Science Behind Repeating Yourself While Wearing a Mask
How many times do you have to ask someone to repeat themselves with a mask on? And how many times have you seen someone pull their mask down to speak in public, instilling fear in the person next to them? It’s a unique time for everyone. Anyone that’s had to order food at a counter, with plexi-glass between staff and customers, and sizzling food/music coming from (Cava’s) speakers understands… our auditory system and attention really gets tested in public now.
When we have our masks on; the audibility and clarity of speech is impacted, and being 6 feet away from others doesn’t help. But there’s obviously a reason behind why we wear them;
“Let's consider a little primer on virology and the policies necessary to mitigate the spread of COVID-19. The unique characteristic of this virus is the route of transmission via small droplets ejected from the mouth. The droplets are expelled when a person with COVID-19 coughs, sneezes, or speaks. Interestingly, speaking actually produces more droplets than does coughing (Chao et al., 2009), and louder speech creates a relatively larger quantity of droplets than does softer speech (Anfinrud, Bax, Stadnytski, & Bax, 2020). When a person speaks, he or she releases nearly 200 viral particles per minute! Thus, it would take five minutes of speaking face to face to receive the dose of particles to readily infect a conversation partner.” (Dr. Barbara Weinstein, PhD)
Now with Applied Speech Acoustics: For every doubling of the distance from the sound source in a free field situation, the sound intensity will diminish by 6 decibels.
“Smply” put: sound diminishes by approximately 6 dB for each doubling of distance.
For example: if you are 2' away from someone who is speaking and move to 4' away, the person's voice will be reduced by 6 dB.
So, health care providers' communication with patients, restaurant staff, daycare staff... will be negatively impacted because of both the social distancing and masking requirements.
The other factor is that the mask reduces airflow. Typically, when we can’t hear someone, we compensate; as I typically do… we read lips. Impossible to do with the masks. Also, low-frequency vowel sounds are easiest to hear because they are higher in intensity. Consonant sounds are higher in frequency and lower in intensity, and so they are more difficult to identify. So, the consonant sounds which are both weak in intensity and high in frequency are difficult to hear (e.g. /p/), especially without the visual cue of lip reading.
Basically; there’s a science to why we can’t hear each other with our masks on, we’re all just adapting to the times. There’s also this available; The Communicator TM Surgical Mask with a Clear Window (Model FM86000) manufactured by Safe N’Clear is a patented FDA registered device that meets ASTM F2100 Level 1 protection surgical mask standards. https://safenclear.com/product/the-communicator-surgical-mask-with-a-clear-window/
Tips for Families and those working with children:
https://www.aota.org/~/media/Corporate/Files/Practice/back-to-school/Tips-for-Families.pdf
https://www.aota.org/~/media/Corporate/Files/Practice/back-to-school/Masks-and-Facial-Coverings.pdf
For more information, schedule a free consult with our team!
Holiday Activities During COVID
Our family is sticking to the theme of keeping the holidays small and intimate, so there’s a little pressure to get creative with the little ones of the family. I figured I would round up some activities and games to give you some ideas! I wanted to keep the listed activities things that children of all ages can enjoy, it might just take a little more adult help for some than others.
A classic that never gets old: Gingerbread houses. You might choose to buy the kit, or you can use graham crackers for a quick substitute; as long as you have some candy and icing.
Pine Cone Bird Feeder: If you live in an area that has pine cones laying around the neighborhood, you can put some peanut butter around it and then roll it in bird seeds; and it’s safer than feeding them stale bread.
Decorate the front door like a present
Homemade ornaments: There are a couple of techniques; You can get one of those clear bulbs from your local craft store and fill them with sparkly craft materials, or make salt dough ones! Here's a recipe: https://www.yummytoddlerfood.com/activities/the-best-salt-dough-ornaments/
If there is snow outside; encourage your little one to make a snowman or snowangels, the heavy work and deep pressure input can help with your childs sensory regulation!
