Working through the Challenges of Wearing a Mask

By Lesley Fraser-Ball, MSW, BCBA, Clinical Professional

As wearing a mask becomes our new normal, supporting an individual with autism to wear one for any amount of time might feel like a mountain to climb. In this blog, I will discuss potential reasons it can be particularly challenging for individuals with autism to wear masks, some alterations/adaptations to try, and suggestions for where to start in supporting your loved one.

Patience and practice are key to teaching and learning any challenging new life skill. It’s also important to keep in mind that some individuals with autism may not be able to tolerate wearing a mask, despite your resourcefulness and attempts to accommodate sensory and cognitive needs. Be kind to yourself and your loved one as you take on this challenge together.

What might impact an individual with autism’s ability to wear a mask

Anxiety: Wearing a mask can make it feel like your airflow is being restricted, and for some individuals with autism, this could cause feelings of increased anxiety. The body’s fight or flight system may be responding to a perceived threat (suffocation), even though there is no actual risk of a mask preventing breathing.

Sensory challenges: The new feelings of elastic over your ears, material across your face, or the heat caused by the mask can be uncomfortable and overstimulating. Individuals with autism might also be extra sensitive to smell inside the mask; clean the mask regularly or use a preferred scent.

Visibility: If you wear glasses, you understand how tricky it is when masks cause them to fog up. (Try tucking tissue between the mask and the bridge of your nose, it may help to position glasses on top of the outer edge of the mask, or clean glasses with shaving cream, soap, or toothpaste to prevent regular fogging.) Wearing a mask can also reduce peripheral vision and be distracting when looking down, particularly for people with autism, who often have difficulty blocking out extraneous sensory information.

Adaptations/alterations to try

• Different shapes of masks: Cloth masks sit close to your face, and masks used for construction/yard work tend to be more rounded and sit away from your face a little more. Some have elastic that goes behind your ears and some tie behind your head.

• An “ear saver” to clip mask loops behind the head instead of looping around the ears. Watch out for skin irritation or breakdown, particularly behind the ears, and adjust as necessary.

• Position mask loops around the earpieces of headphones rather than over ears.

• Tie the mask more tightly or more loosely.

• A bandana that covers your nose and mouth but allows for more airflow from below

• A buff/circular scarf or headband pulled up over your nose and mouth

• A themed mask with favorite characters or Superheroes! Have your loved one choose their preferred mask design.

• Brush teeth (or consider gum or mints) immediately before putting on mask to prevent odors inside the mask

**If your loved one has a chronic lung condition, consult with your health-care provider as to the most appropriate type of mask for them.