Crisis Services
ASERT does not offer crisis services through our Resource Center. If you or someone you love is experiencing mental health distress or thoughts of suicide please call or text 988 for support.
Wearing a Mask and Communication
Overview
As a result of COVID-19, health care providers have recommended people wear masks as a way to prevent the spread of the disease. Wearing masks can be uncomfortable, and for individuals who have sensory sensitivities, it can be even harder. These resources provide a guide for families and caregivers on how to work with loved ones on getting comfortable wearing a mask, different types of masks based on individual needs, as well as information on communicating while wearing masks for individuals who are deaf or hard of hearing.
As we begin entering back into the community, it’s important to follow guidance from officials by continuing to wear masks. Although tolerable for some individuals, this can be a new and difficult task for others. The purpose of this resource is to provide information to families and caregivers on how to help support a loved one to wear a mask.
Talk About It
Start off by having a conversation with your loved one about the importance and reason behind wearing a mask in the community and the safety that it provides to themselves and others. This would be a good time to review the “Wearing a Mask” social story.
Helpful Phrases:
- To leave home safely, there is a new rule that says everyone must wear a mask so that we don’t spread or contract germs and become sick.
- I care about you and your safety, so wearing a mask is important.
Ask Questions
How comfortable do they feel about wearing a mask? If they seem uneasy, acknowledge and normalize their feelings. Questions include:
- Will you hold the mask in your hands? Will you hold the mask up to your nose/mouth?
- Would you mind putting the mask on for a few seconds to practice?
- How would you feel about leaving the house with a mask on? Are you okay with others around you wearing a mask while we are out?
Give Choices
Does your loved one have sensory preferences? Think about their comfort and which kind of mask better suite their needs. Present several choices of masks, or better yet, involve them in making their own mask! Consider the following:
- Some individuals prefer cotton over nylon.
- Elastic around the ears vs. a tie behind the head.
- They might prefer to wear a mask that is their favorite color or design.
Desensitize
Desensitization is a way to gradually build up tolerance of a new behavior or activity over time. One way that family members and caregivers can move towards making wearing the mask a tolerable behavior for your loved one is by using a desensitization tool.
Practice Makes Perfect
Practicing wearing the mask! Try this several times before venturing into the community. One way to practice this new behavior is by using a task analysis tool. Task analysis is a way to break down multiple components into much smaller steps, in order to teach a new behavior. Remember, for some individuals, communication might be more difficult while wearing a mask. It is important to use gestures to your communicate feelings, and use words to replace emotions that might be hidden by wearing a mask.
Reinforce
Provide lots of praise for what they were able to do, even just trying. Using a preferred item or activity as a reward may also be helpful. You could say something like: “You’ve been working very hard. I’m proud of how far you’ve come with wearing your mask!”
Individuals with autism and/or intellectual disabilities may have a hard time trying new things, especially when a new skill has a sensory component. Desensitization is a way to gradually build up tolerance of a new behavior or activity.
A desensitization log can be used to track someone’s progress when learning to tolerate new things, like using hand sanitizer or wearing a face mask. The purpose of this resource is to provide families and caregivers with a tool to help their loved one become more comfortable with new tasks in relation to coronavirus guidelines, such as wearing a mask, hand washing, coughing into the arm, etc.
How to Use:
Think of ways to gradually introduce the new skill:
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- Start small, even just seeing or touching items involved in the new skill.
- Start with what the person can already do!
- Build up the amount of time doing the task over time.
- Pair the skill with something fun, like music
- Reward and reinforce the individual for trying
- Practice multiple times over multiple days, building up over time to get to the new behavior.
Use the log below to write out small steps, gradually building up to the full skill.
Use visuals, pictures, demonstrate it yourself, or a list to show the learner.
Getting Comfortable Wearing Masks
There are many reasons why people are unable to wear a mask. People with autism and intellectual disabilities may not tolerate face masks well due to sensory sensitivities. Masks might feel uncomfortable or make it more difficult to breathe. It can also cause fear and anxiety, because it hides a part of other people’s faces.
There are many ways to make traditional face masks more tolerable.
Give Choices
Incorporate the individual in the decision making process as much as possible. Have them be involved in choices around the type, design, and material the mask is made of as much as possible.
