outdoor (2)

Read the blog post and learn how to utilizing outdoor spaces and routines as a context for supporting early language, physical activity, and consequently, STEM learning. 

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Sarah Pedonti

Sarah is an assistant professor in Birth-Kindergarten Education at Western Carolina University. She supports early childhood teacher candidates in implementing high-quality inclusive environments for diverse children and families, especially in the language and literacy skills that undergird later STEM learning. In her research, she focuses on populations of young children at risk for later reading difficulty, including children in poverty (Head Start/Early Head Start), children with disabilities, and dual language learners (DLLs), as well as children at the intersection of those identities.

12145015262?profile=RESIZE_180x180Derek Becker

Derek Becker is an associate professor at Western Carolina University in Birth-Kindergarten education. He teaches a range of early childhood research methods courses, along with math, science and curriculum. He conducts research on the cognitive and academic benefits of movement and play. He is specifically interested in utilizing outdoor context and harnessing the physical aspects of motor-based play to promote physical and cognitive health.

Outdoor environments can be an authentic and engaging context for supporting the early language and physical activity of children with and without disabilities. Language skills are an important foundational skill for reading comprehension (Hjetland et al., 2017), which is essential to STEM skills such as scientific (Cabell & Hwang, 2020; Siler et al., 2010; Mayer et al., 2014) and mathematical reasoning (Cartwright et al., 2022; Foster et al., 2015; Gjicali et al., 2019).Physical activity has been found to produce improvements in children’s executive function, including attention and self-control (Willoughby et al., 2018), which are also important foundational skills for STEM (Willoughby et al., 2021; Ribner et al., 2023). In this blog, we describe concrete strategies for utilizing outdoor spaces and routines as a context for supporting early language, physical activity, and consequently, STEM learning. 

Language 

Research on language interactions between children and their caregivers specifically in outdoor spaces is limited, but what little research does exist shows us that outdoor interactions can produce: 

  • More responsive and connected conversations between adults and children 
  • More overall talk by children (Cameron-Faulkner et al., 2018)  

There are several dimensions of language that researchers agree support children’s later achievement (LARRC, 2015; LARRC, 2017), including the amount and types of talk (vocabulary) and complexity of talk (syntax). In the following sections, we describe how these dimensions could potentially support STEM learning in outdoor settings. 

Vocabulary 

Vocabulary is important for STEM learning because research shows us that children’s vocabularies predict later academic achievement, and that knowledge of “Tier 2” and “Tier 3” words is particularly important (O’Reilly et al., 2019).  Examples of “advanced”, or “Tier 2” (Beck et al., 2012) vocabulary words that children might be able to learn in outdoor interactions are words like “melt” or “examine”, while “Tier 3” topic-specific words like “bark”, “moss”, “fungus”, or “reptile” may be helpful for types of ecological knowledge. Knowledge of these words is important for later reading comprehension. Many science texts for school-age children include words like these, which are not commonly used in everyday conversation.  

Additionally, while outdoors, children can learn not just nouns for different animals or plants they see, but also action verbs that are supported by physical activity, such as “leap”, “climb”, “step”, or “scramble”.  

Syntax 

Syntax, or grammatical knowledge of the arrangement of sentences and words is another important predictor of later reading comprehension (Catts et al., 2006; LARRC & Chiu, 2018; Storch & Whitehurst, 2002). The more complex a sentence is, the greater reading comprehension is required to understand it. Exposure to complex sentences and utterances from caregivers supports children’s ability to learn those structures and internalize them for use in their own speech and writing.  

For example, adverbial conjunctions such as “because”, “since”, and “so”, serve a “bridging” purpose between two thoughts, and expose children to casual thinking. You might explain the purpose of a pinecone’s scales by saying “Pinecones close when it’s about to rain because they need to keep their seeds dry.” This sentence exposes the child to a complex grammatical structure similar to many scientific texts while also giving a casual explanation for a scientific phenomenon (Owen Van Horne et al., 2023). Therefore, the more exposure children have to this kind of complex language, the more equipped they will be to understand those structures when they encounter them in written texts.  

Cognitive verbs such as “think”, “need”, and “wonder” can also give children experience with both new vocabulary in the form of action-oriented verbs, but also syntactically complex sentence structures. These types of verbs often take a complement clause such as “that” or “if” to complete their meaning, as in “I think (that) the plant is growing”, or “I wonder if it will rain tonight”.  Helping children generate predictions and questions about scientific phenomena gives them experience and practice in using complement clauses. 

