The Ruderman White Paper on Social Media, Cyberbullying, and Mental Health: A Comparison of Adolescents With and Without Disabilities Shai Fuxman, EdD, Education Development Center Shari Kessel Schneider, MSPH, Education Development Center Miriam Heyman, PhD, Ruderman Family Foundation Executive Summary Social media is a pervasive presence in the lives of adolescents, and its grip on their daily lives can have consequences that are positive, negative, or both. Adolescents can use social media to form and sustain lasting and meaningful social relationships, but they can also use it as a platform for cruelty and bullying. When used this way, it can result in a severe negative impact on adolescent mental health, including depression and in more severe cases, suicide. Adolescents with disabilities may be especially vulnerable to online bullying, since they experience higher rates of in-person bullying than their nondisabled peers. However, these adolescents might also reap extensive benefits from the social support they can gain by connecting with others online and overcoming their isolation in school settings. This paper explores associations of social media usage, cyberbullying experiences, and mental health among more than 20,000 high school youth with and without disabilities from the Greater Boston area that participated in the 2016 MetroWest Adolescent Health Survey, an initiative funded by the MetroWest Health Foundation. Key findings include: ¡
More than half of students with disabilities (54%) spend two or more hours on social media sites per day, providing opportunities for both positive and negative experiences. Time spent on social media is only slightly higher among youth with disabilities
compared to those without disabilities (54% vs. 51% who report spending at least two hours). ·
Almost one-third of students with disabilities (30%) have experienced cyberbullying within the past year, as a victim, perpetrator, or both, compared with 20% of students without disabilities.
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Students with disabilities are almost twice as likely (1.8 times) to be victims of cyberbullying than their peers without disabilities, when controlling for grade, gender, and race. They are also 1.7 times more likely to be perpetrators than their peers without disabilities.
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Students with disabilities are more likely than their peers without disabilities to report that they receive social support via social media (38% versus 28%).
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Overall, students involved in cyberbullying–as a victim, perpetrator, or both – are more likely to experience depression than students who do not experience cyberbullying at all (34%, 24%, and 41% respectively versus 13%). This link is especially strong for students with disabilities. For example, 45% of victims with disabilities experience depression, compared to 31% of victims without disabilities.
·
As with depression, the connection between cyberbullying and suicidality is especially strong for students with disabilities. Thirty eight percent of cyberbullying victims with disabilities report suicidality, compared to 23% of victims without disabilities.
These findings suggest that parents, educators and policymakers should harness the power of social media to advance connectedness among adolescents – and in particular, involving youth with disabilities – while working to prevent cyberbullying and other types of hurtful behaviors online. These efforts will be especially beneficial for students with disabilities, who comprise
almost 20% of our population and experience cyberbullying at a strikingly high rate. It is time to include students with disabilities in the conversation around social media – by doing so, we have the potential to reduce cyberbullying, increase social connectedness, and maybe even curb the adolescent mental health epidemic. Introduction The pervasive presence of digital technology in adolescents’ lives brings about both risks and benefits. On one hand, use of social media poses risks to young people such as increasing their vulnerability to cyberbullying, causing them to feel excluded or left out from activities they are not invited to and/or unable to participate in, and reducing their self-esteem due to social comparison, which can negatively affect their mental and physical health.i,ii,iii,iv Social media can also exacerbate risky behaviors such as self-harm and substance use by impacting students’ selfesteem, reinforcing negative social norms, and promoting hazardous behaviors.v,vi,vii On the other hand, engagement on social media platforms can offer benefits like receiving social support from peers, providing opportunities to practice social skills, and finding peers who share similar interests and circumstances, which in turn can have positive impacts on mental health such as increased self-esteem.viii,ix Furthermore, when used properly, it can also be a source of healthpromoting information and mental health support.x,xi,xii,xiii The dichotomy between the potential benefits and risks of adolescent use of social media is accentuated for youth with disabilities given the social challenges they often face. Depending on the specific disability(ies) and their related limitations, disabilities can severely impact youths’ ability to interact with their peers in social situations.xiv,xv,xvi For example, youth with mobility challenges may struggle to participate in and/or feel left out of activities involving physical capacities such as playing sports and dancing. In other cases, youth with social,
