Getting your Disabled Child to Wear a Mask

If I had a nickel for “Well, just have him wear a mask!” I’d be rich. Am I right? Actually, we’ve been working on ‘wearing a mask’ for about two months. And we are now to the point where he will hold it in his hand for a few seconds before he either drops it or throws it. Yay for progress!

goals accommodations mask wearing

Regardless of what our school life looks like in a few weeks, we really need to make every effort with our kids to wear masks. It may enable them to go back to in-person school, have play dates, help protect grandparents and other loved ones and help keep them safe(r).

This blog post is a summary of tips and guidelines for parents. As always, consult with your child’s team. I’m not trying to speak as an OT or behaviorist. If you are concerned about mask-wearing because of medical conditions, consult your medical team. This post will mostly be sensory and behavior-based ideas for parents.

Before I start, I want to say, this is not the venue to debate whether or not mask-wearing has any value (it does), if it’s unsafe (for 99.9% it’s not), or if it violates your personal freedoms (it doesn’t, being inconvenienced is not the same as being oppressed, look it up). This post is for parents who have children who, for a variety of reasons, will not wear a mask and the parents are looking for ideas.

Mask Wearing: Determine your baseline.

If you’re at home without your team, you’re going to have to write your own “Present Levels” for this task. If you haven’t already tried to get your child to wear one, make sure that the first attempt is a pleasant one even if it’s not successful. If it’s a forced event with lots of screaming and tears, you’re going to have to re-create a positive experience.

Think about where your child is right now as far as this task.

  • Child will wear a mask for a very short period of time.
  • Child will allow me to put the mask on, but then pulls it off.
  • Child will hold the mask and will put it on themselves, but will not keep it on.
  • Child will hold the mask in their hand.
  • Child will carry a mask in their pocket.
  • Child is not even comfortable with a mask within their line of view.
  • Child is not comfortable seeing family wear masks.

Why won’t your child wear a mask?

Once you find out what your starting point is, you have to decide what else you have to work with.

If your child is verbal and able to tell you, that’s half the battle.

If your child is not able to tell you, you’re going to have to go with trial and error plus what you know from past experience.

  • What fabrics and textures your child prefers to wear or not wear as clothing.
  • What other things your child will wear: winter hats (start with a mask that goes over the head) or headphones (may want to start with the ear loop masks). Also consider if your child does outdoor winter activities, what face coverings have worked, or sports equipment that has worked.
  • What has or hasn’t worked with your child as far as washing their face, putting lip balm on when needed, etc.

I understand what it’s like to have sensory issues. This is an extreme situation. I feel it’s my job to help him develop coping mechanisms and overcome this challenge. What I’m trying to politely say is this: We’re going to hear things like “I hate it” and “I don’t like how it feels” from our kids, either through words or actions. I think we have to give it all we’ve got. We can do hard things.

You may want to consider private or outside OT, sensory or behavior specialists with this. Most are doing telehealth right now and you may just need a few consults to get going.

Brainstorm an Ideas List of Motivators

What motivates your child? Whether it’s extra screen time or working toward a coveted item, I think this is the time to pull out all the stops.

When my son is successful at the task, he gets to watch a video he likes. If he drops the mask, I stop the video. We have now been able to increase it to him holding the mask in front of his face. (Reminder: at the time of this writing, it took us 2 months to get here, so I truly understand the struggle.)

Choosing their own mask might even be a motivator. Does your child love to smell certain scents? Can you add that scent to the mask?

If your child has a sensory need that is met by touching their face with certain things, what are those things? How can you use that?

Social Stories about Wearing a Mask

There are dozens of social stories out there about wearing a mask.

You can also look on YouTube, many child performers have songs about wearing a mask and social distancing.

Why do people wear masks? It’s OK to ask. In Jack Hartmann’s Why Do People Wear Masks video Jack explains the importance of wearing masks and who wears a mask. Find out that wearing a mask protects you and others too.

Chewing and Excessive Drooling with a Mask

First, consult with your child’s OT or SLP about this. I have an excessive drooler too.

For chewing: If chewing is a sensory need, personally I would just go with it. Just buy more masks and change them frequently. Buy gloves and ziploc bags so that the teacher can help your child replace them and send them home in a closed container.

I would do the same for drooling. Again, consult with an SLP. I have, and we don’t know what to do because my son has an open-mouth posture and low muscle tone. She gave me some mouth exercises which we do, but it’s a slow process.

Mask Wearing IEP Accommodations and Alternatives

Despite our best efforts, we may not make the necessary progress with some of our kids. So then we have to turn to plan B.

Like everything else, look at what your state and your school district has published regarding mask-wearing. See how that can mesh with your child’s needs.

Some suggestions might be:

  • Face Shield
  • There are masks that attach to a baseball hat, so it doesn’t need to touch the child’s ears.
  • A bandanna or similar scarf
  • Holding in front of face instead of wearing
  • Hoodie pulled up and zipped all the way up (the ones that go up above the mouth)
  • Sitting away from classmates (I know, ostracizing, but we have to brain dump all the ideas)
  • Ski Mask
  • Sporting helmet
  • Attachment to seizure helmet (we’re pursuing this)
  • Placement in a building or classroom with exceptional HVAC to handle circulation
  • Safe place to take breaks from mask-wearing

Practicing Mask Wearing

One of the common threads among many of our kids–it takes them forever to learn stuff sometimes! So really commit to this. Set aside a practical time to run through it a few times a day.

Does your child enjoy showers? Ok, how about you put the mask on while you’re waiting for the water to warm up? You can remove it when the shower is ready to enter.

What about right before meals? Makes sense to put it on when you sit down at the table, then when I serve the meal you can remove it.

What about negotiating another task? Instead of practicing violin 20 minutes a day, you can practice 15 and wear a mask for 5.

What chore do they loathe? Trade them–you do the chore if they will wear the mask for the duration (then do the chore sloooowwwly lol).

Think of what the child is already doing and just add it in.

IEP Goals for Mask Wearing

You know my saying: When a child lacks a skill, you either teach them the skill or accommodate the lack of the skill (and of course, accommodate while you’re teaching).

So, if the first day of school arrives and your child won’t wear a mask, you’re going to need both accommodation and a goal. Personally, this is not something I would ask my IEP team to add. At that point, it’s time for accommodations and for the parent to continue to work on at home. I can’t even imagine what things are going to look like, without Ms. Teacher having to remember to verbally prompt my child to wear a mask. They’ll be verbally prompting all the kids, I bet!

The end goal is always going to be for a child to wear a mask for extended periods of time. I kind of added “IEP goals” to the title as tongue-in-cheek.

Open Communication with your School about Masks

First, we’re not alone. And, schools have already thought of this and I’m sure many of them are working on plans.

But don’t be afraid to reach out and contact your child’s teacher or team. “Hey, I’m sure you’re not surprised to learn that Kevin won’t wear a mask for more than 3 seconds. What are some things that are working for other kids?”

Honestly, until I talked with my son’s team, it never would have occurred to me to do it in incremental steps. This issue was black and white to me-you wore it or you wouldn’t wear it. But, he went from throwing it on the floor to holding it to his lips so that he can watch his favorite Count von Count video.

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