The online lives of adolescents with mild or borderline intellectual disabilities in the Netherlands: Care staff knowledge and perceptions

ABSTRACT

Background

This study reports the findings from a Dutch study, exploring care workers’ knowledge and perceptions of the online lives of adolescents with mild or borderline intellectual disabilities.

Method

Using an inductive research design 33 semi-structured interviews were conducted with care workers.

Results

Three themes were derived from the data: (1) The clients’ online world is largely unknown to care workers. (2) The online world is a gateway to an inclusive and connected life. (3) The online world is a dangerous and challenging place.

Conclusion

Care workers have limited knowledge of clients’ online lives. Care workers show ambivalence about the good and bad of the Internet for their clients. They acknowledge the possibilities of the Internet but mostly perceive it as a place of risk and challenge. Paradoxically, care workers report little experiences of incidents of online risks. Perceptional processes might help explain why this paradox exists.

KEYWORDS:

• Intellectual disability
• mild intellectual disability
• professionals
• care workers
• Internet activities
• online lives
• perception
• Netherlands

The positive and protective effects of support on the online lives of adolescents have been acknowledged in the field of online youth studies (Anderson et al., 2017). Much less is known about the effect of support on adolescents with intellectual disabilities (IDs). This is important as adolescents with IDs, in general, have more support needs than their peers without IDs (Nouwens, 2018). Moreover, giving support to adolescents with IDs is often complex and depends on who provides the support, how they provide it and what attitude they have towards the youth’s online lives (Alfredsson Ågren et al., 2020). Although there is some evidence, for example, that providing support increases opportunities for people with IDs online to maintain and create friendships (Raghavendra et al., 2018), express themselves better (Kydland et al., 2012), and gain problem-solving skills (Holmes & O'Loughlin, 2014), caregivers often seem to be ambivalent about the online lives of adolescents with IDs. On the one hand, they want to embrace the Internet as a positive arena where adolescents with IDs can create more positive social networks and become more independent individuals. However, on the other hand, they perceive adolescents with IDs as more vulnerable online compared to other, non-disabled adolescents (Chadwick et al., 2016; Chiner et al., 2017; Löfgren-Mårtenson et al., 2015; Nikken et al., 2018; Ramsten et al., 2019) and therefore need to be protected and safeguarded against the risks of the Internet. However, the empirical evidence that warrants this need, is thin (Chadwick, 2019) and sometimes even points in the opposite direction (Alfredsson Ågren et al., 2020; Didden et al., 2009; Seale, 2014).

Especially social media seem to be perceived as posing a risk to people with IDs by both parents and paid carers (Caton & Chapman, 2016; Holmes & O'Loughlin, 2014; Ramsten et al., 2019; Shpigelman & Gill, 2014). Several studies addressed that these perceptions could prompt care givers to act as gate keepers who control and monitor the online lives of people with IDs (Chadwick, 2019). Seale and Chadwick (2017) add that this should not be appropriate for (young) adults with IDs and only highlights that they are held to different standards than non-disabled people. Gatekeeping may hinder people with IDs to participate in our digital society. From a human rights perspective, this is important as article 9 of the Convention on the Rights of Persons with Disabilities (UNCRPD) clearly states that persons with disabilities need to be enabled to live independently and participate fully in all aspects of life, including in regard to information and communications technologies and systems.

In the Netherlands, many care workers work in group homes with adolescents with Mild Intellectual Disabilities or Borderline Intellectual Functioning (MID/BIF) and often providing them with 24/7 care. In the Netherlands, MID/BIF is defined by having an IQ between 50 and 70 or between 70 and 85, with additional problems in their social adaptive functioning. Several Dutch care organisations have shown a need for online guiding strategies for their staff. This need is also reflected in the literature (Chadwick et al., 2013; Chiner et al., 2017; Löfgren-Mårtenson et al., 2018). However, these care organisations often have little insight in what their staff know about the online lives of their clients with MID/BIF, and how care workers perceive these online lives. Few studies address these questions as care workers who work in group homes with adolescents with BIF are rarely sought out as informants. This research gap is important to address for two reasons. First, although this group of adolescents is often perceived as being extra vulnerable in the Netherlands, they use the Internet largely the same as their peers without MID/BIF (De Cocq & Boot, 2014; Nikken et al., 2018). This increases the risk that the online skills of this group are overestimated by care workers. Second, from the literature can be drawn that the presence of an ID should not be used as a as an indication of how someone uses the Internet (Seale & Chadwick, 2017). There may be groups of people with IDs who are more or less likely to engage in risky online activities, depending on their type of disability (Lough & Fisher, 2016) and the level of their support needs (Bannon et al., 2015).