Other Language Skills to Focus on Outdoors  

Besides the dimensions of vocabulary and syntax, there are other considerations for outdoor language. These include: 

  • Pragmatic language (social conversations like saying excuse me to pass someone on the trail, turn-taking) 
  • Narrative language (pretending to go on a Bear Hunt, retell of important outings) 
  • Print awareness (pointing out signs and maps) 
  • Phonemic and alphabet awareness (reading signs and maps) 
  • Reading motivation (class-made books about field trips and other outdoor excursions are highly salient and have context personalization) 

Citizen science apps such as iNaturalist/Seek and the North Carolina Arboretum’s locale-specific ecoEXPLORE give children the opportunity to document and discuss their observations during outdoor time with other budding scientists. These apps can be used to scaffold rich discussion of outdoor observations, including Tier 2 and 3 vocabulary words and complex syntax for recording and evaluating predictions. They can also be used for supporting reading motivation for early decoders wanting to learn the names of favorite plants and animals. 

Physical activity 

 Outdoor language and STEM learning are also connected to children’s levels of physical activity (Willoughby et al, 2021) and their executive function (Ribner et al., 2023). A child that is ready to learn about a STEM concept such as pollination, must have the relevant vocabulary (e.g., bee, flower, pollen) and be able to link this vocabulary to the broader concept of pollination and the ecosystem that supports the bee and the flower. Executive function is often described as consisting of attention, working memory, and inhibitory control, and for children to learn, they need to be cognitively and emotionally ready to take in and retain the relevant information. Thus, to learn about how plants are pollinated, a child must: 

  • Focus attention to take in information about the bee and flower.
  • Inhibit attending to external distractions (a bird moving across field of vision) and internal distractions (emotions such as fear of being stung by the bee).
  • Retain and remember what they have seen and learn to make connections (bees pollinate flowers, flowers support the bees, bees make honey).

Physical activity, and especially physical activity that occurs in natural outdoor contexts (Boere et al., 2023), has been shown to support children’s emergent executive function and emotion regulation, which undergirds much of STEM learning (Becker et al., 2014; Hansen Sandseter et al., 2023). Researchers recommend that young children (ages 3 to 5) should get at least three hours of natural physical activity each day. This time in physically active play is important because when children move and play, the heart pumps blood to the brain (Mulser and Moreau, 2023), and over time, this can help improve attention and inhibitory control (Christiansen et al., 2019).  

Physical activity in outdoor contexts, particularly those with a measured degree of risk, are also linked to emotion regulation and prosocial skills (Cho et al., 2023; Hansen Sandseter et al., 2023). As a child faces a safe level of risk, such as the potential of being stung by a bee, or of skinning a knee when climbing a rock, mastery, self-confidence, and emotional control can develop. As these experiences occur with peers, children can learn to help support each other, experience this in return, and overcome fear. This can promote pragmatic language, social conversations, turn-taking, and strengthen prosocial skills. 

Children also interact and learn in outdoor spaces through movement and exploration. Gross motor skills involve muscles of the torso, arms, and legs and are used to achieve a movement task such as jumping or climbing. Executive function and gross motor skills are important for exploring outdoor spaces, and participating in cognitively challenging motor activities is linked to improvement in executive function (Hudson et al., 2020). Over time, physical activity and risky play can strengthen a child's executive function, self-control, and emotional control which are linked to school readiness and language development (Fitzpatrick et al., 2014; Imai et al., 2022). 

Skills that might be supported by outdoor exploration include:   

  • Running
  • Crawling
  • Galloping 
  • Hopping
  • Balancing 
  • Leaping
  • Jumping side to side

In summary, outdoor environments offer a motivating and natural context for children and families with and without disabilities to build experience with vocabulary and complex syntax that support STEM reasoning, while also engaging in the kinds of physically active gross motor play that promote pragmatic language, executive function and later STEM skills. Examples of activities you can engage in with your young children outdoors and how they may support language and physical activity skills undergirding STEM can be found below! 

Visit a local trail and… 

Language Extensions 

Physical Activity Extension 

Find a seed or seed-bearing plant 

Ask: “Why do you think the tree made that seed?” 

