Masks! Love them, hate them, or protest them, the CDC recommends that, in addition to keeping six feet of distance from others, people over the age of two should wear them to help prevent the spread of COVID-19.
Great! I wear a mask when I go to the grocery store (the only place I venture) both because it is required where I live and because it reduces my anxiety about the virus. But for Grace who rebukes all accessories and once gladly wore a pretend mask while playing doctor for 10 whole seconds before ripping it of in disgust? Yeah, I don’t see it being that easy.
I’m more than happy to stay holed up at home all summer, but with several upcoming doctor appointments on our radar, I know this will cease to be an option soon. So this is how I plan to prepare her.
Preparing a Child to Wear a Mask
- Explain. In clear, concise language explain that masks help us. We wear them, so we don’t get sick. We wear them to be helpers, so others don’t get sick.
- Use visual supports. Social stories and other visual supports are especially important to aid understanding in people with Down syndrome, who are known to be visual learners. As I’ve previously written, we have had great success in using social stories to prepare Grace for new and sometimes overwhelming situations. See a list of several well-written stories about wearing masks at the end of this post.
- Personalize the mask. Let your child select a mask that interests him: consider a favorite character or sports team. Having two masks on-hand gives your child a choice, which can be empowering and reduce opposition.
- If you’re even an amateur sewer, making masks is fairly easy. The CDC lists instructions for sew and no-sew options here; though I like the size and fit of masks made with these patterns better. If creating one is not an option for you, there are seemingly limitless options available for purchase.
- If you anticipate having elastic pulling on his ears may be a problem, a tie back mask is an alternative, though they seem cumbersome to me. One mother of a son with autism added buttons on his favorite hat as anchor points for his mask’s elastic; see her photo here. You can also make a headband with buttons or sew them onto an existing fabric headband. Ear savers (button anchors for mask elastics, which are sewn on a strap worn behind the head) can be crocheted or made using a variety of materials including cotton and elastic. They can even be made on your Cricut machine (if you’re one of those cool Cricut people).
- Bonus tips for eyeglass wearers who are prone to lenses fogging:
- Add a pipe cleaner inside the top edge, so the mask can be tightened on the nasal bridge by squeezing it.
- Slide the mask up on the nasal bridge (or the glasses down), so the glasses hold the mask close to the nose.
- Wash lenses with soapy water or use an anti-fog solution designed for swimming and ski goggles.
- Start small. Introduce your child to her mask, and touch it to her face. Put it on yourself, a sibling, or stuffed animal. Let your child see herself in the mirror wearing it, and shower her with compliments and praise! Start with a very brief try-on (even 5-10 seconds) followed by praise and a reinforcer (reward).
- Increase time and generalize. Gradually increase the amount of time your child wears the mask. Counting or using a visual timer can help. Consider putting it on during preferred activities that may help distract him. As success at home increases, have him wear it in a variety of environments and situations.
- It’s game time! Before wearing it when it counts, remind her why it is important, perhaps reviewing a social story. Restate her reward. First- then statements can be especially effective: “At the doctor, you must wear your mask. First you put on your mask, then you can watch a video on my phone. No mask, no video.”
- Be realistic. Despite your best efforts and intentions, you may still have a holdout on your hands. If going to a doctor’s appointment or other necessary appointment, consider calling ahead to see if other accommodations are necessary and can be made (e.g., being taken directly back to an exam room). Keep your distance from others, wash hands often, and try to keep your child’s hands away from her face (that one sounds deceptively easy, doesn’t it!?).
I found two great videos presented by psychologists that echo these tips and provide more detailed information on acclimating individuals to masks and providing reinforcement (rewards) effectively to encourage them to keep the masks on. The video from Cincinnati Children’s Hospital is more concise, while the longer video from the Alpine Learning Group includes more video examples of suggestions in practice.
Resources: Social Stories about Wearing Masks
- Wearing a Mask Social Story by Autism Little Learners, available as a downloadable pdf and on YouTube
- I Can Wear a Face Mask, a pdf social story from The Autism Program at Boston Medical Center
- We Wear Masks on YouTube
- Wearing a Mask Helps Stop the Spread of Germs on YouTube
- Let’s Wear Face Masks on YouTube has less detail than the other videos but features real people, which is often a selling point for my kids.
- This visual script shared by Affinity Consulting shares some additional information on the who, where, and whys of masks.