Innov Clin Neurosci. 2026;23(1–3):10–16.

by Larrilyn Grant, MD, MS; Lexi Singh, BS; and Anisha Mandava, MS

All authors are with the Wright State, University Boonshoft School of Medicine Department of Psychiatry and Wright State University Boonshoft School of Medicine, Dayton, Ohio.

FUNDING: No funding was provided for this article.

DISCLOSURES: The authors have no relevant conflicts of interest.

Department Editor: Julie P. Gentile, MD, is Professor and Chair of the Department of Psychiatry at Wright State University in Dayton, Ohio.

Editor’s Note: The patient scenarios presented in this article are composite cases written to illustrate certain diagnostic characteristics and to instruct on treatment techniques. The composite cases are not real patients in treatment. Any resemblance to real patients is purely coincidental.

Abstract: As internet and social media use become increasingly central to youth development, it is critical to address the unique opportunities and challenges these technologies pose for individuals with intellectual and developmental disabilities (IDD). This column explores how digital tools can enhance social connection, identity formation, adaptive skill-building, and access to therapeutic resources in youth with IDD, while also acknowledging the heightened risks of cyberbullying, overstimulation, exploitation, and digital exclusion. Through a review of current literature, clinical vignettes, and practical guidance, we offer a nuanced framework for clinicians to promote safe, inclusive, and developmentally appropriate internet use. We highlight the importance of caregiver support, tailored digital tools, and mental health–informed approaches to digital literacy. Clinicians are encouraged to integrate technology discussions into care planning, advocate for accessible digital environments, and empower youth with IDD to participate meaningfully in the digital world. Keywords: intellectual and developmental disabilities (IDD); social media; internet use; digital inclusion; online safety; cyberbullying; social connectedness; caregiver support

Introduction

The internet is used globally, has become an integral part of everyday life, and supports daily functioning, education, health, and the economy.1 In the United States, 96% of youth report using the internet daily and 95% report using social media.2 With the rapid rise of internet usage and diversity of social media applications, it is important that practitioners review internet usage with youths and take the opportunity to maximize benefits and minimize risks.

Intellectual disability (ID) is characterized by substantial impairments in cognitive functioning and adaptive behavior, affecting a wide range of everyday social and practical skills.3 Some evidence has suggested that individuals with ID are more likely to experience social isolation and loneliness and have smaller social networks.4,5 The use of the internet and social media could increase the quality and frequency of social interactions in this population.6 Despite this potential benefit, there is a digital divide between individuals without disability and individuals with a disability.7,8 Research indicates that more youths with ID do not have access to a smartphone, computer, or tablet compared to neurotypical youths.9 While prevalence rates of internet use are understudied in individuals with ID, some studies suggest that between 80% to 85% of individuals with ID use the internet, with use being on the rise in the last decade.10,11

Despite emerging research, there remains a lack of tailored guidance for clinicians, caregivers, and educators on how to support safe and beneficial digital engagement for youths with ID. This column aims to highlight both the promising opportunities and the pressing challenges of internet and social media use in youths with intellectual and developmental disabilities (IDD). Drawing from the growing body of literature and clinical insights, we explore how digital tools can enhance social connectedness, support skill-building, and expand therapeutic access—while also addressing safety risks, cognitive vulnerabilities, and systemic barriers to inclusion. Practitioners are encouraged to consider these nuanced factors when discussing internet and social media use with patients and families and to promote digital inclusion as an important aspect of holistic care.

