Abstract:
An online survey was conducted to compare the rate of masks wearing behaviour between neurotypical and neurodiverse populations. A greater number of neurodiverse participants reported always wearing a mask.
Introduction:
The impetus for this study came from a post by Lucy (2023) who asked why "neuro atypical" people are so over represented in the Covid conscious community. I responded that it could be likely for the same reason that a higher percentage of Autistic people are 2SLGBTQIA+: "Autistic individuals may conform less to societal norms compared to non-autistic individuals" (Warrier et al, 2020). Lucy suggested a similar study be conducted on mask use. I set up a study to compare the neurotypical (NT) and neurodiverse (ND) self-reported mask-wearing behaviours.
A second study conducted by Weir and colleagues (2021) furthered this assessment that autistic people are more themselves, more publicly authentic and more honest about who they are than NT people. This leads to a potential corollary conclusion: that NT people are more likely to hide parts of themselves from others and possibly also from themselves as they expend more time and energy fostering social relationships through overt displays of similarity. However is not clear if this correlation between Autism Spectrum Disorder (ASD) and authenticity is similar in the ADHD population or in any other ND population.
I could not find a specific study comparing the ND and NT people respecting their use of facemasks, but a study by Clegg and colleagues (2023) investigated the experiences of wearing facemasks for people with ASD by analyzing social media posts of 124 autistic people and distributing questionnaires about masking to 49 of them. Some reported negative sensory issues with masks, but others appreciated no longer feeling the need to monitor facial expressions in order to camouflage their ND responses to others.
In comparing ND and NT responses, I would expect to find that ND people wear masks more often.
Method:
A choice of two single-question polls with four identical options was presented to my Twitter/X followers in a two-thread "tweet", remaining active for three days, from December 13-16, 2023 (Snyder, 2023):
Mini-study on how NT/ND affects mask wearing: Do you still wear a mask at all? Respond to this poll if you're NEUROTYPICAL (NT) - answer in the following tweet if you're neurodiverse (ND - Autistic, ADHD...). Please share!
1. NT - always mask in public
2. NT - mainly mask indoors
3. NT - mask if crowd/sick...
4. NT - don't mask anymoreDo you still wear a mask at all? Respond to this poll if you're NEURODIVERSE (ND - Autistic, ADHD...) - answer in the previous tweet if you're neurotypical (NT).
1. ND - always mask in public
2. ND - mainly mask indoors
3. ND - mask if crowd/sick...
4. ND - don't mask anymore
The thread was reshared 75 times.
Results:
Of 1353 participants, 739 identified as NT and 614 identified as ND. The results confirmed the hypothesis that ND people wear masks more often.
There was a 17.0% increase in ND participants who always wear a mask compared to NT responses. If I combine always and mainly, then there is still a 7.4% increase in ND participants who always or mainly wear a mask compared to NT responses. Combined, 92.1% of ND participants and 85.7% of NT participants wear masks always or mainly.
The most important question to me is, Where the fuck are you people???? Can we start an intentional community somewhere?? Literally nobody I see in stores, gatherings, or on the street wears a mask anymore.
Discussion:
Limitations of this study are obvious and many, but I'll point a few out anyway because that's what we do here. Data is from a significantly skewed sample of participants taken from one social media poll from my personal account, which is part of the Covid-conscious community and largely screaming into the void about the necessity for N95 inside public places for the past few years to just over 5,000 followers. Hence, the sample very likely showed a far greater percentage of people masking than would be found in a random sample of just about anywhere in the world. I'm also part of the ND community, openly ASD, so also have a significant following from that population. Although that should have no effect on the rate of masking, it may generate a mistaken sense of the percentage of neurodiverse people on this social media platform (almost half of the participants significantly higher than in the general population). Despite requesting that people share the polls on their own sites, copy-pasting multiple tweets is onerous, so simple re-posting was the only method of sharing conducted, which happened less that desired, and, when it did happen, was from another member of the Covid-conscious community. However, despite these limitations, the relative rate of masking between the neurotypical and neurodiverse groups might mirror the general population regardless. A further flaw in the research is evident in the comments on the poll. Many people were trying to decide if they better fit the NT or ND designation in the moment rather than from a previous and substantial awareness or from a prior diagnosis. Determining the line between the two types can be complex. Finally, the poll options on X only allow for four choices, and each choice is limited to 25 characters, so the scale could have been improved with more options and a greater clarity of options using a different format, including clarity around what "mask" means (N95 vs surgical vs cloth).
