The development of infants during this pandemic…is it the same?

A significant amount of research has been done over the years on emotional development in infants and the necessary external requirements needed for children to gain a thorough understanding of expression and communication. However, not a lot of research has been done around what happens when an infant is growing up in a world where the majority of individuals are wearing masks, covering crucial areas of one’s face required for understanding and learning. The COVID-19 pandemic has left me, and I would imagine many others, wondering about the impact of mask-wearing on infant psychological development. So, I went to work, scoured the internet and article databases for any and all research on the potential impacts and found that there truly still has not been a lot publicized around this topic. That being said, here’s what I did find:

At birth, a baby is born with neurons that continue to engage in significant development over their first few years of life (Green et al., 2021). The brain grows at such a rapid rate, reaching half of its adult size within the first three months of life, and then continuing to double in size throughout the first year (Greet et al., 2021 ). Brain growth is highly influenced by the infant’s experiences with individuals in their world, relationships and their environment (Green et al., 2021). 

According to Charles Darwin (1872), infant’s ability to read others facial expressions actually has an evolutionarily advantage by aiding social interaction, decreasing misunderstanding during conversations, and therefore helping social beings function more effectively and in cohesion (Green et al., 2021). Most individuals utilize numerous communication cues that act together to convey message and intent, including facial expressions, gestures, body language, words, pitch, tone and facial color (blushing) (Green et al., 2021). The eyes and the mouth have been found to be the most informative regions, as they tend to be the most expressive (Katz & Hadani, 2020). The mouth, specifically, often displays happiness and therefore wearing a mask can hinder coming off as approachable and friendly (Katz & Hadani, 2020). 

Research has also shown that newborns only need a few days to learn how to discriminate between differing facial expressions (happy, sad, surprised) (Green et al., 2021). The activity of face processing in an infant usually involves a two-step progression of face detection; the ability to recognize that what they are seeing is truly a face and then discriminating whether the face is familiar or not (Green et al., 2021). During the process of discrimination and imitation of facial expressions, babies visually focus on the eyes and mouth to varying degrees, but are highly dependent on the facial expression being observed (aka. the mouth region) (Green et al., 2021; Marler & Ditton, 2020). Specifically, at around 6 to 8 months of age, infants spend a lot of time looking at the mouth region in an attempt to learn/master speech (Klass, 2020). A mask covering the face would then negatively affect their ability to develop facial processing, ability to fully develop mastery over speech, and the ability to fully orient to or focus on another’s face, which leads to a disruption in the holistic processing of one’s face (Green et al., 2021; Ong, 2020).

Based on the research done on infant development, researchers have theorized that the inability for an infant to see facial expressions and hindered wordless communication can negatively impact the bonding and attachment process to their primary caregivers (Green et al., 2021). When these processes are impacted, the infant can experience an increase in cortisol levels, which then can negatively impact brain connectivity and growth (Green et al., 2021). Children also rely on their caregiver’s facial expressions and tone of voice to help regulate their response towards people and new situations (Katz & Hadani, 2020).

Here are some other areas of emotional communication that may be impeded in children by chronic mask wearing: kids under the age of 12 may have difficulty recognizing people as they are highly dependent on individual features versus a full context, lack of visibility to the facial musculature in the other person can lead to struggles with emotional recognitions and understanding in social interactions (example: not providing empathy when appropriate because they can’t see the face structure shift), and some children may have issues with speech recognition as they are still learning how to develop their speech skills (Klass, 2020). 

Another area of impact that I came across when researching was the hearing disabled community and some individuals dependence on reading lips to communicate and understand the message and context. Similarly in my mind, an infant who is hearing impaired would then be at an even higher disadvantage with learning emotional communication and development when they are surrounded by individuals wearing masks (Ong, 2020). Another significant population affected by these mask wearing mandates, is the Autism community, where they are not only being asked to navigate a new “norm” and routine, they are also asked to communicate differently than they have been previously taught as safe and effective (Klass, 2020). 

Overall, there has been no research or evidence that children from other cultures with more extensive face coverings and mask wearing mandates fair any worse with facial recognition and emotions. Which leads me to wonder….why? How do these individuals adapt? How have they adapted over time? Potentially another blog post… 

But for now, here are some suggestions I found in my exploration to help aid in children’s emotional development while we are engaging in consistent mask-wearing include: 

• Spending time at home with your children, unmasked, will help them to develop the necessary understanding and knowledge around emotional development and communication. (Emphasizing face-to-face activities and interactions). [This suggestion comes with a note: please regard your physician’s instructions and recommendations on how to navigate in-home mask wearing if your child is immunocompromised or at higher risk for any additional reasons.]

• Encourage your children to communicate more through gestures versus verbalizations.

• Help children to be more explicitly verbal by stating emotions out loud, which will help them to get better at reading people’s eyes and understanding emotional content from other’s tone of voice. Thoughts and feelings should also be verbalized more on your end, to model this new behavior.

• Make your own voice more expressive, your gestures more expressive, your eyes more expressive and slow down your speech especially for younger children (this applies for the elderly population as well).

• Explore if your child has any preconceived notions around masks (associated with doctors, pain, threat, etc). Be sure to communicate the need for wearing masks in an age-appropriate manner.

Remember to be gentle with yourselves if you are interacting with infants and children and attempting to help them learn emotional communication with mask wearing, as we are learning this new process just like they are. You are capable. You can do this. You are not alone. 

Thoughts? Questions? Email drjessicareyka@grassroots-healing.com

*Disclaimer: This blog is made available by Grass Roots Healing, LLC/Dr. Jessica Reyka for informational and communicative purposes only, not to provide psychological services and/or psychotherapy. By using this blog site you understand that there is no psychologist client relationship between you and the blog publisher. This blog should not be used as a substitute for competent psychological services from a licensed/pre-licensed psychologist in your state.*

Resources:

Darwin, C., 1872. The Expression of the Emotions in Man and Animals. Oxford University Press, Oxford.

Green, Janet, et al. “The Implications of Face Masks for Babies and Families during the COVID-19 Pandemic: A Discussion Paper.” Journal of Neonatal Nursing, vol. 27, no. 1, 2021, pp. 21–25., doi:10.1016/j.jnn.2020.10.005. 

Katz, Rachael, and Helen Shwe Hadani. “Are You Happy or Sad? How Wearing Face Masks Can Impact Children's Ability to Read Emotions.” Brookings, Brookings, 21 Apr. 2020, www.brookings.edu/blog/education-plus-development/2020/04/21/are-you-happy-or-sad-how-wearing-face-masks-can-impact-childrens-ability-to-read-emotions/. 

Klass, Perri. “Do Masks Impede Children's Development?” The New York Times, The New York Times, 14 Sept. 2020, www.nytimes.com/2020/09/14/well/family/Masks-child-development.html. 

Marler, Hollyanna, and Annabel Ditton. “‘I'm Smiling Back at You’: Exploring the Impact of Mask Wearing on Communication in Healthcare.” International Journal of Language & Communication Disorders, vol. 56, no. 1, 2020, pp. 205–214., doi:10.1111/1460-6984.12578. 

Ong, Sandy. “How Face Masks Affect Our Communication.” BBC Future, BBC, 8 June 2020, www.bbc.com/future/article/20200609-how-face-masks-affect-our-communication.