Benefits of Social Media and Internet Use for Individuals with IDD

Enhancing social interaction and reducing isolation. Strengthening relationships with family and friends. Individuals with IDD often rely on caregivers for social contact, which can limit the development and maintenance of relationships in their lives and, ultimately, their sense of independence.12,13 However, social media can act as a bridge, empowering them to connect, express themselves, and participate in social life more freely.12 Virtual spaces offer an alternative to face-to-face interaction, allowing individuals to communicate at their own pace and comfort level. Whether gaming, posting videos, or texting, these platforms provide control and independence, boosting their confidence and self-esteem.14

Within a supportive environment, social media use can increase social confidence and improve peer relationships.15 Individuals with IDD enjoy the privacy and autonomy of online spaces, allowing them to interact beyond caregiver oversight.16 While there are specialized websites for individuals with IDD, the majority of people with IDD use mainstream social media sites to interact with a broader and more diverse audience.6

Finding community through shared interest. Online platforms facilitate the development of friendships and provide a sense of community for individuals with IDD. Whether it’s through online communities, Discord servers, or Facebook groups, these platforms offer forums to discuss shared passions, entertainment, and advocacy.12 Many online discussions spill over into real-world interactions, validating their social skills and contributing to the development of their self-identity.13,15

Expressing identity. Social media allows individuals with IDD to control their online presence, choosing how they present themselves to the world. Some openly disclose their disability as part of their advocacy efforts, while others choose to engage without revealing this aspect of themselves.15 Online forums allow individuals with IDD to be recognized based on their interests and passions rather than being defined solely by their disability status.6

Digital advocacy and self-representation. People with IDD use social media as a tool for advocacy to raise awareness about discrimination and promote inclusion. By sharing their experiences, providing resources, and amplifying their voices, they use their platforms to advocate for disability rights.15

Digital platforms as tools for skill development. Strengthening cognitive and adaptive skills. Navigating social media requires decision-making. One must decide what to post, how to respond, and how to manage online interactions. This process fosters adaptive skills and critical thinking for individuals with IDD, often in ways that offline environments might not.15

Educational support and learning tools. Online learning tools for students with IDD offer customized learning activities designed for their specific needs. These tools help students complete structured tasks independently.17 Other assistive technologies, such as speech-to-text technology and screen magnification, also increase accessibility.17

Beyond classroom education, online interventions have proven successful in teaching life skills. Digital tools have successfully taught individuals with IDD tasks such as reading product labels,18 using automated teller machines (ATMs),19 and preparing food.17 These digital learning experiences translate into greater independence in daily living.

Enhancing therapeutic support access. Telehealth and digital interventions. Online healthcare has expanded access to therapy, medication management, and remote monitoring of health in people with IDD.20 Telehealth reduces geographical and logistical barriers and provides more accessibility to medical and psychological care.

Additionally, digital programs have been designed to support speech therapy, cognitive rehabilitation, and navigation of higher education in people with IDD.21 Research also highlights the effectiveness of computerized cognitive behavioral therapy tools for individuals with mild-to-moderate IDD.20 These digital interventions provide guidance that fits the unique cognitive needs of this population.

Mobile applications for emotional regulation and mental health. Some specialized mobile apps have been developed to offer real-time behavioral monitoring, which allows individuals with IDD and their caregivers to track emotional patterns and prevent crises.20 Certain apps provide interactive coping strategies, sensory-friendly mindfulness exercises, and emotional regulation techniques. These apps can help enhance self-awareness and promote mental wellbeing. A recent systematic review highlighted that behavioral and cognitive interventions delivered through digital devices can be effective in improving emotional regulation, adaptive functioning, and overall quality of life in individuals with ID.22

Clinical Vignette 1

Jordan, a 19-year-old individual with mild ID, presented to clinic with his mother for a routine follow-up. His mother reported that he had recently become more engaged online, spending time on social media and gaming platforms. She expressed concern about his screen time and online safety. Jordan, however, shared that these platforms have helped him connect with peers, express his interests, and feel more confident socially. The following vignette captures a clinical conversation exploring the role of social media in enhancing social interaction, fostering identity, and reducing isolation in individuals with ID.

Dr. Patel: Hi, Jordan! Hi, Ms. Thompson! It’s great to see you both. How have things been going since our last visit?

Jordan: (smiling) Pretty good. I’ve been playing more online games lately and joined a group that talks about comic books.

Dr. Patel: That’s awesome, Jordan. What kind of group is it?

Jordan: It’s on Discord. We talk about the new Marvel movies and post our fan art.

Ms. Thompson: (slightly hesitant) He’s definitely spending more time online. I just want to be sure it’s safe.

