Determinant Analysis of Smartphone Addiction in Preschoolers in

Indonesia

Lidia Aditama Putri1, Munisah2, Diyana Faricha Hanum3, Rani Rosita4, Hilda Fitria5, Nurun Nikmah6, Ika
Yulianti7, Rafi’ah8, Herlia Sumardha Nasution9, Rizky Maharja10
1,2,3,4,5
Department of Midwifery, Faculty of Health, Universitas Muhammadiyah Gresik, Indonesia
6
Department of Midwifery, Institute of Health Science Ngudia Husada Bangkalan, Indonesia
7
Department of Midwifery, Faculty of Health, Universitas Borneo Tarakan, Indonesia
8
Departement of Nursing, Institute of Health Science Griya Husada Sumbawa, Indonesia
9
Department of Midwifery, Institute of Health Science RS Haji Medan, Indonesia
10
Academy of Corporate Hygiene and Occupational Health Makassar, Indonesia

Coresponding author: Lidia Aditama Putri

Email: liydyaputri@umg.ac.id

ABSTRACT

Keywords:

INTRODUCTION
The alpha generation is children born after 2010. They are the generation that was born and grew up
when technology and information were developing rapidly in the world, not least in Indonesia. The
alpha generation is already familiar with smartphones and the internet, so they tend to use it in
everyday life, even though they are still very early.
The existence of technology and information that is currently developing very rapidly indeed offers
various facilities. Parents usually have introduced a smartphone as a learning tool for children.
Therefore, children in the alpha generation are expected to be a generation that is smarter than
children born in the previous generation.
However, behind the sophistication and ease in accessing technology and information via
smartphones, there is a danger that lurks children in the alpha generation. Children are interested in
new technology and are accustomed to operating such devices more easily than adults. Children aged
3-6 years are generally very interested in moving and sounding images like those displayed on
smartphones, so the possibility of children becoming addicted to using smartphones continuously
becomes greater
Smartphone addiction is a phenomenon related to the uncontrolled use of smartphones.
People with this problem experience social, psychological, and health problems [1]. Smartphone
addiction in children can cause fatigue, sleep disturbance, impaired vision and hearing, disruption of
the child's relationship with parents, and can even be fatal, which is a developmental disorder and
depression in children. [2] [3] [4] [5] [6]
Worldwide, smartphones are used by 1.85 billion people in 2014. This number is expected to
be 2.32 billion in 2017 and 2.87 billion in 2020. [7] Data obtained based on a survey from the
Association of Indonesian Internet Service Providers (APJII) in 2018 explained that 264.16 million
Indonesians, 171.17 million people used smartphones, this means that 64.8% of Indonesians aged 5
years and over had using a smartphone. [8]

Although, until now there has been no survey that shows the percentage of smartphone
addiction in children, but according to Dr. Tjhin Wiguna, child and adolescent psychiatrists at the
Department of Mental Health FKUI RSCM in the Department of Mental Health FKUI RSCM states that the
phenomenon of children addicted to smartphones, increased in the last three years. The number of
parents who come to ask for a smartphone addiction case consultation to a child protection agency or
bring their child to a psychologist and psychiatrist also increases. The Child Protection Agency handled
17 cases of smartphone addiction in 2003 while the National Commission for Child Protection handled
42 cases of children who were addicted to smartphones. [9]
In particular, children are a high-risk group for smartphone addiction. Children are interested
in new technology and are accustomed to operating such devices more easily than adults. Especially if
a child is given a smartphone at an early age without parental control, this makes one of the high risk
factors for smartphone addiction in pre-school children. [2] In addition to family factors, several other
factors that influence smartphone addiction in children include gender, age, duration of smartphone
use, use patterns, type of school, personality, and social network [10]
The development of information technology at this time hasn’t be avoided by parents. The
presence of a smartphone and the internet is indeed useful for children's learning tools, but on the
other hand it is also dangerous if the child excessively uses a smartphone and even becomes addicted.
Therefore, raising and educating children in the alpha generation has its own challenges for parents
The purpose of this research are analyze the determinants of smartphone addiction in pre-
school children by using path analysis.

