A Systematic Literature Review of Social Media Usage among People with Intellectual Disability

Many people are still excluded from participating in the digital world because of their intellectual disabilities. Participation in the digital world is, however, essential to meaningful contributions to society. This systematic literature review examined 13 articles published between 2015 and 2023 about social media usage among persons with intellectual disability. A combination of keywords and terms was used to search PubMed, Scopus, PsycINFO, Cochrane


INTRODUCTION
Social media refers broadly to Internet-based applications used by individuals for facilitating the sharing of text and multimedia through virtual networks and communities.Essentially, they are Web 2.0 Internet-based applications that allow users to create and share personal content (Kaplan & Haenlein, 2010).A social media site is a website for blogging (e.g., Facebook), social networking (e.g., Twitter), collaboration (e.g., Wikipedia), content-creating communities (e.g., YouTube), or virtual game worlds (e.g., World of Warcraft) (Kaplan & Haenlein, 2010).In 2004, Facebook was created, resulting in a steady increase in social networking site usage.Globally, Internet use and social media are becoming more popular.Among American adults, Fox and Rainie (2014) found that 87% had access to the Internet, while 73% used social networking sites.
Two-thirds of Australian adults who used the Internet at home went online for social networking (Australian Bureau of Statistics, 2014).In Western Europe, 54% and in Eastern Europe, 44% of the population used social media (Dixon, 2017).Youth and children are particularly affected by this.In Europe, children have access to the Internet at an earlier age and in a more diverse manner, which is concerning.It is important to recognise that there are both advantages and risks associated with social networking sites.Children's safety on social networking sites should be protected by laws that help minimise harm (EU Kids Online, 2014).In recent years, the Internet has become increasingly helpful in disseminating information because it can reach a massive audience (Sturm & Quaynor, 2020).
Individuals differ in their intellectual abilities and perceptions when it comes to using digital media.There has been a significant advancement in data-driven urbanism regarding urban governance and smartness (Abella et al., 2017;Kitchin, 2016Kitchin, , 2019)).Several researchers have, however, expressed concern regarding the widening digital divide, resulting in substantial social disparities (Vanolo, 2014).A recent study by Graham (2002) asserts that urban polarisation and technological distancing of the powerful from the less powerful is exacerbated by using social media and information and communication technologies (ICTs).In the age of rapid digitalisation of society, daily activities are increasingly performed through social media (Carretero et al., 2017;Kilinc et al., 2023).In addition, it influences what people do and how they engage in occupations (Larsson-Lund, 2018;Larsson-Lund & Nyman, 2020).It is especially surprising that this has occurred in a technological revolution in which devices have become smaller, faster, cheaper, and easier to operate (Foley & Ferri, 2012).
People with disabilities, especially those with limited intellectual ability, may find that internet use provides flexibility which allows them to perform activities in different ways.This results in a less stressful everyday life (Larsson-Lund & Nyman, 2020).Conversely, people with intellectual disabilities (ID) may also find using the Internet more difficult because it involves cognitive skills (Lussier-Desrochers et al., 2017).Technology usage varies greatly between people with and without disabilities (Hoppestad, 2013).Generally, digital competencies are grouped into five categories: (1) information and data literacy; (2) using the Internet to collaborate and communicate; (3) creating digital content; (4) Internet safety; and (5) problemsolving (Carretero et al., 2017).Learning digital competencies online may be particularly beneficial for young people with ID.Leisure activities, higher education, and employment are already largely out of reach for the group (Lussier-Desrochers et al., 2017).
The likelihood of an individual with intellectual and developmental disabilities obtaining employment or completing postsecondary education is low, and they may also be at risk of poverty and social exclusion (Manzoor & Vimarlund, 2013).People with ID can, however, now become consumers, employees, and voters, thanks to assistive devices, computers, tablets, smartphones, and social media (Johnson et al., 2013;Leopold et al., 2015).It is also possible for people with intellectual and developmental disabilities to benefit from this type of technology by gaining increased health literacy and directing their health care (O'Hara et al., 2008).The use of social media by people with ID has also been shown to be beneficial.Through social media, people can develop relationships, express themselves, and gain self-confidence and self-esteem (Caton & Chapman, 2016;Evans et al., 2018).A few studies examined specific topics, including how people with ID access and use social media (Caton & Chapman, 2016;Rustan, 2020;Shpigelman, 2018;Shpigelman & Gill, 2014), how they use digital devices (Hoppestad, 2013), and how they deal with other viewpoints regarding their Internet usage (Molin et al., 2015).
Intellectual disability (ID) is characterised by a developmental disorder that occurs early in life (before age 18) (Jacob & Pillay, 2020).Individuals with ID have a low intellectual capacity combined with deficiencies in multiple adaptive areas, such as social, mental, and physical skills (Littlejohn, 2002), and their IQ is below 70.People with ID have deficits in intellectual and adaptive functioning in everyday life's conceptual, social, and practical domains (American Psychiatric Association, 2013;Tassé et al., 2016).A person's ID level, which ranges from mild to severe, is determined by their cognitive abilities, such as solving problems or communicating.Furthermore, they cannot respond satisfactorily to social and conceptual situations (American Psychiatric Association, 2013).Several strategies have been used by young people with mild and moderate ID to participate in web-based activities, including personalising devices that can access the Internet and seeking support from others (Ågren et al., 2020a).
Evidence suggests that social media can enhance the quality of life and coping abilities of individuals with ID (Shpigelman, 2018).Persons with ID can develop Internet skills and use digital technology, including smartphones, for communication and informational purposes (Setyawan & Wulandari, 2022).Due to its capacity to provide resources, information, and social and support opportunities, Internet access is crucial.Chadwick et al. (2013) revealed that individuals with cognitive, physical, and sensory impairments find it difficult to use the Internet.Nevertheless, cyber security and safety frameworks for online social media platforms were proposed (Chang et al., 2021) to protect vulnerable individuals in society, especially those with ID.
People with ID face the most significant obstacles to accessing the Internet (Chadwick et al., 2013).In addition to financial difficulties, societal attitudes that can lead to exclusion and a lack of support from the government and stakeholders are some barriers faced by people with ID.Hoppestad (2013) also identified inadequate caregiver support and lack of knowledge or training as obstacles to accessing social media among persons with ID.In Ramsten et al. (2017), it was stated that "there appears to be a lack of organisational support and comprehensive strategies for using ICT in municipal health care for individuals with ID" (p.712).The lack of organisational support and an integrated approach is common in many social institutions despite the apparent need for assistance by persons with ID (e.g., workshops, training, or information) (Ramsten et al., 2017).

