Science Update: Masking doesn’t appear to interfere with children’s ability to follow nonverbal IQ test instructions, NIH-funded study suggests

Surgical mask hanging from the seat of a classroom desk.
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Under appropriate conditions, protective face coverings can successfully be used during intelligence testing without interfering with the ability to understand the test administrator’s instruction, suggests a small study funded by the National Institutes of Health. Groups of young children scored comparably on a test measuring nonverbal intelligence whether they or the test administrators wore masks. The findings help to allay concerns that face masks may interfere with testing by hiding administrators’ facial expressions.

The study was conducted by Jonathan Lichtenstein,  PsyD, Geisel School of Medicine at Dartmouth, and colleagues. It appears in the Archives of Clinical Neuropsychology. Funding was providedby the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.


Little research has been conducted on whether personal protective equipment can influence neurological and psychological testing. Researchers have theorized that masks could distract examinees, make understanding spoken instruction difficult and hide nonverbal communications such as facial expressions. Moreover, existing tests were developed before the COVID-19 pandemic and not evaluated for use with face masks.

The study authors were interested in how face masks might influence testing procedures and results with the Leiter International Performance Scale, Third Edition, a test of nonverbal intelligence. Administrators do not provide spoken instruction and communicate only with gestures and facial expressions.

The current study included 125 children with an average age of about 5 years who were part of a long-term study of cognitive development of children living with HIV in Dar es Salaam, Tanzania. The test was administered twice. The first group served as the control, taking the test before the pandemic, when masks weren’t required, and completed the second assessment an average of roughly 200 days after the first one. The second group didn’t wear masks for the first assessment but wore them at the second assessment, roughly 262 days after the first—a delay due to the pandemic.


The researchers found no significant difference in scores between the two groups. Both groups increased their nonverbal IQ scores from the first to the second visit, which the researchers attributed to the children’s performance improving after they became familiar with the test. The group without masks did not improve their nonverbal IQ scores as much as the group with masks, but the difference was not significant.


The authors said their findings suggest that use of nonverbal neurological and cognitive testing can continue during a pandemic when face masks and other personal protective equipment are required. Although the masks covered the test administrators’ faces and hid certain facial expressions, they still had the ability to make head and arm motions, gestures and eye movements to convey information.

Next Steps

The current study used existing data and was not designed specifically to test the effects of masking on test scores. The authors called for larger studies to verify their results.


Lichtenstein J, et al. Nonverbal neurocognitive assessment during the coronavirus disease of 2019 pandemic: the effect of personal protective equipment. Archives of Clinical Neuropsychology. 2022. external link

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