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Article

Online Picture Book Teaching as an Intervention to Improve Typically Developing Children’s Attitudes Toward Peers with Disabilities in General Schools

by
Yuexin Zhang
,
Wangqian Fu
* and
Shuheng Xiao
School of Special Education, Faculty of Education, Beijing Normal University, Beijing 100875, China
*
Author to whom correspondence should be addressed.
Educ. Sci. 2025, 15(5), 626; https://doi.org/10.3390/educsci15050626
Submission received: 20 March 2025 / Revised: 7 May 2025 / Accepted: 16 May 2025 / Published: 20 May 2025
(This article belongs to the Special Issue Special and Inclusive Education: Challenges, Policy and Practice)
Browse Figures
Versions Notes

Abstract

:
Typically developing peers are the key factor for children with disabilities to participate in inclusive settings. Good peer relationships can improve the social communication and language expression of children with disabilities, and typically developing children play a role as “gatekeepers” in the social activities of children with disabilities in the schools. In this study, 36 primary school students from grades 1 to 3 received online picture book teaching for 3 weeks, 6 units, 12 class hours, and 40 min per class hour with six volumes of disability picture books (including physical disability, deaf and hard of hearing, visual impairment, intellectual disability, learning disability and autism spectrum disorder) selected by experts in summer vocation. The attitudes of typically developing children toward peers with disabilities of participants were tested before and after attending the online picture book course. The teaching of disability-themed picture books online has significantly improved the attitudes of typically developing children in lower grades toward peers with disabilities. Specifically, there are significant differences in the sub-dimensions of emotion and positive behavior and negative behavior before and after the intervention. The results showed that online picture book teaching activities with disability themes can effectively improve the attitudes of typically developing children in primary schools toward children with disabilities in terms of cognition, emotion, and behavior, and they can be used in schools to create an inclusive climate for students with disabilities.

1. Introduction

1.1. The Influence of Peers’ Attitudes Toward Children with Disabilities

Inclusive education is a worldwide trend in education, including in lower-income countries, e.g., China. There are 435,800 students with disability learning in regular schools, accounting for 49.47% of students with disabilities in schools (Chinese Ministry of Education, 2021). In the setting of inclusive education, typically developing peers, children, or students, who are progressing in their physical, cognitive, social, and emotional development at a rate that is considered average or expected for their age group, become a key factor for children with disabilities to participate in school activities, and they play a role as “gatekeepers” in the social activities of children with disabilities (Bottema-Beutel & Li, 2015; Xie, 2018). Inclusive opportunities in schools can help children with disabilities acquire a sense of belonging and participation (Matias, 2003). Good peer relationships can improve the social communication and language expression of children with disabilities. However, the peer relationships of many children with disabilities are not optimal. Studies have found that typically developing children’s understanding of disability often stays in the medical model (Hodkinson, 2007), and children with disabilities often feel alienated in general schools and lack interaction and help from their peers, partly due to the negative attitude of their peers (Nowicki & Sandieson, 2002; de Boer et al., 2012). There are age-related differences and significant individual variations in the attitudes of general students towards peers with disabilities (Schwab, 2018). Elementary-aged typically developing children have a low acceptance of children with disabilities and are more willing to accept children with less impairment and who can interact with them (Bottema-Beutel et al., 2017). They choose their companions based on the personal characteristics of children with disabilities, such as personality, disorder categories, and stereotypes and prejudices against such groups. Children with autism receive a more negative attitude from peers, and they may face the pressure of being “isolated” when participating in peer group games (Bottema-Beutel & Li, 2015). When students with disabilities demonstrate at least one common interest or ability, the inclusive attitude of peers towards them significantly improves (Mamas, 2020).
With the continuous advancement of inclusive education in China, it is particularly important to improve the attitude of typically developing peers toward children with disabilities. The attitude of individuals is reflected in their choices and behaviors, which are important factors affecting the growth and development of themselves and students with disabilities (Bebetsos et al., 2013). If typically developing children lack knowledge of disability and are surrounded by discrimination against people with disabilities (Reiser, 1990), they may tend to have negative attitudes toward children with disabilities, leading to barriers to inclusive education. Improving peers’ attitudes toward children with disabilities is of great importance for the development of children with disabilities (Bogart et al., 2022; Bottema-Beutel et al., 2017).