There are some studies that to some extent address the research gap described above. For example, Ramsten et al. (2019) conclude that care workers perceive people with IDs to be more vulnerable online than people without IDs. Furthermore, these perceptions were not based on care workers’ knowledge about the online lives of their young adult clients with MID but on preconceptions about the vulnerabilities of clients, views of the clients’ parents, the care worker’s own moral values, and societal perceptions of appropriate Internet use. Chiner et al. (2017) and Löfgren-Mårtenson (2008), draw similar conclusions and add that care workers’ perceptions of Internet use by adolescents with MID are influenced by media representations of the Internet. A Dutch survey study by Nikken et al. (2018) also concludes that care workers generally perceive the Internet as very risky for adolescents with MID/BIF, in part due to their negative experiences with clients being bullied, contacting strangers, and seeking sexual activities online. They reported clients having financial problems online, sharing nude videos of themselves, or sharing personal information online.

Ideally, the perceptions of both care workers and clients are sought out (Caton & Chapman, 2016; Chadwick et al., 2013). The aim of this paper is to make a contribution to the evidence base by presenting the results of a qualitative study that gives a detailed and rich description of what care workers know about the online lives of their adolescent clients and how they perceive it. This is important as perceptions affect what decisions care workers make in their daily work. The research questions that are discussed here are:

• What knowledge do care workers have about the online lives of their clients?

• How do care workers perceive the online lives of their clients?

Two important concepts need some clarification. First, when the term online lives is used, it refers to the set of actions people perform and the set of relationships they have when connected to the Internet (Benvenuti et al., 2019). Thus, the online activities and social interactions of adolescents with IDs are part of their online lives. Second, when talking about perceptions of care workers, this paper refers to the process by which people interpret and organise sensation to produce a meaningful experience of the world (Lindsay & Norman, 1977). To put it in the context of the daily practice of care workers: when care workers observe or experience something about the online lives of their clients, they will interpret this information into something that is meaningful to them based on their prior experiences. In forming perceptions, a person’s beliefs, attitudes, motivations and personality are important, influencing factors (Pickens, 2005).

Method

Study design

A qualitative, inductive research design was constructed that used semi-structured interviews with 33 care workers of Dutch care organisation Middin.

Ethical considerations

This study was approved by the research committee of Middin. This committee consists of employee representatives who are responsible for the assessment and approval of research proposals that aim to be conducted within the organisation. The researchers followed the general guidelines as provided by the Netherlands Code of Conduct for Research Integrity (Association of Universities in the Netherlands, 2018). All respondents gave their full consent for the recording and use of their interviews for the purpose of this study. All names of clients, dates, and places were altered or deleted to ensure the privacy of all respondents and their clients.

Recruitment of participants

Care workers were recruited from four group homes of Middin that operate in the South-West region of the Netherlands. These group homes all provide 24 h in home care for people with MID/BIF, but differ in their purpose. All locations serve as living facilities, but one also provides short-term crisis care, while another specificly aims to prepare adolescents for a more independent life with ambulant care. Locations also differ in their clientele. While three locations work with adolescents with MID/BIF, one location specialises in clients with comorbidity (MID/BIF in combination with other mental health problems). Also, only at one location lived clients under the age of 18 years, while the other three provided care for adolescents that are aged from 17 years and up with predominantly young adults.

The research committee of Middin assisted in the recruitment of participants by asking location managers of these four facilities to identify 10 care workers from their team. Inclusion criteria were that participants had to have at least one year's work experience with adolescents with MID/BIF in the age range of 12–27. Further, participants needed to be willing to be interviewed about their daily experiences in guiding these adolescents in their online world.