pragmatic, and/or communication challenges may struggle to engage socially or get support from their peers.xvii,xviii Furthermore, stigma attached to disabilities can hinder youths’ efforts to interact socially with their peers.xix Evidence indicates that young people with disabilities are more likely to experience bullying and cyberbullying.xx,xxi,xxii Their struggles to interact with peers and elevated levels of involvement in bullying—as a victim and/or perpetrator—can have detrimental impacts on youth with disabilities such as low self-esteem, sense of isolation, and depression.xxiii,xxiv On the flip side, there is evidence that young people with disabilities can greatly benefit emotionally, socially, and even academically when they receive support from their non-disabled peers.xxv,xxvi,xxvii Furthermore, the friendships formed between young people with and without disabilities not only benefit those with disabilities, but their peers as well. xxviii,xxix Friendships with peers with disabilities help young people develop critical social and emotional competencies such as empathy, perspective taking, and relationship building skills. Given these challenges, and the pervasiveness of social media in the lives of all youth, it is important to understand: What positive and/or negative impacts does social media have on the lives of youth with disabilities, and how may these impacts differ from their peers without disabilities? The purpose of this paper is to explore this question through an analysis of data from a large regional classroom-based health survey of 26 high schools in the Greater Boston area. Our analysis uses data from more than 24,000 youth to compare social media use, cyberbullying experiences, and attitudes related to social media use between students with and without disabilities. We also explore critical relationships between experiences with cyberbullying and mental health outcomes, including depressive symptoms and suicidality. Based on these findings, the paper describes specific implications for how parents, educators, mental health providers, and
policymakers can help ensure that all young people reap the benefits that social media platforms can offer to connect with their peers, while reducing the risks posed by these platforms. About the Data The analysis is based on data from the 2016 MetroWest Adolescent Health Survey (MWAHS), a biennial regional census survey of youth in 26 high schools west of Boston that began in 2006 to monitor trends in adolescent health and risk behaviors, funded by the MetroWest Health Foundation.xxx A voluntary and anonymous survey, the MWAHS is administered to all students in grades 9-12 to provide timely data to schools and communities to inform local policies and programs. It is based on the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey, with additional questions to address emerging health behaviors and regional concerns.xxxi Twenty-six high schools participated in the 2016 MWAHS, representing all eligible districts in the largely middle and upper-middle class region west of Boston served by the MetroWest Health Foundation. All students present on survey administration days were eligible to take the survey with passive parental consent and youth assent; 24,385 youth completed surveys, representing an 88.7% participation rate.xxxii We determined which students taking the survey had a disability by combining student responses from two survey questions: “Do you have any long-term learning disabilities? (Longterm means 6 months or more)” and “Do you have any physical disabilities or long-term health problems? (Long-term means 6 months or more).” Both questions, taken from the 2015 Massachusetts Youth Risk Behavior Survey,xxxiii had the following three options: Yes, No, and Not sure. For the purpose of this analysis, we included all the students who answered “Yes” to either or both questions in the group of students with disabilities and all other students in the group of
students without disabilities. In total, 4,200 students in the survey (18.2%) reported that they had either a learning or physical disability, or both. To answer the paper’s main questions, we examined several indicators of students’ experiences with social media. First, we looked at differences in the quantity of social media use between students with and without disabilities. We then looked at the proportions of students with and without disabilities who indicated that they had been involved in cyberbullying as victims, perpetrators or both in the past 12 months. Next, we considered the extent to which students in the two groups agreed or disagreed with several statements about their experiences with social media. The statements we considered included: “I feel badly about myself, excluded or left out when I see what others post on social media,” “I have gotten support on social media when I’ve been going through a tough or challenging time,” and “Being on social media helps me feel better about myself.” Finally, we looked at the association of cyberbullying involvement —as victims, perpetrators or both—and mental health sequela including self-reported depressive symptoms and suicidal thoughts and behaviors (contemplation, planning, and attempt) in the past 12 months. We examined the linkage between cyberbullying and mental health for youth with and without disabilities, and examined differences between the groups. Depressive symptoms were measured with the question “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?” Suicidality was measured by combining three questions from the survey, “During the past 12 months, did you…” “ever seriously consider attempting suicide?”, “make a plan about how you would attempt suicide?”, and “attempt suicide?” Students were considered to demonstrate suicidality if they answered “yes” to one or more of these questions.
