A Synthesized Meta-Analysis on the Efficacy of Augmented Reality(AR) in Treating Anxiety Disorders in Generation Alpha Children

Background: Generation Alpha (born ۲۰۱۰-۲۰۲۵) represents a cohort characterized by unprecedented digital fluency, making traditional therapeutic modalities potentially less engaging. Concurrently, childhood anxiety disorders are rising, necessitating innovative, technologically-driven interventions. This synthesized meta-analysis evaluates the current evidence (۲۰۲۰–۲۰۲۵) on the effectiveness of Augmented Reality (AR) and related Extended Reality (XR) technologies in reducing anxiety symptoms in this population. Methods: A systematic search was conducted across Google Scholar and scientific databases for randomized controlled trials (RCTs) and systematic reviews published between ۲۰۲۰ and ۲۰۲۵, focusing on AR/VR interventions for anxiety in children and adolescents (۷–۱۵ years). Data on effect sizes (Standardized Mean Difference, SMD) were extracted or calculated from eight key studies, including both international and Persian-language research. A random-effects model was employed for the pooled effect size calculation, and heterogeneity was assessed using the 𝐼 ۲ statistic. Results: The pooled effect size for AR/VR interventions compared to control conditions (e.g., standard care or waitlist) was significantly large (SMD = -۰.۹۵, ۹۵% CI: -۱.۲۲ to -۰.۶۹), indicating a substantial reduction in anxiety symptoms. Subgroup analysis suggested that while both AR and Virtual Reality (VR) are effective, VR interventions currently show a slightly larger effect size (SMD = -۰.۸۵) compared to AR (SMD = -۰.۷۸), although both demonstrate clinical significance. The analysis also revealed high heterogeneity (𝐼 ۲ =۹۱%), largely driven by a single outlier study (Bulduk et al., ۲۰۲۵) which reported an exceptionally large effect (SMD = -۳.۸۷) in a highly controlled pediatric endoscopy setting. Conclusion: The findings strongly support the use of AR and XR technologies as effective, non-pharmacological adjuncts or alternatives for treating anxiety disorders in Generation Alpha children. The high digital affinity of this generation makes immersive technologies a promising avenue for engaging them in exposure and cognitive-behavioral therapies.Further high-quality RCTs are needed to standardize AR protocols and directly compare AR with established treatments like Cognitive Behavioral Therapy (CBT).