Acta Psychologica 228 (2022) 103646

Contents lists available at ScienceDirect

Acta Psychologica
journal homepage: www.elsevier.com/locate/actpsy

The association between smartphone and tablet usage and

children development
Supattra Chaibal , Salinee Chaiyakul *
Movement Science and Exercise Research Center, Walailak University, Thasala District, Nakhon Si Thammarat Province 80160, Thailand
Physical Therapy Department, School of Allied Health Sciences, Walailak University, Thasala District, Nakhon Si Thammarat Province 80160, Thailand

A R T I C L E I N F O A B S T R A C T

Keywords: Smartphone and tablet usage duration may relate to problems with early development in children. It is imper­
Child development ative to determine the appropriate duration of its usage by children. The purpose of the study was 1) to
Smartphone usage duration investigate the correlation between child development and smartphone and tablet usage duration, 2) to study the
Tablet usage duration
correlation of smartphone and tablet usage duration between children and their caregivers, and 3) to correlate
Parent
Socioeconomic
child development and other factors. A cross-sectional study was conducted. Eighty-five community children
with a mean age of 4.05 ± 0.91 years were recruited as study subjects. Development was assessed using the
Denver Developmental Screening Test II, which includes gross motor, language, fine motor-adaptive and
personal-social developments. Subsequently, details of smartphone and tablet usage for the next seven days were
recorded. The average duration of smartphone and tablet usage was 82.78 ± 62.82 min/day. In addition,
32.94%, 11.76%, 9.42%, and 2.35%, of children were classified as suspected fine motor-adaptive, personal-so­
cial, language, and gross motor development, respectively. The main findings revealed a highly significant
correlation between a child's smartphone and tablet usage duration and their gross motor development. Chil­
dren's smartphone and tablet usage duration showed a positive significant correlation with the duration spent on
smartphones and tablets by mothers and relatives. Father's medical history and family income showed a sig­
nificant correlation with child development. Thus, caregivers must pay attention to the smartphone and tablet
usage time of children, mothers and relatives to prevent abnormal development in children.

1. Introduction less than two years of age spent approximately 2 h/day on social media,
television programmes, smartphones or other hand-held electronic de­
Currently, there has been an increasing use of technology by com­ vices, which impacts their health, especially their brain development
munity infants and children via several devices, such as smartphones, (Canadian Paediatrics Society, 2017; Council on Communications and
tablets, laptops and televisions (The GSM Association and the Mobile Media, 2016). A study reported that children start using touchscreen
Society Research Institute, 2010). Children who spend a duration mobiles from 6 to 36 months of age. Screen scrolling has been observed
accessing mobile internet with a smartphone, and older children showed to develop and improve fine motor skills (Bedford, de Urabain, Cheung,
an increased rate of smartphone use, since smartphones and tablets Karmiloff-Smith, & Smith, 2016). Thus, AAP guidelines suggest that a
provide easy access to the internet and Wi-Fi instead of activity duration limited amount of educational interactive mobile device use may be
(Council on Communications and Media, 2016; The GSM Association acceptable for young children aged two years or below. Park and Park
and the Mobile Society Research Institute, 2010). Radesky et al. (2020) (2021) found that 17% of 1378 preschool children using smartphones
noted that 121 children aged between 3 and 5 years showed an average could experience problematic smartphone use (PSU), as shown by self-
daily smartphone and tablet usage of approximately 115.30 min/day. As control failure (inability to control their smartphone use according to
children were growing up, they increased the duration of smartphone self-set goals), salience (smartphones are the most silence activity in
usage to play games, watch videos and learn online. daily life) and serious consequences (related to negative physical, psy­
The American Academy of Pediatrics (AAP) reported that children chological and social consequences). Almost all children who used a

* Corresponding author at: Physical Therapy Department, School of Allied Health Sciences, Walailak University, Thasala District, Nakhon Si Thammarat Province
80160, Thailand.
E-mail addresses: [email protected] (S. Chaibal), [email protected] (S. Chaiyakul).

