Teaching Mask Wearing to Children with Autism
With Governor John Bel Edwards reinstating the indoor mask mandate which includes K-12 schools, many parents may be faced with questions and challenges regarding mask wearing for their students with autism as they return to school.
A recently published study found that the use of positive reinforcement, shaping and prompting, among other strategies, were effective in teaching a group of children to wear a mask for 10 minutes without challenging behavior (Sivaraman, M., Virues-Ortega, J., & Roeyers, H. 2021). The “mask wearing” teaching was conducted via telehealth with caregivers implementing the strategies to their children. Behavior analysts coached parents in online meetings on how to teach the participants to wear a mask. The children in the study had a history of challenging behavior. The researchers used an “Exposure Hierarchy”: a series of 15 steps or target behaviors, beginning with having a mask nearby and ending with wearing the mask for 10 minutes.
The study also addressed a common concern for caregivers – whether masks decrease oxygen intake. The children in the study wore fingertip pulse oximeters which measured oxygen saturation. The oxygen measures during training indicated masks did not decrease oxygen intake. The participants’ mask wearing also generalized to community settings. The researchers noted several limitations to the study which included not assessing mask wearing for longer than 10 minutes.
While 10 minutes may not be functional for a trip to the grocery store, successfully getting to 10 minutes is a good starting point. Extending the amount of time a mask is worn can be addressed using the same behavior analytic strategies to teach mask wearing, namely, the use of positive reinforcement – providing highly preferred consequences for longer durations of mask wearing. Progressing slowly, systematically and making it “worth their while” can contribute to success. The study is another example of how behavior analytic strategies have demonstrated effectiveness in helping children with autism adhere to health and safety practices.
However, there are some persons with disabilities that may not be able to wear a mask safely – and there are many considerations based on individual differences when addressing mask wearing such as type of mask, over the ear or tie, sensitivity to different fabrics, smells, ability to put on and remove, and others.
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Source: Sivaraman, M., Virues-Ortega, J., & Roeyers, H. (2021) Telehealth mask wearing training for children with autism during the COVID-19 pandemic. Journal of Applied Behavior Analysis, 54(1), 70-86. https://doi.org/10.1002/jaba.802