc ents. There could also be active engagement with the bees. For example, bee often sleep in flowers, and then wake up and crawl out when their backs are rubbed. Simply observing the bees in their habitat offers passive engagement.

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27 Finally, varying degrees of autonomy. Flexible spaces, where people are, for instance, able turn water on or off, offer graduated amounts of individual oversight. Movable, interactive items offer the opportunity for collective decision making and compromise. By providing routes that introduce challenges personal choice in personal assessment (Fried, 2015). Designing opport unities for increasing sense of self efficacy by having the ability to experience risk can be therapeutic and build self esteem, and this is especially beneficial to populations who have been deprived of control in their lives through their experiences wit h stress and trauma. As an example, in a recent project for children who have trouble with sensory integration and sensory processing, the design strategy was to design regions of space according to different sensory needs as indicated by occupational the rapists on site. Children who are in a high arousal state and are seeking sensory input benefit from full range of motion activities such as jumping, climbing, and moving objects. Sensory stimulation that entices the children to participate will be the de sign strategy provided for children who need to arouse their senses or are sensory under responsive. This could include plantings that attract pollinators to observe or plants with aromas or tactile interest. A calming or soothing environment was recommend ed for children who are over responsive to stimuli. The space should be away from spaces with high activity and allow for a space that feels somewhat enclosed and secure. This space would include materials that are soothing to the touch, soft planting s, an d smooth tactile elements. Resources for Desig ning Therapeutic Gardens Marcus and Sachs provide research that informs design decisions and places an emphasis on evidence based design. They address the fact that the paradigm of randomized control trials th at are the standard for scientific research and vetting is not always able to generate productive research when working with sensitive populations as their needs are ever changing. A consistent theme that is discussed in design elements is giving a sense o f control and choice to each user.

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28 Guidelines and case studies are provided in every section for each type of therapeutic space for different populations (Marcus & Sachs, 2013). Moore has developed a guidebook for designing play environments with plants. T he functions that plants can have in play environments are categorized by play value, seasonal interests, sensory experiences, and the importance of shade. Guidelines are provided to aid in varying texture, size, seasonal interest, fragrance, craft, and cu linary uses of the plant choices. The book also discusses how plants can be design elements to create enclosures and soften transitions between spaces. Moore discusses the roles of plants in creating an identity of the space, directing movement, and progra ming activities through intimate and touchable spaces for children of all abilities. Plant and other natural materials can serve as landmarks and encourage wildlife to be a part of the garden (Moore, 1993). In a graphic standards text, there is a section f or Therapeutic Gardens that provides design guidelines for therapeutic gardens and site elements for restorative and enabling gardens for varying populations (Hopper, 2012). This text breaks down both restorative and enabling site elements for different po pulations they serve, mentioning horticultural therapy as a mechanism to be used in restorative gardens and touches on theoretical principals of the limbic system and finding of how these elements can functionally heal the brain or address stress and trauma specifically. To build upon the guidelines from these resources, we can integrate this information with the research on brain modifications from stress and trauma. With th e evidenced based design elements paired with plants as design elements, we can take these ideas further and work with therapists to prescribe activities to integrate their therapeutic services. Focusing on brain science to distinguigh between different th eraputic needs based on a response to trauma allows one to tailor the environments to particular population needs with how best to help them achieve their therapeutic goals. This information does not currently exist within the literature. It is helpful to understand the types of treatment activities planned for horticultural therapy sessions when discussing design programming requirements for therapeutic sessions.

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29 Session organization and planning should be done together with the designers to fully maximiz e the potential of the space. Generation of these plans includes documenting horticultural therapy interventions with understanding the rationale for their use. A horticultural therapy methods resource book by Haller and Kramer presents types of programs, settings, and goals for establishing a horticultural therapy program including outlining treatment planning; session development; motivation and behavior management techniques; documentation guidelines; practical approaches for wellness; and resources for activity ideas (Haller & Kramer, 2016). The information from session planning will guide the layout of the space, including establishing lines of sight, placement of activity areas, and optimal circulation. C onclusion We are now aware of the longitudinal emotional repercussions of trauma. With the understanding of how brains function and how therapeutic interventions can achieve positive results, genera te designs that actively promote healing. Interactions with purposefully designed landscapes stimulate positive brain activities. Rather than recreate nature to elicit passive healing and restorative on the brain and its ability to heal itself to develop design interventions using natural elements appropriately. In other words, we are not simply recreating nature to provide restorative benefits through passive use, we are providing participants the pot ential for active engagement with landscapes that will support the development of positive neural connections, providing immersive experiences for individuals on their own or through facilitation by trained therapists. In addition, the authors suggest that these design strategies are capable of moving beyond institutionalized facilities to support populations in the public realm, providing opportunities for self care and space to practice therapeutic activities on their own. These landscapes also have the a bility to support immigrants and refugee populations who may not feel safe or supported when seeking health services; with this in mind, these types of healing environments should be made widely available in the public realm.