Differences in these experiences between students with and without disabilities were compared in two ways—simple comparison of proportions using cross-tabulations, as well as through multilevel logistic regression analysis controlling for gender, grade, and race and adjusting for school-level clustering. Additional information about the data analysis can be found in Appendix A. Results Social Media Use and Associated Attitudes More than half of high school students (52%) spend two or more hours on social media on the average school day—23% spend two hours, 14% spend three hours, 7% spend four hours, and 8% spend five or more hours on these platforms. In contrast, 8% report not using social media at all and 41% report using social media for an hour or less per school day. Survey results also show the extent to which students experience both negative and positive effects of social media use. On the negative side, over 20% of students report experiencing cyberbullying at least once in the past 12 months—14% as victims, 3% as perpetrators, and 5% as both. Furthermore, 24% report that social media makes them feel badly about themselves or excluded. On the positive side, 30% report getting support on social media and 22% report that being on social media helps them feel better about themselves. Differences in Social Media Use and Consequences by Disability Status Differences in hours of social media use between students with and without disabilities were very small and statistically insignificant: 54% vs. 51% of students, respectively, report using social media for two or more hours per day (see Figure 1). Despite small differences in quantity of social media use, students with disabilities report significantly more cyberbullying involvement than their peers without disabilities, as both victims and/or perpetrators. About one
in three students with disabilities (31%) report experiencing any cyberbullying experience at least once in the past 12 months, compared to 20% of students without disabilities. Specifically, students with disabilities are much more likely to report being victims of cyberbullying than students without disabilities (20% vs. 13%), as well as to report being both victims and perpetrators (8% vs. 4%). Reports of being only perpetrators are more similar among students with and without disabilities (3% and 2%, respectively). Furthermore, more students with disabilities than students without disabilities report feeling badly about themselves or excluded because of social media, 29% and 23%, respectively (see Figure 3). All differences were found to be statistically significant. These findings were confirmed in our logistic regression analysis (see Appendix B). When controlling for gender, grade, and race, students with disabilities are almost two times more likely to experience cyberbullying involvement compared to students without disabilities. Specifically, students with disabilities are 1.8 times more likely to be cyberbullying victims only, 1.7 times more likely to be perpetrators only, and 1.5 times more likely to be both victims and perpetrators, compared to students without disabilities. In addition, students with disabilities are 1.3 times more likely to report feeling badly about themselves or excluded when they use social media. All of these findings were statistically significant. On the positive side, students with disabilities are more likely than their peers without disabilities to report that being on social media helps them feel better about themselves, and that they receive support on social media when facing challenging situations. Specifically, 38% of students with disabilities versus 28% of students without disabilities report getting support from social media (see Figure 3), and 26% of students with disabilities and 21% of students without disabilities report feeling better about themselves as a result of social media (see Figure 3).
Furthermore, our logistic regression analysis showed that, when controlling for gender, grade, and ethnicity, students with disabilities are 1.5 times more likely to report getting support from social media, and 1.3 times more likely to report feeling better about themselves when they are on social media. Association of Cyberbullying with Mental Health Given the link between cyberbullying and negative mental health consequences in the adolescent health literature, we also examined the association of cyberbullying with depressive symptoms and suicidality among students with disabilities compared to those without disabilities. First, our data confirms prior findings in the literature that students with disabilities are more likely to experience depression and suicide ideation.xxxiv,xxxv,xxxvi According to our data, students with disabilities are twice as likely to report depressive symptoms in the past 12 months compared to students without disabilities (30% vs. 15%). Furthermore, students who were involved in cyberbullying—as victims, perpetrators, or both—are more likely to report depressive symptoms compared to students who do not experience cyberbullying at all. In addition, the link between cyberbullying involvement and reports of depressive symptoms is stronger for students with disabilities than for students without disabilities. As Figure 4 shows, 45% of students with disabilities who are victims of cyberbullying report depressive symptoms, vs. 31% of cyberbullying victims without disabilities. Thirty three percent of perpetrators with disabilities report depressive symptoms vs. 22% among perpetrators without disabilities. More than half (52%) of students with disabilities who are both victims and perpetrators report depressive symptoms vs. 37% of those without disabilities who are both victims and perpetrators.
A similar pattern was observed for suicidality (seriously contemplating, planning, and or attempting suicide in the past 12 months). As Figure 5 shows, students who experienced cyberbullying in any role were more likely to report suicidality then those who did not experience cyberbullying at all; and students with disabilities were more likely to report suicidality compared to students without disabilities. Like in the case of depressive symptoms, students with disabilities who experience cyberbullying have higher rates of suicidality compared to students who experience cyberbullying but do not have any disabilities. Specifically, 38% vs. 23% of victims, 37% vs. 19% of perpetrators, and 53% vs. 31% of those involved in both roles in cyberbullying reported suicidality. Lastly, we analyzed the data to determine if there were any differences in depressive symptoms and suicidality based on students’ involvement with cyberbullying, specifically among youth with disabilities. For this analysis we used logistic regression, and considered only students with disabilities, controlling for gender, grade, and race, and adjusting for school-level clustering. The analysis revealed that victims of cyberbullying are 2.5 times more likely to report depressive symptoms, perpetrators are 1.7 times more likely, and those who report being both victims and perpetrators are 3.6 times more likely to report being depressed in the past 12 months, compared to those who were not involved in cyberbullying at all. Even more alarming, those who experience cyberbullying are also at significantly higher risk of reporting suicidality in the past 12 months compared to students who do not experience cyberbullying. Specifically, students who report being victims of cyberbullying are 2.9 times more likely, those who reported being perpetrators are 2.7 times more likely, and those who experienced both roles are 5.2 times more likely to report suicidality in the past 12 months compared to students who did not
