Anxiety Levels In Children Research Articles

Peran Komunikasi Interpersonal Orang Tua dan Anak dalam Mengatasi Kecemasan Menghadapi Ujian Sekolah

This journal discusses the crucial role of interpersonal communication between parents and children in addressing anxiety before facing school exams at SMP Negeri 1 Garut, utilizing the relational dialectics theory. The method employed in this research is qualitative with a descriptive approach. The objective of this study is to comprehend how interpersonal communication between parents and children can help alleviate anxiety levels before school exams. The data used in this research comprise both primary and secondary data. Primary data were obtained through direct interviews with four children and four parents, including a psychologist. Meanwhile, secondary data encompassed journals, books, and other sources such as online searches or the internet. Data collection techniques used in the study include in-depth interviews, field observations, literature reviews, and online searches. The field research results indicate that interpersonal communication between parents and children plays a highly effective and precise role in reducing the anxiety levels of children before facing school exams.

State-Trait and Separation Anxiety Among Mothers with an Only Child Entering Kindergarten

Parents are the first and best teachers for their children. In homeschooling, the level of separation anxiety in kindergarten children is closely related to the level of anxiety in their mothers. The mother's behavior has a greater impact on the child than the father's. Parents' attitudes toward their children, their attitudes toward kindergarten, their own level of education, and their ability to regulate their emotions all affect the level of separation anxiety of children with their mothers. Therefore, it is particularly important to study the anxiety state of mothers when studying kindergarten anxiety in younger children. Since children spend most of their time with their mothers after leaving kindergarten, they chose to study the state-traits and separation anxiety of mothers of only children entering kindergarten". As early as Bowlby's attachment theory, the infant's emotional attachment to the caregiver was mentioned. Hawke et al. argued that, based on Spielberg's theory of state-trait anxiety, the mother's parent-child separation anxiety is a state of infant anxiety caused by short-term separation. When mothers experience occasional separation anxiety, the mother's state emotions include the following three perceived levels: the mother's self-anxiety, the mother's awareness of her child's anxiety, and the mother's anxiety about her child's lack of maternal care.

The Effect of Therapeutic Communication on the Anxiety Level of Children Undergoing the COVID-19 Vaccination

Background: Anxiety is often encountered in society, especially in children, when undergoing the COVID-19 vaccination. Anxiety is a factor influencing children to refuse vaccination. Therefore, nurses need to reduce this level of anxiety through the application of therapeutic communication. This research was carried out to determine the effect of therapeutic communication on children's anxiety levels during the implementation of the COVID-19 vaccination. Methods: A pre-experiment design with a one-group pretest-posttest design was used on 58 respondents who were selected using a simple random sampling technique. The research instrument used was the Zung Self-Rating Anxiety Scale (SAS/SRAS) questionnaire with a Likert scale model, and the results were analyzed using the Wilcoxon Signed Ranks Test statistical test. Results: The results of the Wilcoxon Signed Ranks Test analysis on respondents' anxiety levels showed that there was a decrease in anxiety after therapeutic communication was carried out with a p-value of 0.00 (p < 0.05), which means that therapeutic communication had a significant influence on the anxiety level of children undergoing the COVID-19 vaccination. Conclusion: Therapeutic communication can effectively reduce the anxiety level of children undergoing COVID-19 vaccination.

Effect of audiovisual distraction on pediatric dental anxiety: A cross-sectional study

Background: Children’s oral health and clinical management are significantly affected by dental fear and anxiety. Purpose: This study investigates the effectiveness of audiovisual distraction in reducing the anxiety levels of children visiting for dental treatment. Methods: Sixty pediatric patients ages 6–10 years were included in this cross-sectional study. They were divided into two groups—a study group and a control group—of 30 patients each. The study group was provided with a tablet and headphones that played their favorite shows, and the control group was not provided with any gadgets. For both groups, anxiety levels were scored using the Facial Image Scale. A two-way repeated-measure ANOVA test was used to compare the levels of dental anxiety among the study and control groups at three intervals: before treatment, during treatment, and after treatment. For the tests, the statistically significant difference was assumed at a p ≤ 0.05. Results: The children of both study and control groups had the same anxiety levels (p > 0.05) before the treatment. The study group had reduced anxiety levels compared to the children in the control group during and after the treatment, with p < 0.05. Conclusion: A child’s favorite show can be played using a tablet and headphones for the child, as it has been shown to be an effective and easy method to reduce anxiety in children visiting dentists for operative procedures. This technique of distraction also reduces post-operative stress on the pediatric dentist.