Participants

The location managers provided the names of 40 care workers, of which seven later declined because of their workload. Six of these seven care workers worked at the location that provided care for adolescents under the age of 18. Of the remaining 33 participants, 8 were male and 25 were female. Twelve care workers who participated were distributed in the age range between 20 and 30 years, 10 between 30 and 40 years, six between 40 and 50 years, and five between 50 and 65 years. Most care workers predominantly work with adolescents with MID/BIF in one of the four group homes. However, one participant worked as a behavioural therapist in one of these homes and three participants also provided ambulant care for young adults who have their own home. Participants received at least post-secondary vocational education and training in social work at a full professional level.

Data collection

The semi-structured interviews were conducted by four graduating applied psychology students of Leiden University of Applied Sciences in the Netherlands. All interviews were held at the group home facility were the care workers conducted their work. To establish methodological rigour, the student researchers were trained in conducting in depth interviews and were taught how they could be reflexive during the interview process and while making their transcriptions (e.g., raising awareness about their own experiences, beliefs, and perceptions). To help ensure reflexivity and rigour the student researchers were provided with an elaborate interview protocol. This protocol contained an introduction for respondents about the study and the student researcher, practical reminders (e.g., making notes, checking battery status of the voice-recorder), ethical aspects (e.g., management of research data, privacy of respondents), the main interview topics ((1) knowledge about online lives; (2) perceived advantages and disadvantages of the Internet for clients; (3) perceived challenges and opportunities for clients), additional open-ended questions per topic that helped the student researchers to deepen the topics, and a list of open-ended prompts (e.g., tell me more about that? What happened further?) to stimulate participants to elaborate on their initial answers.

The students also attended weekly feedback sessions with the lead researcher to discuss questions or troubles that arose prior, during and after their data collection. The interviews were recorded on a voice-recorder and transcribed verbatim by the student researchers. All transcripts were checked by the researchers before the data analysis.

Data analysis

The analysis of the data was conducted through an inductive thematic analysis (Braun & Clarke, 2006). By choosing this type of analysis it is to be expected that some depth and complexity is lost, but a rich overall description is maintained. Therefore, it can be considered a useful method for the investigation of under-researched topics (Braun & Clarke, 2006).

Quirkos, a qualitative analysis software tool, was used to facilitate the analysing process. The interview transcripts were analysed using open coding, after which codes were aggregated into themes. Subsequently, these themes were checked against all codes and the entire data set while generating a thematic map of the analysis. The authors refined the thematic map by discussing the themes, how they related to each other, and what overarching story they were telling.

Results

Three overarching themes were derived from the data and describe what care workers know about the online lives of their clients with MID/BIF and how they perceive this: (1) The clients’ online world is largely unknown to care workers. (2) The online world is a gateway to an inclusive and connected life. (3) The online world is a dangerous and challenging place.

The clients’ online world is largely unknown to care workers

Care workers observed their clients using smartphones, tablets, laptops, and gaming consoles intensively on a daily basis. Most of these clients used the group home WIFI, but some had their own Internet subscription. Almost all clients had their own 4G contract for their smartphones. Communal areas in group homes often had a shared gaming console, and there was usually a staff-managed laptop, tablet or desktop that clients could use. However, some clients had more limited online access than others, for example, they either were unable to afford a smartphone or had to rely on unstable group home WIFI networks.

Although care workers observed their clients using the Internet on a daily basis, it was not always clear what they did online. Clients rarely approached care workers about their online activities and were typically unwilling to share what they did online. When they did share information, it was usually because something went wrong (e.g., online gossiping, or bullying on social media), or when they forgot the password to an app or a website. Therefore, most things their clients did online remained unseen. Although care workers wanted to know more about the online lives of their clients, they seemed to have little faith in their abilities to increase their knowledge. Care workers reported that these insecurities largely followed from their own limited computer- and Internet-related knowledge and skills, and clients who appeared to be more tech-savvy than they were. Consequently, care workers found it difficult to start a conversation about the online lives of their clients. Even a young care worker like 21-year-old Lily did not have faith that she had full knowledge of what her clients actually do online, especially in regard to their social media use:

“I think it is a MID-BIF world on its own and we will never fully know it unless a client shares it with you. Or if you accidentally stumble upon it. But, no, I think I have only experienced 5 percent of what they actually do online.”