Dr. Patel: (nodding) That’s completely understandable. Jordan, I think it’s great you’ve found a space to connect with people who like the same things you do. Online communities can help people make new friends and feel more confident.

Jordan: Yeah, I feel more like myself. It’s easier to talk there. Not so much pressure.

Dr. Patel: That makes a lot of sense. Sometimes it’s easier to express yourself online because you can take your time and decide what you want to say. Have you been able to make any new friends in the group?

Jordan: Yeah, there’s one guy from Ohio too. We even talk about stuff besides comics now—like music and shows.

Dr. Patel: That’s fantastic. It sounds like you’re building some real friendships. And Ms. Thompson, I want to reassure you—while it’s important to keep safety in mind, these platforms can also give Jordan more independence and help him feel less isolated.

Ms. Thompson: I see that. He’s more upbeat. He used to be quiet around others.

Dr. Patel: Social media, when used in a supportive environment, can really boost social confidence. Jordan, have you thought about sharing some of your drawings online?

Jordan: (grinning) I did last week! I even got comments from people who liked them.

Dr. Patel: That’s a great way to express who you are. You’re sharing your talents, and you get to choose how much of yourself you share. Some people even use their pages to talk about what it’s like to have a disability—to teach others or to connect with people who understand.

Jordan: I haven’t talked about that stuff yet. I’m still thinking.

Dr. Patel: And that’s completely fine. What matters is that you feel in control. Whether you decide to talk about it or not, your voice matters.

Ms. Thompson: Thank you for framing it that way. I was nervous about him being online, but it’s helping him come out of his shell.

Dr. Patel: That’s the goal—to help Jordan find community and build relationships while staying safe. We can also talk more next time about online safety tips, so you both feel confident.

Jordan: Cool. Can I show you my drawings next time?

Dr. Patel: I’d love that. Thanks for sharing with me today, Jordan. You’re doing great.

Practice point: The Broader Impact of Digital Inclusion

The internet is a powerful tool for individuals with IDD, allowing them more autonomy, access to information, and meaningful social participation. Research suggests that people with limited offline interactions benefit more from engagement in online communities, which is known as “the compensation model.”6

While there are risks associated with social media and internet usage, the key to maximizing its benefits for individuals with IDD is structured support. Caregivers, educators, and healthcare providers are crucial in facilitating safe and empowering digital experiences. With the right resources and support, internet access has the potential to significantly enhance the quality of life for individuals with IDD.

Challenges and Risks

Safety concerns. Cyberbullying and exploitation. Individuals with IDD are more vulnerable to bullying and exploitation than their peers, especially with regard to internet usage.23 It has been found that adolescents with IDD are more likely to be victims of both face-to-face bullying and cyberbullying than their non-IDD counterparts.24 Cyberbullying is also prevalent among students with IDD in special education settings, not just between those with and without IDD. Cyberbullying is associated with depression, unhealthy behaviors such as substance abuse, and problematic internet usage.25 Parental social support,26 encouraging healthy screen time limitations, and providing additional training beyond vocational training in areas such as leisure, health, and safety can improve these outcomes.27

Privacy and data security. Individuals with developmental disabilities face significant risks regarding the privacy and protection of their personal information. In terms of internet usage, individuals with IDD are vulnerable to not only cyberbullying but financial and sexual exploitation.28 Individuals with IDD may have limitations in their cognitive function, comprehension, decision-making abilities, and communication that could increase the likelihood of exploitation of their personal information.29 Many individuals may be solely reliant on information that their caregiver or loved ones provide to them, preventing their ability to function independently and hindering their ability to learn how to protect themselves from abuse. Individuals with IDD might also be reliant on multiple private and community-based organizations for education, employment, and care, which can increase the number of organizations that have access to their information and therefore increase the likelihood that their personal information may be exploited.30 Enhancing control and autonomy in decision-making in these individuals through training and education and developing clear-cut legislation can enhance the privacy rights of these individuals.31

