In this article, I speak about Autism Spectrum Disorder. In my work with the Autism community, I have been told that the preferred language is “Autistic person” rather than “person with Autism.” Although there is some debate in the field of psychology about the appropriateness of not using person-first language, I prioritize feedback from people who exist in the community and, as such, will use their preferred language.
Several states have issued mask mandates, and large corporations like Walmart and Target are requiring that customers wear masks to enter their stores. This has brought up concerns about whether it is safe or possible for everyone to wear a mask, particularly kids and those with sensory issues.
In some countries, such as Japan, masks are commonplace in preventing the spread of colds. Young children are expected to wear masks in public from a young age, and if they are used to this practice, they are typically able to follow this expectation. We are generally comfortable with things we are used to, which is why there are protests about masks but not pants.
There have been concerns about whether it is safe to wear cloth masks for a long period of time. Hospital staff wear masks for 12-hour shifts, and research has shown that masks do not, in fact, cut off oxygen. Parents have expressed concern that masks might pose a choking or suffocation hazard for young children, but pediatricians and the Center for Disease Control have reported that it is safe for children over the age of two to wear cloth masks in public.
Although cloth masks might not make it impossible to catch COVID-19, a report from the Mayo Clinic shows that we can significantly reduce the spread, specifically if everyone wears them. There is still much that we do not know about this virus, but we do know that children significantly contribute to the spread of common colds and the flu.
So we know that wearing masks is safe, but what about those with sensory issues, those for whom a mask might be extremely uncomfortable? Autistic children in particular often have difficulty finding clothes that they can wear comfortably.
“Sensory processing” refers to how our brain interprets what we see, feel, smell, taste, and feel. Some people’s brains take sensory input and interpret something that most people wouldn’t even notice as uncomfortable or even painful. For example, many Autistic people cannot comfortably wear jeans. Imagine if everyone around you wore pants made of sandpaper and could not understand why you didn’t find them comfortable. That is the life experience of someone with different sensory processing. So when I put on a mask, I might feel a bit uncomfortable, but an Autistic person wearing that mask might feel intolerable. Because of this, parents of an Autistic child might be asking if they should seek an exemption to excuse their child from wearing a mask in public spaces or at school.
First, it is accurate to say that an Autistic child is more likely to struggle with wearing a mask than a neurotypical child. However, this does not necessarily mean that Autistic children should not be asked to wear masks. Do you know what else Autistic children often feel uncomfortable wearing? Shoes. Underwear. Seat belts.
When a parent comes into my practice with an Autistic child (or a child with another sensory processing issue) and tells me that they struggle to find clothing that their child can wear comfortably, I never suggest that I write them an exemption allowing the child to go to school in the nude. Instead, I work with the child to communicate what they find uncomfortable about different clothing so that the parent can find fabrics and styles that work for them. As kids wear these clothes, they can begin to expand their comfort zone, and a wider variety of clothes become available to them. Masks, like pants, are part of what we need to wear to be presentable in public, and so we find ways for Autistic children to wear them appropriately.
Similarly, when parents of an Autistic child come to me and say that their child struggles with wearing a seat belt, I do not offer to write an exception to allow the child to ride in cars without a seat belt. Instead, I help the parents talk to their child about why the seat belt keeps them safe, work on distress tolerance, and help the parent find products to make the seat belt more comfortable for the child.
It might be easier for parents in the short-term to tell their child that they don’t have to wear shoes, or to let the child ride without a seat belt. But parents want their child to be safe, and they want their child to be able to spend time with peers and “fit in.” So we help the child find ways to be comfortable, safe, and dressed appropriately.
If your child struggles with wearing a mask, explain to them why we need masks to stay safe. Child Care Connections has a free ebook to talk to kids about masks. Next, let them try a variety of masks with different straps, fabrics, and styles so they can see what is most comfortable for them. Many artists make custom designs and colors, so it can be fun to let your child pick out masks with patterns they like or characters from shows they enjoy. Have them wear the mask for five minutes at a time, then ten, then fifteen, until they are able to keep the mask on while they are out in public.
It can be a struggle to get an Autistic child to wear a face mask, but in the era of COVID-19, we need masks to keep ourselves and others safe. It is natural for a parent to want to save their child discomfort, but our first job is to keep kids safe, which means educating and helping kids feel comfortable in masks.
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