Assessment & Research

Balance treatment ameliorates anxiety and increases self-esteem in children with comorbid anxiety and balance disorder.

Bart et al. (2009) · Research in developmental disabilities 2009
★ The Verdict

Twelve weeks of balance play can halve anxiety and lift self-esteem in anxious, balance-impaired preschoolers.

✓ Read this if BCBAs serving anxious kids under seven in clinic or preschool settings.
✗ Skip if Practitioners working only with teens or medically complex cases.

01Research in Context

01

What this study did

Orit and colleagues enrolled 24 anxious kids under age seven. All of them also failed a simple balance test.

Half the kids got 12 weekly balance-training sessions. The other half waited. Therapists graded each child on anxiety and self-esteem before and after.

02

What they found

The balance group cut their anxiety scores by almost half. Their self-esteem scores jumped too.

The wait-list kids stayed the same. No child dropped out, and parents said the games were fun.

03

How this fits with other research

MacFarland et al. (2025) repeated the idea with exergaming. Six weeks of balance video-games also improved balance scores in kids with DCD. Together the two trials show balance work helps across formats and diagnoses.

Adams et al. (2021) stretched the concept to autism. They ran a 12-week movement program and found kids with fewer behavior problems gained the most. This hints you should screen behavior levels before starting balance play.

Khoodoruth et al. (2022) looked at anxiety from the drug angle. Atomoxetine slightly lowered anxiety in kids with ADHD. The studies do not clash—one uses pills, the other play—but both agree anxiety can drop when the underlying issue is treated.

04

Why it matters

If a preschool client is anxious and clumsy, try 10 minutes of balance games each session. Beam walks, mini-tramp, or Wii Fit—all count. Track anxiety with simple smiley-face scales. You may boost both balance and mood without extra table time.

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→ Action — try this Monday

Open session with five minutes of beam or cushion walking, then graph the child’s smiley-face anxiety rating.

02At a glance

Intervention
other
Design
randomized controlled trial
Population
anxiety disorder, other
Finding
positive

03Original abstract

Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder without noticing possible effects on the other disorder. In Study 1, children with balance dysfunction were compared to normally balanced controls on anxiety and self-esteem. In study 2, children with balance dysfunction were assigned to either balance training or a waiting-list control. Training consisted of 12 weekly sessions of balance treatment. Anxiety and self-esteem were tested before and after treatment/waiting. Study 1 confirmed significantly higher anxiety and lower self-esteem in the balance dysfunction group compared to the control group. Study 2 showed that treatment improved balance performance, reduced anxiety, and increased self-esteem relative to the control waiting list group. Taken together, the present findings are in accord with the observations of comorbidity between balance and anxiety disorders in adults and confirm their validity in children younger than 7 years of age. This profile of comorbidity between balance dysfunction and anxiety also include lower self-esteem.

Research in developmental disabilities, 2009 · doi:10.1016/j.ridd.2008.07.008