Enhancing special care dentistry with waiting room based multisensory‑adapted dental environment: A randomized controlled-trial.

To assess the effectiveness of waiting room based multisensory adapted dental environment (SADE) as a novel, non-invasive behavior management technique in alleviating anxiety levels in children with Down syndrome. This study was conducted in the Department of Pediatric and Preventive Dentistry, D.Y. Patil University School of Dentistry, Nerul, Navi Mumbai. A total of 40 children between 8 and 13 years of age diagnosed with Down syndrome were included in our study. Prior to the first dental evaluation, they were divided equally into two groups using simple randomization via lottery system. Group A (Intervention group): Patients were subjected to a sensory adapted environment (SADE) in the waiting room for 10 min prior to dental evaluation. Group B (Control group): Patients were subjected to a regular dental environment (RDE) in the waiting room for 10 min prior to dental evaluation. Outcome parameters evaluated at baseline and post dental evaluation were anxiety and behavior, using a pulse oximeter and the Modified Venham's Scale respectively. Data were subjected to statistical analysis using SPSS version 21.0 (SPSS Inc. Chicago, IL). The 'p' value<.05 was taken as significant at 95% confidence interval. Mann-Whitney U test was used to carry out the inter group analysis which showed a significant increase in the heart rate (26.00, p=.00) in Group B and a significant decrease in the Modified Venham Scale score (90.00, p=.001) in Group A. The Wilcoxon Signed ranks test was used to carry out the intra group analysis for which a significant difference between the two time intervals for heart rate (-3.69, p=.00) and Modified Venham Scale score (-1.46, p=.03) was obtained in Group A whereas a significant difference was obtained only in the heart rate (-3.04, p=.002) in Group B. Multisensory-adapted dental environment (SADE) in the waiting room effectively improves behavior, reduces anxiety and sensory discomfort among children with Down syndrome.

Level of anxiety among children with cancer and their parents in Riyadh City

Objective: This study aimed to assess the anxiety levels of children with cancer and their parents following admission to the Military Hospital in Riyadh City.Methods: This cross-sectional study was conducted using a proforma between May 2019 to July 2019. Data collection involved the utilization of two tools. The first tool was a structured interview questionnaire design for children, while the second tool was intended for the parents of the children. The study sample comprised children and their parents who accompanied the child during hospitalization and chemotherapy. Approximately 74 children, aged 6-14 years old, diagnosed with cancer and admitted to the Riyadh Military Hospital, were enrolled in this study using convenience consecutive sampling.Results: A total of 148 individuals participated in this study. Seventy-four parents were enrolled, with 68.9% being mothers and 31.1% fathers. Among the parents in the study, 29.7% experienced severe anxiety, 41.9% reported a moderate level of anxiety, and 20.3% had a low level of anxiety. Seventy-four children were included in the study sample, with 48.6% being boys and 51.4% girls. Among the children, 37.8% exhibited high levels of anxiety, 41.9% displayed moderate anxiety, and 20.3% reported low levels of anxiety. Additionally, a relationship was observed between the anxiety levels of parents and the anxiety levels of their children.Conclusions: This study revealed that both children with cancer and their parents are experiencing moderate to severe levels of anxiety. The psychological well-being of cancer patients and their families is not a topic to be overlooked; rather, it is an important subject that requires attention and consideration.

Mengoptimalkan Motivasi Belajar Bernyanyi Anak (Mengatasi Kecemasan Dengan Gerakan Tematis)

This study aims to describe the relationship between anxiety levels and motivation to learn singing with thematic movements in early childhood. This type of research is ex post facto type causal research or correlation research with a quantitative approach. The population in this study were children aged 5-6 years as many as 30 children. The sampling technique used in this study was Simple Random Sampling with group A at NW Pancor Kindergarten as a research sample of 15 children. The data collection technique used a questionnaire. Data were analyzed using Pearson product-moment correlation. The results showed that there was a negative correlation between the level of anxiety and motivation to learn singing with thematic movements of students because r-count&gt; r-table which is 0.85&gt; 0.482, which means Ho is rejected. The conclusion of this study is that there is a significant relationship between anxiety levels and motivation to learn singing with thematic movements in early childhood at NW Pancor Kindergarten, which indicates that the learning approach is effective in increasing learning motivation and reducing children's anxiety levels.&#x0D; &#x0D; Keywords: Early childhood, Singing, Anxiety, Motivation

