Delaware County Medical Society Summer/Fall 2020 - 7

Building Motivation:
Building motivation around mask wearing allows children
to feel in control, practice independence, and be more
invested in the mask wearing experience. Try to find
preferred colors/characters/patterns that the child likes.
Etsy is a great resource for all different kinds of masks.
If a child really loves trucks or dinosaurs or princesses,
find a mask that features these favorites. When possible,
include children in choosing their mask. This helps build
independence and motivation and can help their mask
become something they regard fondly and look forward to
wearing, and less like something they are forced to do.
Just like adults, children will have preferences about the
type of mask that feels most comfortable. Some people like
masks that tie behind the head, others prefer ones that go
behind the ear, others prefer bandana-style face covers, and
some like the turtleneck tube style. If possible, let children
try a couple of different styles. You will then be able to see
which ones are most comfortable and which ones stay on
better.
If you have the ability to have multiple masks for a child,
allow them to make the choice of which one to wear when
it's time to go out. One day, they might be in a dinosaur
mood and another day more of a princess mood. They may
even have a preference depending on what kind of activity
you are doing! Letting children decide builds autonomy,
independence, and a sense of control-and builds their
motivation to wear it.

Use Visuals
Social stories are great tools to help build an understanding
of mask wearing. A social story is an evidence-based
behavior explanation model used to help individuals with
autism adopt and comply with behavioral expectations.
They follow a specific format, are short and illustrated and
always end with a recap of the desired behavior. However,
social stories are not only effective for people on the
autism spectrum. They can be very beneficial for younger,
neurotypical children as well. Links to a social story about
mask wearing and another about COVID-19 are listed
at the end of this article. The story will be most effective
printed and used as a book.

To successfully use a social story, start building in the social
story as part of your daily routine. Read it as you would
any other storybook. The goal is to let the child understand
the hows and whys of masks and to allow space for you to
answer questions as they come up. As they become more
familiar with the story, progress to having your child (and
you!) wear a mask while you read. The goal is to make
mask wearing more comfortable, more routine, and part of
their daily habit. The social story offers a comprehension
and discussion framework and will support children in
understanding more and making their mask part of their
routine.
For children who are preverbal, or who respond better to
visual boards, it can be helpful to use a First-Then board.
First-Then boards help children understand expectations
and give a visual representation of behavior. There are
commercially available First-Then boards, but they can
be easily DIY-ed by drawing on a white board or piece of
paper and then taping images onto it. To use a First-Then
board for mask wearing, start with the mask wearing in the
"first" section, followed by a preferred task/activity in the
"then" section. Make sure to use a clear, concise visual icon,
perhaps a picture of someone wearing a mask or a picture
of you or your child wearing a mask. Then, use an icon for
whatever will happen next (preferably something the child
really loves!). For First-Then boards to be successful, the
"then" must be provided, otherwise the reinforcing power
of the board will rapidly diminish.
continued on next page

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