Helping Individuals with Autism Wear Face Masks

Individuals with autism are experiencing many new challenges brought on by COVID-19, including understanding social distancing practices and why people are wearing face masks.

Many individuals need specific types of support to adapt to this change, especially if they will have to wear face masks when they return to school or go out in the community. Autism New Jersey has heard from parents and professionals across the state who are concerned that individuals with highly restrictive tendencies and sensory sensitivities would understandably not want to wear a cloth face mask.

With many places and spaces reopening with a face-mask requirement, many are understandably worried that these obstacles may restrict full participation and inclusion in the community, school, and other indoor establishments and spaces. If you have these concerns, read our article: Is my Child with Autism Required to Wear a Mask?

Here are some suggestions and resources to help individuals with autism with wearing a face mask:

Explaining the Situation

While some individuals with autism can understand this health concern and tell you what they’re thinking, others cannot. They may not understand the context of what is going on and why wearing a mask is mandatory in certain places. This may lead to confusion, resistance, and intense emotions. Choose a time when your child is calm to speak to them about what a face mask is, why it is required right now, and how to wear it.

Be Clear

Use concrete language when talking about the virus and why a mask is a protective boundary. For example, “Without our masks on, we could catch germs. We don’t want to bring the virus home or give it to our friends and family.” PBS News Hour recently offered some tips and a video for helping individuals with autism understand how to be healthy during COVID-19.

Try a social story

These are a tool to explain a challenging situation using a simple narrative and pictures. The Boggs Center and Children’s Specialized Hospital offer a social story that may help: I Can Stay Healthy by Wearing a Face Mask (Spanish). Or you could create your own that is unique to your child.

Use additional visual supports

Two Way Street has created a COVID-19 chat visual board that provides a visual language display for augmentative and alternative communication devices (AAC). Even if your child doesn’t use AAC, you could print it for the discussion. This Support Understanding packet includes resources, visual supports, social stories, and other suggestions to help your child understand social distancing practices.

Teaching Wearing a Face Mask

Since wearing a face mask may be highly aversive to individuals with ASD, introduce it as soon as possible to help them get used to it. Talk with your child’s team about specific adaptations or suggestions to meet his or her unique needs.

State clear expectations

“If-Then” and “First-Then” language may be helpful: “If we want to go to the store [or back to school], then we have to wear our face mask,” or “First, mask on. Then, outside.”

Start small

Prior to asking your child to wear the mask, some individuals may need to become familiar with it. Consider the following steps over time:

• Holding the mask
• Bringing the mask toward their face
• Touching the mask to the face
• Fitting the elastic over the ears
• Keeping it on for specified amounts of time

Once it is on, a visual timer (physical or an app) may help to indicate how much time remains (start with just a few seconds and work up). It may help if you wear one during these practices as well.

Reinforce the behavior

Since this will likely be a big challenge, make it as motivating as possible.

• Provide a favorite reward as a consequence for keeping the mask on for a certain period of time (remember, start small).
• If your child is passionate about a certain topic, character, or movie, you could purchase a personalized mask. This article from TODAY offers ways to make wearing a mask more comfortable.
• Consider having him/her wear the mask to do a favorite activity (while playing a video game, swinging in the backyard, etc.) to get used to it. This can be a helpful distraction as well as helping it become more habit-forming.
• Have your first outing be very short and to a favorite place (a walk in the park, to buy their favorite meal at curbside pick-up, etc.).

Generalization

Once your child is tolerating the face mask, think of ways to expand the options so he or she doesn’t learn just one narrow set of details. For example, have multiple masks so there is a second and third acceptable choice when one is in the laundry. Have different people ask him/her to wear the mask (other family members, a teacher on a video conference, etc.). Practice at different times and places.

Individuals with autism who cannot verbally express their frustration, confusion, or discomfort with the mask may exhibit aggression or other challenging behaviors. If so, consult with your child’s team for more direct assistance.

Additional Resources

Using Behavioral Principles to Teach Learners with Autism to Cooperate with Wearing Masks – this very helpful 30-minute recording from Alpine Learning Group expands upon the tips above and includes video examples.

The Boggs Center on Developmental Disabilities and Children’s Specialized Hospital –  A Parent’s Guide: Helping Your Child Wear a Face Mask  (Spanish)

Help Your Child Feel Good about Using and Seeing Others Wearing Face Masks (Spanish)

We Wear Masks – A story about Coronavirus (YouTube/Mike McGovern)

Conscious Discipline: printable resources and stories including The Task of the Mask

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For additional information and resources, contact Autism New Jersey at 800.4.AUTISM or email information@autismnj.org.

Learn More:  Autism New Jersey Annual Conference offer dozens of educational workshops for parents and professionals.  Check it out!