Lily also mentioned the social media bubble that she thinks her clients are in. She suspects they mostly talk to other clients, or people they know from previous group homes they stayed in, about their lives and about how they are treated by care workers. Other care workers expressed similar suspicions, but like Lily, had limited knowledge on what their clients do online.

Care workers explore different ways to expand their knowledge. Many care workers used a more passive, observational approach upon overhearing clients talking about their online activities or watching them when they are online (mostly using their smartphones) and tried to interpret what was going on. Care worker Oliver, for example, regularly observed clients when they were busy with their smartphones in the communal area of the house and sometimes suspected that clients were teasing or bullying others after seeing them giggling and looking at other clients while texting on their phones.

Care workers sometimes used this passive approach as a steppingstone to a more active approach. For example, care worker, Mia, occasionally sat down next to a client and pretended to be busy on her own phone but was actually trying to find out what her client is doing online: “Then I casually ask who the person on their screen is without raising suspicions of trying to pry into his or her online activities.” Although Mia’s intentions were not quite clear, care workers often seemed to feel that approaches like these may be considered an invasion of a client’s privacy.

Other care workers took a more active approach by carefully choosing the right moment to talk to clients about their online activities. In their experience, talking about the online lives of clients is a sensitive topic and often clients did not seem keen on sharing what goes on in their online world. In their perception, a successful approach depends on trust, timing and showing a sincere interest in their online lives. Care worker Olivia gives an example of this approach:

“Sometimes I sit down next to them while they are playing Fortnite and while I do not understand much of what they are doing, I ask them if they could explain it to me and they often do this without getting annoyed or angry with me.”

The online world is a gateway to an inclusive and connected life

Care workers acknowledged the possibilities the Internet has to offer for their clients to live a more inclusive and independent online life. The Internet enables clients to educate themselves, for example, by staying up to date on current events through social media, learn about their own health-related issues, or by looking up information on school or personal interests. It also helps them to better organise their lives. They apply for jobs, or social benefits, they use apps that tell them at what time/when school starts or when they have an appointment with their care worker, they shop for goods, services, and food, and sometimes they manage their own bank accounts. Care workers also mentioned that the Internet gives them access to a wide variety of entertainment that helps clients to unwind or escape from their daily routines. Just like their peers without IDs, adolescents with MID/BIF use the Internet to watch movies and television series on streaming services like Netflix, to play online videogames like Fortnite and Warzone, and to a lesser degree to watch porn, gamble, or make vlogs on YouTube.

The Internet also fulfils a need for social connectedness according to care workers. In their perception, most adolescent clients experience difficulties maintaining relationships and creating new ones in their lives, but the Internet gives them new and accessible ways to interact with others, especially since almost all adolescent clients with MID/BIF have smartphones with both WIFI and 4G connections. Easy to navigate social media platforms like WhatsApp, Facebook, Instagram and SnapChat have increased the opportunities to stay connected to family, housemates, other clients they knew from previous care locations, and friends from school. Care worker, Mary, described why this is so important for adolescents with MID/BIF:

“They quite often feel isolated from the outside world, but at the same time, they are also anxious to go outside. Due to the internet it is easier for them to maintain friendships or make new ones, for example with people they met through work.”

Additionally, care workers observed clients investing in new relationships through the Internet. Clients participate and invest in several online communities, especially related to their hobbies or interests, but also use social media to look for romantic or sexual relationships. Female clients seemed more interested in social media platforms like Tinder and Badoo than their male counterparts, but according to care workers they have an appeal to many clients.

Furthermore, care workers generally think that communicating with their clients through social media has impact on the quality of the support they give and responds to the needs of many of their clients. Care workers stressed that talking with clients through a chat-app like WhatsApp sometimes helps clients to connect to care workers, especially clients who experience difficulties connecting in more direct, face-to-face conversations. Care workers experienced that using digital platforms to communicate with clients can even reduce stress and anxiety as the clients have more time to read and interpret text messages and feel less pressure to respond immediately.

