ARTICLE IN PRESS

Disability and Health Journal - (2016) -

www.disabilityandhealthjnl.com
Brief Report

The online behavior of pupils with visual impairment:

A preliminary report
nska, Ph.D.a,*, Klaudia Taba1a, Ph.D.a, and Patryk Stecz, Ph.D.b
Magdalena Wrzesi

a
Department of Psychosocial Rehabilitation, Medical University of Lodz, Lodz, Poland
b
Department of Psychological Research Methodology and Statistics, Institute of Psychology, Faculty of Educational Sciences, University of Lodz,
Lodz, Poland

Abstract
Background: Young people with special educational needs are also users of new media.
Objective: The aim of the study was to determine whether pupils with visual impairment spend more time on Internet use than pupils
without visual impairment and whether youngsters from the study group are engaged in behaviors which could increase risk of problematic
Internet use.
Methods: The study is based on a total of 191 pupils: a study group of 66 partially-sighted pupils and a control group comprised 125
pupils who do not have visual impairment. A self-report questionnaire was constructed for the needs of this study.
Results: Pupils with visual impairment spent significantly less time on Internet use than their peers from the reference groups. Twice as
many pupils from the study group as controls reported no symptoms suggesting potentially problematic Internet use. In addition, the study
group more frequently used online social networking services and e-mails or used the Internet for assignments.
Conclusions: Little difference exists between students with visual impairment and those without with regard to Internet use. Ó 2016
Elsevier Inc. All rights reserved.
Keywords: Online behavior; Pupils; Visual impairment