1.2. Theory of Attitudes and Its Developmental Principles

Attitude generally refers to an individual’s stable and consistent psychological and behavioral inclination towards people or things. In 1960, Rosenberg and Hovland proposed the ABC Model of Attitudes, also known as the tripartite theoretical model of attitudes, wherein attitude is further dissected into three subcomponents: cognition, affect, and behavioral tendency (Rosenberg & Hovland, 1960). Cognition encompasses an individual’s knowledge, beliefs, understanding, and evaluation of a specific object. Affect aspects represent the emotional reaction or preference intensity an individual holds towards their attitude object, expressed through feelings like liking or disliking, affection, or aversion, rooted in prior experiences, peer assessments, and immediate direct perceptions. Behavioral tendency refers to how someone expects or prepares to react when faced with the object of their attitude, focusing on the likely response rather than the actual behavior itself. Generally, these three parts work together to form someone’s overall attitude towards something (Breckler, 1984).
Kelman (1974) suggested that attitude formation or change unfolds through three stages: compliance, identification, and internalization. Initially, at the compliance stage, individuals modify their attitudes superficially to avoid penalties, secure rewards, or fit in with group norms, even if they do not truly accept the new view. Then, in the identification phase, individuals start embracing others’ perspectives or behaviors because they resonate with their admired figures or ideals, although personal attitudes have not fully merged with external influences, leaving a precarious balance. Finally, the internalization stage solidifies new viewpoints within one’s value system, forming a steadfast attitude construct.
According to this theory, we can outline a general developmental process for typical children’s attitudes towards peers with disabilities. Initially, they may appear kind and respectful because of what parents, teachers, or other authority figures expect or model, or, due to societal norms, even if they do not fully understand or accept it internally. With increased exposure and familiarity, children might start to voluntarily emulate the ways in which respected figures, such as teachers, parents, or community role models, interact with children with disabilities, thereby embracing and endorsing compassionate and inclusive attitudes (Diamond & Tu, 2009). As their cognitive and socio-emotional maturity develops, typically developing children might internalize the principles of respecting and accepting children with disabilities as integral parts of their value systems. They genuinely come to understand and appreciate diversity and differences, regardless of disability status (Killen & Rutland, 2011). This culminates in a deeply ingrained, self-motivated belief reflected in everyday behaviors and decisions. A meta-analysis of school-age children’s attitudes towards persons with physical or intellectual disabilities reviews the age differences in children’s attitudes towards disabilities and supports the development model of “contact—cognition—internalization” (Nowicki & Sandieson, 2002).

1.3. Interventions to Promote Acceptance of Students with Disabilities for Peers

The attitude of typically developing students to children with disabilities is not static, and intervention can improve the attitude of typically developing children to children with disabilities (Varcoe & Boyle, 2014), including social contact (Livneh et al., 2014), peer counseling (Lloyd et al., 2017), cognitive intervention (Freer, 2021), situational performance (Bogart et al., 2022), etc. Contact with people with disabilities has been shown to be effective in improving children’s attitudes towards peers with disabilities (Chae et al., 2019; M. Wang & Li, 2020) and will enhance their self-efficacy (M. Wang & Li, 2020). Typically developing children and children with disabilities can also have positive effects when they participate in activities together (Lv, 2021). In addition, social skill training improves key social skills and positive peer interaction behaviors. As a result, typically developing children have more positive behaviors and attitude changes towards peers with disabilities (Lv, 2021).
Interventions at the cognitive level mainly include discussions on knowledge and groups of people with disabilities, disability awareness exercises, and reflective training. Some studies make puppets with disabilities to demonstrate and discuss typical problems faced by them (Zucker, 1988). Some studies have used reading intervention to improve typically developing Latino children’s attitudes and intentions towards peers with disabilities, and the results show that the intervention has a positive effect (Rosinski, 1997). Discussing relevant knowledge about disabilities can improve typically developing children’s attitudes towards children with intellectual disabilities (Siperstein et al., 1988). Through the experimental group and the control group, it was found that, before and after listening to the story and discussion, the attitude of the experimental group positively improved, and it had a significant improvement in adjusting the stereotype of children with disabilities, among which the attitude of the students who had contact with children with disabilities changed the most (Bottema-Beutel et al., 2017). Discussion and reflective exercises in the field of “disability” can also improve students’ thinking styles and attitudes (Melloy, 1990). There are also studies that invite people with disabilities to give speeches on disability concepts and have interactive discussions, which have significant effects (Hodkinson, 2007). However, some studies have selected primary school students and kindergarten students for a 3-week and 6-course intervention plan, and the results show that it has a positive impact on the attitude of kindergarten students, while the impact on the attitude of primary school students is limited (Tufan, 2008). Therefore, some studies have pointed out that cognitive intervention alone will not lead to a great improvement in the attitude towards children with disabilities. The combination of cognitive and behavioral interventions can achieve better results (Nikolaraizi & de Reybekiel, 2001).
In addition, the live performance intervention with a relatively lively and interactive form is more effective in improving students’ attitudes towards children with disabilities (de Boer et al., 2012). The use of artistic works, such as movies with the theme of emphasizing equality between students with disabilities and typically developing children, supplemented by teachers’ explanation, can also improve children’s attitude towards peers with disabilities (Georgiadi et al., 2012).

1.4. Online Picture Book Teaching as Intervention

Online picture book teaching refers to the use of digital platforms (e.g., Zoom, educational apps, interactive e-books) to deliver structured literacy and socio-emotional learning experiences through illustrated stories (Hoel & Jernes, 2024). Unlike traditional in-person reading, it leverages multimedia tools to enhance engagement, accessibility, and interaction. Observational learning theory underscores that individuals can effectively learn novel behavioral patterns, attitudes, and skills without direct personal experience by observing and analyzing the behaviors of others, particularly role models, and the consequences that follow. This theory posits that reinforcement need not be directly experienced, as individuals can acquire information and adapt their cognitive structures, emotional responses, and behavioral outputs solely through observation (Bandura, 1977).
Picture books, as a teaching resource combining text and illustrations, can skillfully utilize vivid and dynamic images along with relatable story lines from everyday life to construct concrete situations that are easy for young children to understand and remember (J. Liu & Huo, 2023). These scenarios often draw from the children’s own life experiences and familiar settings, thereby holding a particular allure and igniting spontaneous enthusiasm for learning. During the reading process, when immersed in these stories, young children rapidly establish connections within their minds between the story content and embedded educational concepts (Mantei & Kervin, 2014). This engagement facilitates a deeper understanding of both the central theme of the stories and the related knowledge points they contain. Therefore, picture book teaching can mobilize children’s multisensory participation, enrich reading experience, and promote the development of children’s learning ability, innovation ability, and psychological ability (Yao, 2019). It provides an important source for children to learn vocabulary (Montag et al., 2015), helps children input more language content (Montag, 2019), promotes the development of children’s emotional expression and social interaction (Duan, 2019), and helps to promote the development of a sound personality and improve their artistic and scientific literacy (Yao, 2017). Janja and Dragica (2013) believe that disability-themed picture books are important educational resources for the development of peers’ attitudes. These books create story characters, are characterized by literature and artistry, and are targeted at young children. They can be used to help promote tolerance and encourage typically developing children to accept different people, thus improving their attitude toward children with disabilities. Meanwhile, children with disabilities can also build a better self-image based on such picture books (Janja & Dragica, 2013). Through the teaching activities of disability-themed picture books, the emotional difficulties among children with disabilities can be improved to help children with disabilities better understand and manage their emotions (Hansen & Zambo, 2007) and to help children with autism develop social and communication skills and enhance their imagination (Tabernero & Calvo, 2020). In addition, it also helps to improve the acceptance attitude of typically developing children toward their peers with physical and mental disabilities and to enhance the interactions between them (Fan, 2012).
The advantages of online teaching, which spans time and space, are convenience, personalization, and diversification. Online teaching has had a profound impact on the development of education during the pandemic and will continue to have an impact even further into the future. Online teaching contains the advantages of timely feedback and evaluation, effective time management, respect for diverse learning styles, and continuous supervision and guidance, which are suitable for applications in interventions (Saiyad et al., 2020).