Despite the above, as care workers also showed ambivalence towards the Internet as a gateway to a more inclusive and independent life. All care workers expressed concerns about the impact that the rapid digitalisation of society has had on their clients. Care workers were afraid that clients will be unable to use the Internet to their advantage, for example, to apply for jobs, or using government services online. Care workers reported that this problem is mainly due to some of the barriers that the Internet raises for their clients, like the many passwords they need to create online, complexity of websites and applications, and the heavy appeal on the writing and reading skills of their clients (more on this in the next section). Therefore, many care workers saw potential benefits of the Internet for their clients, but at the same time had their doubts about the level of independence their clients would be able to achieve online.

The online world is a dangerous and challenging place

Although care workers acknowledged the benefits of the Internet to live a more inclusive, independent, and connected life, they mostly seemed to perceive the Internet as a dangerous and challenging place for their clients. In the interviews care workers referenced the things they felt most worried about when prompting to think about the time their clients spend online. They believed that their clients are at risk to become victims of online aggression, sexual solicitation, or (financial) deception. Care workers also reported being afraid that the large amount of time clients spend online would have a disruptive effect on their wellbeing. Care workers gave examples such as aggressive behaviour after extensive gaming sessions, sleep deprivation, and neglecting personal hygiene.

Most care workers have little experience with online victimisation or offending of clients. Moreover, experiences they shared often did not yield any serious consequences and seemed more incidental than part of a structural problem in their daily work. In general, most of their perceptions seemed to be based on preconceptions they have about the Internet and the capabilities of their clients to act safely and responsibly online. These preconceptions were based on their personal belief system, but also on stories heard from colleagues or stemming from media coverage, as care worker, Judy, explained:

“Yeah, as it happens it was in the news last week that it’s so easy to put sex videos on a pornsite. That makes me think about my work and those girls …  maybe I’m mothering them, but you want them to be careful, especially because it was in the media.”

Although care workers sometimes seemed to be overprotective, considering the small number of incidents they report, they also believed that their concerns are justified. Care workers expressed that when things do go wrong online, they can get out of hand quickly and sometimes have serious and severe consequences for clients. Care workers gave examples of clients being bullied and harassed, clients being pressured into sending nude pictures or extorted to give money or to perform sexual activities to prevent exposure of such pictures, and clients not being able to open a bank account after getting caught acting as a money mule¹ for criminals. Sometimes, the client is not the victim but the perpetrator as clients sometimes bully housemates or care workers online, cause unrest in the local community by posting fake messages that someone has died or accuse other clients of abuse. One client even threatened to kill a mayor through social media because he got a fine.

Care workers said that social media platforms like Snapchat, WhatsApp, Facebook, and Instagram are at the heart of their concerns and negative experiences as care worker, Beth, explained:

“The biggest disadvantage here is those fights and arguments all originate on social media. It goes from posting photos and videos to piss each other off and then they go pitting one client against another client. And this goes on and on and happens a lot around here.”

Social media was also regarded as the place where clients are most susceptible to manipulative or false advertisement (e.g., fake or misleading job opportunities on Instagram, being confronted with high bills on a “free” webcam site), getting lured into fraudulent activities (e.g., purchasing phone subscriptions in their names for other people), or experience problematic sexual behaviour (e.g., sexting, sextortion, grooming).

Care workers gave several possible explanations for the online problems adolescents with MID/BIF experience. First, clients were reported to be particularly vulnerable online because of their cognitive, emotional, and social limitations. Care workers, in general, described clients as gullible, easy to manipulate, impulsive, unable to oversee consequences, and having limited capabilities to learn from their mistakes. Moreover, care workers expressed that the Internet strongly appeals to the writing and reading skills of clients. They observed clients struggling to understand and interpret text messages on social media or instructions on websites, and worry that their clients are unable to distinguish what is real or fake online. Care workers also thought that the lack of online competence could be an explanation for clients' conflicts with one another, both online and offline, as care worker Richard explained:

“Clients experience trouble understanding text messages they receive and often interpret these messages themselves [instead of going to a care worker]. Quite often, this leads to fights and misunderstandings without us knowing about it.”

As mentioned in the second theme, many care workers communicate with clients through social media (mainly WhatsApp), therefore they sometimes experience first hand how these arguments can start. Care workers gave examples of clients who interpreted their messages the wrong way (or the other way around), or who were unable to ventilate their concerns in a respectful and coherent way in a text message. This can cause friction between care workers and clients that sometimes affects their professional relationships.

