Background Childhood anxiety is associated with long-term consequences, including the development of mood disorders and functional challenges, if not treated early. However, literature shows that young children do not receive timely interventions due to long waiting lists, a shortage of psychologists, and an inability to complete interventions that are between 9 and 20 sessions, due to their parents’ competing commitments. Cognitive Behavioural Therapy (CBT) is the main non-pharmacological intervention used for the treatment of anxiety. CBT is a talking-based therapy which helps people explore and manage unhelpful thoughts to reduce distressing emotions or problematic behaviours. While often recommended, CBT alone may not be effective in treating childhood anxiety and is not always developmentally appropriate for younger children. Sensory modulation is a clinical intervention that uses sensory-based strategies to help with emotion regulation and can be adapted for young children. To address a gap in early intervention for younger children with anxiety, a modified CBT plus sensory modulation intervention was developed, which could potentially be delivered by a wide range of clinicians.

Study Design The current study tested the effectiveness, acceptability, and practicality of a 6-session modified CBT plus sensory modulation anxiety intervention developed for children aged 4 to 7 years old presenting with anxiety. The study used a multiple baseline single case experimental design. Six children with clinically significant anxiety were admitted to the study. Four therapists delivered the intervention with the children and their mothers (n=6) at a Child, Adolescent, and Family Service and a Child and Family Care Trust. The six children received the intervention during the study phase, where the intervention was delivered in a staggered fashion. Data, including the levels of each child’s anxiety and functioning, were collected at multiple baseline points, then during and post-intervention and 1-month follow-up. Visual and statistical analyses of data were completed to determine the effectiveness of the intervention. Subjective feedback from the mothers and therapists were also collected. Content analysis was used to analyse the subjective feedback to determine the acceptability and practicality of the intervention.

Results Quantitative findings and visual analysis of data provided evidence supporting the effectiveness of the intervention in treating childhood anxiety. Subjective feedback data showed that the intervention was received as an acceptable and practicable intervention for younger children with anxiety. One month post-intervention data showed that gains were maintained, with four children not meeting the threshold for a primary diagnosis of anxiety with which they were diagnosed upon entering the study.

Implications This study was the first to combine CBT and sensory modulation for younger children presenting with anxiety. The study findings provide preliminary evidence that the intervention was effective, acceptable, and practicable. However, larger randomised clinical trials are required to confirm the effectiveness of the intervention. The results contribute to the further understanding of how to develop age-appropriate interventions for the management of childhood anxiety, including the use of sensory-based strategies for younger children. The manualised intervention has the potential to help address childhood anxiety by providing non-psychology professionals, with a framework for supporting younger children early.