This time of year is a great time to give back to the community and teach children about helping those in need. They can help choose some gently used toys or stuffed animals to donate to a shelter.
Send holiday hards to soldiers overseas
Advent Calendar: giving them something to look forward to days before christmas (typically started at the beginning of December but it doesn't hurt to start now).
Make paper snowflakes. Depending on the childs age, and their scissor skills, parents can help with folding/cutting, or they can participate in coloring them with crayons.
Have them help with baking cookies, or stamp the shapes if you’re doing rolled sugar cookies.
Letter to santa; working on handwriting and sentence structure.
Make Play Dough! Here’s a quick recipehttps://www.diynatural.com/homemade-playdough-recipe/
Youtube read aloud christmas books
Ice Skating with the family
Make a wreath, here are some ideas: https://www.countryliving.com/diy-crafts/how-to/g1056/diy-wreath-ideas/
Elf on the Shelf
Holiday Craft Ideas: https://www.personalcreations.com/blog/christmas-crafts-for-kids
Candy Cane Hunt
Holiday Charades or Pictionary with holiday movie titles, songs or themes
Holiday Bean Toss: https://www.positivelysplendid.com/ornament-bean-bag-toss-game/
I hope you have such a Happy Holiday season with your loved ones, whether its in person or over Zoom. Hope you enjoy this at home!
Value of OT in Acute COVID-19
Finally! We have some educational courses for COVID-10 patients and how Occupational Therapy can help with getting people better. It’s a little detour to our usual pediatric topics but I think this is an important conversation with the way our world is going. I don’t know about you, but the only way I can settle my nerves about the unknown is to learn more about it, make it less strange and more understandable. I have some parts of this particular blog for my fellow Occupational Therapists in acute care, but there’s good information for everyone. The information below is based on a great course I took called “The Value of Occupational Thearpy in the Acute Care Management of Patients with COVID-19,” if anyone else is interested.
A little background
The virus is called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- Cov 2). Along with the same guidelines as HIV/AIDS; HIV is the virus that causes the AIDS disease, SARS-Cov-2 causes COVID-19.
CDC Guidelines: Contact/droplet precautions except during aerosolizing procedures. Examples for when to take airborne precautions are; Tracheostomy, Intubation, CPR, High flow O2.
Illness Severity
Mild to moderate: 81% of patients have mild symptoms up to mild pneumonia
Severe: 14% with dyspnea (difficulty breathing), hypoxia (oxygen deprivation), or >50% lung involvement on imaging
Critical: 5% includes those with respiratory failure, shock, or multiorgan system dysfunction
The clinical presentation for those going to the hospital include generalized weakness, dyspnea, delirium, upper extremity plexopathies, fatigue, anxiety. Other considerations include social isolation, occupational deprivation, stigma, and caregiver exposure/illness risk.
With increased survival rates of ICU admissions, patients are left with what is a new concept called Post-Intensive Care Syndrome. Basically in 2010, The Society of Critical Care Medicine found that with medical advancements there is an increase in survival rate of ICU patients However, those that were leaving the ICU were left with very profound neuromuscular physical deficits as well as psychological and cognitive deficits. Due to the pandemic and influx of critically ill patients, we can reflect some of the research for Post-Intensive Care Syndrome to understand how we can treat COVID-19 patients.
Numbers
As we have heard on the news, the severity of COVID-19 cases have risk factors for neuromuscular impairments including; multiorgan failure, prolonged bed rest, possibly month long intubation and ICU stay. 85-95% of ICU survivors will experience persistent weakness at hospital discharge, possibly resulting in atrophy, sensory loss, foot drop.
Regarding patients 1 year post ICU discharge; 50% experience deficits in ADL’s (ex: bathing, hygiene tasks, feeding, toileting, dressing activities), and 70% with deficits in IADL’s (ex: driving, cooking, cleaning, shopping). Other risk factors include increased need of caregiver support, less likely to go back to work. From a psychological perspective, 1 in 3 experience Depression, 60% experience PTSD. Younger age is correlated with higher rates of depression, anxiety, and post-traumatic stress syndrome, as well as with lower level of education. And importantly, that impairment in executive functioning is associated with higher rates of depression.
