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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.

Verbalize clear, concise directives:
· Whenever you ask children to engage in non-preferred
activities (and mask wearing in the beginning is probably going
to be non-preferred), make sure to use clear, concise directives.
Don't add too many steps or too much white noise in your
instructions. For example, you could simply say, "First put
on your mask, then we're going to the store." Or, "First put
on your mask, then we're going to play a video game." The
more clear and concise the better. Also, the more appealing the
reward, the better, especially at the outset.
· These techniques are also directly applicable to older
individuals with intellectual disabilities or autism. Mask
wearing can pose a significant difficulty for adults with
cognitive challenges. It is important to remember to take time
to explain and gradually introduce masks to them as well, and
to include rewards for success.

Practice and Praise!
· Start small! There are many steps in wearing a mask. With
some children the first steps may be holding the mask, or
putting it close to their face, then holding it on their face, but

not attached. Little steps can make a big difference.
· Once the mask is on, identify success as a short time period!
Practice mask wearing in short intervals and give lots of positive
praise throughout. For some kids, small intervals might be
seconds, minutes, or as long as a half hour. It's okay if the child
can't manage a long duration in the beginning, that doesn't
mean you shouldn't practice!
· Practice during preferred activities. This will help build the
habit and make it more enjoyable for a child by providing a
good distraction. When children are doing something nonpreferred, they will be more likely to focus on the mask.
Whereas if they are engaged in a highly preferred activity, the
child is going to more likely be distracted from their mask
because they enjoy what they are doing! Choose something that
you know they enjoy: watching a show, going outside, playing
with a specific toy, etc. Then say, first we're going to put on a
mask, and then we will get to the fun part.
· Give praise early and often! Children are highly motivated
by praise (for more about the power of play and praise, check
out the Child Guidance Resource Centers' blog at cgrc.
org/powerofplay/). Give lots of positive reinforcement and
encouragement while your child practices wearing their mask.
Wearing a mask is a new skill; one that takes patience and
practice to develop. Building motivation and independence, using
visuals, giving clear directives, practicing, and praising can all
help your child as they adjust to wearing a mask in the coming
weeks. If you are looking for additional resources or have patients
with specific questions, feel free to contact Liia Richmond at
Lrichmond@cgrc.org. We are always available to consult around
behavioral and mental health issues.
Social story for mask wearing: https://bit.ly/3f21e8s
Social story explaining COVID-19: https://bit.ly/3056d3R
About the author: Brianna
Matey, PhD, is the Vice
President for Clinical Services
at Child Guidance Resource
Centers. She has been with
Child Guidance for over 10
years and oversees CGRC's
Delaware and Philadelphia
county services. Brianna
received her graduate
degree in Counseling from Boston University and
Doctorate degree from Philadelphia College of
Osteopathic Medicine and she is a Licensed Clinical
Psychologist and Licensed Professional Counselor.
Brianna specializes in working with individuals to
support their needs around emotional regulation,
developmental delays, anxiety, depression, and
coping skill development.

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