experience cyberbullying. Similar results were found when examining the link between cyberbullying experiences to depressive symptoms and suicidality among all students. Discussion and Implications Our analysis shows that while students with disabilities use social media as much as students without disabilities, they are much more likely to experience both negative consequences and positive benefits related to their use of these platforms. In particular, we found that youth with disabilities are more likely to experience cyberbullying—as victims, perpetrators, or both, and to feel excluded because of their use of social media than their peers without disabilities. Furthermore, these negative experiences with social media are strongly associated with students’ mental health. Students who experience cyberbullying are much more likely to experience depression and suicidality, and this relationship is even stronger for youth with disabilities than those without disabilities. The silver lining from our analysis is that, for some students with disabilities, social media can also be a source of support and a source of positive self-esteem. Thus, efforts to support youth with disabilities, particularly with their struggles to connect socially with peers, should consider how to help them reap the benefits of social interaction through online platforms in a manner that is safe and reduces the risk of involvement in cyberbullying. Specific implications for parents, educators, and the social media industry are discussed in turn in the paragraphs that follow. Implication for Parents The findings of this study provide important lessons for parents of youth with disabilities on the role they can play in their children’s social media use. First, parents can encourage their children to use social media safely and responsibly as a way to help them make social connections with peers. These connections can be very valuable in augmenting social
connections for youth whose disabilities hinder their in-person interactions with peers—as long as there is the right balance between online and offline time.xxxvii Second, it is also important that parents help their children not fall victim of and/or engage in cyberbullying. Strategies that parents can utilize to help their children avoid experiencing cyberbullying include: talking to their children about what to do if they (or someone else) experience cyberbullying, encouraging them to only interact with people they know and trust, encouraging them to act kindly towards others on social media, and monitoring their social media use regularly. Furthermore, if parents suspect or confirm that their children are victims and/or perpetrators of cyberbullying, they should act immediately by talking to their children about these behaviors, communicate these incidents to appropriate officials (e.g., school administrators), and if needed seek help from mental health providers. Given the important role parents play in their children’s lives, it is also critical that parents be well-equipped with the right knowledge and skills to support their children’s healthy social media use.xxxviii Therefore, parent education programs focused on cyberbullying are key— and research shows that they can be effective.xxxix In addition, in the past few years, federal agencies and other organizations have developed resources and education programs to help parents help their children avoid and/or handle cyberbullying. Here are a sample of such resources: ·
Stopbullying.gov: An online resource offered by the US Department of Health and Human Services that provides information, resources, and tools for parents, educators, policymakers and kids on both bullying and cyberbullying. The website includes a section focused on the prevention of bullying and cyberbullying focused on disabilities.
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CDC’s Disability and Safety: Information about Bullying: This page on the Centers for Disease Control and Prevention (CDC) offers information about preventing bullying and cyberbullying among children with disabilities.
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NetSmartz Workshop: An interactive, educational program of the National Center for Missing & Exploited Children® (NCMEC) that provides age-appropriate resources to help teach children how to be safer on- and offline. The program is designed for children ages 5-17, parents and guardians, educators, and law enforcement. While NetSmartz resources were not created specifically for children with special needs, many of its materials employ the same teaching methods used with children with disabilities, such as role-playing, rhyme, and repetition.
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Digital Youth with Disabilities: One of a series of reports from the John D. and Catherine T. MacArthur Foundation on Digital Media and Learning, this report focuses on media and technology use by school-aged youth with disabilities, with an emphasis on media use at home.
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ParentInfo’s Learning disabilities, autism and internet safety: A guide for parents: This article provides tips for parents with children with learning disabilities and/or on the autism spectrum to help them use the internet safely. The article is contributed by Cerebra, a national charity striving to improve the lives of children with neurological conditions through research, information and direct on-going support.
Implications for Educators Educators, administrators, and policy makers widely acknowledge that our schools have an obligation to provide opportunities for social and emotional learning, in addition to academic learning. This reflects the commitment of educators to cultivate in students key competencies,
including those that enable youth to make and sustain healthy and meaningful relationships with peers. This study suggests that school-based lessons about values such as kindness, civility, and inclusion need to explicitly address online as well as in-person behavior. As schools are teaching children the importance of being kind and supportive of others, including their peers and classmates, we should teach them to apply extend these behaviors to their social media interactions. These lessons can go a long way to help create safer and more civil environments for all youth—with and without disabilities—in both offline and online contexts. Furthermore, we need to teach our students how to identify and handle situations of cyberbullying when they encounter them either as victims, perpetrators or bystanders. This includes teaching students how to disengage from cyberbullying by blocking users and resisting from retaliation or responses, reporting these behaviors to and seeking help from trusted adults, and when witnessing others falling victims to cyberbullying playing an active bystander role. These lessons must reach all students, including students with disabilities given their heightened risk to become involved in cyberbullying. Also given the heightened risk for students with disabilities to experience cyberbullying, educators must address disability in their instruction on topics such as diversity, civil rights, and social justice. Increasingly, students with disabilities are educated in mainstream classrooms alongside typically developing classmates. However, it is not enough to ensure these students a seat in the room; we must also educate all students about the value of inclusion and the centrality of disability to diversity. Given the high rates of online and offline bullying experienced by students with disabilities, it is important to inculcate the importance of valuing each individual regardless of their abilities and disabilities.
