Mask Wearing 101
The school year is officially underway for the majority of the country, and the holidays are fast approaching. Today, we are going to address the topic of getting our kids to wear masks. Please note, this post is not intended to be political in any way, and the fact that I need to put a disclaimer like that on a post about public health is ridiculous, but it’s 2020 and here we are.
Tolerating a mask for extended periods of time is (hopefully) a short-term skill but is an essential skill for us to access aspects of a “normal” life. It has become a part of our lives and doesn’t look like it’s going away any time soon.
As we in California hope to return to in-person learning, this will mean our kids will be required to wear a mask for the majority of their school day. If like my family, you are hoping to travel to see family over the holidays, your child will need to tolerate wearing a mask in the airport and on the airplane. As of the writing of this post, all major airlines in the united states require mask wearing in the airport and on the airplane (with the exception of eating or drinking), and are not allowing for any medical exceptions, at all.
How can we get our kids (and some adults) to tolerate mask wearing in increasing amounts of time? DESENSITIZATION. Or also known as systematic desensitization. Many of you may have heard of this as a treatment for phobias, it is the process developed by Joseph Wolpe in the 1950’s where gradual exposure to the feared stimulus paired with relaxation techniques can help a person encounter their feared stimulus successfully over time.
How do we use this in behavior analysis? Ivar Lovaas took this concept and applied it to help people with autism better tolerate stimuli in their environment. People with autism often present with aversions to stimuli in their environment ranging from bright lights, strong smells, food textures, fabrics, and noises. Aversions to these things can lead to a limited repertoire of skills or the onset of maladaptive behaviors as a way of coping with exposure to these stimuli. Think of a child who cannot stand the feeling of tags in their clothing and insisting on being naked the entire day. Alternatively, a person who has an aversion to loud noises refusing to leave the house or covering their ears and body rocking in public as a way to cope with a loud noise. We can alter the environment by cutting tags out of clothing, or buying tag less clothing, but we can’t alter an environment so much that a person will never be exposed to loud noises. This is where systematic desensitization may be helpful.
Wearing a mask is a new skill for anyone who does not work in an industry wear mask-wearing is expected (the medical field, construction, even nail salons have been using masks for years). For those of us who have not had to wear masks before, it can be a completely aversive stimulus. We are exposed to the smell of our own breath in a very real way (do you think gum and mint sales have increased since March?). We suddenly feel out of breath when we reach the top of the stairs, and oh my goodness we were hot during the summer months. These things are not pleasant for adults, yet we wear them because we care about the people around us. The same isn’t true for kids, wearing a mask is just as difficult for them, and they may not have the same understanding of the importance of it as we do. Enter desensitization.
Explain why mask wearing is important
Using simple, age-appropriate language, explain why we must wear masks, why it is important, and the proper way to wear it. Yes, your nose and chin have to be covered, at the same time. Watch videos together, answer their questions to the best of your ability, and be honest. This is not a time for “because I said so”.
Establish a baseline
How long can your child reliably keep on a mask? This is something we need to identify so we know where to start. Can they tolerate the mask on their face at all? Can they tolerate sitting next to a mask? Can they tolerate seeing other adults wearing masks? There is a wide spectrum of where your child may be, it’s helpful to know where to start.
I saw a post on social media before school started urging parents to practice mask wearing often at home, because it was going to be required in school. Expecting kids to go from wearing a mask for 10 minutes in the grocery store, or not wearing a mask at all to wearing one for several hours a day is not feasible. The mom gave a great suggestion: give them free access to screen time as long as they are wearing a mask. This is a great way to establish your baseline. How long can they wear it while they are distracted by the life-blood of children: screen time. If they take it off after 5 minutes, amazing, do that two more times, there is your first target. We like to start with an easily achievable target to help encourage our children to keep up the practice.
Model the behavior you want to see
Part of the desensitization process is relaxation when the stimulus is presented. Always practice mask wearing in a calm and supportive environment. Speak in soft tones, encourage your child, and praise them for wearing their mask. This isn’t the time to say “you need to keep this on your face or you are going to die”. You can put your mask on while they are wearing theirs, practice as a family.
Practice
Practice is the name of the game here; they should have many opportunities throughout the day to practice wearing their mask. Once they meet their goal three times in a row, it’s time to up the ante. A good rule of thumb is to increase the amount of time to be 10% higher than the previous step.
Reinforcement
As with any new skill we are teaching, reinforcement is essential. We want to make sure to provide reinforcement early and often, especially with mask wearing since this is a new and vital skill to accessing the community safely. Here is some more information on reinforcement.
Wearing a mask is not an enjoyable experience for anyone, but is a necessary part of the world we live in. In order to help make sure our kids can continue to access the community in a safe and responsible way, it is imperative that we talk about wearing a mask, teach the correct way to wear one, and check in with our kids often on how they’re feeling about mask wearing and the changes in their lives in general. There are some amazing resources out there to help guide you in your endeavor. My favorites are the town halls Sesame Street has been doing, they are a hit in my house. Here are some additional resources for you, and as always, I’m here to help!
