Evaluating a Graduated Exposure Treatment to Teach Mask Tolerance Among Children with Autism

Abstract

Due to the COVID-19 outbreak, the Center for Disease Control (CDC) recommends that everyone 2 years and older wear a mask while out in a community setting (CDC, 2020a). It is important for children to learn how to tolerate wearing a mask for long durations of time while out in the community. In the current study, which was comprised of 2 experiments, we implemented a graduated exposure procedure to teach mask wearing to 6 children diagnosed with Autism Spectrum Disorder (ASD). The purpose of experiment 1 was to evaluate the efficacy of a graduated exposure procedure to teach mask tolerance across various settings, with generalization probes in the community. The purpose of experiment 2 was to evaluate whether generalization of the procedure occurred specifically in a physician’s office setting during well check procedures. During baseline, participants tolerated masks for anywhere from 0 s to 10 min. After treatment, all participants tolerated the mask for a duration of at least one hour, with maintenance probes indicating 4-5 hour mask tolerance. Further, all participants in experiment 2 were able to tolerate a mask in the physician’s office during well check procedures. Additionally, telehealth parent training sessions were conducted to instruct caregivers how to implement graduated exposure procedures to teach mask tolerance. Data from a social validity survey indicated all parents found the training beneficial.