Risk of Cognitive deficits secondary to prolonged periods of sedation, decreased memory due to hypoxia common with acute respiratory distress syndrome (a symptom with COVID-19).
With an all hands on deck approach to stabilize the patient medically, and precautions for limited use of PPE, making patient isolation harder to keep track or assess delirium (confusion).
Occupational Therapy Assessments
How can OT help? Recent article that showed in COVID-19 survivors that lower grip strength equated to higher rates of intubation, and it also correlated with respiratory muscle strength. -MMT or Dynamometer for measurement of strength
Assessment for Physical Function
-ICU Mobility Scale is a zero to 10, Functional Status Score for the ICU, FSS-ICU (it has a really high 99% inter-rater reliability. It has five features including rolling, supine to sit transfer, sitting edge of bed, sit to stand transfer, and walking), AM-PAC for ADLs (6 ADLs with a scale of one to four grading level of independence), Katz Independence 10 of ADLs includes six ADLs (not great for scaling), Barthel (10 ADLs and mobility tasks including grading it from independent, needs help, and dependent. So here, you only get three ways to identify patient's progress, so not as sensitive but is supported by literature.)
Assessment for Delirium
-CAM assessment method for ICU and the Intensive Care Delirium Screening Checklist are both high inter-rater reliability, high specificity (gold standard), Confusion Assessment Method – Severity (CAM-S), Intensive Care Delirium Screening Checklist (ICDSC), Brief Confusion Assessment Method (bCAM).
Cognition Assessments
-Richmond Agitation Sedation Scale (RASS), The Orientation Log (O-Log), Montreal Cognitive Assessment (MoCA)
Psychological Assessments
Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale – Revised (IES-R)
Intervention!
-Prone Positioning has been shown to improve gas exchange efficiency, increase perfusion and recruitment of dorsal lung, mobilizes secretion. Link: https://www.ficm.ac.uk/sites/default/files/prone_position_in_adult_critical_care_2019.pdf
Repositional strategy to mobilize the lungs, goal is to prolong or prevent intubation, can be done while conscious or when sedated with proper guidelines and precautions.
In order to prevent Brachial Plexopathy, proper prone positioning and nursing education is encouraged. Early Mobilization; the therapy team will assess and treat within safety limitations.
Teamwork; Co-treating with other healthcare professional and Cluster care is great for patient progression. Billing may take a back seat for the benefit of the patient.
Delirium management:
Giving patients the tools they need to interact within their environment, regulating sensory input with hearing aids/dentures/glasses, modify environment; turning on lights, clock visible, collaboration with speech therapy for adaptive strategies, communication, reorientation strategies are all going to help regulate patients.
Early mobility with engagement in ADL’s, modifications with DME (tools to help with activities of daily living) as needed, energy conservation. Preservation of independence and encouragement to continue doing activities will help with recovery. Your OT will also help patients learn breathing techniques, identify this is your breaking point in terms of safety for your fatigue level and then how to manage it.
Management of Mental Health
We learned that deficits and executive functioning are independently linked with increased rates of depression (super important to address). Social engagement with facetimes, calls for those without smart devices can help patients in the ICU. Routines make cluster care easier but also helps patients with mental health. ICU Diaries are also used in OT for improving orientation, memory, psych component of mental health. Mindfulness breathing exercises have shown to reduce anxiety, and patients report improvement.