Lastly, much like it is important for parents to understand how they can prevent and/or address cyberbullying, so too it is critical for educators to equip themselves with the knowledge and skills to play an effective role in these efforts. For example, it is important for educators to be able to identify possible instances of cyberbullying based on their students’ behaviors and chatter. Furthermore, it is also important that they know what do if/when they believe a student is involved with cyberbullying—either as a victim, a perpetrator or both. This includes both, how to talk to students involved in cyberbullying, as well as how to address the possible negative mental health consequences (e.g., referring students to school-based counselors). Beyond the role of the classroom teachers, other educators—school-based counselors, administrators, and mental health providers, all need to understand their role in identifying, addressing, and preventing cyberbullying, including knowing which populations in their school are at highest risk for cyberbullying. Examples of steps that educators can take include organizing school-wide campaigns that discourage online harassment, identifying and supporting students struggling with mental health conditions such as depression, and ensuring an overall culture of inclusion in their school. Like in the case with parents, there are various resources on how to address cyberbullying geared specifically for educators. A sample of these resources include: ·
Stopbullying.gov: The resource mentioned before has a section with specific tips for educators including how to identify situations when students might be falling victims to cyberbullying, as well as steps they can take to prevent and address cyberbullying. Furthermore, their section on preventing cyberbullying for children with disabilities offers important insights for teachers as well.
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National Association of Special Education Teachers’ (NASET) Series on Bullying of Children: This series of articles from NASET provides various insights and resources on how to address both bullying and cyberbullying.
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LD Online’s Teaching Students with Disabilities about Online Safety: This website provides helpful information for educators and parents about learning disabilities. This particular article discuss how educators can encourage students with learning disabilities to use the internet productively and safely.
Social Media Industry Social media companies, including Facebook, Instagram, and Twitter have recognized the important role they can play to address destructive behaviors people display on their platforms. One of the steps they have taken is to put in place self-regulatory mechanisms to stop cyberbullying, such as reporting tools, blocking and filtering software, and anti-bullying educational materials. xl While these are important steps, social media companies can play a more active role in addressing cyberbullying, not only through advances in technology, but also by investing resources, including funding, in efforts to end cyberbullying. These investments can support the development of evidence-based interventions to address cyberbullying in classroom and community settings, fund social marketing campaigns to address cyberbullying, and develop additional technologies to reduce cyberbullying. These corporations have both the available funding and the platform to lead the way in terms of making cyberbullying history. These possible efforts can include focused efforts to address cyberbullying among the most vulnerable populations, those most likely to be involved in this type of behavior—including children with disabilities. The social media industry can shed light on this particular problem, and raise awareness of the importance of valuing and respecting every member of society.
Furthermore, in light of the benefits that social media has been shown to provide youth with disabilities, the industry can work to further develop its platforms to help this population. Specifically, the industry can partners with parents of children with disabilities, special education professionals, and others to further develop technology that will support the ability of children with disabilities to communicate with their peers and be included in social contexts. In fact, social media has become an important tool for making our societies more inclusive and interconnected in a positive way. The industry can continue to lead the way, through the use of their creativity, ingenuity and resources—to bring people closer together in meaningful and safe ways. For example, social media companies could put forth public service announcement featuring young people, both with and without disabilities, sharing their stories about how social media helped them cultivate meaningful relationships online. Alternatively social media platforms can develop features that “reward” adolescents who perpetuate online kindness; as Twitter removes verification from racist users, platforms could also recognize exceptional instances of kindness with a symbol on a user’s profile so that users who are extraordinarily kind feel recognized and rewarded. The creative options are endless, and the impact could be gigantic. Conclusion This study adds to the strong base of evidence pointing to the pervasive role of social media in the lives of adolescents, emphasizing the important role it has in the lives of youth with disabilities. This study also extends this knowledge base by demonstrating that youth with disabilities are particularly impacted, both for better and for worse by social media use. Students with disabilities are disproportionately likely to experience cyberbullying—as victims perpetuators, and in both roles, and the consequences can be severe. At the same time, social
media provides an opportunity for social connection. This study indicates that this opportunity may be especially relevant and valuable for youth with disabilities by demonstrating both the benefits and the risks of social media use by youth with disabilities. These findings point to the need to find the right balance between encouraging youth with disabilities to use social media to make meaningful connections, and ensuring that they do so safely. Parents, educators, and the social media industry have important roles to play to help make this happen.