This brief poll did not generate participant comments about why people choose to wear a mask or not, so the 92% of NDs who willingly wear masks always or mainly could be because of the authenticity and/or it could, as reported by Clegg and colleagues (2023), be a matter of appreciating the reduced need for social masking (altering behaviour to appear more neurotypical) when wearing a facemask. Anecdotally, I discovered that I can interact on online platforms for much longer before anyone notices there might be something wrong with me, which has made remote working and learning all the more desirable, but I haven't noticed any benefits from wearing a mask in public. Furthermore, trying to get others to mask when remote meetings are not possible has led to the most profound ostracization I have ever experienced. Being autistic has always set me apart from others, and now wearing an N95 adds to that isolation in in-person interactions. If the internet ever goes down, I am so fucked.
Overt authenticity and less concern around public opinion in the ND population can sometimes be embarrassing for NT friends or family who are seeking social connections through similarity. As many in the Covid-conscious community have found, once mandates were lifted, wearing an N95 in public can result in ostracization or humiliation from random people on the street, possibly in a quest for the comfort of social cohesion and conformity. Many ND people have already experienced degrees of the same behaviours from peers throughout their lives, which could have opposing effects: either traumatize them into conformity or inoculate them against acknowledging further harassment. At this point in our survival, the divergent, minority behaviour of wearing masks inside public places is necessary for long term survival but could risk the loss of in-person social cohesion as long as leadership is too cowardly to take a stand in favour of protecting the public. Given the greater proportion of mask wearing behaviour in the ND population, it might be the case that the ND shall inherit the Earth.
References:
Clegg, A., Wood, J., Hobson, H. & Sedgewisk, F. (2023, July 17). Facemask wearing and interacting with masked individuals. Autism in Adulthood. https://doi.org/10.1089/aut.2022.0091
Lucy [@lucyveepee]. (2023, December 13). Really, though, why are neuro atypical Ss (#autism, #ADHD, (C)PTSD) so over represented in the #CovidConscious Community? #Covid #LongCovid [X Post]. X. https://twitter.com/lucyveepee/status/1734929549580759210
Snyder, M. [@MarieSnyder27]. (2023, December 13). Mini-study on how NT/ND affects mask wearing: Do you still wear a mask at all? Respond to this poll [X Post]. https://twitter.com/MarieSnyder27/status/1734981134906232836
Warrier, V., Greenberg, D. M., Weir, E., Buckingham, C., Smith, P., Lai, M., Allison, C., & Baron-Cohen, S. (2020, August 7). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nat Commun 11, 3959. https://doi.org/10.1038/s41467-020-17794-1
Weir, E., Allison, C., & Baron-Cohen, S. (2021, September 18). The sexual health, orientation, and activity of autistic adolescents and adults. Autism Research 14:11, 2342-2354. https://doi.org/10.1102/aur.2604
2 comments:
"Combined, 92.1% of ND participants and 85.7% of NT participants wear masks always or mainly." I had the same reaction as you - WTF? Where are these people? I was at a large indoor gathering this morning along with hundreds of other people. Other than me, there were only a handful of people wearing masks. Ironically, many people were talking about how they or their kids were sick without putting two and two together.
It would have been interesting to look at autism vs. NT, rather than grouping autism with other forms of ND. ADHD, another form of ND, is associated with increased risk taking, so these people may be less likely to wear masks. Putting them together muddies the waters. This is the trouble with umbrella terms like ND, BIPOC or 2SLGBTQIA+, which lump disparate groups together whose only common feature is that they have some characteristic outside the statistical norms for the general population. It's hard to draw conclusions from such rough measures.
Yes it would be interesting to tease apart what NT looked like, but that would be outside the scope of the limitations of twitter polls. I could do a full-on survey, though. It would be better if I could be a more randomized audience to take it. Absolutely it's hard to draw any real conclusions with this - except what I already knew, which is that I'm preaching to the choir whenever I tweet about wearing N95s!
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