Developmental and psychological impacts on children were not considered by the Health Protection Surveillance Centre (HPSC) when issuing advice on mask-wearing in schools.
The HPSC guidance in relation to masks in schools was issued solely on the basis of international research on Covid-19 infectivity, with no consultation on potential impacts on children’s development and mental health.
“Developmental and child psychologists were not consulted by the HPSC in the development of these guidelines, therefore the record does not exist,” according to documents released under the Freedom of Information Act.
A separate request sent to the Department of Education revealed that no expert guidance on child development or psychological welfare with regard to teaching staff and students wearing masks was sought there.
The Department of Education said guidance to schools was formed on the basis of advice from the HPSC and therefore no consultations had been held with child psychologists or developmental experts.
Guidance in the “roadmap for the full return to school”, first published by the Department of Education in July 2020, didn’t include advice on wearing masks in schools. The document was updated by the Department of Education on August 7 following consultation with the HPSC and teachers’ unions.
The current recommendation is for teachers at primary and post-primary, as well as secondary school students, to wear face coverings at school when a physical distance of two metres cannot be maintained.
It is not mandatory for primary-school children to wear masks, although on August 25, the Irish National Teachers’ Organisation (INTO) had called for a review of this rule for children aged six and over.
Many scientific studies show clear links between children’s ability to use facial-emotional recognition and the development of important socialisation skills such as empathy.
Well-developed emotional-recognition skills, learned by children observing the faces of carers and peers from birth through to teenage years, have a correlation with positive outcomes for children.
Poor facial-emotional recognition is linked to developmental and psychological issues.
A study of 870 seven-year-olds published in thefound: “Children who had difficulty identifying emotion in faces also were more likely to have more problems overall and, more specifically, with peer relationships among boys and with learning difficulties among girls.”
Other studies show that six-year-olds identify emotions in adult faces by scanning from the eyes to the mouth and back again, and that facial-emotion recognition continues to develop into the teens, reducing temporarily at the onset of puberty.
One study by the University of Bath found that teens with severe antisocial behaviour were less able than their peers to recognise facial expressions of fear, anger, and disgust.
Cork child psychologist Catherine Hallissey said awareness of potential negative side effects on children “in terms of social, emotional, and communication skills” was important, but she did not have any concerns for long-term developmental impacts of Covid-19 measures on primary-age children.
“It’s important to have an open conversation around this and say 'these are the facts, this is the best information we have right now, and here’s how we can counteract this',” said Ms Hallissey, a senior HSE psychologist and mother of five.
“If a child has any communication difficulties themselves or if English is their second language, with reduced facial expression it’s much harder to detect nuance,” said Ms Hallissey, who was speaking in her capacity as a psychologist in private practice and not as a spokesperson for the HSE.
“It certainly impacts facial recognition, which is relevant in younger children.
"Teachers really need to exaggerate their gestures and expressions and use the tonality of their voice: More energy, more brightness in the eyes.”
Children’s mental wellbeing was boosted by the routine of school and mask-wearing could be framed in a “message of resilience and hope,” she said.
“As long as this is balanced with lots of connection and free play, and all the other things that we know foster resilience, then I don’t have concerns about the long-term impacts.”
Children living in deprived settings or with poor parental relationships may be more at risk of any negative impacts of reduced communication, Ms Hallissey said.
“We have a two-tier pandemic: there are families doing relatively well and we have families where this is the straw that breaks the camel’s back. It’s great that schools could reopen because for many children it is their one safe place. The one good adult in their lives is their teacher.”
Ms Hallissey said she was more concerned about the long-term psychological impacts of Covid-19 restrictions on teens than on younger children.
“I’m concerned about long-term changes in behaviour that make us less connected and less social,” she said.
"Young children’s developmental task is to master their body and their world through play and they can still do that. But teenagers are being severely limited.”
The promise of a safe vaccine is a cause for optimism that measures such as physical distancing and mask-wearing could eventually be lifted in schools, Ms Hallissey said.
“I’d be hopeful that this time next year, things would be back to normal,” she said. “Children’s brains change rapidly. Neuroplasticity is our best friend at the moment. I believe it will only take a short period of normality to recover from all of this.
“It’s like any traumatic event: for many people, it will be neutral; for some, there’ll be post-traumatic growth. But some won’t do as well and will need help, so we’re going to need a big investment in mental health services for both adults and children in the future.”
The HPSC did not respond to queries as to why child development impacts were not discussed in relation to guidance on masks in schools.
A total of 187 outbreaks of Covid-19 have been recorded by the HPSC in school settings since records began, out of a total of 8,311 outbreaks documented. There have been 6,228 outbreaks of the virus linked to private homes, while 345 outbreaks have been recorded in nursing homes.
"The first concern in all of this was to limit the spread of coronavirus and everything else has been secondary to that for the past few months,” said Damian White, director of the Irish Primary Principals' Network.
Mr White said primary school teachers are “very much” aware of the potential psychological effects on children of being taught by masked staff and were balancing pupils’ needs with the challenges of maintaining safeguards in schools with varying resources and space.
“It’s hard to define what’s going on in every school because some schools have very small classrooms while others have large ones,” he said.
“Other than when they are within two metres of a student, some teachers can take masks off or use a shield. It’s to do with the capacity to guarantee the appropriate space. When children are out in the yard, teachers can take off their mask and communicate from beyond two metres.
The health concerns of teaching staff needed to be balanced against pupils’ needs, Mr White said: “If you’re a teacher whose health is compromised in some way, and you’re susceptible to picking up an infection, you need precautions to protect your own health as well.
“The pandemic has brought about entirely new ways of doing things and a lot of it was reactionary. It’s only as time goes on that you start to consider what the implications are of various things, and wearing masks would be one of them. We’ll always take directions from the HSE because public health first and foremost is the big concern.”