Story at a glance

  • People with autism may have sensory issues.
  • If their senses are too active, they may find wearing a mask difficult.
  • An autism expert tells us how she would approach teaching a person on the spectrum to wear a face mask.

Health experts widely recommend wearing a face mask to prevent the spread of diseases, including COVID-19. Although there are reports of people who defy mask requirements, there are also people who may be struggling with face masks for physical reasons. Adults and children on the autism spectrum may have difficulty wearing masks.

People with autism may have sensory issues that can either be hypersensitivity or hyposensitivity, meaning overactive and underactive, respectively. Face masks can pose a problem for people with hypersensitivity because they may be unable to tolerate having something on their face or the material of the mask itself activates the touch senses to a point that is intolerable.

This could potentially lead to complications or confrontations in public spaces if masks are required. There are reports of families going shopping and who were asked to leave the store, a special needs student not being able to attend classes and a mother and a 5 year old were taken off a flight because of masks.

Changing America spoke to experts at Firefly Autism, a nonprofit that provides services to adults and children with autism in Colorado. “The very first thing to always remember when we're talking about individuals with autism is every single person is completely different,” says Amanda Kelly, who is the Home-Based Programs Director at Firefly Autism. “It's very hard to say broadly one type of mask is better than another because everybody is entirely individual and completely different.”


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An initial assessment could help understand what part of wearing a mask is difficult and why. It would also help set a baseline. For example, you can determine if the person can tolerate touching a mask, putting it on and wearing it for a few seconds.

A parent could introduce masks of varying styles and materials and see what the child chooses. Then, they could practice wearing the mask for short intervals. “We always want to make sure that we're being very very clear with our expectations and explaining everything ahead of time,” says Kelly.

“Then the idea really is to just try and very strategically build tolerance,” says Kelly. “It might be very very small increments of time the person will tolerate having the mask on.” She suggests giving positive reinforcement along the way. Sesame Street made a video for children with autism to help them practice wearing a mask.

After tolerance has been built up, then you can begin practicing. For example, you can take a short trip to a public space with low stakes, like going to a drive through to get an ice cream. Eventually, they could work up to being able to go out in public with masks for longer periods of time.


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The key to helping a person with autism wear a mask is setting the expectation, says Kelly. She encourages families to slowly and systematically increase the time wearing a mask and not force extra time on them too soon.

For some individuals, wearing a mask may not be possible or they may not be able to engage with the health experts at Firefly Autism, says Kelly. In those cases, they make sure everyone else is wearing a mask and are hypervigilant, or make accommodations like ask the individual to put their sweater over their face.

However, preventive practice is important. Part of that is preparing for all types of scenarios. “We don't want to always be operating on consequences,” says Kelly. “We don't always want to be operating on reactive.”

That ties into the general mission and vision of Firefly Autism. “Where there's a will, there's a way,” says Jesse Ogas, the Executive Director of Firefly Autism. “We will find a way to ensure not just the safety of our families, our students and our staff, but to ensure that these individuals whether they're 18 months, or whether they're 78, that they have access to life changing therapy that will allow them to go on and not only to excel but to live a full life.”


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Published on Oct 21, 2020