Resources on
Facebook- COVIDRehab4OT Group (general COVID), COVID4CCOT Group (critical care)
Royal College of Occupational Therapists: www.rcot.co.uk
Hospital Elder Life Program www.hospitalelderlifeprogram.org § https://help.agscocare.org/products
Johns Hopkins University: Everybody Moves Campaign
Rehabilitative Care Alliance: http://rehabcarealliance.ca/
Resources
Alvarez, E.A., Garrido, M.A., Tobar, E.A., Prieto, S.A., Vergara, S.O., Briceno, C.D., & Gonzalez, F.J. (2017). Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit: A pilot randomized clinical trial. Journal of Critical Care, 37. § American Occupational Therapy Association (2020). The role of occupational therapy: Providing care in a pandemic. Retrieved May 13, 2020 from https://www.aota.org/Advocacy-Policy/Federal-Reg-Affairs/News/2020/OT-Pandemic.aspx. § Bamford, P., Bentley, A., Dean, J., Whitemore, D., & Wilson-Baag, N. (n.d.). Guidance for Conscious Proning. Retrieved May 14, 2020, from https://www.ics.ac.uk/ICS/Pdfs/COVID-19/Guidance_for_conscious_proning.aspxCampbell, C. (2014). The role of occupational therapy in an early mobility program in the intensive care unit. Special Interest Section Quarterly: Physical Disabilities, 37(1). § Centers for Disease Control and Prevention (2020). Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). Retrieved May 13, 2020 from https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical- guidance-management-patients.html. § Clancy, O., Edington, T., Casarin, A., & Vizcaychipi, M.P. (2015). The psychological and neurocognitive consequences of critical illness. A pragmatic review of current evidence. Journal of the Intensive Care Society, 16(3), 226-233. § Costigan, F.A., Duffet, M., Harris, J.E., Baptiste, S., & Kho, M.F. (2019). Occupational therapy in the ICU: A scoping review of 221 documents. Critical Care Medicine, 47(12), 1014-1021. § Desai, S.V., Law, T.J., Needham, D.M. (2011). Long-term complications of critical care. Critical Care Medicine, 39(2). doi: 10.1097/CCM.0b013e3181fd66e5 § Esbrook, C., Jordan, K., Robinson, M., and Wilcox, J. (2020). Occupational therapy in hospitals & inpatient care: Responding to a pandemic. Retrieved from https://myaota.aota.org/shop_aota/product/OL8102 § Karnatovskaia, L.V., Johnson, M.M., Benzo, R.P., & Gajic, O. (2015). The spectrum of psychocognitive morbidity in the critically ill: A review of the literature and call for improvement. Journal of Critical Care, 30, 130-137. § Kho, M.E., Brooks, D., Namasivayam-MacDonald, A., Sandrar, R., & Vrkljan, B. (2020). Rehabilitation for patients with COVID- 19. Guidance for occupational therapists, physical therapists, speech-language pathologists and assistants. School of Rehabilitation, McMaster University. http://srs-mcmaster.ca/covid-19/ § Kofis, K., Roberson, S.W., Wilson, J.E., Pun, B.T., Ely, E.W., Jezowka, I., Jezierska, M., & Dabrowksi, W. (2020). COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic? Anesthesiology Intensive Therapy, 52(2). § Intensive Care Society (2019). Guidance: Prone Positioning in Adult Critical Care. Retrieved May 16, 2020, from https://ficm.ac.uk/sites/default/files/prone_position_in_adult_critical_care_2019.pdf 5/29/20 16 References continued § Parker, A., Sricharoenchai, T. & Needham, D.M. (2013). Early rehabilitation in the intensive care unit: Preventing physical and mental health impairments. Current Physical Medicine and Rehabilitation Reports, 1(4), 307-314. § Quick, T., & Brown, H. (2020). A Commentary on Prone Positioning Plexopathy during COVID 19 Pandemic. The Transient Journal of Trauma, Orthopaedics and the Coronavirus. Retrieved from https://www.boa.ac.uk/policy-engagement/journal-oftrauma-orthopaedics/journal-of-trauma-orthopaedics-and-coronavirus/a-commentary-on-prone-position-plexopathy.html § Schweickert, W.D., Pohlman, M.C., Pohlman, A.S., Nigos, C., Pawlik, A.J., Esbrook, C.L. … & Kress, J.P. (2009). Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomized controlled trial. Lancet, 373, 1874-1882. § Wilcox, M.E., Brummel, N.E., Archer, K., Ely, E.W., Jackson, J.C., & Hopkins, R.O. (2013). Cognitive dysfunction in ICU patients: Risk factors, predictors, and rehabilitation interventions. Critical Care Medicine, 41, S81-S98. § World Health Organization (2020). Infection prevention and control during health care when novel coronavirus infection is suspected. Retrieved from: https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when- novel-coronavirus-(ncov)-infection-is-suspected-20200125
Fun Activities for Kids This Summer (During a Pandemic)
We can almost see the light at the end of the tunnel! School’s coming to an end and parent’s are planning for the summer ahead. But how safe is it for children to enjoy the parks opening back up, and how will parents adjust their usual summer plans to make sure their family is safe? There are options for virtual camps and classes that have been a way for small businesses and community programs to stay running. However, this leads us to asking, how can I keep my child safe?