1.5. The Current Study

Overall, evidence shows that, although the inclusive education of children with disabilities is now an accepted practice, it is often challenged by negative peer attitudes (McDougall et al., 2004; McGregor & Forlin, 2005; WHO, 2001), including in China (Cheng et al., 2021). The lack of a support system persists as a structural problem for inclusive education in China (H. X. Wang et al., 2011). A few intervention studies have been implemented to try to improve students’ attitudes toward their peers with a disability. Relevant observations suggest that disability issues are strongly influenced by traditional historical ideological elements (e.g., Chang & McConkey, 2008; Degenhardt & Zhang, 2015; Poon-McBrayer & McBrayer, 2014; Zhang & Rosen, 2018). It does suggest that the premises of Confucianism and Buddhism may have some conflicting impact on the issues relating to disabilities, namely, a contradictory attitude toward people with disabilities (Poon-McBrayer & McBrayer, 2014; Zhang & Rosen, 2018). On one hand, behaviors such as benevolence and mercy to everyone are encouraged; on the other hand, there is also discrimination or stigma against the ones who cannot be a “jun zi” (superior man). In Chinese philosophy, the internal values are estimated to be higher than the external values, and the Confucian ideal images of a “jun zi” make it difficult, even almost impossible, for people with disabilities to achieve the standard of a superior man. As a result, they cannot achieve “reputation” and “success” and thus always remain in the bottom of social classes.
It is essential to provide interventions to promote positive attitudes and the disability concepts of typically developing children in inclusive schools. In particular, typically developing students in lower grades do not have a comprehensive understanding of disabilities and have limited contact with children with disabilities. In addition, due to the outbreak of COVID-19, online intervention may provide workable implications. Therefore, we undertook an online intervention study aimed at improving students’ attitudes toward their peers with disabilities through picture book intervention. The hypotheses of this study were
Hypotheses 1.
Online picture book teaching intervention can improve the positive attitudes of typically developing children toward children with disabilities.
Hypotheses 2.
With respect to the gender of typically developing children, there will be a difference in attitude toward children with disabilities.
Hypotheses 3.
With respect to the grade level of typically developing children, there will be a difference in attitude toward children with disabilities.

2. Method

2.1. Participants

Upon Institutional Review Board approval, researchers applied purposeful random sampling to recruit participants by posting online summer camp activities. The research group posted the recruitment on WeChat circle of friends and forwarded it to primary school teachers, asking them to help forward the recruitment to parents. WeChat is a multi-purpose messaging, social media, and mobile payment app developed by Tencent primarily in China. According to the age characteristics of the target group suitable for carrying out picture book teaching, the participants were limited to primary school students in grades 1–3 (approximately 6–9 years old). To ensure the effectiveness of online teaching, the number of recruits was limited to 50. The recruitment poster specified the following criteria: (1) students in general schools in grades 1–3; (2) guaranteed time for participating in the whole camp (lasting three weeks); (3) participants can study online at home. There were 50 participants who applied to the camp and met the criteria (19 males and 31 females, average age = 8.24). After the online recruitment phase, the researchers again contacted the registrants one by one to confirm more details of the participants. The reason for obtaining more detailed information regarding demographics of the participants was that the experience of contact with people with disabilities is a vital factor influencing the attitude toward the target group (Bottema-Beutel et al., 2017; Petry, 2018). All the students and their parents who volunteered to participate in the online summer camp were informed and agreed that the activity data would be used for scientific research. After the participants were identified, the researchers sent the informed consent form to the parents. The informed consent form explained the purpose, form, frequency, and main content of the intervention, as well as the confidentiality of this research and the participants’ right to withdraw at any time. After the parents signed the informed consent form, they sent it back to the researchers. The research team assured the participants and their parents of the security of the data. All the names appearing in the text are pseudonyms.
At the end of the summer camp, according to the online course attendance rate (over 90%) and attitude scale measurement before and after completing the course at the same time, the actual effective sample size was 36. There were 14 boys and 22 girls (with average age of 7.13) (Table 1).