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30 CHAPTER IV SEWALL CHILD DEVE LOPMENT CENTER Introduction Sewall Child Development center relocated their headquarters to a new location in the Congress Park neighborhood of Denver, Colorado in January 2016. Sewall serves children who have special needs by creating an inclusive learni ng environment by having the children learn along side their typically developing peers. According to the CEO of Sewall approximately 40% of the children at Sewall suffer from toxic stress caused by living in poverty and the associated stressors of their d aily lives. To alleviate these symptoms and provide developmental services Sewall focuses on providing loving relationships where children can find stability The site is a former Waldorf school with a 0.3 acre space on the North East corner of the lot, re ceiving full sun and covered in weeds. The terrain of the site has been elevated on the perimeter creating a bowl shaped. The perimeter of the site was filled with construction materials taken from digg ing out the basement of the shool with the intentions of the previous occupants to build the g rade to make a new parking lot, which was not completed. The garden will be organized around plants designed to stimulate all five senses and encourage hands on multi sensory and social learning. The garden will inte transdisciplinary intervention model and provide a safe, non threatening space of respite for children during crisis interventions. Grant A grant was co authored with Sewall Child Dev Development for the Colorado Garden Found ation 2016 Major Grant Award of $75,000. In January 2017 Dr. Jody Beck, the VP of Development and I presented to the board of directors and were awarded the grant in the full a mo unt on behalf of the center (s ee Appendices A, B, and C for the grant materials generated as part of this thesis for the award ) The grant amount of

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31 $75,000 will be matched by in kind donations of plant materials and services from the Congress Park Communi ty including the neighborhood Green Team and the Denver Botanic Garden. Design Process The sensory garden is designed around addressing the sensory processing and integration needs of both the children with special needs and typically developing children. Occupational therapists at Sewall have identified three zones of arousal that the children typically fall into. Sensory Over Responsive, meaning the children are overly responsive to stimuli and require soothing environments to calm themselves. Sensory Un der Resonsive, meaning the children are disengaged or unresponsive to stimuli and require activities that will entice them to participate. Sensory Seeking children are those who are seeking sensory input and require activities that engage their full bodies such as climbing and jumping. Through designing for three levels of engagment the garden will accomodate the sensory integration needs of all the children served by Sewall. This will be achieved through separate zones of the garden serving primarily one of the three levels of arousal. Within the sensory seeking zone there will be moments of respit where if a child does begin to feel overwhelmed or under responsive they will have an opportunity for self care by moving toward a nearby calming space without feeling like they need to escape or isolate themselves to a calmer zone far from their current space. Understanding that we often move between zones of arousal and will accomodate for that transition. Client Engagement Meetings have been held with stakeho lders of the garden including the CEO of Sewall Child Development Center and the Principal of REACH Elementary Shool, a charter elementary school from prek to fifth grade, that leases space from Sewall. Teachers, therapists, students, and parents have als o attended design de velopment and feedback sessions. Figure 1. represents results from a feedback session where parents, staff, and students were able to vote on elements of a sensory garden that the y liked best. The board shows examples of activities for three

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32 different sensory processing areas that are typically observed in their students There are spaces left intentionally blank to encourage participation in goal generation for what types of experiences and activities users would like to have in the spa ce. Figure 2. is a graphical analysis of the feedback received by sensory processing categories. A functional use diagram was generated to present to staff at Sewall to engage feedback and assess if the feedback received represented the goals of Sewall (Fi gure 3). FIGURE 1. Feedback Session. Dots represent votes

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33 Figure 2. Graphical Representation of feedback session analysis

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34 Figure 3. Functional Use Diagram Design Development To adderss the sesory processing needs of the children through desig n, we are focusing on three areas of sensory processing. The first, sensory o ver responsive children who are overstimulated and require a calm and soothing environment, providing a safe space with passive interaction with nature like bird or butterfly watc hing that creates a sense of autonomy to choose when to re st or engage with their peers. The second, s ensory under responsive, those who have a low perception of sensory stimuli and need help activating their senses. These spaces of the garden would includ e enticing elements to help the children engage with their environment such as interactive musical elements, activities have a cause and effect lesson, or a sensory pathway that challenges their ab ility to navigate their space. Third, sensory s eeking child ren, or those who have high energy and are seeking an outlet. This space will include

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35 programming for high energy, full range of movement activities like climbing or moving heavy objects, allowing the child ren to use their whole bodies. The idea is that on ce the children have the space to learn how to maintain their optimal zone of arousal they will be able to learn self soothing techniques, build healthy coping mechanism, and be in a better frame of mind to engage socially and cooperatively. Parents and s tudents stressed the desire to keep the space feeling like a retreat from the city and rich to explore the perimeter will be buffered by dense plantings. To achieve this, a meadow will add to the wild and less programmed space to encourage exp lorative and imaginative play. Pathways will range in the challenge that they provide, from safe and stable to challenging with sensory stimulation requiring acti ve concentration to traverse. S ome pathways will be undulating to ch allenge proprioception, or the ability to ori ent themselves in their space. Activ e terrain and fort building will be integrated for sensory seeking children who will need to use their whole bodies to climb and navigate through tunnels. Fort building will provide a range of developmental benefi ts including cooperation, compromise, negotiation, offer room for leadership, vulnerability in asking for help to carry a large log, self efficacy, by being able to carry a smaller log on their own, and help in the development of balance. These spaces are visible from the entrances and draw the sensory seeking children into and through the sit e. Soothing and quieter moments will be dispersed throughout the site that allow kids to move between these levels of arousal when they need to. They will be near acti ve spaces to allow for a s elf determined break that does no t take them out and away from their peers but allows them to recharge and choose when to reengage. For those kids who are overstimulated and not ready to be outside or enter the space there are ca lm moments at the entrance that allow them to survey the space and choose where they want to go and what to engage with. They can go near the active zon es and watch from the side and test themselves with their level of engagement with a safe place to retre at to, or they can stay along the perimeter and explore spaces like the sensory and music walk on their own.

