UTAH (ABC4) – At the beginning of the pandemic, social media was flooded with content showing belligerent opponents of mask requirements. Videos of face-covering refusals quickly made rounds, and many of these individuals cited medical conditions as reasons for why they could not mask. Because of this, the idea of medical mask exemptions became intertwined with the anti-mask movement and has struggled to be taken seriously in society by many.

But medical conditions can affect mask-wearing, largely for members of the disabled community.

According to Matthew Wappett, executive director of the Institute for Disability Research, Policy & Practice at Utah State University, neurodiverse individuals – which is a term that primarily applies to those on the autism spectrum – process sensory information differently than the majority of the population. This often means that specific fabrics may feel painful on the skin, and because the face is such a sensitive area, masks present a particular difficulty for these people.

“I have a nephew who struggles with sensory issues and he can’t wear denim because denim hurts his body,” Wappett explains. “It’s the same thing with masks. A lot of times, the way someone experiences a mask can be extremely uncomfortable.”

Wappett also notes that fabric isn’t the only issue with masking for neurodiverse people. The elastic ear straps, the feeling of breath on the face, or the associated feelings of claustrophobia can also present difficulties for this population.

According to the CDC, individuals with disabilities affecting mask-wearing are exempted from the CDC’s mask requirement. This policy applies to people who would be unable to remove a mask if breathing is obstructed – such as those with impaired motor skills, quadriplegia, or limb restrictions – and those with intellectual, developmental, cognitive, or psychiatric disabilities that wouldn’t understand the need to remove a mask in an emergency situation.

For people with autism or sensory processing issues, the rules aren’t quite as cut and dry.

The CDC website lists “people with a severe sensory disability or a severe mental health disability who would pose an imminent threat of harm to themselves or others if required to wear a mask” as sometimes exempt, determined on a case-by-case basis. The website also adds that: “persons who experience discomfort or anxiety while wearing a mask without an imminent threat of harm would not qualify for this exemption.” People with breathing issues and mobility or communication disabilities are also listed as cases that sometimes qualify for a mask exemption.

Chief Justice John Roberts recently ruled against a request to block a federal air travel mask mandate submitted by a man on behalf of himself and his autistic son. Another man, Lucas Wall, claims he cannot wear a mask because of severe anxiety and is thus stranded at his mother’s residence in Florida. In March, Spirit Airlines made headlines when they kicked a four-year-old, nonverbal, autistic boy and his father off a flight because, according to his mother, the boy would hold his breath or harm himself if he had to wear a mask.

Despite the unclear medical mask mandate guidelines for neurodiverse people – or perhaps because of them – the team at USU’s IDRPP has worked to develop masks that are viable for neurodiverse and autistic people. Other companies and organizations have made similar efforts, and the masks they’ve designed can be made less tight, with softer fabric, or with a transparent window so the mouth is still visible.

According to Wappett, the mask that USU created was primarily intended to help facilitate communication. When masks were scarce at the start of the pandemic, the team used recycled transparencies to create a face shield, very similar to the coverings used in medical settings.

Wappett notes that their mask was designed for a variety of members of the disabled population, not just those who are neurodiverse. Wearing a mask can be a challenge for people with hearing impairments, communication struggles, and breathing difficulties, too.

“There’s a lot of conditions where wearing a mask is difficult and in some cases, life-threatening,” he says.

Still, Wappett encourages those who can wear a mask to do so, in order to protect those who are medically unable.

“I think far too many people have said: ‘I can’t wear a mask, I have a medical exemption, primarily because they don’t want to. It’s important to recognize that there are actual, legitimate conditions out there that prevent somebody from being able to wear a face covering during the pandemic.”