2.2. Measurements

Peers’ attitudes toward children with disabilities. The Multidimensional Attitudes Scale Toward Persons with Disabilities developed by Findler et al. (2007) was applied to this study. In this questionnaire, the children were asked to imagine their thoughts and practices after a scene to detect their attitudes. The instruction was as follows:
Try to imagine this: One day you and your mom go to a party. Just then, one of Mom’s friends comes along with a boy/girl in a wheelchair and sits next to you. Mom says hello to the friend and introduces you and the boy/girl to each other. Then mom and the friend go to another table for a while, and it’s just you and the boy/girl in the wheelchair. If you met the above scenario, what would you do? Check the box below.
After prediction and formal testing, the questionnaire had good internal consistency (α = 0.89). It includes 17 items, which are divided into four dimensions of cognition (e.g., he/she should be an interesting/funny person), emotion (e.g., I feel nervous), positive behavior (e.g., I would like to chat with him/her), and negative behavior (e.g., I will sit on the other side). A 5-point Likert scale was adopted, with scores ranging from 1 point (completely impossible) to 5 points (completely possible). Participants answered the question with the help of parents, who guided them about how to choose the number in the Likert scale. After prediction and formal testing, the questionnaire had good internal consistency (α = 0.89). In addition, students’ homework was collected to reflect their attitudes toward peers with disabilities.

2.3. Teaching Materials and Teaching Design

Picture books were selected to be suitable to meet the learning characteristics of younger students based on the theme of disabilities to guarantee research effectiveness. The picture books were chosen based on the following criteria: pictures books that (1) focus on the topic of one kind of disability; (2) have won national or international picture book awards; and (3) are expert-recommended. According to the above criteria, the authors selected a total of 30 picture books, which included 6 kinds of disabilities and 5 books of each kind. Some of these books were Chinese versions of foreign books (Table 2). Law of the People’s Republic of China on the Protection of Disabled Persons (2008 edition) (The Central People’s Government of the People’s Republic of China, 2024) categorizes disabilities into eight types: visual impairment, hearing impairment, speech disability, physical disability, intellectual disability, mental disability, multiple disabilities, and other unspecified disabilities. This study selected picture books themed around six disability types that are particularly relevant in an educational context: visual, hearing, physical, and intellectual disabilities, all of which are explicitly listed within the legal framework. Autism spectrum disorder, although not distinctly defined among the eight categories, is commonly encompassed under the “other” type. Additionally, learning disabilities are included in this study because, similarly to the aforementioned five types, they are frequently encountered in inclusive education settings in China. This signifies that, in future educational environments, children will very likely encounter classmates with such types of disabilities. Thus, employing picture books themed around these specific disability types as teaching materials is of considerable significance in fostering how future children can peacefully and harmoniously interact with their peers with disabilities. Then, the Delphi method was adopted to further determine the book list. Five specialists in the field of picture book education and special education were invited to score, with a full score of 10. Eventually, six picture books with the highest score in each kind of disability were identified, and the researchers designed their teaching plan according to the list.
Then, the lesson plan was carried out on the 6 selected picture books in Table 2 with the sequence from high to low in the table. The sequence of the book taught in the intervention was decided by type of disability since the physical disabilities and sensory disabilities are the most common disabilities, and they are easier to teach with visible differences with typically developing children. Each picture book was a teaching unit, and each unit had 2 class hours, for a total of 12 class hours. Each class hour was 40 min. In the first lesson of each unit, we read picture books together and taught the story content of picture books to the students. The class was composed of three links: course introduction, picture book explanation/content discussion, and summary. In the summary link, corresponding tasks such as after-class thinking would be assigned as preparation and connection for the second class. After class, researchers collected feedback on children’s tasks in the WeChat group in real time and gave timely responses. The second class was an extended activity consisting of three parts: picture book review, interactive discussion, and summary. The picture book taught in the last class was reviewed to extend relevant knowledge, such as the special needs of children with disabilities, how to communicate with them, etc., focusing on the relevance to real life. The interactive discussion was the focus of the second class. According to the characteristics of online teaching, the main forms include discussion and speech, experience, role playing, watching videos, etc., to stimulate children’s interest in learning and further help them understand the content and role of picture books.

2.4. Intervention

A three-week picture-book teaching activity was conducted on the Tencent Meeting platform Tencent Meeting is a cloud video conferencing product by Shenzhen Tencent Computer System Co., Ltd. (Shenzhen, China) for 50 students who volunteered to participate. Participants were taught for approximately 40 min four times a week. To enhance the interaction between teachers and students in online teaching, 50 students were randomly divided into two parallel classes for teaching; that is, the two classes were taught in different time periods on the same day (one is from 9:00 to 9:40, the other one is from 11:00 to 11:40) by the same teacher.
The teaching of each picture book was divided into two class hours, which means that these six picture books were designated as six themes for 12 units. The first class hour of each picture book is the initial reading of the book, mainly carried out based on the story content. This class consists of three stages: introduction/leading-in, picture book explanation/content exploration, and post-class reflection/task assignment. The second-class hour is an extension activity that mainly extends relevant knowledge from the content of the picture book, emphasizing its relevance to participants’ real lives. This class also consists of three stages: picture book review, discussion and interaction, and post-class reflection/task assignment.
Each class was arranged with a lecturer and a teaching assistant, who was mainly responsible for the check-in and real-time processing of some information in the online teaching process. Both had internship experience in primary school education and picture book teaching experience and conducted online trial lectures for the first two units. A graduate tutor and several graduate students majoring in special education improved the teaching plan after evaluating the lessons. The example of one unit intervention is presented in Appendix A.