METHODOLOGY
Ethical Consideration
The ethic clearance of this study has been issued by Dr. Tjhin Wiguna, child and adolescent psychiatrist
at the Department of Psychiatric Mental Health FKUI RSCM in the Department of Mental Health FKUI
RSCM

Study Design and Sampling

This type of research is analytic research, using cross sectional approach. The sample in this study are
mothers who have children aged 3-6 years who live in Indonesia. The sampling technique is done by
purposive sampling.

Data Collection
This research was conducted from February to June 2020. The research was carried out in Indonesia,
mainly carried out in the Indonesian archipelago, namely the islands of Sumatra, Java, Kalimantan,
Sulawesi, and the Eastern Indonesian Archipelago. The questionnaire is distributed online via the link
https://forms.gle/gWfXDeeoa4b17xFWA

Data Analysis
The independent variables in this study were mother's age, mother's education, mother's occupation,
child smartphone ownership, parental control, rules for smartphone use at home, and smartphone
usage regulations in school. Then the dependent variable in this study is smartphone addiction. The
instrument used in this study was to use a questionnaire that was distributed online throughout
Indonesia.
Data were analyzed using path analysis using the IBM SPSS STATA 13 application. While data
on the biopsychosocial effects of smartphone use using univariate analysis using IBM SPSS 22.

RESULTS
A total of 1932 respondents had filled out the questionnaire and the following results were obtained :

Table 1.Characteristics of respondents

Characteristics Category N %
 Domicily Sumatra Island 256 18.4
Java Island 373 26.7
Kalimantan Island 298 21.4
Sulawesi Island 268 19.2
Eastern Indonesia 197 14.3
Mother’s age < 35 years 984 70.7
≥ 35 years 408 29.3
Number of children < three 1072 77.0
≥ three 320 23.0
Child’s age 3 years 364 26.2
4 years 292 21.0
5 years 212 15.2
6 years 524 37.6
Child’s sex Male 689 49.5
Female 703 50.5
Child’s school level At Home 384 27.6
Play Group 280 20.1
Kindergarten 728 52.3
Mother’s education < Bachelor degree 333 23.9
≥ Bachelor degree 1059 76.1
Mother’s occupation Unemployed (housewife) 544 39.1
Employed 848 60.9
Family income* < average income Indonesia 728 47.7
≥ average income Indonesia 664 52.3
*Average income of Indonesian people is 59 million per year or Rp. 4.916.666 per month in 2020

Respondents who participated the most in this study came from Java, which is the island
with the most populous population in Indonesia, as many as 373 people (26.7%). Most respondents in
this study were <35 years old, as many as 984 mothers (70.7%) and had children less than 2 people.
Based on the age of the children, most were 6 years old, totaling 524 children (37.6%) and most of
them were studying in the Kindergarten Playgroup, as many as 728 children (52.3%) (Table 1).
Table 1 also shows that the level of education of the mothers was mostly graduate
graduates, totaling 1059 people (76.1) and the majority of mothers working outside the home,
amounting to 848 (60.9%). While based on the amount of income, most families have an income below
the average income of the Indonesian population per year, which is 728 (47.7%).

Table 2.Smartphone Use Behavior on Children in Indonesia, 2020

Characteristics Category N %
How much child using smarphone per day? Not every day 584 41.9
0 – 1 times 492 35.3
2 – 3 times 228 16.4
4 – 5 times 44 3.2
More than 5
44 3.2
times
How long child using smartphone per times? 15 – 30 minutes 443 31.8
31 – 59 minutes 161 11.6
1 – 2 hours 534 38.4
More than 2
254 18.2
hours
Can child use internet in own or parent’s Yes 820 58.9
smartphone? No 572 41.1
Application that are often accessed by Photos and
19 1.4
children videos
Youtube 1181 84.8
Games 180 12.9
 Social Media 12 0.9

Table 2 shows the usage habits of smartphones in children in Indonesia. The table shows that the
majority of children in Indonesia use smartphones at least once a day (35.3%) within 1-2 hours (38.4%).
Most children can use the internet through their parents' smartphones and / or through their own
smartphones, as many as 820 children (58.9%). In general, most of the children watched YouTube on
smartphones, as many as 1181 children (84.8%).