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50 Plant Selection An environmentally responsible plant palette, which requires minimal maintenance in our semi arid climate, will be carefully selected to provide year round seasonal interest for active engagement. The plant palete maintenance plan will be generated through a collaborative effort between horticultural therapists at Denver Botanic Garden and Mental Health Center of Denver one of whom is a pa rent at REACH Elementary S chool Plants will be chosen on their ability to provide sensory stimulation for therapeutic horticulture activities and children will be exposed to the plants culinary, medicinal, and spiritual prope rties. Plant based activities will play a substantial role in garden programming. Plant materia l will be used to create barriers and transition space between and with different zones of activity. For example, a sensory seeking activity requiring full ran ge of motion can be shoveling. Students will engag e in this activity near se n sory calming plants that can provide aromatic stimulation and aid in a calming effect to help release the energy spent while shoveling, or provide that transition space when movi ng out of the sensory seeking zone of arousal. The plant selections will be water conscious, manageable, and hardy as these kids will be able to h ave access to the entire space. See Table 7 for plant list in progress. TABLE 7. Plant List

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51 TABLE 7. Plant List Continued

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52 Conclusion T he goal through design is to translate these data on brain development and resilency, and employ a new way of thinking toward programming activities and moments and to create a balance of enabling activit y through support and t he introduction of challenges. C onditions of the grant are that the garden is to be completed by March of 2018. We have received tremendous community support to achieve this timeline. The Congress Park Neighborhood Green Team has offered to provide commun ity outreach to welcome this organization to the neighborhood and coordinate the donation of plant materials from community members of that they divide in their home gardens. The horticulturalist s from Denver Botanic Garden, only a few blocks from the site will coordinate horticultural therapy outreach sessions at Sewall to maximize the potential the rapeutic effects of the garden. Horticultural therapy is a therapeutic modality that builds a rapport between the participants and therapists in a garden setti ng that includes performing nurturing activities while allowing the participants to maintain autonomy with what they are able to do, and choose their level of lo After completing the design development documents a written plan will be made to hand off this project to Sewall to ensure the completion of the build this summer and planting scheduled for fall 2017 The Auraria Urban Horticul ture Club, the Congress Park N eighborhood Green Team, and Denver Botanic Garden have graciously volunteered to help with planting the garden, making this truly a community effort. challenges that create a sense of autonomy or self efficacy.

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53 CHAPTER V CO NCLUSION This thesis project has sought to explore the theories and pardigms regarding nature, restoration, and stress reduction and apply them to theories of emotional processing through sensory integration and well being to generate a discourse on funct ionally healing the brain to mitgate the longitundinal effects of trauma. Chapter 2 is a bibliographic reference section highlight s resour ces useful to understan d ing what happens in the brain what can be done with plants to ameliorate these effects, and ho w to design to maximize therapeutic processes Chapter 3 is comprised of a paper that explores the connection between these ideas and principles T his paper w as submitted f o r p r e s e n t a t i o n a t t h e C o u n c i l f o r E d u c a t o r s i n L a n s c a p e A r c h i t e c t u r e C o n f e r e n c e i n B e i j i n g C h i n a M a y 2 0 1 7 a n d f o r p u b l i c a t i o n i n Landscape Research Record 06 a n d i s ex pected to be p ublished online December 2017. Finally, chapter four describesthe design which was generated to practically ap ply what was learned. How do we create s oothing env i r onments beyond receiving passive benefits of being in nature? Through active participation with natural elements we can develop tools such as positive coping mechanisms to apply when we encounter occure nces of stress and trauma in our daily lives. Through moving these therapeutic interventions into the public realm and outside of institutionalized care facilities an identity can be given to communities that reconizes that stress and trau ma affect us all and that we do no t have to hide that aspect of our lives to protect ou r selves or others. Providing an identity to a community to entice returned visits to develop and practice these coping skills will cultivate communities that in the face of stress and trauma will better know how to cope, be resilient, and feel empowered. Further, through understanding and incorporation of the literature on how brains can rebuild themselves with effective theraputic interventions that can take place in gardens, landsca pe architects can provide resouces for self care and management of the stress response.

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54 These design principles can be applied in public spaces that provide equitable access to practice healthy coping mechanisms through interation with plant materials and green environments. This means that landscape architects help provide environments which give agency to those who need help addressing and coping with trauma in their lives. Through engaging in conversations about trauma encountered in our lives w e begin to generate emphathy and find that we are not as alone as we might have believed. This begins to humanize trauma and make it relatable and understandable rather than something that is seen as necessary to hide. Encountering stress and trauma is a part of a ll lives, impacted in a variety of ways. As landscape architects we need to be forward thinking in how we can construct spaces that recognize persons or groups suffering from trauma and how to accomodate t hem For example, there is great potential for com munities to be devastated by rising waters associated with climage change How as landscape architects can we best aid in relocation efforts and give those who undoubte d ly are experi e ncing a traumatic event a sense of iden t ity or belonging after being relo cated? Can we, through landscape instill healthy coping mechanisms and habits through interacting with landscapes?

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55 BIBLIOGRAPHY Aces Study. (2016, April 01). Retrieved October 2016, from ht tps://www.cdc.gov/violenceprevention/acestudy/ Airhart, D. L. (1988). Horticulture Therapy Activities for Exceptional Students. NACTA Journal, 42, 44. Airhart, D. L. (1987). Horticultural Training for Adolescent Special Education Students. Journal of Th erapeutic Horticulture, 2, 17 22. Adevi, A. A., & Lieberg, M. (2012). Stress rehabilitation through garden therapy: A caregiver perspective on factors considered most essential to the recovery process. Urban forestry & urban greening, 11(1), 51 58. Adevi A. A., & Mrtensson, F. (2013). Stress rehabilitation through garden therapy: The garden as a place in the recovery from stress. Urban forestry & urban greening, 12(2), 230 237. Adil, J. R. (1994). Accessible gardening for people with physical disabilit ies: A guide to methods, tools, and plants. Bethesda (MD): Woodbine House. Alexander, J., North, M. W., & Hendren, D. K. (1995). Master gardener classroom garden project: An evaluation of the benefits to children. Children's Environments, 256 263. Angue lovski, I. (2013). New directions in urban environmental justice: rebuilding community, addressing trauma, and remaking place. Journal of Planning Education and Research, 33(2), 160 175. Annerstedt, M., & Whrborg, P. (2011). Nature assisted therapy: Sys tematic review of controlled and observational studies. Scandinavian journal of public health, 1403494810396400. Berman, M. G., Jonides, J., & Kaplan, S. (2008). The cognitive benefits of interacting with nature. Psychological science, 19(12), 1207 1212. Bowlby (1979). Attachment Theory and its Therapeutic Implications. Adolescent psychiatry, 1 32. Bradley, E., Eastman, L., Parsons, A., & Relf, P. (1998). Non traditional, experimental horticultural programs for at risk youth: Part 2 Program and case stud ies. In Towards a new millennium in people plant relationships: Intl, People Plant Symp. Sydney: Univ. Technology, Sydney, Printing Services (pp. 381 383). Bratman, G. N., Hamilton, J. P., Hahn, K. S., Daily, G. C., & Gross, J. J. (2015). Nature experienc e reduces rumination and subgenual prefrontal cortex activation. Proceedings of the national academy of sciences, 112(28), 8567 8572. Bratman, G. N., Daily, G. C., Levy, B. J., & Gross, J. J. (2015). The benefits of nature experience: Improved affect and cognition. Landscape and Urban Planning, 138, 41 50. Bragg, R., Atkins, G. 2016. A review of nature based interventions for mental health care. Natural England Commissioned Reports, Number 204.