Young people use the Internet as both a source of infor-
mation, and a means of entertainment and socialization. On
the other hand, it has been confirmed that consequences of
excessive Internet use could lead to problems with social
adaptation, decreased life satisfaction or psychological
dependence and emotional impairment.1e3 In addition,
increasing engagement in creating better computer equip-
ment and spending more time on online activities could
also result in poor academic performance and engagement
in risky activities.4,5
Recent years have shown a constant increase in the
amount of Internet users in European countries. Polish
studies indicate that more than 90% of Polish
The prior presentation of abstracts at meetings regarding the research:
Health Psychology Conference with the International Participation
15e17.5.2015, Czech Republic, Vernirovice. Magdalena Wrzesi
nska,
Klaudia Taba1a, Katarzyna Nowakowska-Domaga1a, Patryk Stecz. Visu-
ally impaired pupils’ online behavior: a comparative study.
Competing interests: The authors declare they have no competing
interests.
* Corresponding author. Medical University of Lodz, Department of
Psychosocial Rehabilitation, Pl. Hallera 1, 90-647 Lodz, Poland. Tel.:
þ48 426393327.
E-mail address: magdalena.wrzesinska@umed.lodz.pl (M. Wrzesi
nska).
1936-6574/$ - see front matter Ó 2016 Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.dhjo.2016.04.004
schoolchildren use the Internet, with more than half using
it for at least 2 h on a school day, and nearly 40% for at
least 4 h on a day off. Recent research indicates that in Eu-
rope, dysfunctional Internet use by young people is most
common in Spain, Romania and Poland, and is more com-
mon among boys than girls.6
Young people with special educational needs are also
users of new media.7e9 Little is known of their patterns
of Internet use and their implications.7 Forms of informa-
tion technology are particularly valuable for people with vi-
sual impairment (VI). On the one hand, they represent an
important source of social support by helping them gather
information about visual impairment and facilitating access
to online self-help groups, entertainment, information and
communication with others.8,10e12 However, as a result of
fewer face-to-face social interactions and the lack of oppor-
tunity to develop social skills,13 students with VI might be
likely to develop a preference for online social communica-
tion, which may predispose them to the negative psycho-
logical outcomes associated with Internet use.14
Pfeiffer and Pinquart confirm that young people with vi-
sual impairment use computers more often than their peers
without vision impairment, and that contact with new me-
dia is a compensating factor in situations of social isolation
 ARTICLE IN PRESS
2 M. Wrzesi
nska et al. / Disability and Health Journal
15
faced by this group. An estimated half of older adoles-
cents with visual impairment use the Internet to chat or
send e-mails.16
The main aim of the present study was to determine
whether pupils with VI spend more time on Internet use
than peers without visual impairment. In addition, the study
attempts to confirm whether students with VI engage in be-
haviors which could increase the risk of problematic
Internet use. This will be assessed by evaluating the online
behavior of pupils from a special school for the visually
impaired.
Methods
318 students were approached to take part in the study.
The overall acceptance rate among the participants was
approximately 60%, with a higher acceptance rate among
adult pupils whose parents were not required to give formal
consent. Finally, all 191 students who gave informed con-
sent and were at the same time present during classes took
part in the examination.
The study group (SG) was formed from 66 partially-
sighted pupils (30 boys and 36 girls) ranging in age from
13 to 22 (mean 5 16.7; SD 5 2.02) from one selected spe-
cial school for the blind and partially-sighted impaired in
Poland. The control group (CG) consisted of 125 students
without visual impairment (68 boys and 57 girls), ranging
in age from 13 to 21 (mean 5 16.9; SD 5 2.12). The inclu-
sion criteria for the study group were as follows: attending
a state school for pupils with visual impairment and demon-
strating a visual acuity of less than 20/60 in the better eye
with possible correction but equal to or better than 20/
400.17 The exclusion criteria comprised the presence of
any diagnosed intellectual disability, any physical disability
other than a visual one, or being absent at the time of data
collection. Blind participants were excluded due to their
small number (3 students). The inclusion criteria for the
comparison group were as follows: attending public middle
school or upper secondary school, middle position of the
school in the school rank. The exclusion criteria for the
comparison group were the presence of any physical or in-
tellectual disability, or being unavailable during the
investigation.
The schools were included into the study, and recruit-
ment took place in the schools in September 2013. The
self-administered examination was adapted for partially-
sighted students by the use of a large font. The content of
the form was consulted with teachers working with pupils
with visual impairment. To ensure anonymity and thus in-
crease reliability, school teachers were absent during data
collection for both the study and control groups. The
studies were conducted under the guidance of examination
staff (psychologists and a public health professional).
A self-report questionnaire was constructed for the
needs of the study. The questionnaire contained
- (2016) -
sociodemographic variables such as gender, age and student
GPA (grade point average) according to the Polish scale,
ranging from 1 (failed) to 6 (passed with distinction). It also
recorded the average number of hours of Internet use per
day, recorded as the number of hours online on school days
and at weekends or holidays. The questionnaire included
items concerning specific types of Internet use: social por-
tals, discussion forums, e-mail, searching for information
for assignments, online shopping, blogs and online games.7
Pupils also indicated higher-risk behaviors connected with
Internet use, such as downloading software illegally
without a valid license, publication of photos and movies
on YouTube without the permission of their owners, hack-
ing, communication with a person promoting violence,
issuing threats and insults (cyberbullying), using sites with
pornography or taking part in online gambling.18,19 The re-
sponses were reported on a three-point-scale: never,
seldom, very often.
No definite classification exists for Internet addiction,
and so for the purposes of the present study, pathological
Internet use was based on the list of behaviors which could
increase the risk of problematic Internet use. Although
tools to assess such phenomena as problematic Internet
use are available in the literature, they tend to lack satisfac-
tory psychometric properties, are not adapted to the needs
of people with visual disabilities or are too bulky.20,21
Hence, the criteria for diagnosing mental and behavioral
disorders due to psychoactive substance use according to
the ICD-10 were adopted to conceptualize potentially prob-
lematic Internet use.22 The following analogous criteria
were chosen for behaviors which could increase the risk
of problematic Internet use: increased Internet use (toler-
ance), negative emotion associated with finishing an online
session (i.e. anxiety, fear, sadness or anger), exceeded
planned time for an online session, unsuccessful attempts
to stop the online session, spending excessive time on activ-
ities connected with Internet use, neglecting school and
household duties due to Internet use and using the Internet
despite experiencing sleepiness and hunger. The subjects
indicated the frequency of each characteristic on a scale:
never and during the previous year before the study. The
predictive validity of this scale was assessed by discovering
the strength and direction of a linear relationship between
academic performance and the number of potentially path-
ological behavioral patterns of Internet use in the study
group. As the data concerning GPA score was incomplete,
the results from only 52 of the 66 pupils with visual impair-
ment were subjected to statistical analysis. Pearson’s r indi-
cated a statistically significant, negative correlation
between the number of potential problematic Internet be-
haviors and GPA score (r 5 0.37; p ! 0.01) in the study
group. Cronbach’s alpha, as an indicator of internal consis-
tency for this scale, was 0.78 in the study group, indicating
that the items measured the same construct.
The chi-square test and Yates’s correction were used to
assess differences between subgroup and gender. The
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M. Wrzesi
nska et al. / Disability and Health Journal - (2016) - 3