Literature search
The systematic literature review examined articles published between 2015 and 2023 about social media usage among people with ID.A combination of keywords and terms was used to search PubMed, Scopus, PsycInfo, Cochrane, and MEDLINE.Search criteria included two elements: population of interest (ID) and outcome (social media and Internet use) (see Table 1).The screening criteria were derived from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist (Ghafari et al., 2016;Jacob et al., 2022b).Bibliographic data managers were used to remove duplicates from articles that were retrieved from databases.Reviewers identified relevant articles based on titles and abstracts.A blind review of each article was conducted by two raters.If full-text articles were available, they were retrieved and blindly rated.Independently, two blind raters recorded inclusion and exclusion criteria.Prior to making a final decision on inclusion or exclusion, blind raters discussed whether the study was eligible.

Selection criteria
Research articles on social media and Internet usage among the underlying population were included.There was no restriction on age groups.In the data extraction, the selection stages and attributes were as follows: (1) Participants were parents, caregivers and teachers of persons with ID and children and adults with ID and only participants with mild or moderate ID levels were included; (2) the study needed to be qualitative, quantitative or mixed methods; and (3) articles without explicit references to ID were excluded.Inclusion was limited to full-text articles written in English.A study design, such as cross-sectional or cohort, was not a determining factor for study inclusion, however, studies lacking a case definition or a sufficient explanation of the methodology used to calculate prevalence or incidence were disqualified.Figure 1 is the flowchat of the selected and included numbers of articles.2 show that all the articles reviewed were published between 2015 and 2023.Also, in all the countries where the sample studies were conducted, there were no Internet issues.This is an indication that the problem of remote Internet connection is subsiding irrespective of the location.Figure 2 shows the types of methods used for studies in the articles selected.It was observed that 53.8% of the articles used quantitative methods while 46.2% used qualitative ones.Therefore, the proportion of articles that used quantitative methods was higher than those using qualitative methods.only.However, the proportion of articles that used people with ID and their caregivers is the same as those that used people with ID and their parents.Also, the proportion of articles that used people with ID and non-ID is the same as those that used people with ID and their teachers.