Here’s what we know:
COVID-19 can live up to 72 hours on a plastic and stainless steel surface (Source: New England Journal of Medicine)
The amount of virus living on that surface that would result in contracting the virus is limited.
What we suggest:
Social distancing as a precaution, limiting games or play activities that require close physical contact.
Face Masks for children that are above the age of 2 (refer to blog below on helping children with face mask use)
To help children clean dirt on hands, rinse hands with water, then proceed to use the hand sanitizer
Watch for any signs of COVID-19 symptoms. This can look different from person to person. While most infected people have not gotten very sick, watch out for flu-like symptoms (Source: CDC).
Make preventative actions a habit. Wash hands! Parents are the role models of the house and children typically model parent behavior, so it’s suggested for parents to wash hands, and to make it a family activity.
Stay active! Doing activities will help boost physical and mental health (Source: CDC). Go for walks, bike, or visit a park for outdoor exposure. Indoor activities may include stretching, dancing, or even some gross motor activity games.
Here are some of my favorite Activities:
Board games in prone position (laying on their stomach)
Twister for Proprioceptive input to help regulate your child
Animal Walk races (bear crawls, crab walks, and bunny hops)
Jenga to work on Fine Motor Skills and Motor Planning
Break the Ice for a Fine Motor Activity
Arts & Crafts this allows your child to get creative
Baking/Cooking activities- Depending on your child’s age, you can use this activity to help with reading and following directions
You can even make puzzles more dynamic with a treasure hunt to find the pieces.
Try a new sport now that parks are opening back up- frisbee and soccer are some of my favorites with kids
Build a fort with all those delivery boxes from quarantine
Take a look at Free virtual events for parents and kids, click here to register for our free event next week!
Yoga for kids videos online
Virtual game night via House Party to get friends and family together
Gardening is a fun way for kids to learn how their food is grown and gives great sensory input for regulation
Stay socially connected. Loneliness has a huge effect on immunity and mental health, so keeping those little ones connected with social distancing guidelines are important (Cole, S.W., Hawkley, L.C., Arevalo, J.M. et al., 2007). Use video chats to create virtual playtime, phone calls, cards, letters; any way to make your child feel connected. Check your local school districts for tips and guidelines, community facebook groups, and local libraries. Social media has also been a huge help in the effort for communities to come together, Instagram, Facebook, Twitter, to see what's happening in your area.
Be aware of signs of extreme stress or change in child behavior. This goes for all of us, but especially the little ones of the house may not have developed the introspection, or awareness of how they are feeling. Signs include, excessive worry or sadness, unhealthy eating or sleep habits, or difficulty with attention/concentration.
If you have seen an extreme change in your child’s behavior, talk to your doctor. If you have any questions, or think your child may benefit from our Occupational Therapy Services, please follow this link for a Free Consultation with Smply Therapy.