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56 Brooks, H. D., & Oppenheim, C. J. (1973). Horticulture as a Therapeutic Aid: By Howard D. Brooks and Charles J. Oppenheim. Institute of Rehabilitation Medicine, New York University Medical Center. Carrion, V. G., Weems, C. F., & Reiss, A. L. (2007). Stress predicts brain changes in children: a pilot longitudinal s tudy on youth stress, posttraumatic stress disorder, and the hippocampus. Pediatrics, 119(3), 509 516. Chalquist, C. (2009). A look at the ecotherapy research evidence. Ecopsychology, 1(2), 64 74. Chamowitz, D. (2012). What a Plant Knows: A Field Guide t o the Senses of Your Garden and beyond. Farrar, Straus & Giroux: Oxford, UK. Chawla, L. (2015). Benefits of nature contact for children. CPL bibliography, 30(4), 433 452. Church, T. D., Hall, G. M., & Laurie, M. (1995). Gardens are for People. Univ of C alifornia Press. Cosco, N. G., Moore, R. C., & Islam, M. Z. (2010). Behavior mapping: a method for linking preschool physical activity and outdoor design. Med Sci Sports Exerc, 42(3), 513 9. Eckbo, G. (1950). Landscape for living. Univ of Massachusetts Press. Definitions and Positions. (2012). Retrieved November 2015, from http://ahta.org/sites/default/files/DefinitionsandPositions.pdf Fundamentals of Horticultural Therapy. Anchor Center for Blind Children, Denver, CO. 30 OCT 2015. Lecture. icate Program. Chicago Botanic Garden, Glencoe, IL. 17 MAY 2015. Lecture. Frumkin, H., Geller, R. J., & Nodvin, J. (Eds.). (2006). Safe and healthy school environments. Oxford University Press. Giedd, J. N. (2015). The amazing teen brain. Scientific Ame rican, 312(6), 32 37. Gmez Pinilla, F., Ying, Z., Roy, R. R., Molteni, R., & Edgerton, V. R. (2002). Voluntary exercise induces a BDNF mediated mechanism that promotes neuroplasticity. Journal of neurophysiology, 88(5), 2187 2195. Grinde, B., & Patil, G G. (2009). Biophilia: does visual contact with nature impact on health and well being?. International journal of environmental research and public health, 6(9), 2332 2343. Haller, R. L. (2016). Horticultural Therapy Methods: Connecting People and Plants in Health Care, Human Services, and Therapeutic Programs. CRC Press. Hickman, C. (2005). The picturesque at Brislington House, Bristol: The role of landscape in relation to the treatment of mental illness in the early nineteenth century asylum. Garden Hi story, 47 60.

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57 Hopper, L. J. (Ed.). (2012). Landscape architectural graphic standards (Vol. 27). John Wiley & Sons. Jackson, L. E. (2003). The relationship of urban design to human health and condition. Landscape and urban planning, 64(4), 191 200. Jek yll, G. (1908). Children and gardens. Offices life', Limited. Jekyll, G. (1908). Colour Scheme in the Flower Garden. Country life", Limited. Jekyll, G. (1904). Wood and garden: Notes and thoughts, practical and critical, of a working amat eur. Longmans, Green and Company. Jiler, J. (2006). Doing time in the garden: Life lessons through prison horticulture. New Village Press. Kahn, G. B., & Aronson, S. (2007). Group treatment for traumatized adolescents: Special considerations. Group, 281 292. Kahn, P. H., & Kellert, S. R. (2002). Children and nature: Psychological, sociocultural, and evolutionary investigations. MIT press. Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of environmental p sychology, 15(3), 169 182. Kaplan, S., & Berman, M. G. (2010). Directed attention as a common resource for executive functioning and self regulation. Perspectives on Psychological Science, 5(1), 43 57. al Therapy with Children Affected by 39. Koga, K., & Iwasaki, Y. (2013). Psychological and physiological effect in humans of touching plant foliage using the semantic d ifferential method and cerebral activity as indicators. Journal of physiological anthropology, 32(1), 1. Kohlberg, L., & Mayer, R. (1972). Development as the aim of education. Harvard educational review, 42(4), 449 496. Lane, S. J., & Schaaf, R. C. (201 0). Examining the neuroscience evidence for sensory driven neuroplasticity: implications for sensory based occupational therapy for children and adolescents. American Journal of Occupational Therapy, 64(3), 375 390. Health Center Denver Dahlia Campus for Health and Well CO. 29 OCT 2015. Lecture. Leading Causes of Death. (2017, January 20). Retrieved April 04, 2017, from https://www.cdc.gov/nchs/fastats/leading causes of death.htm Lorber, H. Z. (2011). The Use of Horticulture in the Treatment of Post Traumatic Stress Disorder in a Private Practice Settin g. Journal of Therapeutic Horticulture, 21(1).