2.5. Data Analysis

In the analysis, the valid sample size was 36. The attitude toward children with disabilities of the participants was tested before and after the intervention. The standard score of each dimension was taken as the value of each observation variable. To test whether there was difference in the attitude between different genders and grades, t-test and ANOVA analysis were applied using SPSS 20.0. T-test was used to compare the difference in the attitude between pre- and post-intervention.

2.6. Social Validity

We designed an online picture book teaching questionnaire to investigate all the parents of participants (n = 36) in this study on satisfaction and social validity. The questionnaire contained structured questions and open questions in two divided parts. In the structured part, there were 14 questions, and a 5-point Likert scale scoring method was used to investigate parent’ views on this picture book teaching from three aspects: the acceptability of teaching content (1–4 questions), the feasibility of teaching conditions (5–9 questions) and the satisfaction of teaching effect (10–14 questions). The open part consists of one question, which is mainly to investigate parents’ feedback and suggestions for this online teaching activity. The scores of satisfaction of parents were all over 4.5 out of 5, indicating that the online disability-themed picture book teaching activity had good social validity. The open question is optional for parents to answer. Some parents indicated that the picture book teaching activity conveyed the concept of love and equality for people with disabilities, and their children got to know different friends. Some parents also hoped that similar activities could be held offline.
“I once took her to meet a child with a disability. My child did not show fear or escape reactions. She said this is a friend from the picture book and was willing to contact the child with a disability.”
(Parent 2)
“Usually, he has not really come into contact with children with disabilities, but now when he sees the blind road on the road and knows to avoid it, leaving it for those in need, which is very gratifying.”
(Parent 4)
“We really neglected the education on the disability attitude in our daily life. The picture book teaching is really good, which help him know more about it. When he meets people with disabilities in street, he is not afraid and wants to help them.”
(Parent 5)
In addition, seven parents agreed to be interviewed online after the camp. They were asked if their children had any verbal, emotional, behavioral, and/or other changes on the topic of disability during and after this online camp. Half of them described a behavioral and emotional attitude change toward people with disabilities.

3. Results

3.1. Participants’ Attitudes Before the Online Picture Book Courses

The typically developing student attitudes toward children with disabilities were at a medium level (3.48 ± 0.51), with the highest score in the dimension of positive behavior (4.13 ± 0.68) and the lowest score in the cognitive dimension (2.64 ± 0.49).
To compare the differences between attitudes in the pre-test, a t-test was applied between genders and an ANOVA to grade levels. There were no significant differences between boys and girls. However, significant differences were found between grades. The least significant difference (LSD) test showed that first graders had lower scores (more negative attitudes) on the dimension of negative behavior than the third graders (Table 3). The effect size of the negative behavior score between G1 and G3 (applying the Hedges correction) was approximately −0.994. This negative value indicated that the average negative behavior score of G3 was lower than that of G1, consistent with the information provided that G3 > G1.

3.2. Participants’ Attitudes After the Online Picture Book Courses

The typically developing student attitudes toward children with disabilities were at a medium-high level (3.81 ± 0.43), with the highest score in the dimension of positive behavior (4.52 ± 0.52) and the lowest score in the cognitive dimension (2.84 ± 0.36).
The t-test showed no significant differences between boys and girls. However, significant differences in the emotional dimension were found between grades. The mean of the first graders was significantly lower than that of the third graders (Table 4). The effect size for the affective dimension between G1 and G3 (applying the Hedges correction) was approximately 1.1449. This positive value indicated that G3 has a higher average sentiment score than G1, which was consistent with the information provided that G3 > G1.

3.3. Comparison of Participants’ Attitudes Pre- and Post-Intervention

To compare the differences between the pre- and post-test attitudes, a t-test was applied to 36 children. The results are shown in Table 5.
Table 5 shows that there were significant differences in the total score of the questionnaire and the scores of all dimensions before and after the test. Moreover, the differences in the three dimensions of emotion, positive behavior, and negative behavior as well as the overall score of attitudes were significant (p < 0.01), indicating that this online picture book teaching activity may have had a positive impact on the attitudes of typically developing children in lower grades toward children with disabilities.

3.4. Participants’ Qualitative Responses on Their Attitudes Toward Children with Disabilities

After the first class of each unit, the researcher assigned the corresponding after-class tasks to the students. There was no limit to the form of task feedback, and the students were required to publish it in the WeChat class group. Participants’ feedback was collected and encouraged in real time. The task feedback submitted by students mainly includes text, drawings, recording/audio, video, and so on. Part of the display is shown in Figure 1, Figure 2 and Figure 3. In the paintings, the participants drew children with disabilities together with others. All of them showed close physical contact with children with disabilities, e.g., hand in hand. One of them clearly stated that “I” will help a friend with ASD out of trouble.

