Paper on: The Effects of Face Masks on Young Children as It Pertains to Articulation and Hearing After the Pandemic.

By: Shelly Burke of Society of Pediatric Nurses (SPN) Healthcare Policy and Advocacy Committee (HPAC)

The Effects of Mask Wearing in Infants and Children After the Pandemic 

Introduction: The COVID-19 pandemic brought unprecedented changes to daily life, including the widespread use of face masks as a public health measure. While masks were essential in reducing the transmission of the virus, their impact on children's development, particularly in areas such as language comprehension, emotion recognition, and social interactions, requires careful examination. This paper reviews the effects of mask-wearing during the Pandemic and its impact on children and infants, drawing insights from several peer-reviewed studies. 

Impact on Language Comprehension: Singh and Quinn (2023) investigated the effects of face masks on the language comprehension of bilingual children. Their study found that surgical masks did not disrupt spoken word recognition in English-Mandarin bilingual children. However, transparent face shields posed challenges in English word recognition but not in Mandarin. These findings suggest that language-specific properties influence the impact of face coverings on language comprehension. 

Language Processing and Emotion Recognition Bourke et al. (2023) examined how face masks affected young children's language processing and emotion recognition. While masks did not significantly impair language processing, they impacted emotion recognition, particularly for happy and sad expressions. Children are more easily able to recognize angry expressions, highlighting the nuanced effects of mask-wearing on interpreting social cues. 

Social Attention in Toddlers with Autism Spectrum Disorder (ASD). Vernetti et al. (2024) investigated the feasibility of using live eye-tracking to assess social attention in toddlers with ASD during face-to-face interactions with both masked and unmasked individuals. The study found that while toddlers with ASD paid less attention to social partners overall, the presence of a mask did not significantly alter their social attention. The study suggests that for neurodiverse populations, social attention may be more pronounced than the effects of mask-wearing alone. 

Holistic Face Processing Yates and Lewkowicz (2023) explored whether exposure to masked faces during the Pandemic affected children's holistic face-processing abilities. Their study found that young children maintained robust, holistic face processing despite exposure to masked faces, suggesting resilience in face perception development during early childhood. 

Perception of Mask-Wearing in Preschoolers A study by Kwon et al. (2022) focused on the perception of mask-wearing among preschool children in Korea. Most children understood the protective purpose of masks and did not feel uncomfortable wearing them. Interestingly, younger children perceived masks as an integral part of their physical selves, while older children viewed them more abstractly, indicating developmental differences in perception. 

Mask-Wearing in Early Childhood Education, Farrer Mackie et al. (2023) examined mask-wearing practices in early childhood education (ECE) settings in Florida. The study identified three models of mask-wearing: teachers only, teachers and children, and optional masks. The findings underscored the importance of understanding how mask-wearing policies were implemented at the center level and their influence on health and safety. 

Psychosocial Development and Mask-Wearing Freiberg et al. (2021) conducted a systematic review on the psychosocial impacts of mask-wearing on children and adolescents. The review highlighted potential challenges in processing facial expressions and noted some psychological symptoms, such as anxiety and concentration difficulties. However, the evidence was limited, suggesting a need for further research in this area. 

Conclusion: The studies reviewed indicate that while mask-wearing had some impact on language comprehension, emotion recognition, and social interactions, children displayed adaptability and resilience in many areas of development. The mixed findings on the psychosocial impacts underscore the importance of context-specific studies and targeted interventions to support children's development in the post-pandemic era. Further longitudinal research is needed to understand the long-term effects of mask-wearing on children's developmental trajectories. From the studies conducted after the Pandemic, it can be concluded that the wearing of masks by young children did not have a deleterious effect on language development, speech, and hearing. 

References

Bourke L, Lingwood J, Gallagher-Mitchell T, López-Pérez B. The effect of face mask wearing on language processing and emotion recognition in young children. J Exp Child Psychol. 2023 Feb;226:105580. doi: 10.1016/j.jecp.2022.105580. Epub 2022 Nov 5. PMID: 36347070; PMCID: PMC9637007. 

Farrer Mackie J, Gray HL, Marshall J, Himmelgreen D, Alkon A, Kirby RS. "I Wear a Mask. I Wear It All the Time. The Kids Don't Wear Masks": Early Childhood Education Mask-Wearing During COVID-19 in Florida. Health Promot Pract. 2023 Sep;24(5):944-949. doi: 10.1177/15248399221093972. Epub 2022 May 14. PMID: 35574594. 

Freiberg A, Horvath K, Hahne TM, Drössler S, Kämpf D, Spura A, Buhs B, Reibling N, De Bock F, Apfelbacher C, Seidler A. Beeinflussung der psychosozialen Entwicklung von Kindern und Jugendlichen durch das Tragen von Gesichtsmasken im öffentlichen Raum zur Prävention von Infektionskrankheiten: Ein systematischer Review [Impact of wearing face masks in public to prevent infectious diseases on the psychosocial development in children and adolescents: a systematic review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 Dec;64(12):1592-1602. German. doi: 10.1007/s00103-021-03443-5. Epub 2021 Oct 25. PMID: 34694428; PMCID: PMC8543771 

Kwon M, Jang EM, Yang W. Mask-Wearing Perception of Preschool Children in Korea during the COVID-19 Pandemic: A Cross-Sectional Study. Int J Environ Res Public Health. 2022 Sep 11;19(18):11443. doi: 10.3390/ijerph191811443. PMID: 36141716; PMCID: PMC9516996.- 

Singh L, Quinn PC. Effects of face masks on language comprehension in bilingual children. Infancy. 2023 Jul-Aug;28(4):738-753. doi: 10.1111/infa.12543. Epub 2023 Apr 25. PMID: 37186027. 

Vernetti A, Butler M, Banarjee C, Boxberger A, All K, Macari S, Chawarska K. Face-to-face live eye-tracking in toddlers with autism: Feasibility and impact of familiarity and face covering. Autism Res. 2024 Jul;17(7):1381-1390. doi: 10.1002/aur.3060. Epub 2023 Nov 27. PMID: 38009948 

Yates TS, Lewkowicz DJ. Robust holistic face processing in early childhood during the COVID-19 pandemic. J Exp Child Psychol. 2023 Aug;232:105676. doi: 10.1016/j.jecp.2023.105676. Epub 2023 Mar 10. PMID: 37018972; PMCID: PMC9998297.