| Summary: | <h4>Background</h4>The purpose of the present study was to identify smartphone use patterns associated with problematic smartphone use (PSU) among preschool children. Little is known about PSU patterns in younger children, although the age for first smartphone use is decreasing.<h4>Methods</h4>We applied a cross-sectional study design to analyze data obtained from a nationwide survey on smartphone overdependence conducted in 2017 by the South Korean Ministry of Science and ICT and the National Information Society Agency. Data from 1,378 preschool children were analyzed using binomial logistic regression analysis. This study was conducted in compliance with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology).<h4>Results</h4>Seventeen percent of the sample met the criteria for PSU. The odds of PSU significantly increased with frequent smartphone use and in children who used a smartphone for more than two hours per day. Using smartphones to watch TV shows or videos for entertainment or fun significantly increased the odds of PSU, whereas using smartphones for education, games, and social networking did not.<h4>Conclusions</h4>The findings indicate that one of five preschool children using smartphones could experience PSU. Compared to other age groups, PSU in young children may be more associated with their caregivers. To prevent PSU in preschool children, caregivers need information about the total screen time recommended for children, smartphone use patterns associated with PSU, suggestions for other activities as possible alternatives to smartphone use, and strategies to strengthen children's self-regulation with regards to smartphone use.
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