Here are some resources from the CDC to help you and your family
https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/for-parents.html
https://www.cdc.gov/coronavirus/2019-ncov/about/share-facts-h.pdf
https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/talking-with-children.html
https://genomebiology.biomedcentral.com/articles/10.1186/gb-2007-8-9-r189
To register for our free Virtual Wellness Event:
https://success-street.webinarninja.com/live-webinars/354632/register
Entering Our New "Normal" - After COVID
As shelter-at-home comes to an end and all 50 states are finding ways to open up, we’re facing a new “normal” that will take some getting used to.
New York is currently not opening back up just yet, we’re hearing of possibly opening back up in June, the wait continues. New Jersey has decided to start opening back up in small increments starting with Parks and Golf courses for passive recreation (fishing, hunting, boating, canoeing, hiking, walking, running or jogging, biking, birding, and horseback riding). Picnic areas, playgrounds, exercise stations and equipment, chartered watercraft services and rentals, swimming, pavilions, restrooms, and other buildings and facilities, such as visitor centers, interpretive centers, and interior historical sites remain closed. This past Monday, NJ also started opening non-essential businesses for curbside pick-up, moving into stage two with expanded retail, outdoor dining, indoor dining at reduced capacity, limited personal care and possibly museums and libraries. NY Counties north of the city are starting to do the same. With this new phase comes some concern with how to go about this safely, especially those with little ones, or older adults.
Some quick basic info (CDC):
The virus spreads person to person in close contact, typically within 6 feet contact secondary to Respiratory Droplets. Meaning, via cough or sneezing.
My blogs report scientific based data that has been backed up by research or trustworthy associations. What I find important is to educate the public on not only understanding the nature of the virus, but also to reduce anxiety about how to deal with this re-entering phase.
Our immune systems are built on introducing our bodies to germs and bacteria. Without doing so, we reduce our abilities to fight infection. The take-away from this is, (some) germs are good! The quarantine has reduced our immune system to come in contact and fight germs/illness, so small increments of going for walks and slowly increasing exposure is best for those without symptoms. Of course, if you are sick or have symptoms please stay home and take precaution. But fear and anxiety will be one of the biggest barriers to living healthy lives post-covid.
To help with anxiety- breathing exercises, yoga, and meditation are great outlets. Many small businesses are offering virtual classes, including Smply Therapy in the near future! Also, Peloton, and CycFitness has been offering free packages on their app for a short period of time.
As we open up, the CDC recommends:
Facial Coverings are necessary for entering stores and places where there will be close contact to other people because you don’t know someone elses pre-existing conditions that may make them at increased risk for respiratory distress if infected.
It is always recommended for you to wash hands for 20 seconds. I’ve worked in hospitals and rehab settings that require training on hand washing, so this is always a precaution for caring for your community, and those members that have chronic illnesses. Think of this as a world-wide Hand Washing In-Service for reducing transference of illness. If washing hands is not an option, hand sanitizer with at least 60% alcohol is recommended.
Avoid touching eyes, nose, and mouth. This is good practice for nail biters, and those with acne prone skin like mine.
And lastly, please don’t wear facial masks or coverings if you’re by yourself at home, driving, or anywhere alone where there are no person-to-person contact. Reduced airway may be unsafe for long periods of time.
If you happen to get sick; treat it as any other illness, contact/stay in touch with your doctor, most people that contract COVID-19 have a mild illness and can recover at home. Don’t leave your home, contact your local pharmacy (support local small businesses!) and ask them about delivery. Rest, and stay hydrated. Use over-the-counter medication as needed (consult your doctor), such as acetaminophen to reduce symptoms.