Table 3.
Thematic areas in the selected articles Table 3 presents the popular themes highlighted by the articles selected.It was observed that there were five themes common to the articles selected which included: Usage of social media; inclusion of people with ID; risk and benefits of social media; support received when using social media; and the training of people with ID on the use of social media.

Usage of social media among people with ID
From the selected articles, it could be observed that five out of the total articles highlighted the theme of social media usage and their findings revealed that interest in the use of education programmes, digital media, and a variety of social media applications determined social media usage among people with ID (Heitplatz et al., 2021).According to Yang and Lee (2022), Chadwick et al. (2016), and Arun and Jain (2022), disability increases the correlation between different determinants of mobile internet usage.In addition, people with ID were considered more likely to be online than those without disabilities.Moreover, if parents or siblings provided proper training and assistance, people with ID could learn academically like others if smartphones were available during the daytime.Addressing the interest and training in social media can mitigate the risks associated with social media usage.

Inclusiveness of social media for people with ID
Among the selected articles, three focused on inclusion based on the results.For instance, Ågren et al. (2020a) noted that all participants used the Internet in various ways that enabled them to participate in online activities.Furthermore, White and Forrester-Jones (2020) concluded that adolescents with ID used social media to interact with fewer social contacts.In addition, Lussier-Desrochers et al. (2017) found that the use of social media by people with ID depended on the fit between their resources and their environment.Therefore, it could be deduced that disabilities are not barriers to social media use for people with and without ID.Benefits and risks of social media usage by people with ID Another thematic area observed in the selected articles was the benefits and risks associated with using social media.Two of the selected articles considered the benefits and risks of the use of social media.Ågren et al. (2020b) reported that parents of adolescents with ID perceived the benefits of social media usage but paid less attention to the associated risks.Also, Chadwick et al. (2016) reported that people with ID were perceived to be more at risk from being online than those without.Thus, social media interaction for people with ID may be associated with high risk.Some perceived online risks to individuals with ID are being intimidated, deceived, or harassed online, revealing personal information to others, and being vulnerable to online fraud (Chadwick et al., 2016).

Support for social media usage by people with ID
The results showed that five out of the 10 selected articles reported that people with ID require assistance interacting with others on social media.For example, Molin et al. (2015) highlighted the need for teachers' and parents' perspectives on supporting young people with ID.Also, Chadwick et al. (2018) believed that people with ID shared online identities that did not emphasize or conceal impairment, challenging notions of dependency with participants providing and receiving support.In addition, Patrick et al. (2020) reported that a lack of support prevented many adults with intellectual and developmental disabilities from using technology and social media that could promote self-determination and participation in their healthcare.In conclusion, social media use by people with disabilities largely depends on getting support from people around them.

Training people with ID on the use of social media
From the results, it could be observed that only one article highlighted the need to train people with ID on the use of social media.Although other articles reported the risks, only Patrick et al. (2020) reported that if the people with ID were well-trained, the use of technology and social media could promote self-determination and participation in their healthcare.This is an indication that more studies need to be conducted on the training of people with ID on the use of social media.