Model complex syntax through explanations: “Maybe it grew seed pods because those will help grow more baby trees” 

Model STEM vocabulary: Count the seeds or fruit you find; use the iNaturalist or ecoExplore apps to identify and name the plant. 

Encourage a child with bipedal mobility to hop high enough to snag a seed pod from a low-hanging crape myrtle or climb a magnolia to see the flowers. Encourage a child using mobility aids to roll or lean towards the object of interest. See if they want to help you crack or hull any thicker nuts or fruits by lifting and dropping large rocks on them. 

Look for a water source 

Ask: “What would happen if we dropped a stick in the stream? Where would it go?” 

Model complex syntax  through explanations: “There’s less water in the puddle now because you displaced, or splashed it out, when you jumped in” 

Model STEM vocabulary: “Displaced means moved.” 

Let a child with bipedal mobility leap across a small stream or puddle, or balance on a rock near a stream. Children using mobility aids might use their walker or cane to safely cross a puddle.  Encourage children who are able to hop in small puddles and bodies of water if they have appropriate footwear on and the water is clean. 

Look for an animal habitat (nest, knothole in a tree, burrow) 

Ask: “What do you think lives in there?” 

Model complex syntax through explanations: “Maybe bird that lives in this nest has left so that they can scavenge for food”. 

Model STEM vocabulary: “Scavenge means to hunt.” 

Ask children with both bipedal mobility and using mobility aids to race ahead (but still within sight) on the trail when they spy a potential animal home. Uneven terrain can also offer excellent opportunities for children with ankle or leg braces or orthotics to address therapeutic goals for balance, if appropriately supported. If your child makes a prediction about the type of animal inhabiting various spaces, ask them to show you how that animal moves (scamper, crawl, skip, roll).  

Look for downed trees or logs along the trail 

Ask: “What do you think happened to the tree?” 

Model complex syntax through explanations: “Maybe the rangers cut it down because it had a disease or pest.”  

Model STEM vocabulary: “A pest is a type of destructive insect or animal that can kill many plants” 

See if your child wants to climb or balance on the log while exploring it. Encourage them to count as they gallop or roll alongside the log to informally use non-standard measurement (their paces or rotations) and gauge the length of the log. Children using mobility devices such as wheelchairs can use off-road modifications such as tracks added to their chair. Funding may be sought from foundations focused on adaptive sports equipment. 

 

 

References 

Beck, I. L., & McKeown, M. G. (2007). Increasing young low-income children’s oral vocabulary repertoires through rich and focused instruction. The Elementary School Journal, 107(3), 251–271. 

Becker, D. R., McClelland, M. M., Loprinzi, P., & Trost, S. G. (2014). Physical activity, self-regulation, and early academic achievement in preschool children. Early Education & Development, 25(1), 56–70. https://doi.org/10.1080/10409289.2013.780505 

Boere, K., Lloyd, K., Binsted, G., & Krigolson, O. E. (2023). Exercising is good for the brain but exercising outside is potentially better. Scientific Reports, 13(1), 1140. https://doi.org/10.1038/s41598-022-26093-2 

Cabell, S. Q., & Hwang, H. (2020). Building content knowledge to boost comprehension in the primary grades. Reading Research Quarterly, 55(S1), S99–S107. https://doi.org/10.1002/rrq.338 

Cameron-Faulkner, Thea, & Gattis, J. (2018). Responding to nature: Natural environments improve parent-child communication. Journal of Environmental Psychology, 59, 9–15. https://doi.org/10.1016/j.jenvp.2018.08.008 

Cartwright, K. B., Taboada Barber, A., & Archer, C. J. (2022). What’s the difference? Contributions of lexical ambiguity, reading comprehension, and executive functions to math word problem solving in linguistically diverse 3rd to 5th graders. Scientific Studies of Reading, 26(6), 565–584. https://doi.org/10.1080/10888438.2022.2084399 

Catts, H. W., Adlof, S. M., & Weismer, S. E. (2006). Language deficits in poor comprehenders: A case for the simple view of reading. Journal of Speech, Language, and Hearing Research, 49(2), 278–293. https://doi.org/10.1044/1092-4388(2006/023) 

Cho, H. J., Jung, S., Lee, S. E., Jo, J. H., & Miller, E. (2023). Young children’s self-control moderates the relationship between risky outdoor play and injury experiences in naturalistic settings. Early Child Development and Care, 1–16. https://doi.org/10.1080/03004430.2023.2173187 

