Effects of laughter yoga on separation anxiety in kindergarten children: Children's characteristics and related factors.

Separation anxiety disorder (SAD) can affect the mental health of children negatively. In this study, we assess effects of laughter yoga on SAD in kindergarten children in Rafsanjan, Iran, with an experimental, pre-post-test design. Sample were selected using cluster sampling design, in which we randomly selected four kindergartens in the city and assessed all the students from these kindergartens (n = 221). Two kindergartens were randomly assigned to the intervention group, and two were assigned to the control group. Children who met the inclusion criteria were randomly assigned to either the intervention group (n = 29) or the control group (n = 27). SAD was diagnosed by the Children's Symptoms Inventory-4 (CSI-4), and the Separation Anxiety Assessment Scale assessed the severity of SAD. The frequency of SAD in our study was 25.33 % among 4- to 7-year-old children (with a mean age of 5.50 ± 0.87 years). The majority of mothers were homemakers, while the majority of fathers owned their businesses. The intervention group showed a significant decrease in SAD scores after implementing laughter yoga (p = 0.000). In conclusions, this study found that laughter yoga had positive effects on reducing separation anxiety in children. Given the fact that the prevalence of SAD is higher in preschool children, we suggest that laughter yoga should be combined with the routine of kindergartens. Although we should consider the fact that laughter yoga cannot be a complete alternative for psychological therapies, it should be considered as a method to alleviate the symptoms of the SAD.