The Role of Face Masks in the Recognition of Emotions by Preschool Children

Children's experiences of mask-wearing: a systemic review and narrative synthesis

RATIONALE

Masks have been widely used as a preventative tool during the COVID-19 pandemic. However, the use of masks by children has been controversial, with international guidelines recommending a risk-based approach to national policymakers.

AIMS AND OBJECTIVES

We aimed to conduct a systematic review that explores children's experiences of mask-wearing, drawing on an evidence base that describes mask-wearing in different contexts including air pollution, and to prevent the spread of infectious disease.

METHODS

We searched MEDLINE, Embase and PsycINFO in June 2021, with repeat searches in August 2022 and January 2024, for primary research studies exploring children's experiences of masks. Included studies reported on participants between 4 and 14 years (inclusive), with no restrictions on language where an English translation was available. Two reviewers independently screened titles and abstracts and reviewed full texts, with discrepancies resolved by a third reviewer. We used the Mixed Methods Appraisal Tool for quality appraisal and narrative synthesis to identify key findings. We also conducted stakeholder consultation (Patient and Public Involvement (PPI)) with nine children, where they submitted annotated drawings of their preferred masks to complement our review findings.

RESULTS

We screened 982 titles and abstracts and reviewed 94 full texts. 45 studies were included in the synthesis. Children's experiences of mask-wearing were influenced by their perceived necessity, social norms around their use and parental attitudes. Challenges related to mask-wearing were described, including difficulty reading facial expressions and physical discomfort. Children found it easier to wear masks when sitting and in cooler environments, and they benefited from unmasking during outdoor break time at school. As part of the PPI consultation, children highlighted the importance of mask design and the environmental impact of masks.

CONCLUSION

Children's experiences of mask-wearing were varied and context-dependent, with several mask-design challenges raised. Future policy on mask-wearing needs to consider the context in which mask-wearing would be most beneficial, and how local adaptations to policy can respond to children's needs.

Effects of wearing an opaque or transparent face mask on the perception of facial expressions: A comparative study between Japanese school-aged children and adults

The negative side effects of mask-wearing on reading facial emotional cues have been investigated in several studies with adults post-2020. However, little is known about children. This study aimed to determine the negative influence of mask-wearing on reading emotions of adult faces by Japanese school-aged children, compared to Japanese adults. We also examined whether this negative influence could be alleviated by using a transparent face mask instead of an opaque one (surgical mask). The performance on reading emotions was measured using emotion categorization and emotion intensity rating tasks for adult faces. As per the findings, the accuracy of emotion recognition in children was impaired for various facial expressions (disgust, fear, happy, neutral, sad, and surprise faces), except for angry faces. Conversely, in adults, it was impaired for a few facial expressions. The perceived intensity for happy faces with a surgical mask was weaker in both children and adults than in those without the mask. A negative influence of wearing surgical masks was generally not observed for faces wearing a transparent mask in both children and adults. Thus, negative side effects of mask-wearing on reading emotions are observed for more facial expressions in children than in adults; transparent masks can help remedy these.

Influence of child and adult faces with face masks on emotion perception and facial mimicry

Emotional mimicry, the imitation of others' emotion expressions, is related to increased interpersonal closeness and better interaction quality. Yet, little research has focused on the effect of face masks on emotional mimicry and none on (masked) child faces. To address this gap, we conducted an online experiment (N = 235, German sample, adult perceivers). Masks reduced emotion recognition accuracy for all expressions, except in the case of anger in masked child faces, where perceived anger was even increased. Perceived interpersonal closeness was reduced for masked happy and sad faces. For both child and adult expressers, masks reduced facial mimicry of happy expressions, with no mask effects for sadness and anger expression. A stronger mask effect on facial happiness mimicry of child faces was mediated by the degree of emotion recognition accuracy. Smiles shown by masked children were not recognized well, likely due to the absence of wrinkles around the eyes in child faces. Independent of masks, sadness shown by children was mimicked even more strongly than when shown by adults. These results provide evidence for facial mimicry of child expressions by adult perceivers and show that the effects of face masks on emotion communication may vary when children wear them.