Many risky choices that clients take stem from their need to be normal, according to care workers. They want to do the same things that their peers without MID/BIF do online. Consequently, care workers reported that clients sometimes feel pressured by others because they want to fit in with their peers (e.g., being proud of receiving, possessing or reposting videos through social media that show other clients or people from school getting beat up, bullied, or having sex), or because they want a real relationship with someone (e.g., being pressured into making nude videos by an online boyfriend).

Care workers stressed that although clients sometimes appear to make deliberate choices to engage in risky online activities, they often do not see the harm of their endeavours. Care worker, Annie, gave an example of this when talking about clients getting involved in money laundering:

“We had several clients who were victims of money muling. I think they are recruited via Instagram where someone asks a client if he can put money into the client’s account because this person claims to be homeless temporarily for example. Then this person promises to give the client 20 euro as a bonus for helping him out. These bonuses increase over time if they do it more frequently. These clients do not see harm in doing this, but it is money laundering, and they don’t realize it’s a criminal offense.”

However, in some instances, care workers also thought that there were occasions when clients deliberately tried to hurt others (e.g., hacking into social media accounts, blackmailing other clients by threatening to expose nude videos of them via social media, exposing people online to shame or bully them), scamming others (e.g., not paying for online purchased goods, or selling stuff on the Dutch equivalent of eBay without sending any goods to the buyer), or misleading others (e.g., making sexual innuendos and sending nude pictures to strangers on dating apps without actually intending to meet them).

Discussion and conclusion

This study set out to answer two questions: (1) what knowledge do care workers have about the online lives of their clients? and (2) how do care workers perceive the online lives of their clients? In line with other studies (Chiner et al., 2017; Molin et al., 2015; Ramsten et al., 2019), the findings show that care workers have limited knowledge of the online lives of their adolescent clients with MID/BIF. In this study, the main reason for this lack of knowledge seems to be that clients mostly keep their online lives to themselves. More interestingly, care workers perceive themselves unable to change this. An explanation for their lack of confidence might be that care workers feel too far removed from the online lives of their clients and consequently do not know how to talk about it. This feeling might be increased by clients who seem to be more tech-savy than they are.

Despite this, many care workers try to expand their knowledge by adopting approaches ranging from more passive and observational to more active and dialogical. In doing so, they observe their clients utilise the Internet mostly for hanging out with friends and family, unwinding from school or work by playing videogames or watching Netflix, looking for relationships, finding information, and shopping. These observations do not differ widely from what is already known from the intellectual disability literature (e.g., Caton & Chapman, 2016; Chadwick & Fullwood, 2018; Molin et al., 2017) and youth literature in general (e.g., Boeke et al., 2017; Pew Research Center, 2018; Rideout & Robb, 2019). However, sometimes, care workers experience the negative aspects of the online lives of their clients. As identified in other studies, care workers gave examples of cyberbullying, sexual solicitation, harassment, and financial extortion (e.g., Holmes & O'Loughlin, 2014; Salafranque-St-louis & Normand, 2017).

In line with Chadwick et al. (2016), this study also shows that despite their limited knowledge, care workers are ambivalent about the good and bad of the Internet for their clients. On one hand, they see the possibilities of the Internet as a gateway to an inclusive and connected life. According to care workers the Internet lowers the threshold for adolescents with MID/BIF to live a more independent online life and enables them to be more socially connected to others. On the other hand, care workers are also worried that considering their clients’ vulnerabilities, the Internet creates barriers for their clients that prevent them from keeping up with the rapid digitalisation of society and that increase the risks of online victimisation and offending behaviour. Especially social media are perceived as a risk environment for clients with MID/BIF (in line with Caton & Chapman, 2016; Holmes & O'Loughlin, 2014; Ramsten et al., 2019; Shpigelman & Gill, 2014).

Although this ambivalence came to light when care workers were prompted to think about the good and bad of the Internet for their clients, they mostly perceived the Internet as a place of risk and challenges for their clients. As, according to care workers, they have limited knowledge of the online lives of their clients and do not encounter many serious problems in their daily work this seems paradoxical. However, in the little experience care workers do have, things can get out of hand quickly online with serious and severe consequences for clients. This may cause them to be overprotective, especially because they perceive their clients as vulnerable. Consequently, clients may be and feel over-scrutinised by care workers.