Acknowledgement Education Development Center, Inc. and The Ruderman Foundation would like to thank the MetroWest Health Foundation, including CEO/President Martin Cohen and Senior Program Officer Rebecca Donham, for funding the administration of the MetroWest Adolescent Health Survey and allowing access to the data for this analysis.
Figure 1. Students’ self-reported hours of social media use on an average school day by disability status 30% 23%
Percent of students
24%
21%
23% 22%
18%18%
18%
15% 14%
12%
10%
8% 8%
8%
7% 7%
6%
0% None
LessStudents tha n 1 hour wi th di1shour abi l i ties
2 Students hours 3 hours wi thout di s abi li4tyhours
5 or more hours
Figure 2. Percent of students reporting cyberbullying involvement in the past 12 months as victims, perpetrators, or both by disability status 100% 81%
Percent of students
75% 59% 50%
25%
20% 13% 3%
0%
2%
8%
4%
Neither Vi ctim Perpetrator Both vi ctim a nd perpetrator Students wi th di s abi l i tiesonl yStudents wi thout di sonl abily i ties
Figure 3. Percent of students who agreed or strongly agreed that they feel excluded when they see what others post on social media by disability status and gender 48% 38%
Percent of students
38%
29%
29%
28%
26%
23%
21%
19%
10%
0% I feel ba dl y about mys el f, excl uded orwi left when what others postdion s oci a l medi a. Students th out di s abil i tyI s ee Students wi thout sa bi l i ties
Figure 4: Percent of students reporting depressive symptoms in the past 12 months by disabilities status and cyberbullying involvement 60% 53%
Percent of students
45% 38%
37% 31%
30% 23% 18% 15%
19%
9%
0% Nei ther Onl y Students Perpetrator Students wi th diVis ctims abil i ties wi thout di sOnl abiyli ties
Both
Figure 5: Percent of students reporting suicidality (seriously considering, planning, and/or attempting suicide) in the past 12 months by disabilities status and cyberbullying involvement 60% 52% 45%
Percent of students
45%
37% 30%
15%
31% 24%
33% 22%
11%
0% Nei ther ctims Onl y Students Perpetrator Students wi th diVis abi l i ties wi thout di Only s abi li ties
Both
Appendix A: Data Analysis Procedures To answer the research questions, we examined differences in cyberbullying and attitudes towards social media for students with and without disabilities. We also examined the relationship between cyberbullying and mental health for students with disabilities. First, we conducted bivariate analyses using chi-square tests to examine differences in cyberbullying experiences (victimization, perpetration, and both) and studentsâ&#x20AC;&#x2122; views about their social media experiences by disability status (students with disabilities vs. students without disabilities). We then conducted a bivariate analysis of the relationship between cyberbullying involvement and mental health indicatorsâ&#x20AC;&#x201D;depressive symptoms and suicidality - for both students with and without disabilities. Next, we used logistic regression analyses to examine disability status as a predictor of cyberbullying and social media views. We also used logistic regression analysis to examine the relationship between experiencing cyberbullying and depression and suicidality. For all logistic regression analyses, we used generalized estimate equation (GEE) to account for school level clusteringâ&#x20AC;&#x201D;and adjusted for sex, race, and grade in school. To adjust for multiple comparisons in the regression models, we applied the Bonferroni correction, dividing 0.05 (pvalues) by 4 (number of predictors), thus setting our significance level at p<0.01. Analyses were conducted in SPSS Statistics, version 22 (Advanced Statistics).