Cognitive and emotional considerations. Overstimulation and digital dependence. Individuals with IDD who have access to information and communication technology (ICT) often use them for social connection despite lower overall access and frequency of use than non-disabled peers.6 Clinically, reducing overall online time while supporting alternative avenues for social connectedness may be beneficial, as lower daily computer use has been associated with reduced involvement in cyberbullying.32,33

Individuals with IDD also exhibit atypical sensory processing,34 which can impact behavioral outcomes, especially in terms of social media and internet usage. They may experience heightened sensitivity to sensory stimuli, making them particularly susceptible to overstimulation in digital environments. The internet, with its rapid information flow, bright visuals, and constant notifications, can overwhelm their sensory processing systems, leading to distress and behavioral challenges. Methods that can be used to assist in the reduction of overstimulation include decreasing on-screen clutter, giving options to choose the rate at which information is loaded as to avoid overwhelming individuals, and decreased stimuli, such as flashing or loud noises.11

Navigation of online relationships. People with IDD may struggle with understanding social cues and dynamics, which can make it harder to discern the appropriate level of intimacy or trust to have with online acquaintances. Difficulties in understanding and responding appropriately in social interactions, such as failing to understand or misunderstanding others’ feelings, can cause potential conflict in online relationships. For example, not understanding the nuance of certain words, slang, or underlying messages, many of which can differ from language used in-person, can cause interactions to be more complex. However, usage of the internet does foster the opportunity for positive relationship formation, allowing these individuals to participate in community groups online, develop romantic relationships, learn information, and engage with the community through offered services.35

Barriers to access. Economic disparities. While internet and social media access has generally increased over time, there are still differences among populations. Households headed by someone with a disability generally have a decreased chance in computer ownership and internet use and are more likely to have never accessed the internet compared to nondisabled individuals. Cost is a barrier—those with IDD are likely to be part of a household with lower socioeconomic status.6 Only about 6% of individuals with IDD are engaged in paid employment.11 This in turn can limit the ability to purchase a computer or other internet-accessible device, which limits internet accessibility. Accessing the internet often requires specialized devices or software tailored to the needs of individuals with IDD. The cost of these assistive technologies can be prohibitive, especially in low- and middle-income households where state-based funding is limited in subsidizing these elevated costs.36 National programs such as the Affordable Connectivity Program, in which the Federal Communications Commission (FCC) subsidized purchases of ICTs and the cost of internet service, could be a possible solution in bridging this digital divide.

Lack of tailored interfaces or accessibility. The current nature of digital technologies may make them less accessible to individuals with IDD. Some of these limitations include cognitive and linguistic limitations, difficulty keeping up with frequency in the change of user interfaces and functionalities, and lack of appropriate training or support in their usage. There may be physical limitations as well; many individuals with IDD may be affected in their gross and fine motor skills, which is prohibitive in the usage of a traditional keyboard, mouse, phone, tablet, or other devices. Smaller screens on phones, tablets, or other small handheld devices can make them more difficult to use due to sensory impairments. It can be difficult to remember how to access websites or devices due to many kinds of security measures including codes, usernames, and passwords.9 Options for bridging the digital divide include using simpler language, spacing out controls for those with lower dexterity, increasing customizable setting options, magnification of text, and designing equipment that requires less complicated movement, such as twisting or gripping.11

Clinical Vignette 2

Alex, a 17-year-old individual with mild ID and sensory processing challenges, presented to the clinic with his father for a follow-up visit. Mr. Rivera reported increased time spent online, recent mood changes, and an upsetting incident involving peers from a special education group chat. The visit explores digital safety, cyberbullying, privacy, overstimulation, and healthy internet habits for individuals with IDD.

Dr. Nguyen: Hi, Alex. Hi, Mr. Rivera. Good to see you both again. How have things been going since our last check-in?

Mr. Rivera: It’s been a mixed bag, honestly. Alex is online a lot more. He’s in a few group chats and online gaming servers, but there was an issue last week. Someone in his school’s group chat started saying really mean things—stuff that upset him a lot.

Dr. Nguyen: (turning to Alex) That sounds really hard, Alex. Do you want to tell me more about what happened?

