<![CDATA[Background Rapid increases in gadget exposure among preschool children raise concerns about negative effects on socioemotional and cognitive development. Structured associative play, involving cooperative art and storytelling activities, may counter these impacts by enhancing social interaction among children and engagement with trained facilitators, emotional regulation, and cognitive stimulation. Global recommendations emphasize guided play and parental engagement to mitigate screen-related harms. Objective To evaluate the effects of a four-week associative play therapy program on socioemotional and cognitive development in preschoolers with frequent gadget use. Methods A randomized controlled trial was conducted at Kurnia Sari Kindergarten, Surabaya, involving 80 children aged 4–6 years with moderate to high gadget use (≥1 hour/day, parent-reported), who were randomly assigned to an associative play intervention (n=40) or a control group (n=40). The intervention, delivered twice weekly for 30-40 minutes, consisted of collaborative painting, collage making, storytelling, and literacy-based play. Socioemotional and cognitive outcomes were measured using observation tools adapted from the 2013 Indonesian National Curriculum (CVI=0.86; κ≈0.82). Data were analyzed using independent t-tests, with significance set at P<0.05. Results Children receiving associative play therapy demonstrated significantly higher mean socioemotional and cognitive scores compared to the control group (34.85 (SD 3.21) vs 28.40 (SD 3.76), P<0.001) and 36.10 (SD 3.04) vs 30.25 (SD 3.59), P<0.001), respectively. Both effects were large and clinically meaningful, supporting the efficacy of play-based interventions in early education. Conclusion A structured four-week associative play therapy significantly enhanced socioemotional and cognitive development among preschool children with moderate to high gadget use (≥1 hour/day). Incorporating associative play into early childhood curricula and community-based child health promotion, along with parental education, may help mitigate potential developmental risks associated with early and frequent gadget use. Parental education is also recommended to foster developmental resilience in the digital age.]]>