4. Discussion

Both in the pre- and post-test, participants reported medium to medium-high attitudes toward children with disabilities. The participants’ paintings also demonstrated a friendly attitude towards their peers with disabilities. For instance, they played with the children with disabilities together and expressed their desire to offer assistance to them. This result is similar to existing studies globally that the attitude of typically developing children toward to the children with disabilities can be improved by picture book intervention (Campbell et al., 2004; Kim et al., 2005; Tavares, 2011; C. Wang, 2015). Studies show that picture books can enhance children’s understanding and empathy for disabilities through storytelling and role-taking (Manola et al., 2023). For instance, Cameron and Rutland (2006) found that, after being exposed to stories containing characters with disabilities, children’s attitudes towards their peers with disabilities improved significantly. The friendly interactions demonstrated by the participants in this study might have originated from the positive depictions of characters with disabilities in picture books, reducing “out-group bias” (Pettigrew & Tropp, 2008). Furthermore, the narrative style of picture books (such as the first-person perspective) can help children “think from the perspective of others” (theory of mind), thereby enhancing their acceptance of peers with disabilities (Dunn et al., 1991).
In terms of gender differences, the pre- and post-test scores showed there was no association between gender and attitudes toward individuals with disabilities. It is in line with previous findings that there is no gender difference in the attitude towards peers with disabilities (Campbell et al., 2004; Dachez et al., 2015; Gardiner & Iarocci, 2014; Lu et al., 2020). Primary school students’ positive attitudes toward people with disabilities may be derived more from their love and external factors, such as social praise and public opinion guidance (Wilson & Scior, 2013; Chen & Zhang, 2013). This study found that there was a different attitude of students in different grades toward children with disabilities, and the students in grade 3 showed more acceptance than the students in grade 1. This is inconsistent with Ju’s (2017) finding but was different from Lu et al.’s (2020) finding in China. Lu et al. (2020) found that students in higher grades have more positive attitudes toward disability. This may be due to the growth of age, as elementary children have a stronger awareness of praise from the environment for their attitude and may modify their attitudes to align with social expectations (Ju, 2017). Thus, high-grade children are more accepting of individuals with disabilities in elementary schools.
The results showed that students’ attitudes toward peers with disabilities improved through online picture book teaching. It is consistent with the findings of previous relevant studies (Cameron & Rutland, 2006; Fan, 2012; Mcgregor & Forlin, 2005; Ning, 2018). It is found that students’ attitudes toward children with disabilities could be improved through a specific lesson or curriculum design. Picture book teaching, with the help of pictures, makes it easier for young students to understand the characteristics and differences in disabilities (Ning, 2018). In addition, picture book material is suitably broad to enrich children’s cognition and experience. In particular, the content of relevant knowledge expansion, narrative follow-up discussion, and practical examples in the second lesson of each unit is meant to successfully assist students in better digesting and absorbing the meaning of picture book stories and idioms (Zhan, 2008; Zhou & Liu, 2020).
Specifically, there was a significant difference in the participants’ cognitive dimension pre- and post-test scores of attitudes, indicating that picture book teaching activities may have a positive association with the knowledge of young children toward others with disabilities. Picture book education can boost younger children’s peer acceptability level of self-concept (Rutland, 2004; Zhou & Liu, 2020). Thus, teaching picture books with the topic of “making friends with children with disabilities” is appropriate for the social communication needs of children in this age group, which is beneficial to improving the awareness of disability and gaining the cognitive acceptance of children with disabilities. Picture book teaching focused on the guidance of observation of children and the correlation of image and knowledge to improve their understanding of children with disabilities. During the process of interpreting the picture books, students will be able to intersperse disability types with related knowledge. The combination of perception and reasoning promotes the development of children’s understanding of disabilities. Furthermore, some studies have revealed that younger children’s knowledge of disability is sluggish and dynamic (L. Wang et al., 2019), which might explain why, while cognitive level improvement is considerable, it is not as large as the change in other aspects.
In the dimension of emotional attitudes, there were significant differences before and after the picture book teaching activity, indicating that this picture book teaching activity may promote children’s emotional dimension of disability attitude. Emotion is the positive or negative psychological response to external stimuli such as love and grief, and, thus, the emotional response may directly reveal attitude levels (Ning, 2018). Picture books were used throughout the teaching process of the intervention. The stories in the picture books are simple, and they focus on the interaction with children with disabilities. Picture books contain rich, vivid pictures and easy-to-understand words, which are of great attraction for young children (Ahemaitijiang, 2022). Moreover, the stories in the picture books allow children to resonate with the main character and communicate, nurture children’s bodies and minds, and encourage children to form positive emotional attachments (J. Liu, 2015). Simultaneously, the contact with children with disabilities through picture books assists in the elimination of intrinsic thinking and undetected emotional changes (Ahemaitijiang, 2022). For example, when reading “Be Good to Eddie Lee”, some students clearly demonstrated their affection for Eddie and observed emotional shifts in Christy’s care of Eddie; many children adored Bonnie, who plays an excellent audience in “Madeline Finn and the Library Dog”. It is clear that picture book teaching may help children make beneficial emotional changes (Z. Liu, 2017).
There were significant differences in the behavioral dimensions of children’s attitudes as well, indicating that online picture book teaching activities may play a positive role in promoting behavior guidance, and children were more willing to adopt positive behavior tendencies. It is consistent with previous studies (Schoppmann et al., 2023; Ning, 2018; Yang et al., 2014). Picture book teaching interventions have been demonstrated in studies to improve the development of children’s prosocial behaviors, which include good behaviors such as sharing, collaboration, and comfort (Yang et al., 2014). This form of positive approach is also required while interacting with disabled young people. Students were guided to think about how to get along and become friends with children with disabilities during or after the session. Students were allowed to communicate online, give opinions, and then summarize the skills to interact with children with different types of disabilities. These instructional designs have a positive impact on children’s behaviors.

5. Practical Implications

These results indicate that improvements in attitudes of typically developing children toward peers with disabilities may be due to the online picture book teaching, which provides some practical implications.
First, general schools can actively carry out picture book teaching to promote the attitudes of typically developing students towards students with disabilities. Educators should receive training on using digital picture books to promote inclusion, including strategies for facilitating meaningful classroom discussions.
Second, teaching materials should be chosen based on the characteristics of children’s development. For typically developing children in lower grades, choosing appropriate educational methods and approaches is more effective than simply preaching to improve children’s attitudes. To maximize the effect of an educational intervention for the cognition of children, consider their age and interests and choose picture books to read or games to play to achieve the organic combination of educational content and methods.
Third, the digital can be used to give children a comprehensive and rich cognitive experience of connecting with people with disabilities. Educational authorities should integrate inclusive digital resources into curricula and provide funding for accessible e-books. Schools can establish evaluation mechanisms to assess the impact of online picture book programs on inclusion.