https://doi.org/10.1016/j.actpsy.2022.103646
Received 2 July 2021; Received in revised form 12 June 2022; Accepted 12 June 2022
Available online 21 June 2022
0001-6918/© 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
nc-nd/4.0/).
S. Chaibal and S. Chaiyakul Acta Psychologica 228 (2022) 103646

smartphone for more than 2 h/day showed an increased odds ratio of 2. Methods
7.85 of having PSU. Although the prevalence of duration spent on mo­
bile devices has been reported by previous studies, reports about 2.1. Participants
smartphone and tablet usage duration that might affect child develop­
ment in terms of gross motor, language and personal-social aspects Eighty-five full-term typical community children who were 2 to 5
remain limited. Previous study found that children who classified as the years old from the local villages in Nakhon Si Thammarat province,
routinized use of mobile devices have high personal space, which may Thailand, were recruited as the study participants. The number of par­
further decrease children's social interaction. Social interaction ticipants was calculated from the sample size correlation coefficient
throughout childhood, primary face to face, it is a core factor impacting calculation (Fisher's transformation), which was set to Zα = 1.96, Zβ =
on the development of children's social competence (Hosokawa & Kat­ 0.8 and Z(r) = 0.3 (Cohen, 1988). Inclusion criteria incorporated par­
sura, 2018). Moon et al. (2019) evaluate the relationship between smart ticipants who were healthy, full-term infants with gestational age be­
device usage and development levels and language scores in children tween 37 and 42 weeks and birth weight between 2500 and 4000g.
aged three to five years. Smartphone usage showed a significantly pos­ Children who had a risk or diagnosis related to delayed development
itive correlation with fine motor skills and social development in three- (such as infants who received ventilation and were admitted to the
year-old children. However, smartphone usage time showed negatively newborn intensive care unit (NICU) after birth) and underlying condi­
correlated with expressive language months. tions (such as asthma and neurological, musculoskeletal or congenital
The behaviour of children who were between three and six years of abnormalities) were excluded (Aimsamrarn, Janyachareon, Rattana­
age was influenced from the information and parent characteristics. The thanthong, Emasithi, & Siritaratiwat, 2019). This study was conducted
studies by Chassiakos et al. (2016) and McDaniel (2019) recommended according to the guidelines of the Declaration of Helsinki and was
that preschools can build language skills using videos that teach novel approved by the Human Research Ethics Committee, Walailak Univer­
words, and children can watch these videos on smartphones with their sity, Thailand (WUEC-20-029-01). Parents of typical community chil­
parents, who can teach those words. In addition, the interaction between dren signed consent forms for research participation and agreed for their
parents and children during the using smartphone or tablets affected the children to join this study.
language skill development of children. Moreover, parents who used
smartphones and other devices without their children for long dura­
2.2. Study site and population
tions, rarely have time for interaction with their children may result in
reduced children's language development (McDaniel, 2019). Because
Participants were recruited using convenience sampling. Typical
those children could not effectively learn new words or speak compared
community children who lived in local villages in southern Thailand
with other children. This could affect children's language development
were recruited as participants. Children's houses were single-family
because they could have fewer verbal or nonverbal interactions and may
homes, terraced houses or cottages. The main caregiver was defined as
exhibit the emotions and stresses arising from their parents' use of de­
the person who plays or takes care of the child and could complete the
vices. Several research have been focused on the effect of mother's
questionnaire about the information of their child, which could be a
smartphone usage on the children's behaviour and emotional intelli­
parent, relative or nanny.
gence. Nowadays, there is a limited number of research directly
emphasizing on gross and fine motor and personal-social development.
Furthermore, there are many factors related to child development. 2.3. Measurement instrument
Previous studies identified factors involved in the development of chil­
dren, including maternal age during pregnancy, educational level, 2.3.1. Questionnaire
family income, occupation, interaction, and perception of parents The researcher interviewed the main caregiver by using the ques­
(Chaikongkiat, 2018; Pattanapongthorn, Boonsuwan, & Thanjar­ tionnaire to collect descriptive data, socioeconomic demographic and
uenwachara, 2014). In addition, children's behaviour or development smartphone and tablet usage parameters. The questionnaire consists of
was affected by their caregivers, such as the electronic media usage of three parts:
their parents and relatives. Currently, there are few studies in the
pertinent literature that survey and examine the correlation between the (1) Eight items on children's characteristics including gestational
age of first touchscreen usage associated with developmental mile­ age, one-minute and five-minute of Apgar scores, chronological
stones: gross motor, fine motor, and language. The result showed that age, sex, birth weight and head circumference, delivery method
earlier touchscreen use was significantly associated with the fine motor and health history. For example, the question for this part is “how
milestone (Bedford et al., 2016). No evidence has directly assessed the many weeks of gestational age?” and “what is the type of delivery
relationship between gross motor, fine motor-adaptive, language and method?”.
personal-social development with the duration of smartphone and tablet (2) Seven items on the main caregivers' characteristics including age,
usage by children and parents. Therefore, the objectives of this study number of children, educational level, occupation, family in­
were 1) to examine the correlation between electronic smartphone and come, health history and smartphone or tablet data. For instance,
tablet usage duration and child development, 2) to examine the corre­ the questions of caregivers or parents were “what is the level of
lation between a child's smartphone and tablet usage duration and that parent's education?” and “do you have medical health problem or
of their caregiver, and 3) to study the correlation between other factors underlying disease?”.
such as age, educational level, socioeconomic status and the smartphone The average time to complete interviews in parts (1) and (2)
and tablet usage duration of parents or relatives and child development was 30 min.
in typical children in the community. There are three hypotheses of this (3) Three items on smartphone and tablet usage of children were
study, the smartphone and tablet usage duration of children associated inquired from the main caregivers by interview. The researcher
with their development and the duration of electronic usage of their called parents or main caregivers to collect data twice a day
caregivers. In addition, caregiver characteristics including age, educa­ within five to ten mins. Moreover, the main caregiver recorded
tional level, occupation, medical history and family income correlated the data which is required for the interview were time since start
with child development. of smartphone and tablet use, media type, time of day of device
use and smartphone usage duration over seven consecutive days
for reduced missing data. For example, the smartphone and tablet
usage of children's question was “how many minutes per day does