Discussion of findings
This systematic literature review evaluated articles related social media use among people with ID.The predetermined inclusion criteria identified 13 potentially relevant studies from 716 studies.In the included studies, five significant themes emerged.Social media usage differed between studies in terms of access, devices, and duration.Moreover, there was no single outcome measure used in the studies.According to the studies, ID was referred to using relatively consistent terminology.Seven studies adopted quantitative research methods (54%), while six (46%) adopted qualitative research methods.Increasing internal and external validity requires larger samples.To the best of our knowledge, the use of social media by persons with ID has yet to be extensively investigated.According to the analysis of selected articles, social media use among people with ID is associated with some thematic areas.
These factors were considered to inhibit the effective adoption of social media by people with ID.Internet use can be complex for people with ID since they may have deficits in cognitive, social, and adaptive functioning (American Psychiatric Association, 2013;Jacob et al., 2022a;Tassé et al., 2016).A person's cognitive ability affects their ability to process words, which is an essential digital competency when using the Internet (Wu et al., 2014).Among adolescents in the general population, online interaction is associated with improved friendship quality (Desjarlais & Willoughby, 2010).Adolescents with ID might be able to benefit from this since they experience labelling and discrimination during face-to-face interaction with other members of their community (Holmes & O'Loughlin, 2014).It is also possible to develop new friendships, date, share opinions, and re-establish friendships using social networking sites (Holmes & O'Loughlin, 2014).In addition to reciprocity, empathy, and shared life experiences, social media may reinforce aspects of friendship (Vallor, 2012).
Using online interaction as a primary method of social contact may, however, impede the benefits of this form of social connection.In addition, the results indicate that people with ID experience both benefits and risks when using social media (Chadwick et al., 2016).The Internet may seem like a luxury for many people, however, for some groups it can be a valuable tool for their integration into society and for experiencing many of the benefits of full citizenship.Several barriers are likely to be reduced or eliminated by the Internet, which makes it possible for people with ID to participate in numerous daily online activities (Hoppestad, 2013).Although people with ID stand to benefit most from this technology, they are traditionally the group least likely to be able to access and use it fully.Undoubtedly, this mirrors the inequalities faced by people with ID in other spheres of their lives as well.
Similarly, Buijs et al. (2016) reported cases of financial exploitation and sexual harassment of people with ID while using social media.According to Livingston and Haddon (2009), people with ID are at risk of uploading inappropriate photos, having harmful contact online (e.g., being bullied, groomed, and being unwelcomely persuaded), and being exposed to harmful, manipulative, or exploitative content (e.g., advertising, violent or hateful material, sexually harmful material, extremism).The results suggest that people with ID were more likely to have been warned by their parents about the risks of the Internet than their peers without disabilities (Lathouwers et al., 2009).The included articles also stress the need for training and support for people with ID using social media.The risks associated with social media may be one of the reasons for this.Molin et al. (2015) and Löfgren-Mårtenson (2008) highlighted the importance of teachers and parents supporting young people with ID through social media training and guidance.People with ID often rely on family members for support when using technology (Palmer et al., 2012).

CONCLUSION
This article reviewed the use of social media among people with ID.In recent years, social media has become more popular and is used by people with ID for educational and social purposes that result in positive experiences.Furthermore, the review found that people with ID have a higher risk of being bullied, threatened, or harassed online, giving out too much personal information to others, and being swindled online by marketers.It may not be possible to directly compare the present review with existing literature due to the small sample sizes in the included studies.Several research avenues could be explored in the future.More extensive studies with a more methodologically rigorous approach are necessary to: (1) determine whether there is gender-based harassment; and (2) determine the best way to protect people with ID from online scams and make sure people with ID get the most out of social media platforms.
Further research is also needed to determine whether individuals with ID should have unlimited social media access regardless of age and gender.There are several limitations to our review.The only publications we included were those written in English due to resource constraints.In addition, we adopted a reductionist approach by excluding articles that did not provide open access to social media usage among persons with ID.The goal was to improve study homogeneity, however, this means that we were unable to investigate the potential mediating and moderating mechanisms that may play a role in the use of social media by those with other disabilities that are not necessarily ID.The third limitation was that we excluded material published in newspapers or books, so publication bias could still exist (e.g., omitting unpublished studies).A limitation of the study pool should also be emphasised.The social media usage of adolescents with ID is comparable, but they interact with fewer friends and on these sites.Friendship quality was the same between students who were typically developing and students who were not.
There was a significant correlation between social media use and reported friendships, but not between social media use and critical remarks

Qualitati ve
Teachers' and parents' views on how support could be provided for young with ID were important.

Figure 1 .
Figure 1.Flowchart of the systematic literature search Figure 2. Proportion of data collection methods used in the selected articles

Figure 3 .
Figure 3. Articles and the categories of participants Results show possible relationships between Internet usage indicators and age (in three age bands), gender, and living situation.The use of social media by people with ID depended on the fit between individual resources and environmental support.Parents of adolescents with ID perceived the benefit of social media usage but paid less attention to the associated risk.