6. Limitations

There were some limitations in this study. First, the participants were different in age and grade, which may influence their attitudes. Meanwhile, they were from different families, whose attitude may be associated with their parents’ attitude. Therefore, further research should increase the experimental control. Despite the different backgrounds, all participants showed a more positive attitude after the intervention. Second, the intervention lasted for 3 weeks, although the intervention results show that the effect of picture book teaching activities on children’s attitudes toward people with disabilities was positive. The long-term effects need to be further explored in subsequent studies. Third, this study tested the participants’ attitudes with a self-report questionnaire, which may have a response survey bias. Further follow-up studies could be designed to determine the practical effect. In addition, this study only selected picture books in six categories of disabilities that are relatively common in China, but the types of disabilities in general schools are more diverse and varied (e.g., attention deficit and hyperactivity disorder, emotional behavior disorder). Therefore, in the future, more disability-themed picture books should be selected as much as possible so that typically developing students can have a more comprehensive understanding of children with disabilities. Despite the aforementioned limitations, the research findings have provided strong support for the assertion that online teaching can lead to more positive attitudes of typically developing students towards students with disabilities.

Author Contributions

Conceptualization, Y.Z. and W.F.; methodology, S.X.; software, S.X.; validation, Y.Z., W.F. and S.X.; writing—original draft preparation, W.F. and S.X.; writing—review and editing, Y.Z. and W.F.; funding acquisition, Y.Z. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the Faculty of Education, Beijing Normal University [grant number YLXKPY-XSDW202407].

Institutional Review Board Statement

The University Institutional Review Board approved the intervention for research purposes in compliance with the 1964 Helsinki Declaration (BNU20210804) on 28 March 2019.

Informed Consent Statement

Consent was obtained from the participants and their parents.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Conflicts of Interest

The authors have no relevant financial or non-financial interests to disclose.

Appendix A. An Example of One Picture Book’s Teaching Design (No Inconvenience)

The First Class Hour (40 min)
Teaching goal1. Understanding the content of the story and getting to know the leading role who has a physical disability (Amin).
2. Combining practical experience to understand the similarities and differences between children with physical disability and selves.
3. Learning how to actively interact with children with physical disabilities.
Teaching materialsPowerPoint of the picture book.
Pictures and videos of the related topic.
Teaching processLeading-in
5 min		Showing the pictures on the PowerPoint and asking the questions: What can you discover by looking at the pictures? Have you ever seen someone in life using a crutch like this boy? (Inspiring students to think and leading into the topic)
Main content
30 min
  • Reading together: New semester begins and a new student named Amin has transferred to the class.
  • Teacher question: Look, where is Amin at this time? Why doesn’t he play with others?
  • Reading together: The little monkey in the class always learns the way that Amin walks. The other classmates don’t like the little monkey doing this, but they don’t know how to help Amin.
  • Teacher’s question: Kids, if you were also a classmate of Amin, what would you do to help him?
  • Participants think, discuss, and answer, while teachers summarize and introduce the turning points of the story.
  • Teacher guidance: You have all expressed your opinions, it’s great! So, guess what do you think will happen to Amin and his classmates next?
  • Reading together: One day, the little monkey’s foot was injured, and now it can only walk behind Amin. Amin and the little monkey went home together and bravely chased away a big dog to protect the little monkey. Do you have any feelings after reading this?
  • Participants think, discuss, and express their opinions.
  • Teacher’s summary: You said it very well, and so did the children in the story.
They also started to like Amin. As long as the ball is thrown lower, Amin can play with them. When hiking, slow down a bit, and Amin can keep up. So, there’s no inconvenience!
Summary/extension Activities/task assignment
5 min		How would you get along with a new classmate like Amin in your class?
Encouraging the participants to try to experience the feeling of being on crutches with the help of their parents. Text, audio (voice/recording), video, and other forms about your feelings are encouraged to be shared online.
Online feedback processingCollecting online feedback from students and encouraging them in a timely manner.
The Second Class Hour (40 min)
Teaching goal1. Review the story content and explain the reasons for the change in attitude of the little monkey.
2. Further deepen understanding of children with physical disabilities and learn coping strategies.
3. Combining practical thinking and understanding of accessible facilities.
Teaching materialsPPT of the picture book.
Pictures and videos of the related topic.
Teaching processLeading-in 5 minWe met Amin last class. The small task assigned by the teacher was also completed very well by everyone! Does anyone want to share their feelings in class?
Main content
30 min
  • Role play: I’m really happy to hear everyone’s sharing, it’s really great! Next, I want to take everyone to a small activity. We know that Amin and the injured little monkey went home together, and even drove away the big dog. So, what conversation will they have on the way home? Think about how the little monkey used to mock Amin. Now, the teacher will invite you to play the roles of Amin and the little monkey. Le’s show it together!
  • Teacher’s summary: Through your performance, it really made me feel as if I had seen Amin and the little monkey getting along harmoniously.
  • Watching a video: Let’s watch a video to further understand these children who have difficulty in movement.
  • Teacher’s question: How do you feel after watching this video?
  • Participants discuss and share opinions.
  • Teacher’s guidance: These children with difficulty in movement can be very powerful, too. We call them friends with physical disabilities. Many factors can cause physical disability, and there are different types of physical disability (showing example pictures). Do you know about any celebrities with physical disabilities?
  • Integration into life: In daily life, people have also built many facilities for friends with physical disabilities to make their travel accessible. We call them accessible facilities. Have you seen them in your daily life?
  • Participants discuss, and, then, teachers show pictures and explain their uses.
Summary/extension Activities/task assignment
5 min		Summary of these two classes:
Task: You are asked to design an accessible facility. What aspects would you consider in designing it? How do you think designing it can better help these friends?
Text, drawing, audio (voice/recording), video, and other forms about your design are encouraged to be shared online.
Online feedback processingCollecting online feedback from students and encouraging them promptly.