non-parametric ManneWhitney test was used to compare
the average amount of hours per day of Internet use be-
tween the control and study groups. Effect sizes were re-
ported to illustrate the strength of the statistical
relationships. A p-value of less than 0.05 was regarded as
statistically significant. Statistical analysis was conducted
using Statistica Software, version 10. The study was
approved by the Ethics Committee of the Medical Univer-
sity of Lodz no RNN/802/14/KB.
Results
The average number of hours per day of Internet use is
shorter in pupils with VI compared to peers who do not
have a visual impairment (SG: mean 5 2.64; SD 5 2.10
vs CG: mean 5 3.54; SD 5 3.02; z 5 2.54; p ! 0.01).
The Wendt formula (r 5 0.78) revealed the effect size to
be approaching large in this case. Pupils with VI visited
discussion forums (c2 5 28.06; p ! 0.001), sent e-mails
(c2 5 41.75; p ! 0.001) and used the Internet for learning
purposes (c2 5 46.33; p ! 0.001) more frequently than
students without visual impairment (Table 1).
The pupils with visual impairment were twice as likely
to not declare any symptoms of potential problematic
Internet use as the control group (SG: N 5 27 (40.9%) vs
CG: N 5 25 (20.0%); c2 5 8.53; p ! 0.05). Pupils from
the study group were most likely to report spending a lot
of time on activities related to the Internet, exceeding the
intended session time or feeling a need for increased
Internet use during the previous year (Table 2). Boys with
VI were more likely to report engaging in downloading
illegal files (c2 5 8.73; p ! 0.05), hacking (c2 5 7.61;
p ! 0.05) and visiting porn sites (c2 5 8.50; p ! 0.05)
than girls with VI (Table 3).
No significant differences were found between SG and
CG regarding the majority of risky online behaviors. A sig-
nificant trend was only observed between the study and
control groups regarding downloading software illegally
without valid licenses: 43.2% for the study group compared
to 24.2% for controls (c2 5 7.74; p ! 0.05).
Discussion
As most papers addressing trends in Internet use focus
on youngsters without disabilities, little is known about
the online activities of younger Internet users with disabil-
ities.7 In general, youngsters with VI investigated in the
present study were found to devote less time to Internet
use than the members of reference group. On the one hand,
despite the availability of screen reading software, most
homepages in the Internet are unsuitable for pupils with vi-
sual impairment. As a consequence, it is much more chal-
lenging for a VI person to process information (i.e.
perception, encoding) on an inaccessible or readjusted web-
site. It takes more time, requires higher use of attention re-
sources and its effectiveness depends on the quality and
effectiveness of assistive computer software.23 On the other
hand, the more modest amount of time devoted to the
Internet by the study group may be attributed to the fact
that the parents of students with visual impairment tend
to be overprotective and much more restrictive.7 Parents
and school guardians who supervise the pupils with VI
may have a significant influence on the frequency of use
of modern technologies, as previously noted in the case
of parents who take care of adolescents with other types
of physical disability. Normally, the parents of children
with congenital and early acquired disabilities (i.e. VI)
endeavor to enhance their abilities through all stages of
development. Such aims, including parental control for
Internet use, especially targeted at preadolescents, might
represent an effective way of maintaining and internalizing
healthy behavior, and protecting them from inappropriate
use of new media.7
On the other hand, Kroksmark and Nordell report that
pupils with VI are more likely to engage in passive leisure
activities than pupils who are not.10 Moreover, they tended

