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Helping children with autism adapt to wearing face masks

Released: 4/15/2021

April is National Autism Acceptance Month

Cooperation can be a challenge for children with autism spectrum disorder (ASD) under the best of circumstances. And with the stress and disruptions of the coronavirus pandemic, those challenges have intensified for many families, according to Michelle Hartley-McAndrew, MD, medical director of The Children's Guild Foundation Autism Spectrum Disorder Center at Oishei Children’s Hospital. 

At the same time, following instructions is especially important right now, says McAndrew.

“It’s becoming clearer that even as more and more people get vaccinated and things begin to open up, face masks will most likely continue to be part of our daily lives for the foreseeable future, and getting kids with ASD to follow these guidelines is key to keeping them safe.”

Features of ASD such as impaired social and communication skills, insistence on sameness, or consistency, and sensory challenges can make mask wearing difficult and uncomfortable. Many individuals on the spectrum are highly sensitive to touch so the feel of the mask on the face, strings around ears and dampness from one’s breath can make the experience almost intolerable. 

McAndrew adds that the 1 in 54 U.S. children diagnosed with ASD often times struggle to make eye contact and read others’ facial expressions, so interacting with another child or adult wearing a face mask that covers all but their eyes can make perceiving others’ emotions even more challenging. 

If you’re the parent of a child with ASD, read on for tips on how to increase cooperation while still respecting your child’s autonomy and building confidence with mask wearing: 

  • Demonstrate using the face mask on a preferred object or person, such as a stuffed animal, a doll or a family member.
  • Practice mask-wearing while your child is calm and do so for short durations of time, allowing for breaks as needed.  
  • Empower your child by given them control, letting them choose the print or fabric of their mask. 
  • If your child is bothered by the elastic straps around their ears, try a mask design that uses strings that tie around the head or clips that hold the straps together away from the ears. 
  • Try having the child practice during a special, preferred activity – something they can only do as they practice wearing a mask to help build their tolerance and create positive associations. 
  • Set your child up for success. Plan outings requiring mask-wearing in low-demand environments that are quiet and calm.
  • Show your child a photo of themselves wearing a face mask and use it as a visual cue alerting them to put on their mask before an outing. The photo can be kept close to the door or on a phone or tablet that is easily accessible.
  • Practice together – one, two, three, mask on!

See below for additional interactive and printable resources:

For more information and resources related to autism spectrum disorder, click here or call The Children’s Guild Foundation Autism Spectrum Disorder Center at Oishei Children’s Hospital at (716) 323-6560.