2
S. Chaibal and S. Chaiyakul Acta Psychologica 228 (2022) 103646

a child spend on their smartphone and tablet?” and “what is the 3. Results
period in daily that child spends on a smartphone and tablet?”.
Eighty-five children (43 boys and 42 girls) participated in this study.
2.3.2. Denver Developmental Screening Test (Denver II) All participants were healthy, full-term infants with normal gestational
Denver II is a screening tool to detect developmental delays from age, Apgar score and birth weight. Fifty children were born by vaginal
birth to 6 years of age (Chiu & DiMarco, 2010; Moraes, Weber, Santos, & delivery, whereas 35 children were born by caesarean section. The
Almeida, 2010). The assessment comprises 125 items divided into four findings revealed that children began using smartphones and tablets at
category skills of development: gross motor (32 items), fine motor- an average age of 2.77 ± 1.04 years and continuously used them for 1.33
adaptive (39 items), language (25 items) and personal-social (29 ± 0.83 years. The average smartphone and tablet usage time was 82.78
items). For each skill evaluated by the items on the assessment, there ± 62.82 min/day and 6.25 ± 1.42 days/week. In addition, most children
was a specific subset that 75% to 90% of the children passed. A child spent time using smartphones and tablets by watching cartoons in the
received a ‘caution’ label when they failed a skill that 75% to 90% of the Thai and English languages. Only 11 and six children reported that they
same age children passed and a ‘delay’ label when the child did not used smartphones and tablets for playing games and watching docu­
perform an activity passed by >90% of the children of the same age. The mentaries, respectively. Moreover, the smartphone usage time in
screening tool was used to evaluate and classify the children into three younger children aged between two and three years was approximately
groups: (1) normal group: children with no delays and a maximum of 115.62 ± 94.33 min/day, and the time decreased as the children grew
one caution label; (2) suspect group: children with two or more caution older. Children mostly used smartphones and tablets during the daytime
labels and/or one or more delay labels; and (3) untestable group: chil­ (06:01 a.m. to 09:00 p.m.). In addition, it did not show a statistical
dren that refused to perform one or more skills completely or children difference in the characteristics between boy and girl subjects. The
with more than one skill in the subset of skills passed by 75% to 90% of characteristics of the participants, including chronological age, gesta­
children (Chiu & DiMarco, 2010; Moraes et al., 2010). Denver II showed tional age, birth weight, head circumference, Apgar score, weight,
a high test-retest reliability (0.90–0.95) and a Cronbach's α coefficient of height and duration spent on smartphones and tablets, are shown in
0.95–0.96 (Shahshahani, Vameghi, Azari, Sajdi, & Kazemnejad, 2010). Table 1.
The assessment was performed in the participants' homes where parents Table 2 presents the characteristics of the parents and caregivers,
or caregivers were close to the participant. During the assessment, the including their age and smartphone usage duration, educational level,
child was awake, alert and not crying. The duration of the assessment occupation, medical history and family income. The results showed that
was approximately 30 min for each participant. If the assessment was the main caregiver of children was the mother (76.47%), followed by the
not completed, the researcher had to repeat the assessment within two father and a relative, including a grandparent and nanny. The average
weeks. The assessor used in this study is a physical therapist who had smartphone usage times of the father, mother and relative were 179.52
experience using the Denver II for at least three years. The assessor ± 134.96, 190.45 ± 165.37 and 210.00 ± 183.71 min/day, respec­
performed the test with 10 children who were not included in the main tively. The fathers of three participants had underlying diseases, namely,
study within a 7-day interval. Cronbach's α coefficient for inter-rater hypertension, diabetes, gout and allergy, whereas the mothers of three
reliability and intra-rater reliability were 0.898 (95% CI 0.821–0.942)
and 0.998 (95% CI 0.993–1.00), respectively. Kappa's measure of
Table 1
agreement was 0.806.
Mean and standard deviations for characteristics of participants and smartphone
and tablet use (n = 85).
2.4. Procedure Demographic data Participants; Mean (SD)