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58 Louv, R. (2008). Last child in the woods: Saving our children from nature deficit disorder. Algonquin Books. Louv, R. (2011). The nature principle: Human restoration and the end of nature deficit disorder. A lgonquin Books. Louv, R. (2016). Vitamin N: The Essential Guide to a Nature Rich Life. Algonquin Books. Marcus, C. C., & Sachs, N. A. (2013). Therapeutic landscapes: An evidence based approach to designing healing gardens and restorative outdoor spaces. John Wiley & Sons. Milton, M. J., & Corbett, L. (2011). Ecopsychology: A perspective on trauma. European Journal of Ecopsychology, 2, 28 47. Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy (norton series on in terpersonal neurobiology). WW Norton & Company. Moore, R. C. (1990). Childhood's domain: play and place in child development. MIG communications. Moore, R. C. (1993). Plants for Play: A Plant Selection Guide for Children's Outdoor Environments. MIG Comm unications, 1802 Fifth St., Berkeley, CA 94710. Moore, R., & Cosco, N. (2013). Greening Montessori School Grounds by Design. NAMTA Journal, 38(1), 219 234. Moore, R. C., & Wong, H. H. (1997). Natural Learning: The Life of an Environmental Schoolyard. Cr eating Environments for Rediscovering Nature's Way of Teaching. MIG Communications, 800 Hearst Ave., Berkeley, CA 94710. Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. WW Norton & Company. Pearc e, J. W., & Pezzot Pearce, T. D. (1994). Attachment theory and its implications for psychotherapy with maltreated children. Child abuse & neglect, 18(5), 425 438. Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhoo d trauma, Infant mental health journal, 16(4), 271 291. Pittenger, C., & Duman, R. S. (2008). Stress, depression, and neuroplasticity: a convergenc e of mechanisms. Neuropsychopharmacology, 33(1), 88 109. Preventing suicide: A global imperative. (n.d.). Retrieved April 04, 2017, from http://www.who.int/mental_hea lth/suicide prevention/world_report_2014/en/ Ravi, B., & Kannan, M. (2013). Epigenetics in the nervous system: an overview of its essential role. Indian journal of human genetics, 19(4), 384.

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59 Robinson, C. W., & Zajicek, J. M. (2005). Growing minds: The effects of a one year school garden program on six constructs of life skills of elementary school children. HortTechnology, 15(3), 453 457. Roley, S. S., Mailloux, Z., Miller Kuhaneck, H., & Glennon, T. (2007). Understanding Ayres' Sensory Integration. Roth, T. L. (2012). Epigenetics of neurobiology and behavior during development and adulthood. Developmental psychobiology, 54(6), 590 597. Selhub, E. M., & Logan, A. C. (2012). Your brain on nature: The science of nature's influence on your health, happi ness and vitality. John Wiley & Sons. Siegel, D. J. (2015). The developing mind: How relationships and the brain interact to shape who we are. Guilford Publications. Simson, S., & Straus, M. (1997). Horticulture as therapy: Principles and practice. CRC Press. Sakallaris, B. R., MacAllister, L., Voss, M., Smith, K., & Jonas, W. B. (2015). Optimal healing environments. Global Advances in Health and Medicine, 4(3), 40 45. Teicher, M. H., Andersen, S. L., Polcari, A., Anderson, C. M., Navalta, C. P., & Ki m, D. M. (2003). The neurobiological consequences of early stress and childhood maltreatment. Neuroscience & Biobehavioral Reviews, 27(1), 33 44. Therapeutic Garden Characteristics. (2012) Retrieved October 2015, from http://www.ahta.org/assets/docs/therapeuticgardencharacteristics_ahtareprintpermission.pdf Ulrich, R. (1984). View through a window may influence recovery. Science, 224(4647), 224 225. Ulrich, R. S., Simons, R. F., Losito, B. D., Fiorito, E., Miles, M. A., & Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of environmental psychology, 11(3), 201 230. Ulrich, R. S. (1979). Visual landscapes a Landscape research, 4(1), 17 23. Van Den Berg, A. E., & Custers, M. H. (2011). Gardening promotes neuroendocrine and affective restoration from stress. Journal of Health Psychology, 16(1), 3 11. Van der Kolk, B. (2014). The b ody keeps the score: Mind, brain and body in the transformation of trauma. Penguin UK. Van der Kolk, B. A., & McFarlane, A. C. (Eds.). (2012). Traumatic stress: The effects of overwhelming experience on mind, body, and society. Guilford Press.