Table 1
Types of online activities
Pupils with visual impairment Pupils without visual impairment

Never Sometimes Always Never Sometimes Always

p-value
N (%) (effect size)

Social portals 12 (18.2) 14 (21.2) 40 (60.6) 21 (16.8) 37 (29.6) 67 (53.6) p O 0.05

Discussion forums 39 (59.1) 17 (25.8) 10 (15.1) 115 (92.0) 9 (7.2) 1 (0.8) p ! 0.001
F 5 0.38
E-mail 23 (34.9) 30 (45.4) 13(19.7) 102 (81.6) 16 (12.8) 7 (5.6) p ! 0.001
F 5 0.47
Searching information for learning purpose 2 (3.0) 19 (28.8) 45(68.2) 46 (36.8) 54 (43.2) 25 (20.0) p ! 0.001
F 5 0.49
Online shopping 38 (57.6) 16 (24.2) 12 (18.2) 88 (70.4) 28 (22.4) 9 (7.2) p O 0.05
Blogs 45 (68.2) 12 (18.2) 9 (13.6) 76 (60.8) 26 (20.8) 23 (18.4) p O 0.05
Game online 27 (40.9) 16 (14.2) 23 (34.9) 72 (57.6) 27 (21.6) 26 (20.8) p O 0.05
F e Cram
er’s phi.
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Table 2
Engagement in behaviors which could increase the risk of problematic Internet use in the year before the study
Pupils with visual impairment Pupils without visual impairment

Never Last year Never Last year

p-value
N (%) (effect size)

Feeling a need for increased use of Internet 39 (75.0) 13 (25.0) 65 (65.7) 34 (34.3) 0.24
Negative emotions associated with finishing online activities 57 (95.0) 3 (5.0) 96 (85.7) 16 (14.3) 0.06
(i.e. anxiety, fear, sadness or anger)
Exceeded planned time for Internet session 38 (65.5) 20 (34.5) 57 (51.8) 53 (48.2) 0.09
Unsuccessful attempts to stop online session 48 (82.8) 10 (17.2) 73 (72.3) 28 (27.7) 0.14
Spending a lot of time on activities connected with Internet use 31 (54.4) 26 (45.6) 36 (33.0) 73 (67.0) 0.01
F 5 0.21
Neglecting school and household duties due to Internet use 45 (81.8) 10 (18.2) 71(70.3) 30 (29.7) 0.11
Using Internet despite the awareness of its damaging effect 49 (83.1) 10 (16.9) 82 (77.4) 24 (22.6) 0.39
(i.e. hunger, sleepiness)
F e Cram
er’s phi.

to spend less time with their peers and face challenges in
participating in interpersonal interactions.24 One possible
reason for this is that pupils with VI may be prone to social
isolation brought on by the limited number of opportunities
to learn social skills through observing interactions.25,26
Our findings did not indicate considerably higher use of
Internet in the study group. This could be due to the fact
that the social situation of Polish people with disabilities,
and their parents or guardians, tends to limit their access
to the Internet, although of course, any difference in
behavior may be attributed to a number of possible cultural
differences.18,27
Pupils from the study group were more likely to use dis-
cussion forums, and send e-mails and seek information for
learning purposes than their peers from references group. It
is difficult to generalize our study in this context, because
of the small number of participants. Although Pfeiffer
and Pinquart investigated computer usage and the present
study examines Internet habits, similar results were
observed, insofar that computers and Internet were used
for learning purposes more often by students with visual
impairment.15 This may be attributed to the compromised
degree of social independence and global functioning of
the group with visual impairment. We conclude that both
computers and the Internet play important roles in the edu-
cation of young people with visual impairment, but this hy-
pothesis should be confirmed by a study based on a larger
study group.
Ko et al claim that the specific features of new media
may represent a threat for young people through their pas-
sive reception or active participation in various online activ-
ities.28 The students with VI took part in the same risky
behavior as their peers. Within the group of pupils with
VI, the boys more often downloaded illegal files, hacked
or watched sexual images online than the girls. European
research confirms also that the risky behaviors reported
by young people, such as various forms of pathological on-
line behavior, are more common among boys than girls.19
Meeting a single criterion of problematic Internet use
was not the optimal predictor of negative behavioral pat-
terns.29 Our findings suggest that the multiple symptoms
of problematic Internet use are associated with decreased
GPA. Moreover, the study and reference group were signif-
icantly different only with regard to spending extended

