SensorySmart™ Strategies for Wearing Masks during the Pandemic

The COVID-19 pandemic is disorienting and scary for all of us. It has been a marvel for me as an occupational therapist to see how well so many of my clients —children, teens, and adults alike — have coped with this surreal disruption of daily routines.
 As we adjust to the “new normal” many are still learning to take the proactive steps needed to protect the safety of themselves and others: washing hands frequently, physically distancing, and wearing a mask.

Wearing a mask has been especially difficult for people with sensory challenges who struggle with certain textures, tags, seams, and other tactile sensations. What’s more, some people with processing difficulties rely on facial cues to help them understand what a person is saying and to identify the person. This makes wearing a mask or sometimes just seeing someone with a covered nose and mouth unpleasant, distressing, or downright intolerable.

If you are struggling with this for your child or yourself, you are not alone! Fortunately, there are many sensory smart strategies that can make wearing a mask easier. It will help to first analyze the problem:

Solutions and Strategies

Just like clothing, there is a range of fit and comfort when it comes to masks. There is no one-size, one-style fits all. Some masks are more sensory-friendly than others, and it may take you and your child some trial and error to find the most comfortable material, shape, and strap design. Here are a few ideas:

While some people like disposable surgical masks, they often do not fit well, do not seal well, and can get hot. If you or your child prefers these though they are too loose, fold the mask in half lengthwise, form a knot by the edge of the mask, and gently push the sides of the mask beneath the knot. You can tie additional knots if needed to improve mask fit.

Disposable Mask

If it’s a reusable mask (rather than disposable surgical mask or KN95/N95), wash it in hot water with unscented detergent before wearing. This will remove any chemical sizing and packaging smells from the plastic wrapper. Wash it after every time it is worn.

Many tactile sensitive kids and adults feel better with all-cotton masks that have soft, adjustable cotton straps such as those from Joah Love. Many stores such as Target and Old Navy also have a selection of soft cotton masks for kids and adults.

Joah Love mask

Straps make a big difference. Experiment with masks that have ear loops and those with straps that go behind the head which can tug hair and irritate sensitive scalps (wearing under a ponytail reduces this to an extent). Your child may be happier with softer straps that can cinch up with a tug rather than elastic straps that can pinch and be too tight. You can also add a Cord lock to adjust straps.

Cord Lock

There are also extenders you can add to the loops which you can find online.

Extenders

Search the internet for headbands with buttons for mask loops. You can easily make your own too.

Headbands with Buttons

If the person likes wearing a baseball cap, sew buttons on the hat and attach the loops to the buttons instead of around the ears or behind the head.

cap with buttons

Look into themed-masks with favorite characters, preferred colors, team names, and so on. Personalizing it and allowing your child to choose the mask helps with acceptance and willingness to wear it. There are loads of themed masks available on Etsy, Amazon and elsewhere such as this cute theme mask

Theme Masks

Fun and Function Social Masks have a transparent window that keeps facial expressions visible. This helps kids and adults tune in to nonverbal cues and social nuances, allows lip reading, and lets kids more easily recognize familiar faces.

The Social Mask

If eyeglass fogging is a problem, add a strip of medical tape along the top of the mask to seal it and prevent warm air from leaking upward under eyeglasses. Or spray eyeglasses with anti-fog goggle spray such as Tyr or Optix.

eyeglass fogging

It may help to put a drop of a preferred pure essential oil on the outer side of a mask (never against the skin or directly in front of mouth or nose) so the user inhales a scent they love. Essential oil preference is highly individualized so you’ll need to experiment. Use only the highest-grade, therapeutic essential oils and remember to apply just one drop to avoid sensory overload! Try this at home before going outside for the day.

Peace and Calming

Shallow mouth breathing is common among kids and adults. Practice taking deep, calming breaths through the nose rather than mouth. A visual such as Take 5 Breathing can really help. The Take 5 Breathing video works well for many people. You can also download a Take 5 Breathing Poster.

Alternatives: Gaiters and Shields

Some people prefer a gaiter style covering which is basically a stretchy fabric tube. There are loads of these available online. Again, to be effective they need to fit snugly so that air does not escape through gaps in the material.

Gaiter Style Covering

Masks protect others by filtering the droplets we emit when we exhale, cough, sneeze, talk, sing and so on. Face shields provide others with some protection but obviously air escapes around the edges of the shield and thus they are not as effective if used without a mask. A mask and shield worn together provides greatest protection, essential if you or your child are sick or have a compromised immune system. There are many available online and increasingly in stores. Higher quality shields provide increased visual clarity, are easier to disinfect, and last longer. Three favorites are those from:

Little Lives PPE PediaShield™ created by doctors with medical grade plastic and non-toxic headband foam for kids and adults.

Little Lives PediaShield™

Third Kindness High-quality medical grade face shields for kids and adults with solid or cute decorated headbands.

Third Kindness shield

Shield Pals Adorable styles for kids and adults with clear, high-quality shields.

Sheild Pals shield

Tips to Build Acceptance

Social Stories, Videos and Books

Social stories and videos about COVID-19 and wearing a mask are easily found online on sites including Autism Resource Central.

Reading a book together helps to normalize this period in history. You may want to help your child keep a diary about their experiences or write a book of their own to share with their children and grandchildren some day.

Sarah Wears a Mask

COVID-19 for Kids

Thank You Helpers

About the Author

Lindsey Biel, M.A., OTR/L is a pediatric occupational therapist with a private practice in New York City where she evaluates and treats children, adolescents, and young adults with sensory processing issues, developmental delays, autism spectrum disorders, and other challenges. With the COVID-19 pandemic, she now offers teletherapy to families and schools nationwide.Lindsey is co-author of the award-winning Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, with a foreword by Temple Grandin. She is also the author of Sensory Processing Challenges: Effective Clinical Work with Kids & Teens and has authored two chapters in Dr. William Steele’s book Optimizing Learning Outcomes as well as contributed to the all-new edition of Kim West’s classic Good Night, Sleep Tight.

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