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60 APPENDIX A. Colorado Garden Foundation Grant Application 31 January 2016 HISTORY Established in 1944, Sewall Child Development Center has a long standing reputation for providing services to people with disabilities in the Denver community, starting with services for people with polio and evolving to early childhood education and intervention. Today, Sewall provides education and therapeutic supports for young children (birth 6) of all abilities through a continuum of programs. Sewall fulfills our mission to provi de inclusive, joyful learning environments using the power of partnerships, diversity, and belonging to enrich the social and academic growth of every child and family. In 2015, Sewall supported approximately 600 children across our programs. The last yea r was a time of tremendous growth at Sewall. In January 2016, Sewall moved its headquarters to a newly renovated building that provides a much improved learning environment and space to grow. Sewall has experienced a dramatic increase in the number of chil dren being referred through Denver Public Schools and is working in partnership with them to open and maintain several classrooms in high needs Denver neighborhood, including eleven satellite locations. Sewall operates 12 half day classrooms, 7 full day c lassrooms, and as a result of community need, provides therapeutic supports at two different locations in the metro area; one in southwest Denver and one in the Far Northeast. The number of Colorado children under 5 with an identified special need rose fr om 11,000 in 2008 to 19,328 in 2014, the percentage of children living in poverty is 10 percent higher in Denver County than in all of Colorado according to the U.S. Department of Education. MISSION STATEMENT specially those who learn differently or are at risk for school failure, build a solid foundation for elementary school by meeting the individual educational, therapeutic, and personal needs of every child. rogramming is inclusion, and Sewall classrooms are living examples of how Sewall encourages diversity on all levels. Over half of the children served by Sewall are identified as having special needs, including autism, a range of physical disabilities, Down Syndrome, ADHD, and fetal alcohol and drug exposure. Roughly sixty percent of them live in poverty and many live with a single parent, in foster care, or with custodial relatives Sewall offers an array of early education and intervention programs to mee t the individual needs of every child through the use of our unique transdisciplinary intervention model. Sewall's transdisciplinary teams, comprised of early childhood educators and special educators, physical and occupational therapists, speech pathologi sts, and mental health professionals, staff every program collaboratively and work together to support each child. partnerships, diversity, and belonging to enrich the social and academic gr owth of every child and family. PROJECT PURPOSE Sewall is requesting funding for the installation of a sensory and therapeutic garden that will foster the intellectual, emotional, and physical development for the 300 children fro m Sewall and their

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61 partner, REACH Charter Elementary School. The one third acre space will be a specialized learning environment focused on children ages 3 9 with and without alternative learning needs. By simultaneously supporting and nurturing all childr en while they use the space side by side, the garden This outdoor educational garden, adjacent to an existing playground environment, will be organized around plants designed to stim ulate all five senses and encourage hands on multi sensory and social learning. An environmentally responsible plant palette, which requires minimal maintenance in our semi arid climate, will be carefully selected to provide year round seasonal interest fo r active transdisciplinary intervention model and provide a safe, non threatening space of respite during crisis interventions. This garden will provide more benefit to students and community than the typical schoolyard. Because Sewall is open year round, the garden will be more fully occupied than most school landscapes. In addition, the grounds will be available to the broader community as a therapeutic space and offer summer camp programs. Sewall has the commitment of an in kind match of plant material from the Congress Park Neighbors Green Team who will liaise with community members to facilitate the donation of hardy perennials and volunteer hours fo r installation.

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62 APPENDIX B Colorado Garden Foundation Grant Application 31 October 2016 31 October 2016 Colorado Garden Foundation 959 S Kipling Pkwy #100 Lakewood, CO 80226 Dear Colorado Garden Foundation Grant Selection Committee, Sewall Child Development Center is pleased to present this proposal for your review. The last year was a time of tremendous growth at Sewall. In January 2016, Sewall achieved a long awaited goal and moved its headquarters to a newly renovated building at 940 Fillmore St. in the Congress Park neighborhood of Denver. This renovated space provides a much improved learning environment and space to grow. Our new campus offers outdoor space for a sensory garden that will enhance the development of each and every child. Over half of the children served by Sewall have special needs; including autism, physical disabilities, Down Syndrome, ADHD, fetal alcohol and drug exposure. Roughly sixty percent of them live in poverty and many live with a single parent, in foster care, or w ith custodial relatives. Our proposal requests $75,000 in funding to build an outdoor sensory garden that can serve as an educational environment. Adjacent to the more formalized play environment, the garden will be organized around natural materials desig ned to stimulate all five senses and encourage hands on multi sensory, and social learning. It will allow therapeutic horticulture techniques to be integrated threatening space that serves as an opportunity for needed respite during crisis interventions. A predominantly xeric and native plant palette will be selected to provide year round seasonal interest. Students from both the Fillmore St. headquarters and the nine satellite locati ons will have year round access to the garden. The garden building and outdoor spaces. As a community focused organization, the grounds will also be available to the surrounding neighbors as a therapeutic space when the academic schedule allows. This garden project is strongly supported by members of the local community. The Congress Park Neighborhood Green Team has committed to cultivating community relationships between Sewall and its new neighborhood home. Sewall currently operates a community garden with strong participation from parents, staff, and the local community. pro gram; it is a horticulturally related community improvement project that emphasizes education and therapy. Furthermore, it connects neighboring home gardeners and plant material sourced from their home gardens with a school landscape with focus on communit y benefit. We appreciate the Colorado Garden Foundation taking an interest in supporting our sensory and therapeutic garden and would be more than willing to provide additional information or answer any questions regarding our project. Sincerely, Heidi H eissenbuttel, MA ECSE President and CEO Sewall Child Development Center 940 Fillmore St. Denver, CO 80206

