Abstract
BACKGROUND: The rapid increase in screen time among preschool children has become a growing public health concern, as digital gadgets are increasingly integrated into children's daily lives. Excessive screen exposure may reduce opportunities for direct social interaction and experiential learning, thereby increasing the risk of adverse personal-social development outcomes. Personal-social development is a critical component of early childhood growth, enabling children to interact effectively with peers and their environment. This study aimed to examine the association between the duration and intensity of screen time and the risk of suboptimal personal-social development among preschool-aged children. METHODS: A quantitative cross-sectional study was conducted involving 98 parents of preschool children recruited from a single preschool setting in Bandung, Indonesia. Data were collected using structured, parent-reported questionnaires assessing screen time duration and frequency, and the risk of suboptimal personal-social development, based on a previously applied personal-social development instrument in the Indonesian context. Personal-social development scores were categorized into optimal (lower risk) and suboptimal (higher risk) based on an established cut-off. Screen time variables were classified according to risk-based thresholds. Descriptive statistics, chi-square tests, and multivariable analyses were performed to examine associations while adjusting for child age and parental education. RESULTS: The findings showed a statistically significant association between screen time duration and the risk of suboptimal personal-social development (p < 0.001), as well as between the intensity of gadget use and the risk of suboptimal personal-social development (p < 0.001). Children with prolonged daily screen time (≥120 minutes) had a higher risk of suboptimal personal-social development (53.1%) compared with those with limited screen exposure. Similarly, children who used gadgets frequently (>3 times per day) were at greater risk of suboptimal personal-social development than those with moderate or minimal use. CONCLUSION: Prolonged duration and high intensity of screen time are significantly associated with an increased risk of suboptimal personal-social development among preschool children. These findings highlight the importance of parental monitoring and the establishment of appropriate limits on screen use during early childhood. Health professionals, educators, and policymakers should work collaboratively to promote balanced digital habits and screen time awareness as part of early childhood development strategies in the digital era. This study contributes to achieving SDG 3 (Good Health and Well-being) and SDG 4 (Quality Education), particularly Target 4.2 on early childhood development.