Brain response to errors in children who stutter

PurposeHeightened rates of social anxiety have been reported in adults who stutter (AWS), but it is unclear whether anxiety is heightened also in children who stutter (CWS). Objective neurophysiological responses such as the error-related negativity (ERN) have been associated with anxiety, and ERN was reported to be increased in AWS. In this study, we examined whether ERN and error positivity (Pe) are increased in CWS. We further characterized ERN associations with age and anxiety in CWS relative to children who do not stutter (CWNS). MethodsEEG data were recorded from twenty-four CWS and twenty-four matched CWNS aged 3–9 years as they performed a Go/No-Go task. Parent-reported anxiety, and child-reported speech-associated attitude measures were collected. Linear regression models tested the effects of age, group, and their interaction, and the effects of anxiety, group, and their interaction on ERN and Pe. ResultsContrary to expectations, no ERN or Pe difference were observed between CWS and CWNS. However, larger ERN amplitudes were associated with older age in CWS but not CWNS, suggesting altered development of the error monitoring system in CWS. Association of Pe with anxiety also differed between groups: smaller Pe amplitudes were associated with higher level of parent-reported child anxiety in CWNS but not in CWS. Neither anxiety nor self-reported communication attitude differed between groups. ConclusionsBrain responses to errors were overall comparable between CWS and CWNS. However, CWS differed in how error monitoring responses varied with age and with anxiety levels. More research is warranted to examine how these factors contribute to persistent stuttering.

Evaluation of the Relationship Between Oral and Dental Health and Dental Anxiety Levels in Children: A Review

Regular dental visits facilitate early diagnosis and treatment of oral and dental diseases. It has been shown that patients who regularly visit the dentist have a much healthier oral environment compared to those who do not visit regularly and only go to the dentist when necessary. Dental anxiety is a challenging situation for both the patient and the dentist. The patient's negative attitude towards treatment leads to avoidance of dental procedures. This is a significant barrier to carrying out necessary treatments at the right time and in an ideal manner. Our literature review concluded that children experiencing dental anxiety have worse oral and dental health compared to those who do not. Implementing correct behavioral guidance techniques to prevent dental anxiety will also positively contribute to the patient's oral and dental health.

Mobile application for sensory deprivation of neurodiverse children during dental treatment

Relevance. Dental care for children with autism spectrum disorders (ASD) requires modification of the conventional treatment setting, which includes many sensory stimuli that influence the behaviour of these children. However, it is not possible to eliminate all dental treatment stimuli from clinical practice. The development of a new method for digital priming of neurodiverse patients was facilitated by the need to mitigate unavoidable dental treatment stimuli to achieve sensory deprivation, expressed as reduced anxiety and improved cooperation.The study aimed to investigate the level of cooperation and anxiety in children with ASD before and during dental treatment using a developed mobile application.Material and Methods. Forty-three children aged 7 and 12 years old with con-firmed ASD of varying severity participated in the study. The cooperation and anxiety level in children with ASD were assessed according to the Larry L. Venham clinical anxiety rating scale before and during treatment using the mobile application.Results. During dental treatment, the children with mild/moderate autism showed a statistically significant (p &lt; 0.05) decrease in their anxiety level and improvement of the cooperativeness profile, which indicates a positive effect of the developed mobile application on the level of anxiety and cooperation.Conclusion. Further research is necessary to evaluate similar information and communication technology types as a part of significant approaches to sensory deprivation, behaviour improvement, and dental treatment outcomes in vulnerable children.

Preoperative anxiety management in children. Benefits of humanoid robots: an experimental study.

