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Assessment of Feasibility of Face Covering in School-Aged Children With Autism Spectrum Disorders and Attention-Deficit/Hyperactivity Disorder

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The effect of pediatric transmission of SARS-CoV-2 on the spread of COVID-19 remains a concern in creating policies for school reopening.1,2 Although children have a lower prevalence of developing overt COVID-19 symptoms than adults, asymptomatic transmission may contribute to the spread of COVID-19.3 Cloth face coverings are considered a key strategy in reducing the spread of SARS-CoV-2. However, policy makers and parents are concerned about students’ ability to mask effectively.4 We report the outcome of using positive behavior supports to promote masking in verbal school-aged children with autism spectrum disorders (ASD) and/or attention-deficit/hyperactivity disorder (ADHD) attending a summer day treatment program.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: March 25, 2021.

Published: May 17, 2021. doi:10.1001/jamanetworkopen.2021.10281

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Aaronson B et al. JAMA Network Open.

Corresponding Author: Benjamin Aaronson, PhD, Department of Pediatrics, University of Washington, PO Box 357920, Seattle, WA 98195 (ba1@uw.edu).

Author Contributions: Drs Aaronson and Glick had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Aaronson, Glick, Kirk, McCloud, Sasser, Englund.

Acquisition, analysis, or interpretation of data: Aaronson, Glick, McCloud, Zerr.

Drafting of the manuscript: Aaronson, Glick, Kirk, Sasser, Englund.

Critical revision of the manuscript for important intellectual content: Aaronson, Glick, Kirk, McCloud, Zerr, Englund.

Statistical analysis: Aaronson, Glick.

Administrative, technical, or material support: Aaronson, Kirk, McCloud, Sasser, Zerr, Englund.

Supervision: Aaronson, Englund.

Conflict of Interest Disclosures: Dr Kirk reported receiving grants from Solera Pharmaceuticals outside the submitted work. Dr Englund reported serving as a consultant to Sanofi Pasteur, Meissa Vaccines, and AstraZeneca and receiving grants from AstraZeneca, Pfizer, and GlaxoSmithKline outside the submitted work. No other disclosures were reported.

Additional Contributions: We would like to thank our participating families who modeled and promoted face covering. Our extensive team of research assistants and staff modeled, taught, and encouraged face covering across activities, while simultaneously collecting data and implementing our summer treatment program. The summer treatment program was operated by the University of Washington Autism Center.

References
1.
Christakis  DA .  School reopening—the pandemic issue that is not getting its due.   JAMA Pediatr. 2020;174(10):928. doi:10.1001/jamapediatrics.2020.2068PubMedGoogle ScholarCrossref
2.
Lee  B , Raszka  WV  Jr .  COVID-19 transmission and children: the child is not to blame.   Pediatrics. 2020;146(2):e2020004879. doi:10.1542/peds.2020-004879PubMedGoogle Scholar
3.
Posfay-Barbe  KM , Wagner  N , Gauthey  M ,  et al.  COVID-19 in children and the dynamics of infection in families.   Pediatrics. 2020;146(2):e20201576. doi:10.1542/peds.2020-1576PubMedGoogle Scholar
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Esposito  S , Principi  N .  To mask or not to mask children to overcome COVID-19.   Eur J Pediatr. 2020;179(8):1267-1270. doi:10.1007/s00431-020-03674-9PubMedGoogle ScholarCrossref
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Morris  CA , Deochand  N , Peterson  SM .  Using Microsoft Excel to build a customized partial-interval data collection system.   Behav Anal Pract. 2018;11(4):504-516. doi:10.1007/s40617-018-0259-3PubMedGoogle ScholarCrossref
6.
Falk  A , Benda  A , Falk  P , Steffen  S , Wallace  Z , Høeg  TB .  COVID-19 cases and transmission in 17 K-12 schools—Wood County, Wisconsin, August 31-November 29, 2020.   MMWR Morb Mortal Wkly Rep. 2021;70(4):136-140. doi:10.15585/mmwr.mm7004e3PubMedGoogle ScholarCrossref
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