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Figure 1. A drawing by the participant after the unit on physical disability.
Figure 1. A drawing by the participant after the unit on physical disability.
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Figure 2. A drawing by a participant after the unit on visual impairment.
Figure 2. A drawing by a participant after the unit on visual impairment.
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Figure 3. Feedback by a participant after the unit of autism spectrum disorder. Note: The participant wrote, “This is my friend John.” (left) “I want to help him, the boy with ASD, out of trouble.” (right).
Figure 3. Feedback by a participant after the unit of autism spectrum disorder. Note: The participant wrote, “This is my friend John.” (left) “I want to help him, the boy with ASD, out of trouble.” (right).
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Table 1. Samples (n = 36).
Table 1. Samples (n = 36).
BoysGirlsTotal
Grade 14 (11.1%)7 (19.4%)11 (30.6%)
Grade 23 (8.3%)6 (16.7%)9 (25%)
Grade 37 (19.4%)9 (25%)16 (44.4%)
Have contact with CWD4 (11.1%)5 (13.89%)9 (25%)
No experience with CWD10 (27.7%)17 (47.2%)27 (75%)
Total14 (38.9%)22 (61.1%)36 (100%)
Note: CWD = children with disabilities.
Table 2. Information regarding the picture books.
Table 2. Information regarding the picture books.
Theme of DisabilitiesName of the Picture BookPublication information of the Book
Physical disabilityNo inconvenienceShi, Z. T. (2012). No Inconvenience. Nanjing: Nanjing Normal University Press.
Deaf and hard-of-hearingI have a sister—My sister is deafPeterson, J. W., & Ray, D. K. (1977). I Have A Sister, My Sister Is Deaf. New York: Clinical Pediatrics.
Visual impairmentA beautiful mind sees the worldHaniger. (2012). A Beautiful Mind Sees the World. Wuhan: Hubei Children’s Publishing House.
Intellectual disabilityBe good to Eddie LeeFleming, V. (1997). Be Good to Eddie Lee. Lundon: Penguin.
Learning disabilityMadeline Finn and the library dogPapp, L. (2019). Madeline Finn and The Library Dog. New York: Holiday House.
Autistic spectrum disorderJohn from the StarsSlovenia, Karajek, & Helena. (2016). John from the Stars. Beijing: Beijing Children’s Publishing House.
Table 3. Pre-test of attitude toward children with disabilities between grades.
Table 3. Pre-test of attitude toward children with disabilities between grades.
DimensionGradeFLSD
G1 (n = 11)G2 (n = 9)G3 (n = 16)
negative behavior3.48 ± 0.964.04 ± 0.984.46 ± 0.973.31 *G3 > G1
* p < 0.05.
Table 4. Post-test of attitude toward children with disabilities between grades.
Table 4. Post-test of attitude toward children with disabilities between grades.
DimensionGradeFLSD
G1 (n = 11)G2 (n = 9)G3 (n = 16)
emotional3.21 ± 0.913.93 ± 0.884.15 ± 0.734.31 *G3 > G1
* p < 0.05.
Table 5. Comparison between pre- and post-test of attitude (n = 36).
Table 5. Comparison between pre- and post-test of attitude (n = 36).
DimensionPrePosttp
cognitive2.64 ± 0.492.84 ± 0.36−2.730.010 *
emotional3.32 ± 1.093.81 ± 0.90−3.050.004 **
positive behavior4.13 ± 0.684.52 ± 0.52−4.050.000 ***
negative behavior4.06 ± 1.034.57 ± 0.59−3.130.004 **
attitude total3.48 ± 0.513.81 ± 0.43−4.410.000 ***
* p < 0.05, ** p < 0.01, *** p < 0.001.
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Zhang, Y.; Fu, W.; Xiao, S. Online Picture Book Teaching as an Intervention to Improve Typically Developing Children’s Attitudes Toward Peers with Disabilities in General Schools. Educ. Sci. 2025, 15, 626. https://doi.org/10.3390/educsci15050626

AMA Style

Zhang Y, Fu W, Xiao S. Online Picture Book Teaching as an Intervention to Improve Typically Developing Children’s Attitudes Toward Peers with Disabilities in General Schools. Education Sciences. 2025; 15(5):626. https://doi.org/10.3390/educsci15050626

Chicago/Turabian Style

Zhang, Yuexin, Wangqian Fu, and Shuheng Xiao. 2025. "Online Picture Book Teaching as an Intervention to Improve Typically Developing Children’s Attitudes Toward Peers with Disabilities in General Schools" Education Sciences 15, no. 5: 626. https://doi.org/10.3390/educsci15050626

APA Style

Zhang, Y., Fu, W., & Xiao, S. (2025). Online Picture Book Teaching as an Intervention to Improve Typically Developing Children’s Attitudes Toward Peers with Disabilities in General Schools. Education Sciences, 15(5), 626. https://doi.org/10.3390/educsci15050626

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