Incorporating Masks in the Educational Lives of our Exceptional Students

by Raymond T. Heipp. Ph.D.

The 2019-20 school year ended in the most unique manner possible. As we look toward the 2020-21 school year, we see more things we have never encountered becoming a norm in the daily lives of our students. Masks are going to be one of those “new norms” for most of our student population.  Although we would like to believe that adherence to this would be as simple as saying, “wear your mask,” we know that there are many other realities we are going to face when working with our exceptional students.

We begin this discussion on masks with a couple of specific ground rules. First, we are going to be sticking with researched facts from groups like the American Academy of Pediatrics, the Center for Disease Control, along with research from teams at recognized institutions like Johns Hopkins University and the Cleveland Clinic. One of the reasons for this is that groups are taking decontextualized facts and creating stories around them, confusing the general public. One such current example is the notion floating around on social media that masks create higher levels of Carbon Dioxide intake leading to other significant health issues or CO2 intoxication. Those statements are not true. In fact, the World Health Organization has already presented their statement on this, “the prolonged use of medical masks can be uncomfortable, however, it does not lead to CO2 intoxication nor oxygen deficiency.”  Although some of those videos come from “experts,” please realize that doctors, nurses, and researchers wear masks, including surgical masks like the ones I will describe below, every day for prolonged periods. 

Our next foundational point is that the overall health of both the students and staff are of the utmost importance. The overall health that is often overlooked by the outside world for our exceptional students is the mental health aspect. This is another reason why groups like the American Academy of Pediatrics have put forth guidelines for the potential reopening of school buildings. I personally have read some very well-crafted pieces by individuals whose concern is the physical health of the students.  However, they either ignore or brush over the importance of the mental health side too. For some of our exceptional individuals, returning to the disinfected and safety-conscious classroom will decrease their anxiety levels and potentially reduce higher rates of escalations which have been reported by some home environments. It is a delicate balance, but one that must be reviewed as part of the whole plan.

With those aspects in mind, we look how many states that have already put forth guidelines for returning have included the use of masks. Some of these states, like Ohio, have also added a provision where it is acceptable to use a medical face shield. So how do we do this and how do we enforce it with our students? The first thing we must determine is what will work best for each of our exceptional students. Remember, they are on Individualized Education Plans for a reason and their learning needs to be tailored to them directly. The use of either a mask or shield is going to be determined by a couple of things. First, what are their sensory needs? It is great news when an individual is able to simply put on a mask and use it. For some individuals, they might need to have a mask extender, or strap, that fits on the mask loops so that the loops don’t rest on their ears.

If we are able to have them wear masks, then we need to look at what kind of mask is the best for them. We hear a lot about N95 respirator masks, as those are the ones which most professionals use. These are more expensive and are not necessarily the best option for our students in the classroom. Classroom use and interactions with others within that monitored environment suggest the use of more of the basic and well-know surgical masks. Pricing on these is more reasonable now that most of the sales surge for them is slightly on the down. These masks provide the same level of filtered breathing that works well for classroom environments. We do need to remember that these masks need to be replaced on a regular basis. Both styles of masks add a strong level of protection against viruses entering and exiting through the nose and mouth. Cloth masks also offer protection, but at a lesser level. The critical thing to remember about using a cloth mask is that they need to be washed on a daily basis. Who is doing that washing, school or home? How do we know that it is getting done? If we have the answers to these questions, and the student is good with wearing this type of mask, it can be a positive long-term solution.

For some individuals, the inability to see the mouths and lips of another move creates comprehension problems.  So we want to identify those situations where it is beneficial to use clear masks.  These masks are excellent to use when working with the deaf or hard of hearing populations.  They also work well for some individuals on the autism spectrum, with Down Syndrome, or with other intellectual issues where seeing the mouth move aids in understanding.  Speech Therapists also want to be aware that these masks offer the ability for their students to see their mouths move.

Face shields can also be beneficial here. Is a face shield going to be something that an individual can wear? There are two types of face shields available. The first type can be reused, and the second, and less expensive, is meant to be worn only once. The reusable ones offer the individual the opportunity to see everything around them and not have any restrictions felt on the lower face. The research, tracing back to a 2014 study by Lindley et al., points to the fact that a face shield will protect the mouth, nose, and eyes from any droplets that have been sneezed or coughed on with a 96% level of effectiveness from 18 inches away. This study does indicate that the face shield can be effective when exposed to droplets from the front at longer distances too. Dr. Amesh Adalja from Johns Hopkins University and Dr. Frank Esper from the Cleveland Clinic see many advantages to face shield usage in the future. 

The CDC cautions that studies up to this point on face shields have been limited and is why they have not given them a full endorsement. Plus, another point to consider with our exceptional students is that these may need to be cleaned on a regular basis throughout the day. The shields would have to be removed from the head, wiped down, and then replaced. This activity could be disruptive to the individual and may need to be trialed out to see which equipment might best suit the individual’s needs.  For some cases, the face shield may be the perfect alternative.

How do we encourage our students to wear masks? The best example I have seen is to use some mascot as the classroom example. I have asked my good friend Lambykins to pose for you as an example. Have the students begin practicing with a mask here in the summer! Start by having them place the mask on something else, like a stuffed animal and have the individuals around them wearing masks as well to be a model for them.  The more we can acclimate them now, the easier it will be in the fall. 

We want our exceptional students to succeed! Giving them the skill of wearing a mask or a shield will be helpful for their lives. It also might prepare them if they ever have to go into a hospital or need to wear a mask for some other health reason. By beginning to work with them and their caregivers now, along with recognizing that we may need to try some different alternatives until we get the “right” one, we will protect their overall health and get them back into a safe and secure learning environment!

Lambykins modeling the proper way to use a mask!


Posted in SH Special Education Today Newsletter