Table 3
Risky online behavior in pupils with visual impairment
Male pupils with visual impairment Female pupils with visual impairment

Never Sometimes Always Never Sometimes Always

p-value
N (%) (effect size)

Downloading the software illegally without valid license 10 (33.3) 8 (26.7) 12 (40.0) 26 (72.2) 6 (16.7) 4 (11.1) p ! 0.05
F 5 0.36
Publication of photos and movies on YouTube without 27 (90.0) 1 (3.3) 2 (6.7) 35 (97.2) e 1 (2.8) p O 0.05
permission of their owners
Hacking 20 (66.7) 7 (23.3) 3 (10.0) 34 (94.4) e 2 (5.6) p ! 0.05
F 5 0.34
Communication with person promoting violence 24 (80.0) 3 (10.0) 3 (10.0) 35 (97.2) 15 (12.0) 1 (2.8) p O 0.05
Cyberbullying 24 (80.0) 3 (10.0) 3 (10.0) 35 (97.2) 1 (2.8) e p O 0.05
Watching sexual images online 17 (56.6) 8 (26.7) 5 (16.7) 33 (91.7) 3 (8.3) e p ! 0.05
F 5 0.36
Gambling online 25 (83.3) 5 (16.7) e 35 (97.2) 1 (2.8) e p O 0.05
F e Cram
er’s phi.
 ARTICLE IN PRESS
M. Wrzesi
nska et al. / Disability and Health Journal
periods on activities related to the Internet. Our results sug-
gest that students with visual impairment do not appear to
be more exposed to potentially problematic online behavior
than the control group.
It should be emphasized that the present evaluation is the
first of its kind in this part of Europe. Research on the pat-
terns of use of new media among young people with visual
impairment in Poland is as yet in its initial stages and it is
too soon to discuss its potential for generalization. Too few
participants took part in our study to determine the level of
potential problematic Internet use on the basis of our scale.
However, the negative correlation between the number of
problematic online behaviors and GPA score during the
previous year could predict the satisfactory validity of the
scale. Because of rigid rules of inclusion, 40% of potential
participants were not studied. The limited communication
between pupils who lived in boarding houses in remote lo-
cations and their parents could substantially affect the study
participation rate. Although students from the comparison
group did not live in boarding houses, they were not willing
to take part in the study.
Two measures were taken to limit the effect of other
bias. Firstly, a reference group was included to provide bet-
ter validity of results, which addressed any potential mea-
surement bias and provided greater statistical significance
for the results. Secondly, the risk of social desirability ten-
dency was minimized by ensuring full anonymity for the
participants and conducting the interviews without the pres-
ence of school teachers.
Conclusions
The findings confirm that students display similar
Internet habits, regardless of their sightedness status. Our
study has been developed in a nationwide population study.
We hope that the specific results on online behaviors in Pol-
ish pupils with VI will be extended and more information
about psychosocial determinant of the risk of problematic
Internet use will be obtained.
Acknowledgments
The authors would like to offer their special thanks to
Prof. J

ozef Kocur for providing guidelines, Dr. Marek
Komasi
nski for help with project organization, to Irena
Szyma
nska for consultations concerning statistical analysis,
and Ed Lowczowski for approving the English version of
the manuscript. We would also like to thank Anna Tomas-
zewska, Magdalena Dominiak-Szymczak, Magdalena
Dajw1owska from the Special Schools for Blind and Low
Vision Children in q

od
z, Poland.
This work was funded by the Ministry of Science and
Higher Education of the Republic of Poland no 502-03/5-
127-03/502-54-134.
- (2016) - 5
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