Child Face Coverings in Schools
Guidance for Evaluating a Child’s Medical Tolerance for use of Face Coverings in Schools
Recommendations from the Centers for Disease Control and Prevention (CDC); the American College of Allergy, Asthma, and Immunology; the American Lung Association; and the American Academy of Pediatrics, and pediatric providers may determine a child is medically unable to tolerate a face covering for the following reasons:
- The child has a medical contraindication (e.g., difficulty breathing at rest).
- The child is developmentally (physically or intellectually) disabled, such that they are unable to remove a mask if needed.
- Children with asthma and other chronic respiratory conditions (e.g., cystic fibrosis) should wear a face covering as they are more susceptible to infections. Such conditions, by themselves, are not an indication that a child is unable to medically tolerate a face covering.
- Behavioral techniques (e.g., cognitive behavioral therapy) may be utilized for children who experience anxiety when wearing a face covering. Parents should consider remote learning options until anxiety resolves and the children learn to wear a face covering.
- Remote learning is recommended for children at high risk for infection due to a weakened or compromised immune system or condition or for children who live with an individual who is at high risk for infection due to a weakened or compromised immune system. Physicians should review the Centers for Disease Control and Prevention’s list of those who are at higher risk of severe illness if they are exposed to coronavirus.
Recommendations for Evaluating Symptomatic Individuals
Many of the symptoms of COVID-19 infection are also common in other childhood illnesses. Therefore, every symptomatic person should be evaluated on a case-by-case basis by their health care provider and decisions about testing for SARS-CoV-2 should be based on patients’ personal health histories. Health care providers are strongly encouraged to test for SARS CoV-2 when patients have had a known exposure or present with any COVID-19 symptom due to the undescriptive clinical presentation of COVID-19, and potential for co-infection. Many COVID-19 cases have been observed in persons who originally discounted their symptoms due to other existing conditions, e.g., allergies. Prompt and early diagnosis of COVID-19 infection can prevent further transmission. Children returning to school after being diagnosed with a non-COVID-19 illness must meet the criteria for returning to school for the illness with which they have been diagnosed. At a minimum, the child must be fever-free for at least 24 hours without the use of fever-reducing medications. Additionally, children who are close contacts to confirmed cases, regardless of symptoms, should be tested.
Last Updated: 5/3/2022