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63 AGENCY INFORMATION Sewall has a rich history of providing services to the Denver Community for 72 years. Sewall has one goal: to help all young chi ldren, especially those who learn differently or are at risk for school failure, build a solid foundation for elementary school by meeting the individual educational, therapeutic, and personal needs of every child. To help each child build a solid foundati on for school success, Sewall provides high quality, inclusive education in responsive classroom communities in partnership with families. Sewall offers an array of early education and intervention programs to meet the individual needs of every child thro ugh the use of our unique transdisciplinary intervention model. Sewall's transdisciplinary teams comprised of early childhood educators and special educators, physical and occupational therapists, speech pathologists, and mental health professionals, staff every program collaboratively and work together to support each child. are living examples of how Sewall encourages diversity on all levels. Research shows all children benefit from individualized learning within supportive communities. Our mixed age classrooms include three and four year olds. Between one third and one half of the children in each class have identified special needs. Children with and without sp ecial needs learn side by side, with all therapies occurring within the natural setting of the classroom and outdoor playground. Each classroom represents a wide range of cultural, ethnic, and socio economic backgrounds. Sewall is routinely evaluated by ou tside organizations including the Department of Human Services licensing and Colorado Shines (formerly Qualistar). Our high quality programming, combined with our consistent success in preparing young children with and without special needs for ongoing aca demic and personal success, has earned us the following: The National Association for the Education of Young Children (NAEYC) accredits Sewall, a distinction awarded to only 7 percent of early childhood education organizations in Colorado. Accreditation was renewed in July 2012 for five years. Sewall was the first early childhood program to receive Qualistar's highest four star rating. Today, all Sewall classrooms maintain a three or four star rating. Sewall will continue to work with Qualistar as it tran sitions to Colorado Shines. The federal Division of Early Childhood (DEC) named Sewall as one of 20 national replication sites that demonstrate recommended practices for inclusion of young children. ORGANIZATION HISTORY Established in 1944, Sewall Child D evelopment Center has a long standing reputation for providing services to people with disabilities in the Denver community, starting with services for people with polio and evolving to early childhood education and intervention. Today, Sewall provides edu cation and therapeutic supports for young children (birth 6) of all abilities through a continuum of programs. Sewall fulfills our mission to provide inclusive, joyful learning environments using the power of partnerships, diversity, and belonging to enric h the social and academic growth of every child and family. In 2015, Sewall supported approximately 600 children across our programs. CURRENT PROGRAMS Inclusive Preschool Program l and therapeutic in tervention and an opportunity for children of all abilities and learning styles to learn side by side. In order to meet growing community need, Sewall increased its inclusive satellite program from 3 classrooms in the fall of 2012 to 10 in fall of 2015, in creasing our total preschool classrooms to twenty. Roughly 300 children are served in the preschool programs; approximately 60% are low income

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64 Early Childhood Care Program Sewall provides 9 full day preschool and toddler programs at 3 sites: 940 Fillmor e, Strive, and Dahlia. This program offers one of the few inclusive options in Denver for families with children who have complex developmental or medical concerns serving 118 children annually. Approximately 60% are low income. Infant/Toddler Program Se and therapeutic supports to young children with special needs in their homes. Therapists and specialists partner with parents and care givers, helping them to support their development al needs. Program serves up to 40 children annually; approximately 60% are low income. Head Start Disability Services Program indirect services to children with special needs in 47 Denver Head Start classroom s, while simultaneously providing training and consultation to Head Start classroom teachers. Sewall provides service to 150 children this year; approximately 95% are low income. Diagnostic and Evaluation Clinic T he assessment team, which includes a cli nical psychologist, speech pathologist, physical therapist, and a developmental pediatrician, provides comprehensive evaluations and reports for children with developmental concerns. In 2015, the team conducted 72 evaluations; 95% of those children were Me dicaid eligible. Family/Parent Engagement Program Sewall partners with parents to support the individual needs of each child and family particular ly our families in clini c. T his includes home visits, ongoing family support, advocacy, and resource manage ment to promot e parenting skills and facilitating and fostering a peer network between families. Approximately 80% of families supported are low income. PURPOSE OF GRANT Sewall is requesting funding from the Colorado Garden Foundation for the installat ion of a sensory and therapeutic garden that will foster the intellectual, emotional, and physical development for the expected 300 children and students who will regularly use this garden from Sewall and our partnership with REACH Charter School. The one third acre space will be a specialized learning environment for both Sewall and REACH, focused on children with alternative learning needs while at the same time providing benefit to their typically developing peers. Installation of this garden will offer a safe and inviting outdoor space that will serve to reduce the amount of time children spend in crisis. By simultaneously supporting and nurturing all children while they use the space side by side, lusivity for all children. The project is supported by a wide range of community partners, all of whom are committed to its completion. education plan. As students a re in need of a crisis intervention, access to the space will provide a place for these interventions. A subsidiary goal is to increase the level of community engagement with the school. In addition to facilitating donation of plants, materials and other d onations, the Congress Park Neighborhood Green Team has committed to cultivating a relationship between Sewall and the neighborhood to assist in community outreach and engagement, specifically focused on ongoing volunteer commitments to maintain the garden Involving the neighbors of Congress Park neighborhood, and will continue helping the organization meet its sustainability goals. A combination of new and ongoi ng activities will be performed in the sensory and therapeutic garden. A digging area located in the current playground will be relocated in the sensory garden to provide a physical outlet for emotional release as the activity can provide a sensory motor r elief response with whole body movement and interaction with soil. New activities will include students. Planting and harvesting activities will serve t o aid in the development of fine and gross motor skills. To that end, plants such as lemon balm that can be picked and made into a tea will be

