How to get 5-year-old to consistently cover mouth when couging?

Question

My 5-year-old son started developing a dry cough yesterday (yay...). He has trouble remembering to cover his mouth when he coughs, despite our reminding him every time he does it, and despite in the past during extended illnesses him finally catching on after our repeating reminders.

Given the possibility of COVID-19 being the cough source, we want to extra make sure the cause of his cough is spread as little through the house as possible. Is there a way to quickly and effectively get him in the habit of covering his mouth the moment he feels a cough or sneeze coming on?

Answer 1

Getting someone into the habit of doing anything requires repetition, as that is what a habit is largely: a settled or regular tendency or practice.

The best way to establish a habit in a child from my experience is to gently remind them to do the habitual action immediately after the "cue" for the action. In this case, it would be to:

1. Hear your child cough
2. If they didn't cover: Remind them to cover their mouth
3. Praise them for covering their mouth

The praise is appropriate either if they did cover their mouth, or if they didn't but they covered their mouth when you told them to (yes, this is pointless, but it establishes the habit).

There are some more rigorous explanations of this method, such as here; that site goes into some detail about the relationship between "cue", "routine", and "reward".

It's not something that will happen instantly, but it does work over time. The key is not to be upset when they fail - don't be negative about it at all. Just be positive. Polite reminder to do the action (don't forget to cover your mouth!), praise for doing it (good job covering your mouth), and then repeat!

Answer 2

Don't talk - just act:

Every time the child is coughing without hiding his face in the elbow - not covering the face with the hand, because the virus can be spread by hand shake and then having contact with hands in the face (nose, mouth openings) - you can order quarantine in the children room.

If you don't act like this your child and yourself and the whole nation will be in a shut down and national quarantine sooner as you think. And then you will have time for discussions and explanations. (And then the children and all others too will be habit.)

If we were in a war the authorities would activate the sirens now. This is not the time of apocalyptics but it is the only chance to stop the spreading of this virus and to keep the hospital beds free for people who need it.

The other alternative would be that everyone has to cough with open mouth that all are infected as soon as possible with probably thousands of deaths. When everyone is infected the virus can't spread any more.

Edit 1:

We all know that it - covering the face, but not with the hand - should work like an unconditioned reflex. But at it is not unconditioned it has to be conditioned. There are 2 ways:

• reinforcement of the goal behavior (that’s what Joe describes)
• or negative consequences = “punishment” of the wrong behavior (the alternative we don’t prefer)

Edit 2:

My answer 3 days ago was a time out in his room every time the child forgets to cover his face. 3 days we are at the point that all children, coughing are not, can‘t see their grand parents for weeks. And people elder than 65 years are asked to stay inside. A week ago we still were shopping and met young mothers with 4 children in the super market running around. Meanwhile this is forbidden and teenagers are punished if they are in groups outside. Germany, France, Switzerland, Austria ...

Children are not victims of this virus but they can be infected and spread and there is no time to loose! No time to wait for developing habits. Also in the USA they will be isolated or walk around with a mask.

Edit 3:

After the discussion about “praise” vs. “punishment” (s.comments below) I’ve edited “punishment” = negative consequences. OP clearly says that he has remembered the child (5 years!). He should have learnt it with 3 years.

Btw. I’d like to emphasize that I wrote “wrong” behavior and not “bad”. Unfortunately “punishment” and “praise” is always associated with good and bad. Consequences should be logical (positive or negative).

It is clear that children - and adults! with naive stereotypes consider negative consequences = punishment. (Look at the religions: negative consequences lacking of hygiene are interpreted as punishment of the gods. Same problem we have with our bad! dealing and habits with our environment and animals.)