COMMENTARY
Translating Preclinical Environmental Enrichment Studies for the
Treatment of Autism and Other Brain Disorders: Comment on
Woo and Leon (2013)
Elisa L. Hill-Yardin and Anthony J. Hannan
The University of Melbourne
Environmental enrichment (EE) has been shown to induce beneficial effects in mouse models of autism
spectrum disorder (ASD), as well as animal models of a variety of other neurological and psychiatric
disorders. Investigation of the mechanisms responsible for these changes in animal models will facilitate
translation of EE and associated therapies to patient cohorts. In the accompanying article, Woo and Leon
demonstrate clinical benefits of sensorimotor enrichment in patients with ASD. We discuss the impli-
cations of these findings for future development of therapeutic approaches for ASD and other brain
disorders.
Keywords: environmental enrichment, Autism Spectrum Disorder, sensory, animal models, treatment
Woo and Leon’s (2013, pp. 487– 497) study applies environ-
mental enrichment (EE) in the form of increased sensorimotor
stimulation to patients and identifies significant improvements
in subjects exposed to EE compared with controls. This work is
important, as it attempts to directly translate work from animal
models to benefit patients with autism spectrum disorder
(ASD). The fact that this study shows improvements in cogni-
tive performance and autism severity following sensory enrich-
ment in this relatively small cohort is promising. Following
appropriate follow-up on a larger scale, this EE approach for
ASD could be developed for widespread applications. The
effective treatment of behavioral aspects of ASD with sensori-
motor enrichment holds several lifestyle advantages for indi-
vidual patients, in addition to socioeconomic benefits to general
communities.
Sensory abnormalities are present in the overwhelming majority of
ASD patients (Leekam, Nieto, Libby, Wing, & Gould, 2007) and pose
significant challenges for these patients and their families (Schaaf,
Toth-Cohen, Johnson, Outten, & Benevides, 2011). Such abnormal-
ities may present as apparent indifference to pain/heat/cold, adverse
response to specific sounds or textures, excessive smelling or touch-
ing of objects, and/or fascination with lights or spinning objects. The
fact that sensory processing abnormalities are a prominent feature of
ASD further reinforces the need for treatment of these symptoms in
patients and the potential for impacting other symptoms of ASD by
manipulating neural pathways involved in sensory processing. Sen-
sory alterations are emerging as an integral component of ASD, and
modulation of sensory processing may assist in improving other core
behavioral features of ASD, for example, stereotypy (Sidener, Carr, &
Firth, 2005).
In light of the high prevalence and impact of inappropriate
sensory processing in ASD, the implementation of EE paradigms
to benefit ASD patients is a logical and positive step. However,
there are a number of issues to consider in order for such an
approach to be optimized for wider clinical implementation. Pa-
tient heterogeneity predicts that individuals with ASD will respond
to EE in differing ways. These responses may be due to complex
genetics and environmental influences resulting in differing levels
of sensory abnormalities or responsiveness of people with ASD at
baseline.
The study by Woo and Leon (2013) identifies a potential therapy
that has several practical advantages for patients and their families.
The implementation of an EE protocol that can be conducted by
parents (following minimal training) in the home using inexpensive
materials has broad applications. For the community, it is clear that
there are substantial socioeconomic advantages to undertaking this
kind of approach. For families and individuals, timely access to
services (including diagnostic evaluation) is a major issue, and per-
haps if these treatments are targeted to patients for whom this will be
effective, accessibility to other services in general can be improved.
The benefits to patients (who, together with sensory issues, often
exhibit anxiety disorders) and families in having the ability to carry
Elisa L. Hill-Yardin, Enteric Neuroscience Laboratory, Department of
Physiology, The University of Melbourne, Parkville, Victoria, Australia;
Anthony J. Hannan, Florey Institute of Neuroscience and Mental Health,
The University of Melbourne, Parkville, Victoria, Australia.
Elisa L. Hill-Yardin and Anthony J. Hannan are supported by the
following awards regarding neural plasticity and Autism Spectrum Disor-
der: NHMRC 1047674 (Anthony J. Hannan and Elisa L. Hill-Yardin),
NHMRC 1034785, ARC Future Fellowship FT3 (Anthony J. Hannan), and
US DoD AR110134 (Elisa L. Hill-Yardin).
Correspondence concerning this article should be addressed to Anthony
J. Hannan, Florey Institute of Neuroscience and Mental Health, Melbourne
Brain Centre, University of Melbourne, at Genetics Lane, Royal Parade,
Parkville, Victoria 3010, Australia. E-mail: anthony.hannan@florey.edu.au
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Behavioral Neuroscience © 2013 American Psychological Association
2013, Vol. 127, No. 4, 606 – 609 0735-7044/13/$12.00 DOI: 10.1037/a0033319
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