Total Male Female

The main caregivers were asked questions to obtain demographic
and socioeconomic information about their children. The researcher 1. Number of participants; n (%) 85 (100) 43 (50.59) 42 (49.41)
2. Age; years 4.05 (0.91) 3.98 (0.98) 4.13 (0.84)
called the caregivers to obtain data regarding the time that the children 3. Gestational age; weeks 38.79 (1.12) 38.79 (1.28) 38.79 (0.95)
started using their smartphone and tablet, the media type, the time of 4. Birth weight; grams 3098.32 3095.28 3101.43
day that the device was used, and the duration spent on the device over (308.47) (292.69) (327.37)
the next seven days. Research asked the caregiver to estimate the 5. Birth head circumference; 33.05 (1.96) 33.15 (1.73) 32.94 (2.19)
centimetres
average daily used and then the researcher use that data to calculate an
6. Apgar score
average duration for 7 days period. After that, the gross motor, fine at 1 min 8.99 (0.11) 9.00 (0.00) 8.98 (0.15)
motor-adaptive, language and personal-social development of children at 5 min 10.00 (0.00) 10.00 (0.00) 10.00 (0.00)
were assessed according to the Denver II test. 7. Weight; kg 15.22 (2.79) 15.66 (3.33) 14.77 (2.04)
8. Height; cm 98.29 (8.73) 99.26 (8.95) 97.31 (8.50)
9. Age at start of smartphone/ 2.77 (1.04) 2.48 (1.06) 3.07 (0.95)
2.5. Statistical analyses tablet use; years
10. Time since start of 1.33 (0.83) 1.51 (0.95) 1.06 (0.82)
smartphone/tablet use; years
The data concerning the personal characteristics of the participants 11. Duration on smartphone/
and their parents or main caregivers were analysed in terms of the mean, tablet (7-days report);
standard deviation, frequency and percentile. For children's data, the min/day 82.78 83.25 82.28
duration of smartphone and tablet usage was calculated by averaging (62.82) (63.58) (62.83)
<1 h (n, %) 33 (38.80) 18 (41.90) 15 (35.70)
over the 7 days period. Independent t-test was used to test the differ­ 1–2 h (n, %) 33 (38.80) 16 (37.20) 17 (40.50)
ences for the participant characteristic between boy and girl. The cor­ >2 h (n, %) 19 (22.40) 9 (20.90) 10 (23.80)
relation between a child's smartphone and tablet usage duration and days/week 6.25 (1.42) 6.28 (1.42) 6.21 (1.44)
that of their caregivers was analysed by Pearson's correlation coefficient. 12. Smartphone/tablet usage time
per age group; min/day
The chi-squared test was used to analyse the correlation between sub­
2–3 years of age (n = 8) 115.62 86.00 164.99
categories of smartphone and tablet usage duration and child develop­ (94.33) (94.03) (87.23)
ment and to correlate child development and subcategories of other 3–4 years of age (n = 32) 84.82 88.28 79.76
factors such as age, educational level, and socioeconomic status. Sta­ (63.61) (73.42) (48.19)
tistical significance was set at p value < 0.05 using IBM SPSS statistics 4–5 year of age (n = 45) 75.48 77.50 73.99
(54.93) (44.88) (62.09)
Version 23.0 (IBM Corporation, United States).

