A digital anxiety intervention for children with reading difficulties

INTERVENTION: The digital anxiety intervention is a web‐based and clinician‐led program that delivers Cognitive Behavioural Therapy (CBT). The intervention was developed given that reading difficulties and anxiety tend to co‐occur and become a vicious cycle. These children tend to struggle with understanding content of existing digital anxiety interventions as they tend to be text heavy. A team of leading researchers in the field of anxiety and reading, and user experience specialists worked collaboratively via co‐design process. The co‐design process involved 3 X1‐hour semi‐structured interviews and 2 X2‐hour workshops (N=18; n=8 parents, n=6 children and n=4 clinicians). Researchers, clinicians and user experience specialists discussed findings from the qualitative methods to design the intervention accessible for children with reading difficulties and anxiety. The intervention is an exposure‐focused program which aims to teach children strategies to manage their anxiety. The intervention includes strategies such as gradual exposure, psychoeducation, and cognitive restructuring. The intervention will be delivered on google‐classrooms and includes videos and worksheets. Children will be guided through the digital anxiety intervention with the clinician (Provisional or Registered Psychologist) via telehealth (one‐on‐one video calls) for 1 X60‐minute session per week for 10 weeks. The intervention will be delivered by psychologists who are co‐investigators on this study. They will have experience in working with children and delivering CBT. Psychologists will be provided with a 1 hour training and orientation session to provide them details about the study and intervention, and orient them to the therapist manual which was designed specifically for this study and p CONDITION: Anxiety;Reading difficulties ; ; Anxiety ; Reading difficulties; Mental Health ‐ Anxiety PRIMARY OUTCOME: Anxiety (parent‐reported) measured by the Spences Child Anxiety Scale‐Parent[Baseline, 5‐week, 12‐week (primary timepoint), and 24‐week follow‐ups post‐baseline] SECONDARY OUTCOME: Anxiety (child‐reported) measured by the Spences Child Anxiety Scale‐Child[Baseline, 5‐week, 12‐week, and 24‐week follow‐ups post‐baseline] Reading accuracy measured by Castles and Coltheart Test 2 (CC2)[Baseline, 12‐week, and 24‐week follow‐ups post‐baseline] Reading anxiety (child‐reported) measured by The Macquarie Oxford Reading Anxiety Test‐ Child (MoRAT‐C)[Baseline, 5‐week, 12‐week, and 24‐week follow‐ups post‐baseline ; ] Reading anxiety (parent‐reported) measured by The Macquarie Oxford Reading Anxiety Test‐ Parent (MoRAT‐P)[Baseline, 5‐week, 12‐week and 24‐week follow‐ups post‐baseline] Reading fluency measured by Test of Word Reading Efficiency 2 (TOWRE)[Baseline, 12‐week, and 24‐week follow‐ups post‐baseline.] Remission of anxiety measured by the Anxiety Disorders Interview Schedule (ADIS ‐V) ‐ Parent[Baseline and 12‐week follow‐up post‐baseline] Self‐concept measured by Reader Self‐Perception Scale (RSPS)[Baseline, 12‐week post‐intervention, and 24‐week follow‐up ] INCLUSION CRITERIA: • Children aged 7‐12 years in Australia • Reading level ‐1 standard deviation (SD) below average on (1) one or more word lists from the Castles and Coltheart Reading test (CC2; regular, irregular or nonword lists) and/or (2) the nonword or irregular word list from the Test Of Word Reading Efficiency (TOWRE) • Diagnosis of (1) any anxiety disorder based on the DSM‐5‐TR (i.e. social anxiety disorder, separation anxiety disorder, generalised anxiety disorder, panic disorder, agoraphobia, specific phobia or unspecified anxiety disorder) and/or (2) obsessive compulsive disorder assessed using the ADIS‐V. • Normal or corrected to normal vision and hearing (parent self‐report) • Willingness to give written informed consent (verbal student assent) and willingness to participate to and comply with the study.