“Parents and kids were already suffering from alarmingly high levels of anxiety and stress. Then came the national conversation on when and where to unmask. Not surprisingly, reactions of exhausted parents range widely on the decision to lift school mask mandates — from “the sooner the better” to “no way, too soon.” Seattle’s Child talked to parents, therapists and health providers to hear their thoughts.
“Rapid changes are really hard and always have been,” says Adana Protonentis, a South Seattle mother of two. That’s not true just for neurodiverse kids like hers; it’s true for most kids, parents, teachers and caregivers. Transitions are often incredibly anxiety-provoking.
And here we are again.
On Feb. 17, Gov. Jay Inslee announced that starting March 21, masks would not be required in most places, including K-12 schools and childcare facilities. Then, on Feb. 28, Inslee and King County health officials moved up the date to March 12. School districts were allowed to choose whether or not to implement a face mask requirement. Seattle Public Schools along with many other school districts in the state chose to make masks optional as of March 14th.
Once again parents are facing difficult decisions.
Some local families worry about the possibility of masks coming off too early. They may be in support of continued masking because Covid still very much in the community. They want to follow the science. Others don’t want a repeat of 2021’s short-lived mask mandate reversal. They say unmasking schools fills them — and their kids — with anxiety.
“It’s like last summer when we ended the mask mandate before the delta wave, basically declaring victory too soon,” says Seattle mother of two Heather Ketchpaw.
Still, some, like Jen, an Issaquah mother of three who preferred her last name not be used, are eager to see face coverings go. “Covid will be here forever, and we need to learn to live with it,” she says.
Whereas Jen and other parents we spoke to who have been pressing for an end to mask mandates say masks have caused too much social, emotional and developmental harm to kids, other parents say they believe unmasking now will exacerbate an already alarming children’s mental health crisis in Washington.
And, they add, dropping masks too soon could prove physically or emotionally harmful for kids with certain medical concerns, those with disabilities, kids who have family members at home who cannot be vaccinated, or children who experienced “no-mask anxiety.” That’s the term coined by some news outlets in 2021 to describe distress and fear around removing masks, which for many families have been a symbol of safety in an uncertain world. [See Busting myths about kids and masks].
“I can’t wait to see my daughter walking to school without a mask,” says Lola Onjolio, whose 7-year-old daughter attends school in Renton Highlands. “But she’s already telling me she wants to keep wearing one because ‘What if it’s not safe?’ We’re working on her fears – at least she’s not wearing one to bed anymore – but I mean we’ve been here before and then came omicron, right?”
In her family, Protonentis says. “We’ve spent all this time telling our kids this is something we do to keep you and other people safe. To suddenly say ‘That thing that keeps you safe? We’re going to take that away now,’ that freaks them out.”
Recommendations from the CDC do not weigh the potential social-emotional impact of masking, and simply advise that vaccinated individuals should wear masks “indoors in public if you are in an area of substantial or high transmission.”
The World Health Organization encourages a similar guideline to mask in areas of high transmission, but also highlights “Potential impact of wearing a mask on learning and psychosocial development,” as an important factor in deciding to mask children.
“The mask issue has unfortunately turned into an all in or out,” says Adam,* a Woodinville father of two. Adam, who works in a medical field but preferred his real name not be used, doubts that many kids are properly wearing masks, and he argues face covering does have a negative impact.
“Unfortunately I have seen and treated more kids recently dealing with extreme anxiety, depression, anger, drugs, suicide and domestic violence than I thought possible,” Adam says. “Children not being able to see a friend smile at them, a teacher come up and give a soft smile of encouragement, or just another person’s face in general has caused more damage than I think we are willing to realize. The anxiety of kids going out and constantly thinking about, ‘Do I have my mask?’ is not a way to live. The ‘distance’ the masks have created is so unnatural.”
Many parents who want to follow science struggle to weigh seemingly conflicting data about the benefits, or harm, of masking. Separating fact from rumor is difficult and time-consuming. [See Myths about Masks.]
Devon Atchison, a Queen Anne mother of two, echoes Ketchpaw’s concerns about her kids spending six hours a day sans mask filtration.
“I feel nervous about mandates lifting. The CDC has said that we’re not ready to lift it. If science says it’s not time yet, it’s not time yet,” says Atchison.
Ketchpaw says the conversation leads to more questions: “How will kids react to some parents requiring them versus other parents sending kids without masks? Will there be questions? Teasing? Pressure to take it off? Will teachers be asked by parents to enforce individual preferences? I’m stressed out just thinking about it.”