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S. Chaibal and S. Chaiyakul Acta Psychologica 228 (2022) 103646

Table 2 Table 4
Number and percentage of characteristics of parents and relatives (n = 85). Correlation between variables (age at start of smartphone and tablet use,
Characteristics Father Mother Relative
chronological age and duration spent on smartphone and tablet by fathers,
(n = 80) (n = 79) (n = 17) mothers and relatives) and smartphone/tablet usage of children (n = 85).

n % n % n % Variables r p value

1. Age; years 1. Age at start of smartphone/tablet use − 0.030 0.784

<35 36 45.00 50 63.29 3 17.65 2. Chronological age − 0.057 0.603
≥35 44 55.00 29 36.71 14 82.35 3. Duration spent on smartphone/tablet
2. Main caregiver (n = 85) 3 3.53 65 76.47 17 20.00 Fathers (n = 80) 0.133 0.259
3. Smartphone usage time 54 67.50 67 84.81 9 52.94 Mothers (n = 79) 0.294 0.015*
min/day; mean (SD) 179.52 190.45 210.00 Relatives (n = 17) 0.703 0.002*
(134.96) (165.37) (183.71) *
p value < 0.05 derived from Pearson's correlation coefficient.
<1 h 17 31.48 25 37.31 2 22.22
1–2 h 8 14.82 11 16.42 2 22.22
>2 h 29 43.70 31 46.27 5 55.56 at start of smartphone and tablet use, chronological age, or time spent on
4. Educational level smartphones and tablets by fathers.
Primary school 30 37.50 16 20.25 – –
The purpose of this study was to evaluate the correlation of four
Secondary school 35 43.75 47 59.50 – –
Vocational certificate/Bachelor's/ 15 18.75 16 20.25 – – aspects of development with the smartphone and tablet usage time of
Master's and Doctorate children and other factors, including age, educational level, economic
5. Occupation status and smartphone and tablet usage duration of parents. Moreover,
Lecturer/teacher/official worker 9 11.25 9 11.39 – – this study also correlated the duration spent on smartphones and tablets
Business owner 20 25.00 27 34.18
by children and their caregivers. Smartphone and tablet usage time was
– –
Employee 44 55.00 21 26.58 – –
Agriculturalist 6 7.50 4 5.06 – – divided into three categories: <1 h/day, 1–2 h/day and >2 h/day. The
Unemployed 1 1.25 18 22.79 – – results revealed a significantly high correlation between the smartphone
6. Medical history and tablet usage time of children and gross motor development (χ2 =
Yes 3 3.75 3 3.80 – –
6.657, p value = 0.036). Father's medical history had a high correlation
No 77 96.25 76 96.20
with the gross motor development of children (χ2 = 12.157, p value <
– –
7. Family income n %
<15,000 baht 58 68.24 – – 0.001). Furthermore, the results also showed a significant correlation
≥15,000 baht 22 31.76 – – between family income and the personal-social development of children
(χ2 = 4.169, p value = 0.041). However, the results did not show a
significant correlation between the children's smartphone and tablet
participants had thalassemia and thyroid disease. The results demon­
usage duration and their fine motor-adaptive, personal-social or lan­
strated that 36.47% of parents had two children in their family, followed
guage development, as shown in Table 5.
by one, three and more than three for 28.24%, 21.17% and 14.12%,
respectively. Moreover, the results showed that the most frequent parent
4. Discussion
occupation was employee, followed by business owner, unemployed,
lecturer and agriculturalist. In addition, 68.24% of parents had a family
This study found a significant correlation between smartphone and
income <15,000 baht.
tablet usage duration of children and their gross motor development.
According to the Denver II assessment results, gross motor, fine
Children's time spent on smartphones and tablets over seven days
motor-adaptive, personal-social, and language aspects categorized par­
showed a positive significant correlation with the time spent on smart­
ticipants into the normal and suspected development groups. Table 3
phones and tablets by mothers and relatives. In addition, other factors
shows that the number of children in the suspect group in all considered
that impact gross motor development were father medical status and
aspects was less than the number of children in the normal development
family income, which were also related to the personal-social develop­
group. There were 32.94%, 11.76%, 9.42%, and 2.35% of children
ment of children.
classified as suspected development for fine motor-adaptive, personal-
Eighty-five children started using smartphones and tablets at an early
social, language and gross motor development, respectively.
age (2.77 ± 1.04 years). Younger children spent more time on smart­
In this study, the children's smartphone and tablet usage duration
phones and tablets than their older counterparts. This is contrary to
over seven days consecutive was recorded. The results revealed that the
previous studies that reported children using screen time, as well as an
time spent on smartphones and tablets by children showed a significant
average daily increase of it with age (Bedford et al., 2016; Zhao et al.,
positive correlation with the time spent on smartphones and tablets by
2020). This might be related to Thai culture. Some children have over
their mothers (r = 0.294, p value = 0.015) and relatives (r = 0.703, p
three years to attend pre-kindergarten during the daytime. Children
value = 0.002), as shown in Table 4. However, there was no correlation
under the age of three years almost always spent the daytime at their
between the time spent on smartphones and tablets by children and age

