Seems like pen lineart with colored pencils to finish? Interesting subject matter - it's got that psychological childhood freakiness that fits with stuff like the Binding of Isaac.

The shading/coloring from the pencils is good and consistent, and it gives everything some texture, too. The handdrawn lines give the bear a good fuzzy edge.

The bear arm and snout in the foreground could use some wrinkles or shading to give them that "slightly forward" perspective, but other than that it's up to usual practice.