She points to the added tension in homes like hers, when a child wants to take off her mask in school and a parent wants it to stay on. Of her and her daughter’s perspective, Ketchpaw says: “We really differ on the topic.”
Numerous repeated, vetted studies have substantiated the efficacy of properly worn masks in slowing the spread of COVID-19. Several people we talked to say they will send their kids to school masked whether or not it’s mandated.
“I’m really worried about my youngest, who’s not eligible [for vaccination] because of his age,” says Katie Skorupa, mother of two in Snoqualmie. “We will continue to mask as a family until he’s fully vaccinated, regardless of a mask mandate being lifted.”
Still, rapid transitions, pandemic uncertainty, and cycling guidelines like yes-no mask mandates can fill the whole family with agitation.
According to the CDC and the Washington Chapter of The American Academy of Pediatrics, rates of anxiety and depression among school-age children have skyrocketed since March 2020. In the same time period, mental health–related emergency department visits have increased upwards of 24% for children ages 5 to 11 and 31% for those ages 12 to 17, according to the CDC.
In addition to their concerns about whether kids should stay masked or not, many parents wonder about the impacts of long-term masking on children’s mental health and overall development.
We talked with clinical experts and learning specialists regarding several areas of parent concern.
Does Wearing a Mask Affect Speech Development?
Although research has yet to confirm it, some teachers, parents, and child development experts believe masks may temporarily impede language development among young children.
Speech pathologist Mona Best recognizes that masks bring unique challenges to speech development and therapy. Best works with children from kindergarten through grade 5 in the Tahoma School District and with issues ranging from articulation to complex communication for preverbal kids.
When mask mandates are in place, Best wears a face shield so students can see her whole face clearly. Her students have worn masks with clear panels during sessions. The clear panel workaround has been helpful, but Best says masks have limitations, since progress relies on dynamic feedback during therapy. As therapists peer through a foggy window on a masked child, that feedback can be hard to both give and receive.
But Best has found students to be resilient, even when they are required to wear a mask. Katie Skorupa’s son makes Best’s point: “My youngest, L, had a speech delay before the pandemic and was able to graduate out of required services while wearing a mask and shield.”
“Communication is so much more than just the words you’re hearing,” speech pathologist Best says. “Many of the students I (have seen) rely on their visual system to problem solve.” Body language, gestures, visual cues in the upper half of the face, tone and pace of speech all contribute to effective communication.
Gretchen Rohrbaugh’s third-grade son is a case in point. He has relied on visual cues like lip-reading and body language to communicate, which made virtual school, “impossible,” Rohrbaugh recalls. Still, Rohrbaugh, a Fall City resident, says masks make understanding her son more difficult, and “it takes so much more effort to communicate, learn, and make friends.”
Best stressed that “spaciousness, presence and an unhurried way of being” are the best tools for supporting kids with communication challenges whether they are masked or not.
Disability and Neurodiversity Issues Impact Mask Decisions
Protonentis highlights a key concern: When it comes to the question of lifting mask mandates, “We might see ableism rear its ugly head.”
“Disabled folks have been traumatized so much throughout this pandemic. We’ve had rhetoric about how COVID ‘only’ hurts people with underlying health conditions, as if those lives are less precious.
“We’ve seen resentment and hostility from folks who aren’t willing to follow COVID suppression protocols to make things safer for folks with increased risks. In the context of school, I would have questions about how [teachers] plan to keep an eye on bullying or judgment coming from kids who decide to go mask-free versus kids who decide to keep masks on. How do we support the kids in navigating the social and emotional components of that transition?”
She adds that medically fragile or disabled kids may need to transition away from masking at a different pace from other children.
“I hope we’re thinking about how to make sure that these kids feel affirmed and supported as they navigate this uncertain time,” Protonentis says.
Masking uncertainty has been particularly challenging for parents of neurodiverse children (there are as many as 48,000 autistic children in Washington), children with sensory challenges, and disabled children. Along with sensory disorientation, parents say that their kids have expressed confusion around inconsistent social norms.
“We used to refer to flexibility as the f-word,” Adana Protonentis says of her two neurodivergent children, who both have anxiety disorders. “They’re feeling really depleted in terms of their ability to be flexible.”
When Protonentis asked her children how they would feel about unmasking, her son said, “I would think I’m being tricked. That doesn’t sound real.”