Table 3
Number, percentage, mean and standard deviations for normal and suspected child development assessed by the Denver II (n = 85).
Area/categories Normal Suspected

Children Duration on smartphone/tablet; min/day Children Duration on smartphone/tablet; min/day

n % Mean (SD) n % Mean (SD)

1. Gross motor 83 97.65 81.32 2 2.35 143.58

(62.83) (15.15)
2. Fine motor-adaptive 57 67.06 75.23 28 32.94 98.17
(48.61) (83.74)
3. Personal-social 75 88.24 84.15 10 11.76 72.50
(62.21) (69.88)
4. Language 77 90.58 80.93 8 9.42 100.65
(61.15) (79.74)

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S. Chaibal and S. Chaiyakul Acta Psychologica 228 (2022) 103646

Table 5 concepts and strategies that they learn from face-to-face interaction with
Correlation between variables (time spent on smartphone and tablet of children their parents or caregivers (Canadian Paediatrics Society, 2017; Chang
and parents, demographics of parents such as age, education level, occupation et al., 2019). Activities on smartphones and tablets, including watching
and medical history and income) and development, measured using Denver II. cartoons and playing games without parents, did not improve these
Variables Child development; χ2 (p value) children's ability to speak (Council on Communications and Media,
Gross motor Fine motor Personal- Language 2016).
adaptive social Moreover, this study showed a significantly positive correlation be­
1. Duration spent on 6.657 0.632 5.759 0.975
tween the duration spent on smartphones and tablets of children and the
smartphone/tablet (0.036)* (0.729) (0.056) (0.614) duration of smartphone and tablet use of mothers and relatives. The AAP
of children reported that when parents spend a long time on mobile devices, it
2. Father's data reduced the time that parents spent playing with their children (Cana­
Duration spent on 0.539 1.181 3.060 2.630
dian Paediatrics Society, 2017; Council on Communications and Media,
smartphone/tablet (0.764) (0.554) (0.217) (0.269)
Age 0.021 1.279 2.886 0.090 2016). Piya-amornphan, Santiworakul, Cetthakrikul, and Srirug (2020)
(0.886) (0.258) (0.089) (0.764) reported that active play was associated with family time (r = 0.485, p
Education level 0.488 2.470 3.766 3.651 value < 0.001) and that optimal physical activity especially develops the
(0.783) (0.291) (0.152) (0.161) thinking process during childhood. The AAP reported that an increased
Occupation 0.932 5.017 6.418 4.781
(0.920) (0.286) (0.170) (0.310)
duration of parental use of media was consistent with fewer verbal and
Medical history 12.157 0.004 1.237 1.886 nonverbal interactions between parents and children (Canadian Paedi­
(<0.001)** (0.951) (0.266) (0.170) atrics Society, 2017; Council on Communications and Media, 2016).
3. Mother's data Dysfunctional relationships occur during parental neglect and smart­
Duration spent on 2.459 0.273 0.265 0.106
phone addiction (Fischer-Grote, Kothgassner, & Felnhofer, 2019).
smartphone/tablet (0.292) (0.873) (0.876) (0.949)
Age 0.156 0.018 2.673 0.525 Therefore, parents should be aware of their own smartphone usage time
(0.693) (0.892) (0.102) (0.469) instead of focusing only on the smartphone usage time of their children
Education level 1.397 1.860 4.524 2.262 (Council on Communications and Media, 2016).
(0.497) (0.394) (0.104) (0.323) There are several factors that impact early development in children.
Occupation 3.952 3.211 1.472 5.763
(0.413) (0.523) (0.832) (0.218)
The research findings demonstrated a significant association between
Medical history 0.081 1.712 0.452 0.351 gross motor development and fathers' medical history. From the litera­
(0.776) (0.191) (0.501) (0.553) ture review, the father's income, education level and occupational were
4. Family income 0.953 2.058 4.169 0.186 the factors related to children's development (Derikx, Houwen, Meijers,
(0.329) (0.151) (0.041)* (0.666)
Schoemaker, & Hartman, 2021). This is the first study that showed the
*
p value < 0.05 derived from Chi-squared test. relationship between motor development and father's health. It might be
**
p value < 0.001 derived from Chi-squared tests. caused by the health problems such as gout, hypertension and diabetes
reduced the physical activity of those fathers and disturbed the inter­
home with caregivers in which a child has an opportunity to play action between father and child to do an activity to promote motor
