Mask Compliance Training for Individuals With Intellectual and Developmental Disabilities
Gentle blocking plus free treats and praise turns mask refusal into mask tolerance for most adults with IDD in under two weeks.
01Research in Context
What this study did
Six adults with intellectual or developmental disabilities were in the hospital. None would keep a mask on.
The team used a changing-criterion design. Each day the person had to wear the mask a little longer.
If the person tried to pull the mask off, the therapist gently blocked the reach. They also gave favorite snacks and toys for keeping it on. Free treats were available any time.
What they found
Five of the six people quickly met the longer-time goals. Four reached the final goal of one hour.
Mask wearing went from zero seconds to thirty-plus minutes in about two weeks.
How this fits with other research
Carr et al. (2002) and Saini et al. (2016) already showed that blocking plus free treats beats either one alone for body-focused habits. MShawler et al. (2021) moved the same package to a brand-new skill: keeping a mask on.
Capio et al. (2013) used the same steps for hand mouthing in a group home. The 2021 study copies the logic in a hospital ward during COVID.
St. Joseph et al. (2022) reviewed twenty-four studies on health routines like tooth brushing and blood draws. Their top package was video modeling plus treats. MA et al. skipped the video but kept the treats and added blocking, showing the core idea still works when time is short.
Why it matters
You can teach mask tolerance in two weeks with items you already have: gentle blocking, small edibles, and a few toys. Start with five seconds and add a minute each day. No fancy software needed. This keeps clients, staff, and families safer during flu season or the next outbreak.
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02At a glance
03Original abstract
Since the arrival of the novel coronavirus, recommendations for public masking have emerged to decrease infection rates. For a variety of reasons, tolerating wearing a mask is challenging for many individuals with intellectual and developmental disabilities (IDDs). Therefore, we evaluated behavioral strategies to promote compliance with wearing a mask with six hospitalized individuals diagnosed with IDDs. One participant was compliant with wearing the mask for extended durations during baseline while engaging in various activities (e.g., academics, leisure). For the other five individuals, engagement in activities alone was ineffective. Blocking mask removal, reinforcement for mask wearing, and noncontingent access to preferred activities or competing stimuli were then evaluated using a changing-criterion design in which the duration participants were required to tolerate the mask gradually increased. Increases in compliance with mask wearing were achieved with all participants; however, the terminal duration was attained for only four of the five individuals.<h4>Supplementary information</h4>The online version contains supplementary material available at 10.1007/s40617-021-00583-7.
, 2021 · doi:10.1007/s40617-021-00583-7