Because perceptions determine behaviour toward and can cloud judgments of others (Pickens, 2005), this paradox might be explained by examining some important perceptional processes. A full elaboration of these processes would be beyond the scope of this paper, so it will focus on a few selected issues that may lie at the root of care workers’ perceptions. First, according to attribution theory (Heider, 1958) people attribute the most likely causes of behaviour to factors within a person (internal attribution) or to factors that lie outside a person’s sphere of influence (external attribution). When care workers perceive clients with MID/BIF as vulnerable to online risk because of their limitations (e.g., being naïve, unable to oversee consequences), they may overestimate the role of their clients’ intellectual limitations and underestimate external factors, like having bad luck, being victimised by smart cyber criminals, or just being inattentive. This fundamental attribution error might help explain why these negative perceptions seem to dominate among care workers.

Second, availability bias might be another perceptual error that could explain the paradox as described above. Care workers are often unaware of the positive experiences that clients have online and are mostly confronted with the negative aftermath of what transpired in the online lives of clients. Consequently, care workers may find it easier to recall the negative than the positive aspects of the online lives of clients. A related explanation that finds some support in the literature as well as the results of this study is that people in general (Brands & Van Wilsem, 2019), as well as care workers in particular (Löfgren-Mårtenson, 2008), are fearful of the online world because of media coverage on online risks. Care workers may consider their clients extra vulnerable to these perceived risks, and subsequently talk more about how they worry about the online behaviour of their clients.

Finally, there are two perceptional processes that might shed some light on the paradox: selective perception, and social perception. The process of selective perception explains that people tend to selectively interpret information based on their beliefs, attitudes, and experiences (Robbins & Judge, 2019). If care workers believe that clients are extra vulnerable online based on their preconceptions of their clients and the Internet, it may be more difficult for care workers to talk openly with them about their online lives. Social perception is about how people perceive others. As recognised in the literature (e.g., Pelleboer-Gunnink et al., 2021), one of the mechanisms that determines how care workers perceive someone socially is stereotyping. If care workers believe that clients with MID/BIF share certain characteristics, like an inability to learn, or being gullible, they might overgeneralise these preconceptions about people with MID/BIF. Consequently, this might limit free choice and self-determination in the online lives of people with MID/BIF.

This study has some limitations that warrant discussion. First, although identifying care workers’ perceptions of the online lives of their clients is an important step in understanding the choices care workers make in their daily work, this study would have benefited of a deeper understanding of the underlying attitudes and beliefs that shape these perceptions. Second, if availablilty bias has an effect on care workers’ perceptions on the online world in their work, it may have a negative effect on the internal validity of this present study. This could mean that the interviews do not fully reflect the scope of care workers’ knowledge of the online world of their clients nor how they perceive it. Third, transferability of the findings is difficult because of the relatively small respondent sample and the fact that the sample was drawn from one care organisation. Perceptions of the respondents may not represent those from other care organisations. Also, most respondents in this study worked with adolescents in the age between 17 and 27. Therefore, the findings may not be representative for care workers who work with younger adolescents. Finally, all professionals in this study work with adolescents with MID/BIF. Their observations may not reflect the experiences of professionals who work with adolescent with other types of IDs.

Despite these limitations, the current study was able to sketch a picture of the knowledge and perceptions care workers have of the online lives of adolescents with MID/BIF. As care workers have little confidence in their abilities to get to know their clients in their online lives and perceive these lives predominantely as risky, this should prompt care organisations to invest in supporting their staff and strengthen their position. Care organisations need to form a strategy that addresses the education of staff and the provision of guidelines on how to give support to clients in their digital lives. An important first step that care organisations could take directly, is to give care teams the opportunity to collectively share how they perceive the online world, how their clients live their online lives, and their own role in these lives. This could raise awareness among care workers that their perceptions may negatively affect the support they give their clients and potentially infringe their clients’ rights and liberties under the UNCRPD.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Dutch Research Council (NWO): 023.004.084.

Notes

1 A money mule is a person who launders money for someone else by receiving money from their bank account and transferring it to a third party or give it to a third party in cash, obtaining a commission for it.