*Seek Medical Attention if:
You have trouble breathing
Persistent Pain or Pressure in chest
New Confusion
Inability to wake, stay awake
Blue color lips or face
Some of these symptoms may feel real if you’re feeling anxious about having the virus. With the shift in routine and the lack of social interaction, our mental health may be compromised. For precautionary measures, if you're feeling unsure if you’re having trouble breathing, you can purchase a Pulse Oximeter to make sure your Oxygen level is in the normal range- above 95% for those without pre-existing respiratory illness. If it dips below 93%, the CDC recommends supplemental Oxygen for those with COVID-19. Basically, if your Oxygen level % Saturation dips below 95%, contact your doctor.
If you’re worried about a loved one that you don’t live with, utilize video calling platforms like Facetime, Zoom, Skype to check up on them. But also stay calm, stay social, we need to take care of our mental health just as much as our physical health.
Any other questions can also be directed through my site! Feel free to email me at smplytherapy@gmail.com. You may also message us @smplytherapy on Instagram, or Facebook.com/smplytherapy/ !
References
https://www.washingtonpost.com/science/2020/03/31/coronavirus-human-connection-social-distancing/
https://genomebiology.biomedcentral.com/articles/10.1186/gb-2007-8-9-r189
https://pubmed.ncbi.nlm.nih.gov/20668659/
https://www.sciencedirect.com/science/article/pii/S2095254618301005
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/
https://pdfs.semanticscholar.org/0ec4/ca4cbefa851f3d078f83ea8ef61b4a623bf9.pdf
https://rightasrain.uwmedicine.org/well/health/hygiene-hypothesis
How to Help Your Little One Wear Masks During COVID-19
Wearing masks has quickly become a norm in today’s world due to COVID-19, this may feel odd for adults, and especially the little ones. Facial masks are not required for children under 2 years old, but that leaves a good amount of kiddos that may not understand how to adapt and feel comfortable with their mask. Here are a few things to consider when preparing for the necessary food shopping, or errand;
There are a few reasons your child may have difficulty wearing the mask
Anxiety - the sensation of airflow is different and may feel like they are suffocating. This is tricky because masks that protect your child will have a thicker threshold for them to breathe into.
Sensory processing - the feeling of the mask on their face and ears may cause discomfort.
Visual input - If your child wears glasses, they may fog up, and the mask reduces the visual field for looking down.
Smell - I think we’re all a little more conscious of our breath when it’s our only source of air.
Here are some tips
To address the anxiety I would recommend a social story (example provided at the end of the article)
Show pictures with family and friends with masks
Talk calmly but directly about the importance of the mask prior to outing
Play with a stuffed animal and have them putting the mask on them
You may use a visual timer at home to increase time with mask on
Don’t force the mask!
Brush teeth before leaving the house, or have a mouth freshener handy
If your child wears glasses, he may benefit from putting a piece of tissue between bridge of nose and mask to reduce fogging up
If you’re handy with sewing, you can sew buttons on a hat or headband as a secondary option to looping at the ears. Some are available online.
When picking a mask for your child- opt for a soft (possibly cotton) fabric, allow them to choose the fabric if available.
Add the mask to a costume! Make it fun with a halloween costume you might have handy and wear other parts of the costume. Maybe even add a piece of candy for a temporary spring halloween.
Some kids may be adverse to smells, but you can try adding a calming essential oil to a small piece of cloth to place inside the mask
Use of a fidget may help to keep hands busy and redirect focus on something else
For those with medical conditions like Epilepsy, seeing changes in facial expression is essential for distinctive pre-seizure facial expressions. For those children they may be medically exempt by a physician. There are also some masks sold with clear sections at the mouth if that is what their parents prefer.
For those on the Autism Spectrum or with Sensory Processing Disorders, children may have an especially difficult time with masks. This is due to increased sensitivities for the way their body processes clothes and new experiences. The important thing is to not force the mask, try some of the tips above to help transition, start with the social story, have them play with a stuffed animal to put the mask on them.
Social Story by Autism Little Learners- https://drive.google.com/file/d/1B2FEF1DTXpmgH8ZL79Vg7E_Bu7ZOkB0A/view
If you have more questions, we are always here to help. Email us at smplytherapy@gmail.com or book a session!