The purpose of this study was to determine whether the use of a humanoid robot (Estrabot) could reduce preoperative anxiety levels in children. An experimental study was conducted at Azienda Ospedaliero Universitaria delle Marche Hospital, involving the Pediatric Surgery ward and the Operating Room (OR). Patients aged between 2 and 14 years who underwent minor surgery were included. The Instruments used were the Children's Emotional Manifestation Scale to evaluate anxiety levels, and Estrabot, a humanoid robot that interacts with people. Medical records between April and May 2023 were analyzed and the data was anonymous. The level of anxiety is extrapolated in Pediatric Surgery during the administration of oral pre-medication, and in the Operating Room, during the induction of anesthesia. Patients were divided into an intervention group treated with Estrabot, and a control group without a robot. The population consists of 60 patients (86.7% male) with a median (IQR) age of 6 (4-8) years. The median (IQR) anxiety score during premedication was 7 (5-11), while the median (IQR) anxiety score during anesthesia was 6 (5-10). A significantly lower level of anxiety was reported in the Estrabot group. Patients in the Estrabot group had significantly lower anxiety levels in different age groups. A humanoid robot can reduce preoperative anxiety levels in children during premedication and the induction of anesthesia.

LADOBALA For Children in the Agronursing Area

Optimal development is the goal that the child is expected to achieve during maturation which can be categorized into 5 domains, one of which is fine motor development. Fine motor development takes longer to achieve than gross motor development so it is necessary to stimulate one of them with a play approach. This study aims to analyze the development of LADO BALA play therapy (playdough Natural ingredients) on fine motor development and anxiety levels in children in the agricultural area. This research is a quasy experiment research with one group pretest-posttest design. The respondents in this study were 78 pre-school children with purposive sampling techniques. The measuring tools used in this study were DDST sheets to assess development and Faces Image Scale (FIS) to assess anxiety. The novelty in this study is that the media used is the result of the development of researchers, namely playdough with natural ingredients, namely wheat flour, salt, food coloring, warm water by utilizing local resources and wisdom in the agronursing area, namely using coconut oil which is safe and beneficial for children's skin health. The data obtained were analyzed with the Wilcoxon signed ranks test to determine the influence between variables. The results of each analysis were obtained namely p = 0.001 which stated that there was an influence of the development of playdough play on fine motor development and anxiety levels in children in the agriculture area. Playing lado bala facilitates children's development through squeezing, shaking, and increasing creativity in children, as well as making children feel happy so as to reduce anxiety in children.Playing ladobala can be one of the stimulations of fine motor development in pre-shool children in the agronursing area and ladobala media can be made by children with parents with easily available and safe materials.&#x0D;

Effect of therapeutic play using a toy nebulizer and toy mask on a child's fear and anxiety levels

PurposeThis study aimed to examine the effect of therapeutic play using a toy nebulizer and mask before inhaler treatment on children's fear and anxiety levels in a pediatric emergency department. Design and methodThis randomized controlled clinical trial included 84 children aged 3–8 years who were admitted to the pediatric emergency department with respiratory system disease. This study was registered in the Clinical Trials database.Therapeutic play was applied to the children in the therapeutic play group with a toy nebulizer, toy mask, and amigurumi doll, after which the children received treatment with these devices. The children in the control group received nebular treatment using a standard nebulizer and a mask. The children were required to answer the ‘Children's Fear Scale’ (CFS) and ‘Children's Anxiety Metre–State’ (CAMS) before and after treatment. ResultsFear and anxiety levels were significantly lower in the therapeutic play group than in the control group (p = 0.001). A statistically significant difference was found between the two groups regarding acceptance of the mask used during treatment and adaptation to the treatment (p = 0.001). ConclusionsTherapeutic play with a toy nebulizer and mask effectively reduced fear of hospitals and related anxiety in children. Practice implicationsPlaying therapeutic play with a toy nebulizer and toy mask during nebulization is a promising strategy to reduce children's fear and anxiety.

The Application Of The Intervention "Puzzle Play Therapy" To Anxiety Levels In An. E Who Was Hospitalized At Bantul Hospital

Background: Hospitalization is a common event in children and can be a traumatic experience for children, which can cause tension and fear and can cause emotional or behavioral disturbances weeks or months after the child leaves the house. Playing in preschool-age children is an important activity and can make children free from the tension and stress experienced, one form of play that is appropriate for children Preschool is playing puzzles. Puzzle is a game that is useful to reduce anxiety levels in children. Objective: To determine the effect of puzzle play therapy on reducing anxiety in preschool-age children who are hospitalized in the Nakula Sadewa room of RSUD Bantul. Method: The research design used was a case study design on An.E with anxiety problems due to hospitalization. Puzzle therapy interventions were carried out four consecutive days with a time of 15-20 minutes each puzzle play therapy intervention. Theinstruments used to measure anxiety levels are the Preschool Anxiety Scale (PAS) with criteria of mild anxiety (&lt;28), moderate anxiety (28-56), severe anxiety (57-84) and panic anxiety ( &gt;85) . Results: The results of the case study showed a decrease in anxiety scores in children. On the first day before the puzzle therapy intervention, the child's anxiety level was at a score of 54 ( moderate anxiety), after four puzzle therapy The day in a row the child's anxiety level dropped to a score of 21 (mild anxiety). Conclusion: The application of puzzle therapy in An.E can reduce the anxiety level of preschool-age children who experience anxiety due to hospitalization.

