The federal Centers for Disease Control and Prevention advises us that everyone over the age of 2 should wear a face covering when out in public or with people who they don’t live with, in addition to maintaining social distancing and good hand washing. For children who have been mostly at home during the pandemic, going back to school will mean wearing a mask throughout the day, probably for a longer time than they have so far. Not only are masks safe to wear, they actually create safety for the wearer and the people around them.

For many children, wearing a face covering is reassuring and gives a sense of control. But some children (and adults) have unfounded fears about mask wearing and for them, wearing a mask may trigger anxiety. Sometimes the anxiety even causes difficulty breathing, making the child think the mask itself is causing the difficulty breathing or other symptoms. So, let’s be clear. Wearing a mask is safe, doesn’t interfere with breathing, and is a sign of respect for one’s own health and the health of the people around them. In fact, masks are particularly important for children with respiratory problems including asthma.

There are a few mental health and developmental conditions that pose serious challenges to mask wearing, including for some children with autism spectrum disorders, sensory processing difficulties, or psychotic illnesses.

For the rest, anxiety is something that can be overcome with parental support or mental health interventions.

If your child experiences anxiety over wearing a face covering, try the following tips to help them feel more comfortable.

• First, wear a mask yourself.
• Explain to your child how wearing a mask will help prevent spreading COVID-19 to other people … and keep you safe, too.
• If possible, let your child pick out a mask they like or decorate a mask so it feels personal to them.
• Encourage your child to feel good about wearing their face covering. Motivate them with praise, talk about how it feels to help others, or allow them to earn special privileges for wearing their mask.
• If needed, teach your child relaxation skills, such as deep breathing and muscle relaxation.

For children with lots of anxiety, help them practice being brave:

• Make a point to practice relaxation skills when they are not experiencing anxiety so that they are well prepared to use the skills when the anxiety is present.
• Have them wear their mask at home, first for short periods, and then for more extended periods, practicing relaxation skills as needed to keep the mask on.
• Praise your child when they’re wearing their mask.

If your child’s anxiety gets in the way of wearing the mask, talk to your child’s pediatrician or seek mental health support.  Learn more in this video from Dr. Mary Margaret Gleason.

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About Mary Margaret Gleason, MD

Dr. Mary Margaret Gleason is a pediatrician and child psychiatrist at CHKD. She is interested in mental health promotion and creating collaborative systems of care that support early intervention and timely access to quality mental health care. A recent transplant from New Orleans, she is thrilled to join the mental health team at CHKD as the vice chief of its growing mental health program. She is also the division director of child and adolescent psychiatry at Eastern Virginia Medical School. Dr. Gleason looks forward to sharing her background in leading residency training programs, early childhood mental health, and developing clinical and research programs to enhance CHKD’s new mental health initiatives.