Christiansen, L., Beck, M. M., Bilenberg, N., Wienecke, J., Astrup, A., & Lundbye-Jensen, J. (2019). Effects of exercise on cognitive performance in children and adolescents with ADHD: potential mechanisms and evidence-based recommendations. Journal of clinical medicine, 8(6), 841. https://doi.org/10.3390/jcm8060841 

Fitzpatrick, C., McKinnon, R. D., Blair, C. B., & Willoughby, M. T. (2014). Do preschool executive function skills explain the school readiness gap between advantaged and disadvantaged children?Learning and Instruction, 30, 25–31. https://doi.org/10.1016/j.learninstruc.2013.11.003 

Foster, M. E., Anthony, J. L., Clements, D. H., & Sarama, J. H. (2015). Processes in the development of mathematics in kindergarten children from Title 1 schools. Journal of Experimental Child Psychology, 140, 56–73. https://doi.org/10.1016/j.jecp.2015.07.004 

Gjicali, K., Astuto, J., & Lipnevich, A. A. (2019). Relations among language comprehension, oral counting, and numeral knowledge of ethnic and racial minority young children from low-income communities. Early Childhood Research Quarterly, 46, 5–19. https://doi.org/10.1016/j.ecresq.2018.07.007 

Hansen Sandseter, E. B., Kleppe, R., & Ottesen Kennair, L. E. (2023). Risky play in children’s emotion regulation, social functioning, and physical health: an evolutionary approach. International Journal of Play, 1-13. https://doi.org/10.1080/21594937.2022.2152531 

Hjetland, H. N., Lervåg, A., Lyster, S.-A. H., Hagtvet, B. E., Hulme, C., & Melby-Lervåg, M. (2019). Pathways to reading comprehension: A longitudinal study from 4 to 9 years of age. Journal of Educational Psychology, 111(5), 751–763. https://doi.org/10.1037/edu0000321 

Hudson, Kesha N., Haley M. Ballou, and Michael T. Willoughby. (2021) Improving motor competence skills in early childhood has corollary benefits for executive function and numeracy skills. Developmental Science, 24(4), e13071. https://doi.org/10.1111/desc.13071 

Language and Reading Research Consortium (2017). Oral language and listening comprehension: Same or different constructs? Journal of Speech, Language, and Hearing Research, 60(5), 1273–1284. https://doi.org/10.1044/2017_JSLHR-L-16-0039 

Language and Reading Research Consortium. (2015). The dimensionality of language ability in young children. Child Development, 86(6), 1948–1965. https://doi.org/10.1111/cdev.12450 

Mayer, D., Sodian, B., Koerber, S., & Schwippert, K. (2014). Scientific reasoning in elementary school children: Assessment and relations with cognitive abilities. Learning and Instruction, 29, 43–55. https://doi.org/10.1016/j.learninstruc.2013.07.005 

Mulser, L., & Moreau, D. (2023). Effect of acute cardiovascular exercise on cerebral blood flow: A systematic review. Brain Research, 148355. https://doi.org/10.1016/j.brainres.2023.148355 

O’Reilly, T., Wang, Z., & Sabatini, J. (2019). How much knowledge is too little? When a lack of knowledge becomes a barrier to comprehension. Psychological Science, 30(9), 1344–1351. https://doi.org/10.1177/0956797619862276 

Owen Van Horne, A. J., Curran, M., Cook, S. W., Cole, R., & McGregor, K. K. (2023). Teaching little kids big sentences: A randomized controlled trial showing that children with DLD respond to complex syntax intervention embedded within the context of preschool/kindergarten science instruction. International Journal of Language & Communication Disorders, 00, 1– 19. https://doi.org/10.1111/1460-6984.12882 

Ribner, A. D., Ahmed, S. F., Miller-Cotto, D., & Ellis, A. (2023). The role of executive function in shaping the longitudinal stability of math achievement during early elementary grades. Early Childhood Research Quarterly, 64, 84–93. https://doi.org/10.1016/j.ecresq.2023.02.004 

Siler, S., Klahr, D., Magaro, C., Willows, K., & Mowery, D. (2010). Predictors of transfer of experimental design skills in elementary and middle school children. In Intelligent Tutoring Systems: 10th International Conference, ITS 2010, Pittsburgh, PA, USA, June 14-18, 2010, Proceedings, Part II 10 (pp. 198-208). Springer Berlin Heidelberg. 

