They take care of the vegetable garden and chickens, participate in work in the vineyard and olive grove, packaging wine and oil and making deliveries to local restaurants, they also help with tastings. They practice dance, yoga, fencing, gymnastics, tennis, kayaking, rafting, go on nature walks, go to the seaside, visit cities of art, exhibitions and museums. These are the recreational and working activities of young adults with autistic neurodivergence who participate in the project Scipione. On the hills of Lucca, in the premises of the agricultural society Pieve S. Stefano - Villa Sardini, they are involved in a programme that, under the guidance of a group of dedicated operators, seeks to enhance the individual potential of the children and to foster their self-determination and independence.
The Scipione project puts into practice many of the principles underlying the latest neuroscientific research on brain development and well-being, in particular the so-called environmental enrichment. This concept originated in animal research, and was first brought to the attention of the scientific community by Donald Hebb, one of the fathers of psychobiology. Hebb noticed that some rats he brought home from the laboratory as pets for his children developed greater abilities to perform cognitive tasks, compared to conspecifics raised in captivity. He theorised that exposure to a stimulating environment, very different from the sterile cages of a research laboratory, produced beneficial changes in the animals' brains, improving their cognitive functions.
Since that insight, the study of environmental enrichment has taken hold in many research laboratories. From an experimental point of view, this type of research is carried out by breeding animals (initially mainly rodents, but in recent times also non-human primates have been targeted) in large cages capable of housing a large number of individuals. The cages are equipped with toys, wheels for running and mazes. Their conformation is systematically changed to ensure unpredictability and dynamism. To date, after decades of research, not only has Hebb's observation been confirmed, but numerous benefits of environmental enrichment for the wellbeing of the nervous system have been revealed, from the promotion of synaptic plasticity, to the enhancement of adult neurogenesis, from the reduction of neuro-inflammatory phenomena, to the increased expression of neurotrophins. All this promotes the reorganisation of brain circuits through self-induced molecular changes.
But if environmental enrichment brings these positive results in experimental animals, is it possible to apply it for the benefit of people? Lamberto Maffei, a neuroscientist who for years devoted his research to the study of brain development and its plasticity, proposed several years ago that the enriched environment could influence brain development in general. He tested this hypothesis by showing that rodents born and bred in an enriched environment reached maturity in visual functions more quickly, due to an action of the environment on specific molecules guiding brain development. 'The environment acted on these molecules at such an early age that this effect could not, however, be attributed to the visual components of the environment, as light could not yet act on visual cells at that age,' he explains. Nicoletta Berardi, retired professor at the University of Florence, who experienced the development of this field of research first hand. "The richness of the environment acted through maternal care, which was more accurate in an enriched environment than in a non-enriched environment, therefore through contact, tactile stimulation.
At this point, Maffei's group wondered whether the same principle also applied to humans. In an experiment carried out in collaboration with the IRCCS Fondazione Stella Maris and the Pisa neonatology department, Maffei's research group showed that massaging human and rodent infants had the same effect of accelerating visual development and, indeed, it was the whole brain development that was promoted. In short, this research shows that it is nothing other than affectionate contact that promotes brain development!
The benefits of environmental enrichment therefore also apply to humans and we can imagine this approach as a viable alternative to pharmacotherapy; in short, a kind of 'endogenous pharmacotherapy', as suggested Alexander Salt, research manager at the CNR Institute of Neuroscience, who started to transpose the concept of an enriched environment in adult people. "We recently completed a study in which we administered exercise sessions to patients with amblyopia (lazy eye), a condition in which one of the two eyes expresses reduced visual ability due to weakened connections in the primary visual cortex," Sale says. "Our results show that physical activity improves the resilience of this condition by improving cortical plasticity." But that's not all. A 'mind gym' dedicated (mainly) to elderly subjects has been set up in the CNR Research Area in Pisa. This place, currently unique in Italy, is part of the programme 'Train the Brain' and offers participants exercise sessions and activities that stimulate cognitive processes. The study is still ongoing, but from the preliminary results it seems that this approach can slow down the progression of age-related cognitive decline in a clinically significant way, in short, that it can be used as a kind of endogenous pharmacotherapy, scaling back the use of drugs to leverage the plastic capacities that the brain already possesses.
A further challenge is to try to use the concept of the enriched environment for the benefit of neurodivergent people. Exercise is one of the main components through which the enriched environment exerts its benefits on the brain. However, when physical activity is combined with an emotionally meaningful experience, the impact on quality of life can be even more profound. And some experiences with patients suffering from even severe neurological diseases are beginning to demonstrate this. Michela Fagiolini, associate professor at Harvard Medical School and director of IN-CNR, has launched a swimming activity project for girls suffering from Rett syndrome in collaboration with a patients' association and Harvard Medical School. This condition is a severe pathology of brain development, characterised by intellectual disability, breathing difficulties, speechlessness, and almost total inability to communicate non-verbally. The disease also leads to a progressive deterioration of motor skills in all limbs, making movement increasingly difficult. This is precisely why swimming was chosen as a good exercise opportunity even for those with motor difficulties: even people unable to walk can move around in the water with greater ease.
"The initiative is called the 'Adaptive Swim Program'," explains Fagiolini. "Every weekend, some members of the Harvard University swim team meet in the pool with the girls with Rett syndrome, creating an opportunity for interaction that has proven beneficial to both parties: the swimmers become passionate about the experience, just as the girls develop a strong bond with the programme. In some cases, the patients even started communicating their eagerness and desire to participate to their parents. During the weekend, at the time they are supposed to leave for the pool, some of them show signs of enthusiasm and attract the parents' attention to make sure they don't miss their appointment".
In short, this experience seems to show that the benefit goes far beyond motor improvement: an opportunity for sharing is created that enriches the body and mind, providing these girls with a space in which they can feel involved, expected and happy. Not only that: the neurotypical volunteers also gain a new awareness of neurodiversity through this. Through their interaction with the girls, they understand that, beyond the difficulties, everyone has their own inner strength and a desire to live and connect with others.
One of the crucial aspects of environmental enrichment is sharing, connecting people, whatever their "neurotype". To date, however, it remains very difficult to organise programmes that exploit the benefits of environmental enrichment and the mixing of people. There are, of course, economic reasons that hinder the possibility of setting up such initiatives. But there is another reason worth thinking about. We often tend to think that neurodivergent people should be protected from challenges and difficulties, ending up placing them in impoverished contexts. Just think of some projects that were conceived with the best of intentions, but end up turning into the opposite. One example is school support, which sometimes takes place by isolating 'difficult children' from the classroom, even for several hours at a time. Another is work placement programmes in which alienating and repetitive tasks are assigned, sometimes useless and lacking any real recognition. Admittedly, these are efforts designed in the direction of the welfare of certain categories considered 'fragile', but one wonders whether this kind of logic, in which compassion merges with stigma, is not obsolete.
The Scipione project, thanks to a spontaneous intuition, tries to overturn precisely this logic and recreate the ideal conditions that are hypothesised to promote brain well-being. By alternating playful-sports activities, participation in company work and cultural activities, in a context of sharing between people, the programme recreates a complex and dynamic reality, in many ways analogous to the empirical definition of environmental enrichment. Parents report that they have noticed progress in the children as a result of their participation in the project activities, in particular an increase in their autonomy and sense of responsibility. It remains to be seen, of course, whether these are improvements that can also be detected by clinical observation.