smartphones and tablets more than a child who went to pre- development. Fathers with high physical activity could promote
kindergarten at approximately 20 min/day. An average daily seven- adequate child physical activity to improve gross motor development by
day recording showed a duration of smartphone and tablet use of playing, creating stimulating situations with many opportunities to
82.78 ± 62.82 min/day. This is consistent with previous studies that move (Derikx et al., 2021). Mustafaoglu et al. (2018) suggested that
suggested that children aged two years old or older spend less than an parents should generate physical activity and positive social interaction
average of 2 h/day on smartphones and tablets (Council on Communi­ with children to accomplish healthy growth and development.
cations and Media, 2016; Canadian Paediatrics Society, 2017; Hosokawa In addition, personal-social development shows a significant corre­
& Katsura, 2018; Mustafaoglu, Zirek, Yasaci, & Ozdincler, 2018; Rade­ lation with family income. More than half of the families in this study
sky et al., 2020). These differences might relate to the results of Denver had low income, their parents left a child with a caregiver all daytime for
II; almost all children in this study were categorized as normal rather work. The main reason reported parents less time to concentrate on free
than a suspect. This study revealed that 32.94% of children were clas­ play with a child. Conger, Conger, and Martin (2010) reported that
sified as a suspected fine motor-adaptive skill. There are only a few family income is related to child development, as it has additive con­
studies that assessed fine motor development associated with smart­ tributions to family characteristics and human development. Further­
phone and tablet usage. Bedford et al. (2016) found that early more, there have been numerous studies about parents being concerned
touchscreen scrolling at 6 to 36 months old was associated with earlier about the negative and positive effects of children's smartphone usage
fine motor achievement. This contrasting result might be caused by the on their development (Genc, 2014; Chang et al., 2019; Mustafaoglu
difference in activity or media type during smartphone usage. The main et al., 2018). Most parents were concerned that the negative effects of
activity of this study was watching cartoons, so children might have smartphone usage can cause physical and mental problems (Genc,
performed less touchscreen scrolling. In contrast to this evidence, chil­ 2014). A few studies have demonstrated a highly positive perception of
dren aged two years can hold smartphones firmly on their hands. Chil­ parents regarding the effects of smartphones on early development such
dren who are four years of age learn to perform multi-finger touchscreen as language and social development. Smartphone usage can improve
gestures (Yaday & Chakraborty, 2021). child development, develop creative thinking, develop individual
The children's smartphone and tablet usage duration correlated with problem-solving skills and provide greater opportunities early (Musta­
their gross motor development. Because preschool children sat for a long faoglu et al., 2018; Chang et al., 2019).
duration and concentrated on a smartphone, children did not move or The limitation of this study is not longitudinally followed child
engage in activities to drive gross motor development. Furthermore, development. Long-term monitoring of early development in preschool
Hosokawa and Katsura (2018) reported that children who used mobile children could provide evidence about the developmental trend because
technology for >60 min on a typical day were significantly associated delayed development is represented in the long term in children who
with emotional/behavioural problems and hyperactivity or inattention. spend long durations of time on smartphones and tablets. The number of
For language development, preschool children aged 2–5 years should subjects is too small for using an advanced correlation statistic to predict
learn, begin to understand and remember new words, relationships, children's development, especially linear or logistic regression analyses.
Further study should emphasize the different media types and

