Elizabeth Dickinson, a business communication professor at the University of North Carolina at Chapel Hill, studied nature deficit disorder through a case study at the North Carolina Educational State Forest system (NCESF), a forest conservation education program. Dickinson argues that it is what Louv's narrative is missing that prevents nature deficit disorder from effecting meaningful change. She attributes the problems described by nature deficit disorder as coming not from a lack of children outside or in nature, but from adults' own "psyche and dysfunctional cultural practices". According to Dickinson, "in the absence of deeper cultural examination and alternative practices, deficit disorder is a misdiagnosis—a problematic contemporary environmental discourse that can obscure and mistreat the problem."