Hand-Holding's Effect on Children's Pain Perception and Anxiety during Dental Anesthetic Injections.

Local anesthetic injections are an essential tool in dentistry, particularly in pediatric dentistry. The needle penetrating the tissue can cause stress, anxiety, and pain. Studies have shown that using touch may alleviate pain and reduce patient anxiety. Yet, this has not been tested in pediatric dental patients. Therefore, this study examined the effect of hand-holding on children undergoing local anesthetic injections. Its effect on children's pain perception was tested, with the hypothesis that pain perception would be lower for children whose hand was held by an assistant. Additionally, the study examined whether hand-holding would affect children's anxiety levels and cooperation. Fifty-five children, who underwent dental treatment within the Department of Pediatric Dentistry at Tel Aviv University, were recruited. The patients were randomly divided into two groups. In the study group, the assistant gently placed her hand on the patient's hand during the anesthetic injection. In the control group, the same treatment was performed without the hand being placed by the assistant. After the anesthetic injection, the child's pain and anxiety levels were assessed using visual analog scales (VAS). The patients' pulse was measured. The level of cooperation was evaluated using the "Frankl" scale. Interestingly, although the trends aligned with this study's hypotheses, no significant effect of hand-holding on pain, anxiety, or cooperation during anesthetic injections was found.

Evaluation of Children's Anxiety Level in Relation to a Dental Visit/Treatment and Their Parents' Dental Fear.

The patients' fear of the dentist plays an important role in the everyday life of a dentist. The anxiety level of children in relation to dental treatment/visits and to their parents' dental fear was evaluated in three different centers. Assessments of a modified CFSS-DS (mCFSS-DS) were performed by questionnaire with 60 children and their parents. Children's dmft/DMFT scores, age and gender were evaluated in relation to the parents' perception of their child's anxiety levels. For statistical evaluation, Kruskal-Wallis and Wilcoxon tests as well as Spearman's correlation coefficient (Spearman) were used. The significance level was set at 0.05. There were no significant differences regarding children's mCFSS-DS between the three centers (p = 0.398, Kruskal-Wallis). The parents' mCFSS-DS scores correlated significantly with their children's mCFSS-DS scores (p = 0.004, Spearman). However, the mean mCFSS-DS score of the children was significantly higher than the mean score of parents' perception of their child's anxiety (p = 0.000, Wilcoxon). The age of the child had an influence on the mCFSS-DS score (p = 0.02, Kruskal-Wallis) but neither the children's gender (p = 0.170, Kruskal-Wallis), nor the dmft/DMFT showed an impact (p < 0.725, Spearman). Although a positive correlation was found between the results of the children's and parents' questionnaire, many parents underestimated the anxiety level of their children.

The effect of dry heat and dry cold application on pain, anxiety and fear levels before blood sample collection in school age children (7–12 years): A randomized controlled study

BackgroundBlood sampling, which is frequently performed on children admitted to hospital, causes them pain, anxiety and fear. ObjectivesThe study was carried out to determine the effects of dry heat and dry cold application before blood sampling on pain, anxiety and fear levels in school age children. MethodsThe study was conducted between June and January 2021 with a parallel-group randomized controlled experimental design. It was carried out with 117 children who applied to the Pediatric Blood Collection Polyclinic of a training and research hospital. The children were assigned to dry heat application, dry cold application and control group by simple randomization. Data were collected using the Child-Family Introductory Information Form, Wong Baker Faces Pain Rating Scale (WBFPS), Child Fear Anxiety Scale (CFAS) and Medical Procedure Fear Scale (MPFS). In the data analysis, descriptive statistics, the Kruskal-Wallis H test, the Dunn test, Yates correction and the Pearson Chi-Square test were used. A level of p < 0.05 was considered statistically significant. ResultsIt was found that children who were treated with dry heat and dry cold before blood sampling experienced less pain. The anxiety of the children in the dry heat treatment group was lower than the control group. According to the children's MPFS Operational Fear sub-dimension median scores, procedural fear was found to be lower in the dry heat application group. Practice implicationsPediatric nurses can safely use dry heat and dry cold application in the management of invasive procedure-related pain, and dry heat application in the management of anxiety. Trial registrationThis trial is registered with the US National Institutes of Health (ClinicalTrials.gov) under the number NCT05974319.