Storch, S. A., & Whitehurst, G. J. (2002). Oral language and code-related precursors to reading: Evidence from a longitudinal structural model. Developmental Psychology, 38(6), 934–947. https://doi.org/10.1037/0012-1649.38.6.934 

Willoughby, M., Hudson, K., Hong, Y., & Wylie, A. (2021). Improvements in motor competence skills are associated with improvements in executive function and math problem-solving skills in early childhood. Developmental Psychology, 57, 1463–1470. https://doi.org/10.1037/dev0001223 

Willoughby, M. T., Wylie, A. C., & Catellier, D. J. (2018). Testing the association between physical activity and executive function skills in early childhood. Early Childhood Research Quarterly, 44, 82–89. https://doi.org/10.1016/j.ecresq.2018.03.004 

 

 

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Outdoor Play and Sun Safety

Outdoor learning contributes positively to foundational STEM skills. However, children are at high risk of suffering sun burn from overexposure to UV radiation. Following are several recommendations for supporting sun safety and helping children with disabilities benefit from outdoor play.

Sarah Pedonti's headshot
By Sarah Pedonti

Ph.D. candidate in Applied Developmental Psychology and Special Education at the University of North Carolina at Chapel Hill’s School of Education

About the author: Sarah Pedonti, M.Ed., is a Ph.D. candidate in Applied Developmental Psychology and Special Education at the University of North Carolina at Chapel Hill’s School of Education. Her research focuses on early reading and language interventions for young children with or at risk for developmental language disorders. She has worked in varied settings serving young children with disabilities, including Early Head Start, Head Start, North Carolina Pre-K (co-located within a Title I Engineering Magnet Elementary School), NC State’s Engineering Place Summer Programs, and the Office of Head Start’s National Center on Early Childhood, Development, Teaching, & Learning (NCECDTL)

Outdoor learning  is important for helping young children with and without disabilities to regulate attention (Szczytko et al., 2018) and improve learning engagement (Norwood et al., 2019) and contributes positively to foundational STEM skills such as spatial working memory (e.g. remembering the position of cards during a game of memory; Schutte et al., 2015). Yet, there may be hurdles to safe participation in outdoor learning for some children with disabilities, including sensory hypersensitivities which may cause difficulty with safety precautions such as sunscreen. 

Sunscreen use is important: one in five U.S. citizens will be diagnosed with skin cancer in their lifetime (Guy et al., 2015). Although children are at low risk for developing skin cancer in childhood, sun safety behaviors in childhood can prevent the overexposure to UV rays which are responsible for skin cancers in later adulthood (Autier et al., 1994a,b). A childhood history of severe sunburn significantly raises one’s lifetime chance of developing skin cancer (Iannacone et al., 2012; US Department of Health & Human Services, 2014). Some children with disabilities may be particularly at risk for severe sunburn due to genetic skin conditions such as ichthyosis or Ehler-Danos syndrome, or due to developmental disabilities such as autism (Kanellis, 2020). Some children with autism and other developmental disabilities may display sensory hypersensitivity (Baranak et al., 2007) to “light” tactile experiences like sunscreen application (Baranek & Berkson, 1994; Quinde-Zlibut et al., 2020). Sensory (e.g., autism) or physiological (e.g., icthyosis or similar dermatological disorders with acutely sensitive skin) difficulties associated with sunscreen application can make outdoor summer activity difficult for families. Following are several recommendations for supporting sun safety and helping children with disabilities benefit from outdoor play and to understand the scientific rationale for sun protection:

Universal:

  • Limit outdoor time to morning and late afternoon hours outside peak sun exposure when possible.
  • Reapply every 90-120 minutes- even “waterproof” sunscreens need reapplication, and will need so even more frequently if you’re in the water (FDA, 2019)
  • Seek the shade! Use a sun-tent or umbrella at the beach, and use playgrounds that have shady spaces under trees or sun sails.
  • Don’t forget the hat! 13% of all skin cancers occur on the scalp. (Prodinger et al., 2018)

Individualized:

Most of all, have FUN! Outdoor learning supports children with disabilities to learn, participate with their peers, and benefit cognitively from STEM experiences that occur outdoors. Sun safety precautions can protect children from future risk of skin cancer while encouraging their present-day learning!