“He said he’d feel uncomfortable and unsafe and would want to know he could do school from home until he felt comfortable,” she says.
Impact of Mask Wearing on Infant Social and Emotional Development
Since 2020, parents have expressed concern about how babies’ emotional development may be impacted by parents being masked at birth, as well as the ongoing masking of caregivers.
Psychotherapist Emily Anderson assures parents that they should feel confident their little ones will thrive with a masked caregiver.
“You may have to work harder to develop their sense of safety,” Anderson says. But, “babies’ brains are incredibly plastic and attachment is not as fragile as we think it is,” she says. “If something like masking could knock attachment off the rails, we wouldn’t have survived as a species. We are much more adaptable than that.”
Cultural Inclusion and COVID Disproportion in Mask Wearing
Anderson points out that many concerns about masking and children represent a Western perspective.
“There are cultures that have worn face coverings in public for millennia,” she stresses. In those cultures, babies are developmentally and emotionally on track.
At the same time, unmasking in the midst of a school year may increase anxiety in populations disproportionately impacted by COVID-19. Mom Adana Protonentis wholeheartedly agrees. A child’s sense of safety is shaped by their identity.
“Context matters,’’ Protonentis says. “Some of us have experienced more grief and loss during COVID and the stakes around masking feel different. Pacific Islander, Black, Indigenous and disabled communities have been hit especially hard by the pandemic.
“The level of risk I feel as a Black, disabled person is different from the level of risk my white in-laws might feel,” she adds. “For kids who have lost loved ones to COVID, or who have loved ones who are experiencing long-term effects of COVID, the decision to stop wearing a mask may feel fraught. And we have to understand that the kids in that position are most likely to be from marginalized communities, because systemic oppression created conditions for marginalized communities to be more exposed to and particularly vulnerable to COVID.”
Mask Wearing and Anxiety Among School-age Kids
And what about the dramatic increase in anxiety among children and adolescents during these COVID-19 years? Is masking to blame? Could removing masks be the solution for anxious kids and families?
There is no evidence that masking alone is the culprit in the current child mental health crisis in Washington and across the U.S.
More likely parent and child anxiety is born of a combination of COVID-related stressors —instability at work or home, fear of the disease, loss of loved ones, stress over finances, being isolated or distanced from friends.
Seattle mom Erin MacDougall has three children, one too young to be vaccinated, and says parents are already mentally overtaxed.
“The mental health burden on students and their families during the pandemic are immense,” she says. “Adding another anxiety-driving decision and potential peer pressure around masking or not masking while at school is irresponsible.”
“What is affecting kids the most is how parents are holding up,” says Emily Anderson. When parents are stressed, kids’ anxiety increases, and vice versa but there are effective ways to manage anxiety in both ourselves and our kids.
Anderson adds, “It’s important that we hold our kids’ anxiety in a context, and be careful not to send our kids the signal that there’s nothing to worry about.” Children are always aware of large-scale upsets. Anderson says parents need to validate kids’ emotions while also focusing on the steps being taken to stay safe and emphasizing to kids what they can control.
Mental health experts remind parents they too need to focus on what they can control. Readiness for change, for example, can reduce anxiety. When and if mandates are ended, families should openly discuss the possibility of their return. Readiness can help reduce anxiety.
Parents should remind kids that the need for masks may come and go, like the need for warm jackets in winter. Such simple comparisons can help normalize the on-again, off-again aspect of this particular disease-fighting tool. Adding occasional “mask practice” to earthquake practice at home might help as well.
No matter what, hold on to faith in the buoyancy of youth, these experts stress. In times of challenge, children may have to adopt new tools and cut new paths to developing the skills they need to thrive. But human adaptation theory assures kids raised during the pandemic will make their way.
Research will continue to emerge on long-term masking within epidemic environments, and increased anxiety among children in times of great unknown. With it will come better information on how to best mitigate negatives and nurture children’s physical and mental health.
In the meantime, if you feel caught in the middle of wanting to keep your kids safe while at the same time wishing for them the fuller freedom of an unmasked childhood, you are not alone.
“Masks feel like a hard Band-Aid for us to peel… they have provided so much safety to our family,” says Sarah Orza, West Seattle mother of two. “When I think about getting to see children’s sweet smiles directed fully again at each other, I get excited.”
Katie Anthony, boy mom and jumpsuit savant, writes about feminism, family, and other f-words at KatyKatiKate.com. Seattle’s Child staff reporters contributed to this article.