Table 3. Univariate analysis on determinants of smartphone addiction on children in Indonesia,

2020
Characteristics Category N %
Mother’s age Young mother 984 70.7
Old mother 408 29.3
Mother’s education Low education 333 23.9
High education 1059 76.1
Mother’s occupation Unemployed (housewife) 544 39.1
Employed 848 60.9
Parent’s control Low control 772 55.5
High control 620 44.5
Child personal Not have personal
376 27.0
smartphone smartphone
Have personal smartphone 1016 73.0
Family smartphone rules No 1152 82.8
Yes 240 17.2
School regulation about
Not have regulation 908 65.2
smartphone use
Have regulation 484 34.8
Smartphone addiction Low risk 544 39.1
High risk 848 60.9

Table 3 explains the descriptive analysis of the research variables, most of the study
respondents were young, namely 984 young mothers (70.7%). Most of the mothers had high education
(76.1%) and had work outside the home (60.9%). Based on parental control over the use of children's
smartphones, the majority of respondents have weak control, which is 772 (55.5%). Most of the
toddlers also have a personal smartphone, which is 1016 (73.0%). Most of the regulations on the use of
smartphones at home have not been disciplined, as many as 1152 people (82.8%). In the school
environment, most do not yet have regulations regarding the prohibition of using smartphones, which is
as much as 908 (65.2%). Most children have a high risk of smartphone addiction, which is as much as
848% (848%).

Table 4. Bivariate analysis on determinants of smartphone addiction on pree-school children in

Indonesia, 2020
Smartphone Addiction OR CI 95% p
Variables Category Low Risk High Risk Lower Upper
n % n % Limit Limit
Mother’s age Young 332 23.9 652 46.8 2.12 1.68 2.69 0.000
Old 212 15.2 196 14.1
Mother’s education Low 109 7.8 224 16.1 1.43 1.11 1.86 0.006
High 435 31.3 624 44.8
Mother’s Housewife 172 12.4 372 26.7 1.69 1.35 2.12 0.000
Occupation Employed 372 26.7 476 34.2
Parents control Low 248 17.8 524 37.6 1.93 1.55 2.40 0.000
High 296 21.3 324 23.3
Child personal No 114 8.2 262 18.8 1.69 1.31 2.17 0.000
 smartphone Yes 430 30.9 586 42.1
Family smartphone No 480 34.5 672 48.3 1.96 1.44 2.68 0.000
rules Yes 64 4.6 176 12.6
School regulation No 388 27.9 520 37.3 1.58 1.25 1.98 0.000
about smartphone Yes 156 11.2 328 23.6
use

The results of the bivariate analysis of the independent variables on the dependent variable
of the study using chi square are shown in table 2. The results of the analysis show that there is a
relationship between maternal age (OR = 2.12; 95% CI = 1.68 to 2.69; p = 0.000), maternal education
(OR = 1.43; 95% CI = 1.11 to 1.86; p = 0.006), mother's occupation (OR = 1.69; 95% CI = 1.35 to 2.12; p =
0.000), mother's occupation (OR = 1.69; 95% CI = 1.35 to 2.12 ; p = 0.000), parental control over the
use of a child's smartphone (OR = 1.93; 95% CI = 1.55 to 2.40; p = 0.00o), ownership of the child's
personal smartphone (OR = 1.69; 95% CI = 1.31 to 2.17; p = 0,000), rules for smartphone use in the
family (OR = 1.96; 95% CI = 1.44 to 2.68; p = 0.001), and regulations for smartphone use in schools (OR
= 1.58; 95% CI = 1.25 to 1.98; p = 0.000) risk of smartphone addiction in children
Picture at number 1 shows the fit model after estimation with path analysis using the IBM
SPSS STATA 13 application. There is a positive direct effect of child smartphone ownership on the risk
of smartphone addiction and is statistically significant (b = 0.74; 95% CI = 0.46 to 1.01; p = 0.000).
There was a positive direct effect of parental control on the risk of smartphone addiction and was
statistically significant (b = 0.59; 95% CI = 0.59 to 0.36; p = 0.000). There was a positive direct effect of
parents' work on the risk of smartphone addiction and was statistically significant (b = 0.52; 95% CI =
0.28 to 0.76; p = 0.000). There is a positive direct effect of maternal age on the risk of smartphone
addiction and is statistically significant (b = 0.89; 95% CI = 0.63 to 1.14; p = 0.000), in detail it can be
seen in table 5.
There is a direct negative impact of school regulations on the ownership of a child's personal
smartphone and is statistically significant (b = -0.53; 95% CI = -0.80 to -0.27; p = 0.000). There was a
positive direct effect of regulation of smartphone usage at home on parental control and was
statistically significant (b = 0.77; 95% CI = 0.47 to 1.07; p = 0.000). There was a positive direct effect of
children's smartphone ownership on parental control and was statistically significant (b = 0.74; 95% CI =
0.49 to 0.99; p = 0.000). There is a positive direct effect of mother's education on mother's work and is
statistically significant (b = 1.54; 95% CI = 1.27 to 1.80; p = 0.000), in detail it can be seen in table 5.

