Peer-reviewed article

Effects of laughter yoga on reducing depression and anxiety in children with autism spectrum disorder and parenting stress in their parents: study protocol for a randomised-controlled feasibility trial.

Chung JOK, Lam CY, Leung SF, Bressington D, Chong ACY · 16 Jun 2026

Abstract

Introduction Both children with autism spectrum disorder (ASD) and their parents are at a high risk of experiencing anxiety and depression. Recent studies have indicated that laughter yoga can create happiness and reduce negative emotions in adults. However, there are limited studies about how laughter yoga benefits children with ASD and parents of children with ASD. This feasibility study aims to explore the recruitment, retention rate, protocol adherence and acceptability of a laughter yoga programme in children with ASD and their parents. Moreover, it investigates the safety issues and the effects of laughter yoga on reducing depression and anxiety in children with ASD, as well as parenting stress in their parents. Methods and analysis This study protocol describes a feasibility study aimed at evaluating the feasibility and acceptability of a laughter yoga intervention for children with ASD and their parents. This feasibility study uses a randomised, wait-list-controlled trial and pre-test-post-test design. The primary outcomes include recruitment rate, screening rate, attendance rate, dropout rate, perceptions of laughter yoga, difficulties encountered and safety issues. The secondary outcomes focus on depressive and anxiety symptoms among children with ASD and parenting stress levels. Data will be collected before the intervention (T0), immediately after the intervention (T1) and 3 months after the intervention (T2). 66 children with ASD and their parents will be recruited in Hong Kong through social media posts. Participants will be randomly assigned to either the laughter yoga group or the wait-list-control group. The laughter yoga group will receive the intervention which consists of 12 classes of 1-hour laughter yoga over 6 months. After the intervention, families will be invited to join a family-based semi-structured interview, which aims at understanding participants' experiences, safety concerns and feedback they may have. The wait-list control group will receive no treatment until the completion of T2. The collected data will be used to evaluate the feasibility and acceptability of laughter yoga for children with ASD and their parents. Ethics and dissemination This study was approved by the Human Subject Ethical Subcommittee of The Hong Kong Polytechnic University (No.: HSEARS20230723002). The results of the research project will be published in an academic journal. Trial registration number NCT06326255.