Make Masks from Soft Materials
Although masks are preferred, general face coverings are also acceptable if it is necessary to go out into public, or if support staff are coming into the home. A mask made out of soft cotton, a bandana, or other household items may work better for some individuals.
If individuals aren’t able to tolerate anything touching their face, using a face shields may be an alternative option. While face shields do not protect as well as a mask, it still provides a level of protection.
The CDC recommends that homemade face masks can be breathed through, covers the nose and mouth and are washed after each use. It is not recommended for children under two years old.
Practice
Get the person used to the face mask by practice wearing one at home before going in public.
Replace or Change Uncomfortable Parts
Sometimes masks can be altered to be more comfortable. On some masks, elastic ear loops can be replaced with cotton straps. Face masks that have metal across the nose can be replaced with more comfortable material.
Make it Fun
Create a game around wearing a mask outside. You can turn the mask into a costume or play a game of see who can leave it on the longest. Have them practice by putting a mask on a toy, stuff animal or doll. Distracting them with favorite activities may be another way to help them get more comfortable wearing a mask.
Did you know that people with hearing loss and some people with disabilities rely on your lips and facial expression to communicate? 
Your mouth and eyes reveal visual information like emotion, tone of voice, and even American Sign Language grammar.
It is important to wear a mask for protection from COVID-19; however, this can pose a communication barrier for some.
Why is the clear mask the best mask to facilitate communication?
50% to 85% of the message is lost
Much more of the message can be received
Here are several different options for directions on how to make your own mask with a clear panel:
- https://www.instructables.com/id/Face-Mask-Adapted-for-Deaf-DeafBlind-and-Hard-of-H/
- https://www.adultadvocacycenters.org/news/pattern-for-mask-with-clear-window-panel-now-available/
- https://www.hsdc.org/wp-content/uploads/2020/04/HSDC-Instructions-for-Clear-Window-Masks.pdf
- https://pealcenter.org/wp-content/uploads/2020/05/Clear-Facemasks.pdf
To prevent fogging, rub a dot of dish soap, white toothpaste, shaving cream, or white bar soap over the interior of the clear panel & buff dry with a soft cloth. Try it on your glasses, too!
The Deaf community, Etsy, and local mask makers may be able to assist as well.
Covering the majority of the face can make it difficult to convey emotion and communicate with others. It is important to be conscious of the communication that is lost while wearing a face mask. Below are some tips to supplement communication.
Try different tips based on the needs of the person you are interacting with.
- Be patient
- Get the other person’s attention before speaking
- Make eye contact, if possible
- Use context clues within the situation
- Take off sunglasses and hats to allow the other person better access to your face
- Ensure adequate lighting
- Be aware of your environment – Move away from noises and distractions, if possible
- Speak louder – Masks tend to muffle sound
- Use short, simple sentences
- Speak face-to-face and at eye level
- Clarify if you are unsure what the other person is saying
- Use gestures or real-life objects – Wave, point, give thumbs-ups, and so on to reinforce what you’re saying
- Use your body language to accentuate your emotions – Such as head tilts, head nods, and your posture
- Be aware of and use your eyes and eye brows to emphasize communication
http://fischerasl.weebly.com/facial-expressions.html
- Write it down if you need to – Thicker, dark letters on white paper are more easily seen from 6 feet away
- Use some sign language that is commonly known such as thank you, please, and sorry
https://www.babysignlanguage.com/dictionary/first-signs/
- Use a clear face mask
Other downloads
| Name | Description | Type | File |
|---|---|---|---|
| Tolerating Masks | This resource provides information on how to help loved ones tolerate wearing a mask. | Download file: Tolerating Masks | |
| Desensitization Log | This resource provides tips for how to work on desensitizing individuals to unpleasant tasks like wearing a mask or washing hands. | Download file: Desensitization Log | |
| Getting Comfortable Wearing Masks | This resource provides tips for getting helping an individual get comfortable wearing a mask. | Download file: Getting Comfortable Wearing Masks | |
| Clear Face Masks | This resource provides information about clear face masks and helpful links about how to make your own. | Download file: Clear Face Masks | |
| Tips for Supplementing Communication While Wearing a Face Mask | This resource provides tips for how to help communicate with others while wearing a mask. | Download file: Tips for Supplementing Communication While Wearing a Face Mask |
This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.