# Targeting neurobehavioral substrates of effortful control to reduce childhood anxiety: The Camp Kidpower study protocol

## TL;DR

This study tests a new play-based intervention, Camp Kidpower, to improve attention and impulse control in preschoolers with anxiety, aiming to reduce symptoms and improve outcomes.

## Contribution

The study introduces a novel RDoC-informed intervention targeting effortful control to address childhood anxiety.

## Key findings

- The trial will assess the impact of EC training on anxiety symptoms and neurophysiological markers like ERN and ICPS.
- Exploratory analyses will examine factors like baseline EC and parental psychopathology as moderators of intervention efficacy.
- If effective, the intervention could offer a scalable, community-based alternative to traditional CBT for young children.

## Abstract

Early childhood anxiety affects up to 20% of preschoolers, with long-term implications including depression, substance abuse, and suicide. Despite some success with exposure-based cognitive behavioral therapy (CBT), many children retain clinically significant symptoms, highlighting the need for innovative interventions. This study integrates the Research Domain Criteria (RDoC) and experimental medicine frameworks to target effortful control (EC)—the capacity to regulate attention and impulses—to reduce anxiety in young children through a novel intervention, Camp Kidpower.

This randomized clinical trial involves 90 preschoolers diagnosed with anxiety disorders, assigned to either an EC training camp or an active comparator condition (child-led play; CLP). The EC intervention incorporates play-based activities targeting selective attention, inhibitory control, and working memory, delivered over five weekly sessions with at-home practice. Anxiety and EC were assessed pre- and post-intervention using clinician ratings, parent/teacher reports, lab-based tasks, and neurophysiological measures (e.g., error-related negativity [ERN] and interchannel phase synchrony [ICPS]). Exploratory analyses include dose-response effects and moderators such as baseline EC, parental psychopathology, and child temperament.

Camp Kidpower aims to enhance EC to mitigate anxiety in preschoolers, addressing the limitations of traditional CBT by offering an accessible, community-based intervention. This study will provide insight into the neurobehavioral mechanisms linking EC and anxiety, inform the design of targeted treatments, and evaluate potential moderators of intervention efficacy. If successful, the intervention could be disseminated broadly to clinics, schools, and community settings.