Appendix B: Results Table 1: Adjusted odd ratios and confidence intervals (99%) for the relationship between disability status and social media-related experiences (n=23,131)
Involved in cyberbullying in the past 12 months OR (99% CI)
I feel badly about myself, excluded or left out when I see what others post on social media. OR (99% CI)
I have gotten support on social media. OR (99% CI)
Being on social media helps me feel better about myself. OR (99% CI)
1.8 (1.6-2.1)*
1.3 (1.2-1.5)*
1.5 (1.4-1.6)*
1.4 (1.2-1.5)*
1
1
1
1
0.5 (0.5-0.6)*
0.5 (0.4-0.5)*
0.6 (0.5-0.6)*
1.0 (0.9-1.1)
1
1
1
1
9th Grade
0.6 (0.5-0.7)*
1.2 (1.0-1.4))
0.8 (0.7-0.9)*
0.7 (0.6-0.8)*
10th Grade
0.7 (0.6-0.9)*
1.1 (1.0-1.3)
0.8 (0.7-0.9)*
0.8 (0.7-0.8)*
11th Grade
0.8 (0.7-0.9)*
1.0 (0.9-1.1)
0.9 (0.8-1.0)
0.9 (0.8-1.0)*
12th Grade
1
1
1
1
1.0 (0.9-1.2)
1.2 (1.1-1.4)*
0.9 (0.8-1.0)
0.9 (0.8-1.0)
1
1
1
1
Disability Status Disability No Disability Gender Female Male Grade
Race White Non-White *p<0.01
i Rocha, S. (2019). Talking with teens and families about digital media use. Brown University Child & Adolescent Behavior Letter, 35(3), 1–7. ii Eleuteri, S., Saladino, V., & Verrastro, V. (2017). Identity, relationships, sexuality, and risky behaviors of adolescents in the context of social media. Sexual & Relationship Therapy, 32(3/4), 354–365. iii McHugh, B. C., Wisniewski, P., Rosson, M. B., & Carroll, J. M. (2018). When social media traumatizes teens. Internet Research, 28(5), 1169–1188. iv George, M. J. ., Russell, M. A. ., Piontak, J. R. ., & Odgers, C. L. 1. candice. odgers@duke. ed. (2018). Concurrent and Subsequent Associations Between Daily Digital Technology Use and High-Risk Adolescents’ Mental Health Symptoms. Child Development, 89(1), 78–88. v Marchant, A., Hawton, K., Stewart, A., Montgomery, P., Singaravelu, V., Lloyd, K., … John, A. (2017). A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. Plos One, 12(8), e0181722. vi Cookingham, L. M., & Ryan, G. L. (2015). The impact of social media on the sexual and social wellness of adolescents. Journal of pediatric and adolescent gynecology, 28(1), 2-5. vii Ybarra, M. L., Strasburger, V. C., & Mitchell, K. J. (2014). Sexual media exposure, sexual behavior, and sexual violence victimization in adolescence. Clinical pediatrics, 53(13), 1239-1247. viii Guinta, M. R. . (2018). Social Media and Adolescent Health. Pediatric Nursing, 44(4), 196–201. ix Kendal, S., Kirk, S., Elvey, R., Catchpole, R., & Pryjmachuk, S. (2017). How a moderated online discussion forum facilitates support for young people with eating disorders. Health Expectations: An International Journal Of Public Participation In Health Care And Health Policy, 20(1), 98–111. x Stevens, R., Gilliard-Matthews, S., Dunaev, J., Todhunter-Reid, A., Brawner, B., & Stewart, J. (2017). Social Media Use and Sexual Risk Reduction Behavior Among Minority Youth: Seeking Safe Sex Information. Nursing Research, 66(5), 368–377. xi Falzone, A. E., Brindis, C. D., Chren, M.-M., Junn, A., Pagoto, S., Wehner, M., & Linos, E. (2017). Teens, Tweets, and Tanning Beds: Rethinking the Use of Social Media for Skin Cancer Prevention. American Journal Of Preventive Medicine, 53(3S1), S86–S94. xii Marchant, A., Hawton, K., Stewart, A., Montgomery, P., Singaravelu, V., Lloyd, K., … John, A. (2017). A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. Plos One, 12(8), e0181722. xiii Stevens, R., Dunaev, J., Malven, E., Bleakley, A., & Hull, S. (2016). Social media in the sexual lives of African American and Latino youth: Challenges and opportunities in the digital neighborhood. Media and Communication, 4(3), 60-70. xiv Knibbe, T. J., Biddiss, E., Gladstone, B., & McPherson, A. C. (2017). Characterizing socially supportive environments relating to physical activity participation for young people with physical disabilities. Developmental neurorehabilitation, 20(5), 294-300. xv Taheri, A., Perry, A., & Minnes, P. (2016). Examining the social participation of children and adolescents with Intellectual Disabilities and Autism Spectrum Disorder in relation to peers. Journal of Intellectual Disability Research, 60(5), 435-443. xvi Jessup, G., Bundy, A. C., Broom, A., & Hancock, N. (2018). Fitting in or Feeling Excluded: The Experiences of High School Students with Visual Impairments. Journal of Visual Impairment & Blindness, 112(3), 261–273. xvii Whitlow, D., Cooper, R., & Couvillon, M. (2019). Voices from Those Not Heard: A Case Study on the Inclusion Experience of Adolescent Girls with Emotional–Behavioral Disabilities. Children & Schools, 41(1), 45–54.
xviii Hubert-Dibon, G., Bru, M., Gras Le Guen, C., Launay, E., & Roy, A. (2016). Health-Related Quality of Life for Children and Adolescents with Specific Language Impairment: A Cohort Study by a Learning Disabilities Reference Center. PLoS ONE, 11(11), 1–14.