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65 featured in the landscape. Tactile activities including touching plants and navigation over sensory pathways will stimulate ambulatory development, balance, and navigation development. The land for the garden is an unused part of the existing school site and does not need to be acquired. We are requesting $75,000 from the Colorado Garden Foundation for expenses incl uding site work, grading, utilities, draining, and erosion control. We expect the sum of our in kind donation and matches to equal the sum of the funds requested from the Colorado Garden Foundation. These in kind donations will include design and construct ion services, donations of plant and other materials, and community volunteer workshops for installation of plants and site furnishings. This project is expected to be completed in the fall of 2017 in three phases. Phase 1 will occur in spring 2017 and wi ll included construction drawing completion and permit acquisition. Phase 2 will occur in summer of 2017 and will comprise the hard installation including site work, demo, grading, utility installation, drainage, erosion control, and ground remediation. Ph ase 3 will begin in the fall of 2017 and be comprised of community engagement workshops to build site furnishings and install plant material. COLLABORATION with Denver Public Schools to provide our inclusive preschool program, not only at our 940 Fillmore St. headquarters, but also in nine satellite locations. We opened new classrooms at the Dahlia Campus for Health and Well being in partnership with the Men tal Health Center of Denver in fall 2015. Sewall will continue working with Denver Public Schools and community partners to expand into more neighborhoods in the coming years. by providing disability services for all children with identified special needs. We provide consultation and training to all Head Start teachers in delegate agencies throughout Denver. Collegiate partnerships include University of Colorado Denver, Universi ty of Denver, Community College of Denver, and Arapahoe Community College. VOLUNTEER INVOLVEMENT AND IN KIND CONTRIBUTIONS to Sewall each year. Volunteers help in a variety of ways, from volunteering in classrooms to participating on committees for fundraising events. We estimate that volunteers spend a total of 5,335 hours donating their time and energy to assisting Sewall each year. Volunteers participate in activities throughout the school year, including annual seasonal festivals and fundraising events and assist with projects like playground installations, building maintenance, and painting everything from classroom murals to stripes in the parking lot. Graduate student Catharine McCord a Master of Landscape Architecture candidate at the University of Colorado Denver and horticultural therapist is working with Sewall for her thesis project and will provide design development services as an in kind contri bution. Jody Beck an assistant professor who lives in the neighborhood is chairing the thesis. He and Emmanuel Didier, Landscape Architect and Professor in Practice will be providing in kind support as they guide the Lee McCoy, horticulturalist and horticultural therapist at the Denver Botanic Garden located in the neighborhood with Sewall will provide an in kind contribution of plant selection expertise. Neighborhood community members of the Congress Park Neighborhoo d Green Team are committing in kind expertise in many areas. Members include Landscape Architect Melanie Reber who will provide assistance with construction document drawings for permitting and construction and landscape designer Susan Bardwell who will d evelop a maintenance plan and provide onsite community build supervision. Emily Hunter is the point of contact for the Green Team which will coordinate member volunteer activities including: administrative services, landscape architecture expertise, constr uction expertise,

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66 purchased plant donations, installation labor, ongoing maintenance, facilitation of landscape architectural donated services, and donation of other supplies. EVALUATION Expected results are to complete construction of the garden and engage with the community through relationship building and community contributions. This would be evident though the completion of the design, acquisition of plants and materials, preparation and planting of the garden, interdisciplinary team approach. At Sewall, we measure success through the children we serve. Sewall deploys thorough, ongoing evaluation across all program s, and rigorously monitors the progress of each child. To monitor the progress of all children, Sewall began using Teaching Strategies GOLD (TS Gold) during the fall of 2011. These include social emotional, physical, language, and cognitive development, as well as academic areas of growth such as literacy, math, and art. Every preschooler served by Sewall who has identified special needs has an Individual Education family. These IEPs outline specific categorical goals for each child and strategies for achieving those goals. This garden project is intended to enhance these educational practices and build upon the already strong record of success in serving our t arget population. In particular, we would define the success of this garden project in three areas; its integration into curricular activities, its use as a component in IEPs, and its value as a space of respite during crisis interventions. Success will be measured by the degree to which this takes place. The role of the garden in our program delivery will be included in all of the above assessment and evaluation programs as appropriate. Reflective observations about the use of the sensory garden and outdoo r learning environment will be used to enhance learning and therapeutic interventions. Graduate student Catharine McCord will apply to present the outcome of the project at conferences such as the American Society for Landscape Architects (ASLA) and the Am erican Horticultural Therapy Association (AHTA). Sewall will allow future researchers at the University of Colorado Denver to access available and non confidential documentation of both educational and therapeutic uses of the garden for continued research. Sewall has not previously been awarded funding through the Colorado Garden Foundation. If our project is awarded this grant, a commemorative plaque will be placed in a high visibility area of the garden showcasing the generosity of the Colorado Garden Fo undation. The Congress Park Neighborhood Green Team plans to announce the project and project updates in their monthly newsletter. This neighborhood organization partners closely with community businesses to foster neighborhood relationships. Sewall can pa rtner with its satellite locations and provide outreach through these organizations as well as local media and news outlets. The University of Colorado Denver press and communications offices will be contacted and given information necessary to issue a pre ss release and generate internal publications disseminated to thousands of students and alumni. BOARD OF DIRECTORS Our 17 member Board of Directors is charged with providing strategic direction and oversight for programmatic, fundraising, financial, and a dministrative activities at Sewall. Working in collaboration with Leadership Team, members serves a minimum term of three years and is on at least one standing committee. Board members also solicit supporters and participants for special events and bring potential new supporters into Sewall. We are proud of the fact that 100 percent of our board members make personal gifts to Sewall annually. Board of directors include; Sarah R. Allen (Board Development and Capital Campaign), Barbara Bieber (Development), John Chahbandour (Program), Charon Earnest (Program and Marketing), Chuck Fish (Executive and Finance), William C. Holland (Executive and Board Development), Linda

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67 M. Kanan, Ph.D. (Program), Marc Kleiner (Executive and Development), Gene Koelbel (Program a nd Development), Randall Sylvan (Parent Seat), Jason Waldron (Finance), Ashley Walker (Development). REACH 2016 Budget Summary Revenue subtotal program revenue $ 3,508,221.00 subtotal G&A $ 295,000.00 940 Fillmore development $ 918,500.00 Total Revenue $ 4,721,721.00 Expense subtotal program expense $ 3,895,696.00 G&A $ 635,481.00 940 Fillmore Development $ 181,440.00 Total Expense $ 4,712,617.00 Net Income (Loss) subtotal program income $ (387,475.00) G&A $ (340,481.00) 940 Fillmore Development $ 737,060.00 Net Cash Flow $ 9,104.00 Depreciation Expense $ 105,975.00 Net Income (Loss) $ (96,871.00)

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68 APPENDIX C Colorado Garden Founda t ion Interview Materials 18 January 2017

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82 APPENDIX D. Sewall Child Development Center Handouts

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83 APPENDIX E Green Team Handouts

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84 APPENDIX F Feedback Session Board