The effect of anxiety and depression levels of children with celiac disease on quality of life

PurposeThis study was conducted to examine the effect of anxiety and depression levels on quality of life in children with celiac disease. Design and methodThis descriptive and correlational study was conducted with 98 children diagnosed with celiac disease who applied to the pediatric outpatient clinic of a university hospital in Eastern Anatolia between September 2021 and August 2022. Data were collected using the State-Trait Anxiety Scale, Depression Scale, and Quality of Life Scale through face-to-face interviews conducted by the researchers. Percentage distribution, mean, independent samples t-test, Pearson correlation analysis and regression analysis were used to analyze the data. ResultsIt was found that 62% of the participant children were female and their mean age was 11.69 ± 4.15 years. The mean scores of state anxiety, trait anxiety, depression and quality of life of children with celiac disease were 42.46 ± 5.42 (high), 43.83 ± 7.08 (high), 23.37 ± 4.79 (high) and 43.67 ± 19.67 (low), respectively. Regression analysis revealed that anxiety had a statistically significant relationship with quality of life. ConclusionsIt was found that children with celiac disease experienced high levels of depression and anxiety along with physical functionality and psychosocial health problems and this negatively affected their quality of life. It is recommended that children with celiac disease should be followed up and supported psychosocially. Practice implicationsThat healthcare professionals can contribute to reducing the depression and axienty and improving the quality of life by strengthening the social support systems of childrens with celiac disease.

A narrative review on the effectiveness of therapeutic communication in reducing anxiety in children during dental treatment procedures

Background: Dental anxiety is anxiety about dental treatment carried out before or immediately after a dental treatment procedure, which will have an impact on the difficulty of the dental team in carrying out dental treatment. One of the interventions that the dental team can carry out with pediatric patients is therapeutic communication. Objective: This study aims to further discuss regarding the effectiveness of therapeutic communication in reducing anxiety in children during dental treatment procedures. Methods: A systematic search of the Google Scholar database, then a narrative review of the identified articles was conducted with a focus on articles published in the last 10 years. Discussion: Therapeutic communication, a non-pharmacological intervention, plays an important role in managing anxiety in children when undergoing dental treatment procedures, because it has the benefit of reducing psychological problems in children such as anxiety, fear and changes in behavior, especially during dental treatment procedures. Some scientific evidence shows a significant value of p &lt;0.05 and an OR value &gt;1 which indicates a correlation between therapeutic communication and the level of dental anxiety. Conclusion: Based on the results of the narrative review conducted, we conclude that the better the therapeutic communication carried out by the dental team, the lower the level of anxiety in children during dental treatment procedures.

Effects of Cooperative, Competitive, and Solitary Exergames on Cognition and Anxiety Levels in Children with Developmental Disabilities.

Objective: Exergames are playing an important role in person-centered therapy, health care services, and in the rehabilitation field. This study aimed to compare the effects of cooperative, competitive, and solitary exergames on cognition and anxiety levels in children with developmental disabilities (DD). Materials and Methods: This study was a randomized controlled trial pretest-posttest including 36 children with DD who were allocated to the cooperative exergame group (CGG), competitive exergame group (CmGG), and solitary exergame group (SGG). The exergame program was performed two times a week for 8 weeks and the outcome measurements were conducted before and after the program. A paired sample t-test and one-way analysis of variance (ANOVA) were used to analyze the changes within and between the groups. Results: The result indicated a significant improvement in memory, attention, and visual perception in all groups; the CGG and CmGG showed a high increase in attention compared with the SGG. However, only the CGG presented a significant improvement in the language subscale. In terms of anxiety, only the CGG presented substantial improvements in all anxiety subscales. The CmGG showed improvement in social phobia and the SGG in physical injury fears, social phobia, and general anxiety fears. Conclusion: The findings suggest that cooperative and competitive exergames may be used to effectively improve cognitive functions; cooperative exergames can be applied as the most effective method to reduce anxiety compared with the other game types for children with DD.