 

References

Autier, P., Doré, J. ‐F, Schifflers, E., Cesarini, J. ‐P, Bollaerts, A., Koelmel, K. F., Gefeller, O., Liabeuf, A., Lejeune, F., Lienard, D., Joarlette, M., Chemaly, P., & Kleeberg, U. R. (1995). Melanoma and use of sunscreens: An EORTC case‐control study in Germany, Belgium and France. International Journal of Cancer, 61(6), 749–755. https://doi.org/10.1002/ijc.2910610602

Boyd, B. A., Baranek, G. T., Sideris, J., Poe, M. D., Watson, L. R., Patten, E., & Miller, H. (2010). Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Research, 3(2), 78–87. https://doi.org/10.1002/aur.124

Baranek, G., Boyd, B., Poe, M., David, F., & Watson, L. (2007). Hyperresponsive sensory patterns in young children with autism, developmental delay, and typical development. American Journal on Mental Retardation, 112(4), 233–245. https://doi.org/10.1352/0895-8017(2007)112

Baranek, G. T., & Berkson, G. (1994). Tactile defensiveness in children with developmental disabilities: Responsiveness and habituation. Journal of Autism and Developmental Disorders, 24(4), 457–471. https://doi.org/10.1007/BF02172128

Food and Drug Administration (2019) Sunscreen: How to Protect your Skin. https://www.fda.gov/drugs/understanding-over-counter-medicines/sunscreen-how-help-protect-your-skin-sun#infants

Guy, G.P., Machlin S., Ekwueme, D.U., & Yabroff, K.R. (2015) Prevalence and costs of skin cancer treatment in the US, 2002–2006 and 2007–2011. American Journal of Preventative Medicine, 48(8) 183–7.

Iannacone, M. R., Wang, W., Stockwell, H. G., O’Rourke, K., Giuliano, A. R., Sondak, V. K., Messina, J. L., Roetzheim, R. G., Cherpelis, B. S., Fenske, N. A., & Rollison, D. E. (2012). Patterns and timing of sunlight exposure and risk of basal cell and squamous cell carcinomas of the skin - a case-control study. BMC Cancer, 12(1), 1–11. https://doi.org/10.1186/1471-2407-12-417

Kanellis, V. G. (2020). Barriers to sun safety in autism spectrum disorder. In Biophysical Reviews (Vol. 12, Issue 4, pp. 791–792). Springer. https://doi.org/10.1007/s12551-020-00732-2

Norwood, M.F., Lakhani, A., Fullagar, S., Maujean, A., Downes, M., Byrne, J., Stewart, A., Barber, B., Kendall, E., (2019). A narrative and systematic review of the behavioural, cognitive and emotional effects of passive nature exposure on young people: Evidence for prescribing change. Landscape and Urban Planning, 189, 71-79.

Prodinger, C. M., Koller, J., & Laimer, M. (2018). Scalp tumors. Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 16(6), 730–753. https://doi.org/10.1111/ddg.13546

Schutte, A. R., Torquati, J. C., & Beattie, H. L. (2017). Impact of Urban Nature on Executive Functioning in Early and Middle Childhood. Environment and Behavior, 49(1), 3–30. https://doi.org/10.1177/0013916515603095

Szczytko, R., Carrier, S.J., Stevenson, K.T., (2018). Impacts of outdoor environmental education on teacher reports of attention, behavior, and learning outcomes for students with emotional, cognitive, and behavioral disabilities. Frontiers in Psychology, 3

Tripp, M., Herrmann, N., Parcel, G., Chamberlain, R., & Gritz, E. (2000). Sun protection is fun! A skin cancer prevention program for preschools. Journal of School Health, 70(10), 395–401. https://doi.org/10.1111/josh.2000.70.issue-10

Quinde-Zlibut, J. M., Okitondo, C. D., Williams, Z. J., Weitlauf, A., Mash, L. E., Heflin, B. H., Woodward, N. D., & Cascio, C. J. (2020). Elevated thresholds for light touch in children with autism reflect more conservative perceptual decision-making rather than a sensory deficit. Frontiers in Human Neuroscience, 14, 122. https://doi.org/10.3389/fnhum.2020.00122

US Department of Health & Human Services. (2014) The Surgeon General’s Call to Action to Prevent Skin Cancer. Washington, DC: US Dept of Health and Human Services, Office of the Surgeon General.

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