5
S. Chaibal and S. Chaiyakul Acta Psychologica 228 (2022) 103646

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Funding Derikx, D. F. A. A., Houwen, S., Meijers, V., Schoemaker, M. M., & Hartman, E. (2021).
The relationship between social environmental factors and motor performance in 3-
This research was supported by Research Institute for Health Sci­ to 12-year-old typically developing children: A systematic review. International
Journal of Environmental Research and Public Health, 18(14), 7516. https://doi.org/
ences (RIHS), Walailak University (grant numbers WU-IRG-63-052, 10.3390/ijerph18147516
2020). Fischer-Grote, L., Kothgassner, O. D., & Felnhofer, A. (2019). Risk factors for problematic
smartphone use in children and adolescents: A review of existing literature.
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CRediT authorship contribution statement Genc, Z. (2014). Parents’ perceptions about the mobile technology use of preschool aged
children. Procedia Social and Behavioral Sciences, 146, 55–60. https://doi.org/
Supattra Chaibal: Conceptualization, Methodology, Data curation, 10.1016/j.sbspro.2014.08.086
Hosokawa, R., & Katsura, T. (2018). Association between mobile technology use and
Formal analysis, Funding acquisition, Resources, Investigation, Writing child adjustment in early elementary school age. PLOS ONE, 13(12), Article
– original draft, Writing – review & editing. Salinee Chaiyakul: e0208844. https://doi.org/10.1371/journal.pone.0208844
Conceptualization, Methodology, Data curation, Formal analysis, McDaniel, B. T. (2019). Parent distraction with phones, reasons for use, and impacts on
parenting and child outcomes: A review of the emerging research. Human Behavior
Funding acquisition, Resources, Investigation, Writing – original draft, and Emerging Technologies, 1(2), 72–80. https://doi.org/10.1002/hbe2.139
Writing – review & editing. Moon, J.-H., Cho, S. Y., Lim, S. M., Roh, J. H., Koh, M. S., & Kim, J. K. (2019). Smart
device usage in early childhood in differentially associated with fine motor and
language development. Acta Paediatrica, 108(5), 903–910. https://doi.org/10.1111/
Declaration of competing interest
apa.14623
Moraes, M. W., Weber, A. P. R., Santos, M. C. O., & Almeida, F. A. (2010). Denver II:
The authors declare that they have no known competing financial Evaluation of the development of children treated in the outpatient clinic of project
interests or personal relationships that could have appeared to influence einstein in the community of Paraisópolis. Einstein, 8(2), 149–153. https://doi.org/
10.1590/s1679-45082010ao1620
the work reported in this paper. Mustafaoglu, R., Zirek, E., Yasaci, Z., & Ozdincler, A. R. (2018). The negative effects of
digital technology usage on children’s development and health. Addicta: The Turkish
Acknowledgements Journal on Addictions, 5(2), 227–247. https://doi.org/10.15805/
addicta.2018.5.2.0051
Park, J. H., & Park, M. (2021). Smartphone use patterns and problematic smartphone use
This research was supported by a grant from RIHS at Walailak Uni­ among preschool children. PLOS ONE, 1–12.
versity (grant numbers WU-IRG-63-052, 2020). The authors gratefully Pattanapongthorn, J., Boonsuwan, C., & Thanjaruenwachara, N. (2014). In The study of
Thai early child development (pp. 1–113). Ministry of public health Thailand.
acknowledge the research assistance by Wilaiwan Phongsapan, Maslin Piya-amornphan, N., Santiworakul, A., Cetthakrikul, S., & Srirug, P. (2020). Physical
Mitumphunt, Kanassanan Kumpananurak and Arissar Saisahut and their activity and creativity of children and youths. BMC Pediatrics, 20, 118. https://doi.
contribution to subject recruitment and general support. Special thanks org/10.1186/s12887-020-2017-2
Radesky, J. S., Weeks, H. M., Ball, R., Schaller, A., Yeo, S., Durnez, J.Barr, R., … (2020).
is for all public health volunteers who facilitated subject recruitment. Young children’s use of smartphones and tablets. Pediatrics, 146(1), Article
We would like to express our appreciation to the parents and caregivers e20193518. https://doi.org/10.1542/peds.2019-3518
of home-raised children in Nakhon Si Thammarat province, Thailand. Shahshahani, S., Vameghi, R., Azari, N., Sajdi, F., & Kazemnejad, A. (2010). Validity and
reliability determination of Denver developmental screening test-II in 0–6 year-olds
in Tehran. Iran Journal Pediatric, 20(3), 313–322.
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