binomial binomial
binomial
binomial
-.53
School_regulation Childs_personal_smartphone
School_regulation -.53
Childs_personal_smartphone
1.4
1.4
logit logit
logit
logit

.74
.74
.74
.74
binomial binomial
binomial
binomial
.77
family_smartphone_rules.77 Parents_control
family_smartphone_rules Parents_control
-1.4 -1.4 .59
logit logit .59 binomial
logit logit binomial

Smartphone_addiction_risk
Smartphone_addiction_risk
-1.9 -1.9
binomial binomial logit
logit
binomial binomial .52
.52
1.5
1.5
Mothers_Education
Mothers_Education Mothers_occupation
Mothers_occupation
-.71
-.71
logit
logit logit
logit
.89
.89

binomial
binomial

Mothers_age
Mothers_age
logit
logit

Picture no. 1. Path Analysis Determinant of Smartphone Addiction

Table 5. Path analysis on determinants of smartphone addiction on pre-school children in

Indonesia, 2020
 CI 95%
Path
Dependent Variable Independent Variables Lower Upper p
Coefficient
Bound Bound
Direct Influence
Smartphone  Child personal
0.74 0.46 1.01 0.000
addiction smartphone
 Parents control 0.59 0.36 0.82 0.000
 Mother’s occupation 0.52 0.28 0.76 0.000
 Mother’s age 0.89 0.63 1.14 0.000
Indirect influence
Child personal 
School regulation -0.53 -0.80 -0.27 0.000
smartphone
Parents control  Family smartphone rules 0.77 0.47 1.07 0.000
 Child personal
Parents control 0.74 0.49 0.99 0.000
smartphone
Mothers occupation  Mothers education 1.54 1.27 1.80 0.000

Table 6. Multivariate analysis on smartphone addiction effect on pree-school children

in Indonesia, 2020
95% CI for odds ratio
Variables SE OR Lower p
Upper Bound
Bound
Tired body 0.13 1.43 1.12 1.85 0.005
Sleep disorder 0.14 2.44 1.87 3.17 0.000
Tantrum 0.12 5.60 4.40 7.14 0.000
Social disorder 0.13 0.74 0.55 0.90 0.005

Conclusion
There is an effect of body fatigue on the effects of smartphone addiction (OR = 1.43; 95% CI = 1.12 to
1.85; p = 0.005). There was an effect of sleep disturbance on the effects of smartphone addiction (OR
= 2.44; 95% CI = 1.87 to 3.17; p = 0.000). There is the influence of tantrum children on the effects of
smartphone addiction (OR = 5.60; 95% CI = 4.40 to 7.14; p = 0.000). There is an influence of social
disorders of children on the effects of smartphone addiction (OR = 0.74; 95% CI = 0.55 to 0.90; p =
0.005).

LIMITATION
The limitation in this study is this study only has a small subjects due to limited research resource and
time before submitting the final report.

ACKNOWLEDGEMEN
The author appreciates the Faculty of Health Sciences in the Midwifery Study Program at
Muhammadiyah University Gresik and the Ethics Committee Dr. Tjhin Wiguna, child and adolescent
psychiatrist at the Department of Mental Health FKUI RSCM at the Department of Mental Health FKUI
RSCM. Finally, we would like to thank all the respondents who participated in this study

Conflict of interest: Authors declare no conflict of interest.

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