Alex: (looking down) They kept sending messages—calling me names and saying I was dumb. Then someone shared a picture I didn’t say they could.

Dr. Nguyen: (gently) I’m really sorry that happened. What you experienced is called cyberbullying—and sadly, it’s something a lot of people with disabilities face. It’s not okay, and we’re going to talk about how to keep you safe and feeling better.

Mr. Rivera: I didn’t even know it was happening until he got really quiet and stopped wanting to use his computer for a few days.

Dr. Nguyen: It’s great that you noticed the change. Mood shifts, withdrawing, or getting more anxious can all be signs. We want to make sure Alex feels safe and supported—not just offline, but online too.

Alex: (quietly) I liked talking to people before that. It made me feel like I had friends.

Dr. Nguyen: That makes a lot of sense. Online spaces can be great for finding friends or being part of a group. But we also need to know how to spot when something’s not right. Like if someone asks for private information, makes you feel scared or confused, or tries to pressure you to do something.

Mr. Rivera: That’s part of my worry. He doesn’t always know what’s okay to share. I found out he gave his email and birthday to someone last month.

Dr. Nguyen: That’s a common risk for teens both with and without IDD. Understanding privacy online can be tricky. We can work on that together—like learning not to share things like full names, where you live, or passwords. And we can set up protections, like stronger privacy settings.

Alex: Sometimes the screens just get too loud and bright too. I get a headache, but I don’t want to stop.

Dr. Nguyen: I hear you. With your sensory sensitivity, too much screen time—especially flashing images, loud sounds, or lots of information at once—can be overwhelming. We can adjust your settings to make things calmer. And it might help to build in screen breaks so your brain and body get time to rest. Do you mind if we set this up together on your phone?

Alex: No, I’d like that, that way I have say into when the breaks will be.

Mr. Rivera: We’ve been talking about maybe turning off the tablet earlier at night. He gets upset when it’s time to stop.

Dr. Nguyen: That’s a good goal. We can come up with a plan where Alex still has online time, but with limits to avoid digital overload. Maybe we set a timer or use a visual schedule. That way he knows what to expect. Alex, what do you think about this?

Alex: A lot of my friends get off at 10 pm, so maybe we could set a timer at 9:30 pm to give me time to finish?

Mr. Rivera: I think that sounds like a good plan.

Alex: I like watching videos about drawing and anime. Some of the people I follow talk about autism and other stuff too. It’s cool.

Dr. Nguyen: That’s fantastic. You’re learning and connecting—which is great. And some people even use social media to speak up about things that matter to them, like disability awareness. Just like in real life, we want to help you learn who to trust and how to feel in control of your own voice.

Mr. Rivera: I think we just need tools, like how to talk about what’s going on and what’s safe or not.

Dr. Nguyen: Absolutely. I can connect you both with a digital safety training resource and a tool kit for teens with IDD. And we’ll follow up next time on how it’s going. Alex, you’re doing a great job speaking up. That’s an important first step.

Alex: (smiling slightly) Thanks. I just want to keep my friends…but be okay.

Dr. Nguyen: And you will. We’ll help you stay connected—but protected.

Practice Point: How to Approach internet Use

In a 2017 study, over 90% of caregivers expressed concerns about the safety of internet use for individuals with ID.37 More than one-third reported restricting online activities, with 1 in 5 supervising internet use directly by sitting alongside the individual or employing content control filters. While these concerns are understandable, overly restrictive practices may limit the many potential benefits the internet can offer, including social connection, skill development, and independence. Notably, fewer than half of caregivers reported receiving any formal training on managing internet safety for individuals with ID.37 Many caregivers expressed a desire for more guidance and education—particularly from government agencies and nonprofit organizations. To promote safe and meaningful online engagement, individualized support and training should be provided to both individuals with ID and their caregivers. Parent-child interventions, such as Intergenerational Digital Citizenship Groups, may be a promising strategy to bridge gaps in understanding and foster collaborative, informed approaches to digital inclusion.38,39 Refer to Box 1 for more ideas on how practitioners can approach internet usage.

