What's the psychological impact on children of wearing masks?

Analysis: we know masks are an effective anti-Covid measure, but we know much less about their psychological impact on wearers, especially children

By Clare Bohan, Darragh McCashin and Sinéad Smyth, DCU

There were certainly mixed feelings voiced when the decision was announced that children from third class up would wear masks in schools. For children, parents and teachers, this is one more thing that now has to be navigated during the school day: "do you have your school bag, lunch box, water bottle, tissues, homework, coat? Mask?" Apart from the cognitive load of adding to the never-ending list of things to remember each morning, what might be the psychological impacts of requiring primary school children to wear face masks in the classroom?

Another change to daily routines

The wearing of face masks by primary school children is another tool in the defence against Covid-19 and is one of a number of changes that children have experienced since the onset of the pandemic. This isn't as sudden or dramatic as the initial school and business closures in March 2020 for example. With teachers wearing masks since September 2020, it is something that children will have had time to adjust to.

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From RTÉ 1's Six One News, primary school pupils adjust to face mask rules

Despite what we know about their effectiveness as a public health measure, we know much less about the short or long term psychological impact of masks on wearers, especially children. Furthermore, we know very little about children’s perceptions of mask-wearing in school or in general, with children’s voices largely absent in the debate and in the research.

What do we know about masks and emotional recognition?

One of the few areas where there is some research is in emotional recognition. Recognising emotions in others is an important part of how we interact and socialise. Unsurprisingly, children are better able to identify emotions in uncovered faces compared to masked faces. Overall however, they are still quite good at identifying emotions in mask-wearing faces.

Furthermore, adults and children don’t just interpret people’s emotions solely based on facial expression. Other bodily cues, voice tone, and both the context and setting play a role in how we understand the intentions and sentiments of others. Indeed, it is possible that we will all learn to pay more attention to the other cues that are still available in order to compensate for the facial expressions hidden by masks. This is because our brains are highly plastic, and this neuroplasticity occurs more frequently in children - in essence, our brains respond and (re)adapt to complex new stimuli and events so that we can relearn ways to function.

From RTÉ Radio 1's Today With Claire Byrne, school principal Louise Tobin and parenting columnist Jen Hogon on new guidelines around children wearing masks in schools

Are there other potential impacts of prolonged mask wearing?

Currently, there is a lack of research that looks at the impact of mask wearing for children on things like mood, concentration, and self-expression. Is it possible that these aspects will be impacted? Put simply, we don’t know. Although mask wearing is now part of classroom life for many age groups in several European countries, there have not yet been any long-term analyses on psychological outcomes. Furthermore, given that so many social opportunities have been lost or changed due to public health restrictions, it would be difficult to determine the actual or potential psychological impact of mask wearing alone.

Managing masks

While substantial evidence is yet to emerge on any psychological impacts of mask wearing on primary school children, there are steps that can be taken in order to make sure that children are comfortable and properly equipped to learn in a masked environment.

· We can’t assume that everybody knows how to put on and remove a mask correctly and teachers and parents may need to provide support to students particularly during the initial weeks. This might involve showing a child (or modelling) the correct way to put on, adjust, remove, store and even wash a mask. Opportunities to practice, and regular encouragement at home and in school may also be helpful in establishing safe mask-wearing practices.

From RTÉ Radio 1's Morning Ireland, Aileen Hickie from Parentline on parents' concers over primary school children having to wear masks in classrooms

· Think about ways to develop fun ways of embedding safe behaviours (for example, the most colourful mask).

· Establishing routines is also important for overall psychosocial development. So, add packing masks to the list of things that need to be checked off daily.

· We need to continue to educate and remind children about the reasons behind public health measures like mask wearing. Overall, outline the benefits of collective behaviour ('your mask protects me, my mask protects you’) which is a concept that children in 3rd class and above can learn about and discuss.

· Teachers and students might need to remind themselves to communicate their feelings more using words when masked, rather than relying on facial expressions. This can remove potential ambiguity from conversations and make sure that they are clearly understood. Using ‘guess the expression’ games can help with developing this skill.

We need to continue to educate and remind children about the reasons behind public health measures like mask wearing

· Mask-wearing in schools should be implemented with regular opportunities for mask-free breaks. This should include safe opportunities to socialise as well as to learn without masks wherever possible. The Department of Education guidelines clearly point to the need for regular breaks from mask-wearing.

· Finally, maintain regular check–ins with children as to how they’re thinking, feeling and behaving regarding masks. Allowing them to express themselves in this new pandemic-dictated environment will help parents and schools respond more effectively to their needs.

Dr Clare Bohan is a Lecturer in Psychology at the School of Psychology at DCU. Dr Darragh McCashin is an Assistant Professor in the School of Psychology in DCU. His research specialises in digital mental health interventions across clinical and forensic populations. Dr Sinéad Smyth is an Associate Professor in psychology at the School of Psychology in DCU. Her research focuses on behavioural interventions for education and health. She is an Irish Research Council awardee.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ

What's the psychological impact on children of wearing masks in school?

Another change to daily routines

What do we know about masks and emotional recognition?

Are there other potential impacts of prolonged mask wearing?

Managing masks

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