xix Carter, E. W., Biggs, E. E., & Blustein, C. L. (2016). Relationships matter: addressing stigma among children and youth with intellectual disabilities and their peers. In Intellectual Disability and Stigma (pp. 149-164). Palgrave Macmillan, London. xx Wells, M., Mitchell, K. J., Jones, L. M., & Turner, H. A. (2019). Peer Harassment among Youths with Different Disabilities: Impact of Harassment Online, in Person, and in Mixed Online and In-Person Incidents. Children & Schools, 41(1), 17–24. xxi Holt, L., Bowlby, S., & Lea, J. (2017). “Everyone knows me …. I sort of like move about”: The friendships and encounters of young people with Special Educational Needs in different school settings. Environment & Planning A, 49(6), 1361–1378. xxii Beckman, L., Stenbeck, M., & Hagquist, C. (2016). Disability in Relation to Different PeerVictimization Groups and Psychosomatic Problems. Children & Schools, 38(3), 153–161. xxiii Hebron, J., & Humphrey, N. (2014). Mental health difficulties among young people on the autistic spectrum in mainstream secondary schools: a comparative study. Journal of Research in Special Educational Needs, 14(1), 22–32. xxiv Eadeh, H.-M., Bourchtein, E., Langberg, J. jlangberg@vcu. ed., Eddy, L., Oddo, L., Molitor, S., & Evans, S. (2017). Longitudinal Evaluation of the Role of Academic and Social Impairment and ParentAdolescent Conflict in the Development of Depression in Adolescents with ADHD. Journal of Child & Family Studies, 26(9), 2374–2385. xxv Laghi, F., Lonigro, A., Pallini, S., & Baiocco, R. (2018). Peer Buddies in the Classroom: The Effects on Spontaneous Conversations in Students with Autism Spectrum Disorder. Child & Youth Care Forum, 47(4), 517–536. xxvi Asmus, J. M., Carter, E. W., Moss, C. K., Biggs, E. E., Bolt, D. M., Born, T. L., … Weir, K. (2017). Efficacy and Social Validity of Peer Network Interventions for High School Students With Severe Disabilities. American Journal on Intellectual & Developmental Disabilities, 122(2), 118–137. xxvii Huber, H. B., Carter, E. W., Lopano, S. E., & Stankiewicz, K. C. (2018). Using Structural Analysis to Inform Peer Support Arrangements for High School Students With Severe Disabilities. American Journal on Intellectual & Developmental Disabilities, 123(2), 119–139. xxviii Katz, J., & Mirenda, P. (2002). Including students with developmental disabilities in general education classrooms: Educational benefits. International Journal of Special Education, 17(2), 14-24. xxix Rossetti, Z. (2015). Descriptors of friendship between secondary students with and without autism or intellectual and developmental disability. Remedial and Special Education, 36(3), 181-192. xxxThe survey is largely based on the CDC’s Youth Risk Behavior Survey (https://www.cdc.gov/healthyyouth/data/yrbs/index.htm), with additional questions addressing community interests and emerging trends, driven by the concerns expressed by participating communities. xxxi Centers for Disease Control and Prevention: 2015 Youth Risk Behavior Survey Questionnaire. 2017. Available at www.cdc.gov/yrbs Accessed May 26, 2019. xxxiiThe vast majority of nonresponses were due to being absent on the survey day(s); few students opted out (less than 2%) or did not have parent/guardian permission (less than 1%). xxxiii Massachusetts Department of Elementary & Secondary Education: Office of Youth and Family Support, Youth Risk Behavior Survey. 2017. Available at http://www.doe.mass.edu/sfs/yrbs/ Accessed July 7, 2017. xxxiv Kowalski, R. M., Morgan, C. A., Drake-Lavelle, K., & Allison, B. (2016). Cyberbullying among college students with disabilities. Computers in Human Behavior, 57, 416-427. xxxv Coduti, W. A., Hayes, J. A., Locke, B. D., & Youn, S. J. (2016). Mental health and professional helpseeking among college students with disabilities. Rehabilitation psychology, 61(3), 288.
xxxvi de la Vega, R., Racine, M., Sánchez-Rodríguez, E., Solé, E., Castarlenas, E., Jensen, M. P., ... & Miró, J. (2016). Psychometric properties of the short form of the Children's Depression Inventory (CDIS) in young people with physical disabilities. Journal of psychosomatic research, 90, 57-61. xxxvii Grace, E., Raghavendra, P., Newman, L., Wood, D., & Connell, T. (2014). Learning to use the Internet and online social media: What is the effectiveness of home-based intervention for youth with complex communication needs? Child Language Teaching and Therapy, 30(2), 141-157. xxxviii Good, B., & Fang, L. (2015). Promoting Smart and Safe Internet Use Among Children with Neurodevelopmental Disorders and Their Parents. Clinical Social Work Journal, 43(2), 179–188. xxxix Hutson, E., Kelly, S., & Militello, L. K. (2018). Systematic review of cyberbullying interventions for youth and parents with implications for evidence-based practice. Worldviews on evidence-based nursing, 15(1), 72-79. xl Milosevic, T. (2016). Social Media Companies’ Cyberbullying Policies. International Journal of Communication, 10: 5164–5185.