Hidden faces, altered perceptions: the impact of face masks on interpersonal perception

The pandemic has made wearing masks commonplace, prompting researchers to investigate their effects on interpersonal perception. Findings indicate masks obstruct face identification and expression recognition, with lower face cues being most affected. When judging attractiveness, masks can enhance the appeal of less attractive faces, but reduce the appeal of more attractive faces. Trust and speech perception outcomes are inconclusive. Future studies could focus on individual differences in how masks influence our perception of others.

Face masks influence emotion judgments of facial expressions: a drift-diffusion model

Face masks slow the spread of SARS-CoV-2, but it has been unknown how masks might reshape social interaction. One important possibility is that masks may influence how individuals communicate emotion through facial expressions. Here, we clarify to what extent-and how-masks influence facial emotion communication, through drift-diffusion modeling (DDM). Over two independent pre-registered studies, conducted three and 6 months into the COVID-19 pandemic, online participants judged expressions of 6 emotions (anger, disgust, fear, happiness, sadness, surprise) with the lower or upper face "masked" or unmasked. Participants in Study 1 (N = 228) correctly identified expressions above chance with lower face masks. However, they were less likely-and slower-to correctly identify these expressions relative to without masks, and they accumulated evidence for emotion more slowly-via decreased drift rate in DDM. This pattern replicated and intensified 3 months later in Study 2 (N = 264). These findings highlight how effectively individuals still communicate with masks, but also explain why they can experience difficulties communicating when masked. By revealing evidence accumulation as the underlying mechanism, this work suggests that time-sensitive situations may risk miscommunication with masks. This research could inform critical interventions to promote continued mask wearing as needed.

Hidden Costs of the COVID-19 Pandemic Response

"First, do no harm" [...].

Context reconsidered: Complex signal ensembles, relational meaning, and population thinking in psychological science

This article considers the status and study of "context" in psychological science through the lens of research on emotional expressions. The article begins by updating three well-trod methodological debates on the role of context in emotional expressions to reconsider several fundamental assumptions lurking within the field's dominant methodological tradition: namely, that certain expressive movements have biologically prepared, inherent emotional meanings that issue from singular, universal processes which are independent of but interact with contextual influences. The second part of this article considers the scientific opportunities that await if we set aside this traditional understanding of "context" as a moderator of signals with inherent psychological meaning and instead consider the possibility that psychological events emerge in ecosystems of signal ensembles, such that the psychological meaning of any individual signal is entirely relational. Such a fundamental shift has radical implications not only for the science of emotion but for psychological science more generally. It offers opportunities to improve the validity and trustworthiness of psychological science beyond what can be achieved with improvements to methodological rigor alone. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exploring the role of COVID-19 pandemic-related changes in social interactions on preschoolers' emotion labeling

During the COVID-19 pandemic people were increasingly obliged to wear facial masks and to reduce the number of people they met in person. In this study, we asked how these changes in social interactions are associated with young children's emotional development, specifically their emotion recognition via the labeling of emotions. Preschoolers labeled emotional facial expressions of adults (Adult Faces Task) and children (Child Faces Task) in fully visible faces. In addition, we assessed children's COVID-19-related experiences (i.e., time spent with people wearing masks, number of contacts without masks) and recorded children's gaze behavior during emotion labeling. We compared different samples of preschoolers (4.00–5.75 years): The data for the no-COVID-19-experience sample were taken from studies conducted before the pandemic (Adult Faces Task: N = 40; Child Faces Task: N = 30). The data for the with-COVID-19-experience sample (N = 99) were collected during the COVID-19 pandemic in Switzerland between June and November 2021. The results did not indicate differences in children's labeling behavior between the two samples except for fearful adult faces. Children with COVID-19-experience more often labeled fearful faces correctly compared to children with no COVID-19 experience. Furthermore, we found no relations between children's labeling behavior, their individual COVID-19-related experiences, and their gaze behavior. These results suggest that, even though the children had experienced differences in the amount and variability of facial input due to the pandemic, they still received enough input from visible faces to be able to recognize and label different emotions.

