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Children Avoid Sick Faces and Improve With Training: A Stage 2 Registered Report
Journal article   Open access   Peer reviewed

Children Avoid Sick Faces and Improve With Training: A Stage 2 Registered Report

Tiffany S. Leung, Guangyu Zeng, Sarah E. Maylott, Arushi Malik, Shuo Zhang, Krisztina V. Jakobsen and Elizabeth A. Simpson
Infant and child development, Vol.35(4), e70134
2026-07

Abstract

avoidance behavioural immune system childhood eye tracking health pathogen avoidance sick face perception
Children are vulnerable to disease, yet are poor at recognizing and avoiding sickness. We recruited 5–9‐year‐olds ( N = 120, 38% female, 60% White, 48% Hispanic/Latine) to test whether children's sickness sensitivity can be improved through training. Children randomly assigned to engage in a game‐based disease training, compared to a control group, showed greater improvement in pre‐ to post‐training sickness avoidance accuracy, reported using facial features of lassitude (e.g., drooping eyelids) more often when trying to determine facial health, and had higher disgust sensitivity. However, we did not find support for our hypothesis that younger children benefitted more from training than older children. These findings suggest that children's sickness sensitivity may be malleable. Developing interventions for children's pathogen avoidance, that account for the flexibility of children's disease detection system, may reduce disease transmission and improve public health. Trial Registration: This study was pre‐registered on the Open Science Framework at https://osf.io/25jx4 and as a https://doi.org/10.1002/icd.70024 Children show room for improvement in recognizing and avoiding sick faces, so we tested a method to strengthen this sensitivity. Disease training improved children's facial sickness avoidance accuracy, altered their visual attention to faces, and increased their disgust sensitivity. Disease trained children reported using lassitude facial features—namely the eyes—to make their sickness recognition decisions, similar to adults.
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https://doi.org/10.1002/icd.70134View
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