Resources

A variety of resources are available to assist parents, caregivers, and educators in promoting internet safety for individuals with IDD. These resources offer guidance on topics such as cyber safety, sexual health, and digital citizenship. They include toolkits, curricula, printable materials, and online articles, each designed to address specific aspects of online safety and empowerment for individuals with IDD (Table 1).

 

Clinical Vignette 3

Isaiah, a 16-year-old individual with moderate IDD, presented to clinic with his grandmother, Mrs. Bennett. She reported growing concerns about his internet use, particularly after he attempted to video chat with a stranger he met in a gaming forum. She was unsure how to supervise his online behavior and was looking for concrete tools and education. The clinician introduced her to structured digital safety resources tailored for families and youths with IDD.

Dr. Collins: Hi, Mrs. Bennett. Hi, Isaiah. It’s good to see you both again. How have things been going lately?

Mrs. Bennett: Honestly, I’m a bit worried. Isaiah’s been spending a lot of time online. Last week, he tried to video chat with someone he met in a game. He didn’t realize it could be risky.

Dr. Collins: That’s a common concern, and it’s good you caught it. A lot of teens—especially those with IDD—don’t always understand what’s safe or private online. But there are some really helpful resources we can walk through together today.

Isaiah: (looking nervous) I didn’t know it was bad. He said he liked my drawings.

Dr. Collins: (reassuringly) I know you were just trying to make a friend. And that’s okay—we’re going to help you learn how to stay safe while still doing the things you enjoy online.

Mrs. Bennett: That would be great. I’ve been watching over his shoulder, but I don’t always know what to say or what to block.

Dr. Collins: You’re not alone. Most caregivers feel that way. There’s a toolkit from Montgomery County’s Board of Developmental Disabilities that’s designed just for parents like you—it covers internet safety, healthy relationships, and how to have these conversations with teens. I’ll print the PDF for you today.

Mrs. Bennett: Oh, good. I’d love something I can read and use with him. Does it have examples?

Dr. Collins: Yes, and even better—it has sample scripts for how to talk about things like privacy and sharing personal info. There’s also a set of visual safety cards from the Sexuality Education Counselling and Consultancy Agency (SECCA)—these are great for kids like Isaiah who benefit from more concrete cues. We can go through a few together now.

Isaiah: (interested) Are there videos too?

Dr. Collins: There are! The Cyber Safety Resource Collection from PAAutism.org has videos and tip sheets made just for people with disabilities. We can look at one on safe texting today.

Mrs. Bennett: I didn’t know there were this many tools out there.

Dr. Collins: And that’s why we’re talking about them. Let’s pick 1 or 2 resources to start with and build from there. We can also use the Internet Safety Curriculum to help Isaiah practice online decisions step-by-step.

Isaiah: Will I still get to keep my games?

Dr. Collins: (smiling) Of course—we’ll just learn how to play them safely. You’ll be in control, and your grandma will help you make smart choices.

Mrs. Bennett: Thank you, Dr. Collins. This is exactly what we needed.

Conclusion

As internet and social media use continue to shape the daily lives of youths, it is essential that individuals with IDD are not left behind. Digital platforms offer meaningful opportunities for social connection, identity exploration, skill development, and therapeutic support. However, these benefits must be balanced with the reality of increased vulnerability to cyberbullying, exploitation, overstimulation, and inequitable access. Mental health professionals, educators, and caregivers play a critical role in helping youths with IDD navigate this digital landscape safely and confidently.

By integrating digital literacy into clinical conversations, advocating for accessible technologies, and supporting caregivers with targeted training, clinicians can promote digital inclusion as part of holistic, developmentally appropriate care. Psychotherapy provides a valuable space to build emotional awareness around digital experiences, foster safer online behaviors, and strengthen family communication. As research and digital tools continue to evolve, so must our strategies for helping youths with IDD participate meaningfully—and safely—in the digital world. Empowering this population through informed, supportive engagement is not only possible but essential for promoting autonomy, self-expression, and mental wellbeing in the digital age.

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