Mapping the perception-space of facial expressions in the era of face masks

With the advent of the severe acute respiratory syndrome-Corona Virus type 2 (SARS-CoV-2) pandemic, the theme of emotion recognition from facial expressions has become highly relevant due to the widespread use of face masks as one of the main devices imposed to counter the spread of the virus. Unsurprisingly, several studies published in the last 2 years have shown that accuracy in the recognition of basic emotions expressed by faces wearing masks is reduced. However, less is known about the impact that wearing face masks has on the ability to recognize emotions from subtle expressions. Furthermore, even less is known regarding the role of interindividual differences (such as alexithymic and autistic traits) in emotion processing. This study investigated the perception of all the six basic emotions (anger, disgust, fear, happiness, sadness, and surprise), both as a function of the face mask and as a function of the facial expressions’ intensity (full vs. subtle) in terms of participants’ uncertainty in their responses, misattribution errors, and perceived intensity. The experiment was conducted online on a large sample of participants (N = 129). Participants completed the 20-item Toronto Alexithymia Scale and the Autistic Spectrum Quotient and then performed an emotion-recognition task that involved face stimuli wearing a mask or not, and displaying full or subtle expressions. Each face stimulus was presented alongside the Geneva Emotion Wheel (GEW), and participants had to indicate what emotion they believed the other person was feeling and its intensity using the GEW. For each combination of our variables, we computed the indices of ‘uncertainty’ (i.e., the spread of responses around the correct emotion category), ‘bias’ (i.e., the systematic errors in recognition), and ‘perceived intensity’ (i.e., the distance from the center of the GEW). We found that face masks increase uncertainty for all facial expressions of emotion, except for fear when intense, and that disgust was systematically confused with anger (i.e., response bias). Furthermore, when faces were covered by the mask, all the emotions were perceived as less intense, and this was particularly evident for subtle expressions. Finally, we did not find any evidence of a relationship between these indices and alexithymic/autistic traits.

How experience shapes infants' communicative behaviour: Comparing gaze following in infants with and without pandemic experience

The COVID-19 pandemic has been influencing people's social life substantially. Everybody, including infants and children needed to adapt to changes in social interactions (e.g., social distancing) and to seeing other people wearing facial masks. In this study, we investigated whether these pandemic-related changes influenced 12- to 15-months-old infants' reactions to observed gaze shifts (i.e., their gaze following). In two eye-tracking tasks, we measured infants' gaze-following behavior during the pandemic (with-COVID-19-experience sample) and compared it to data of infants tested before the pandemic (no-COVID-19-experience sample). Overall, the results indicated no significant differences between the two samples. However, in one sub-task infants in the with-COVID-19-experience sample looked longer at the eyes of a model compared to the no-COVID-19-experience sample. Within the with-COVID-19-experience sample, the amount of mask exposure and the number of contacts without mask were not related to infants' gaze-following behavior. We speculate that even though infants encounter fewer different people during the pandemic and are increasingly exposed to people wearing facial masks, they still also see non-covered faces. These contacts might be sufficient to provide infants with the social input they need to develop social and emotional competencies such as gaze following.

The COVID-19 pandemic, mask-wearing, and emotion recognition during late-childhood

Face masks are an effective and important tool to prevent the spread of COVID-19, including among children. However, occluding parts of the face can impact emotion recognition, which is fundamental to effective social interactions. Social distancing, stress, and changes to routines because of the pandemic have also altered the social landscape of children, with implications for social development. To better understand how social input and context impact emotion recognition, the current study investigated emotion recognition in children (7-12 years old, N = 131) using images of both masked and unmasked emotional faces. We also assessed a subsample of participants ("pre-pandemic subsample," n = 35) who had completed the same emotion recognition task with unmasked faces before and during the pandemic. Masking of faces was related to worse emotion recognition, with more pronounced effects for happy, sad, and fearful faces than angry and neutral faces. Masking was more strongly related to emotion recognition among children whose families reported greater social disruption in response to the pandemic. Finally, in the pre-pandemic subsample, emotion recognition of sad faces was lower during versus before the pandemic relative to other emotions. Together, findings show that occluding face parts and the broader social context (i.e., global pandemic) both impact emotion-relevant judgments in school-aged children.