To minimize the spread of COVID-19, many municipalities have mandated the use of masks in indoor facilities. In St. Catharines, the mandatory mask bylaw came into effect on July 17, 2020¹ with the rest of the Niagara Region following on July 31, 2020². Studies suggest that masks are effective in reducing the spread of COVID-19; however, the use of masks creates additional challenges for individuals who are deaf and hard-of-hearing. New research suggests that wearing a mask attenuates or reduces the volume of sound by 10-20 dB, decreasing the overall volume and clarity of speech3,4,5.
In addition to making speech less clear, masks prevent individuals from being able to use visual cues, such as lipreading, to supplement what they are hearing. Many individuals who are deaf or hard-of-hearing have taken to social media and other online sources to bring awareness to the additional communication challenges that masks create for them. Below is a link to an excellent article that explains the additional challenges that wearing masks create for individuals who are deaf or who have some degree of hearing loss:
Just What Are Hearing Aids Supposed To Do?
After reading the article above, you may wonder, “Aren’t hearing aid(s) supposed to help” The short answer is “yes”, the long answer is “it depends on many factors”.
Hearing instruments are the most effective way to treat hearing loss. They help to improve speech clarity by amplifying sounds that an individual can no longer hear with an emphasis on speech sounds. However, hearing aids are not a cure for hearing loss and individuals who wear hearing aids may still rely on lipreading to some extent. While removing the mask and ensuring a safe social distance (2m) from each other is an alternative, it is important to realize that even those who wear hearing devices will likely still struggle to hear and understand you. The reason for this is because hearing devices are designed to work optimally when the speaker is within a 2m distance in front of the listener. However, this optimization is conditional on being in an ideal quiet listening environment, which rarely exists in the real word.
Although the impact of a hearing loss is different for every individual, it is important to know that even “quiet” environments may be difficult for those who have a hearing loss due to the presence of background noise – for example, relatively “quiet” noise sources like fans/air conditioners, and people typing on keyboards in a small quiet office can make it very difficult for people with hearing loss to hear you. One of the most common coping strategies for these individuals in these situations is to get as close to the speaker as possible. However, getting closer to the speaker contradicts social distancing guidelines, which in turn, leads to the need for masks.
So, What Can I Do?
There are many things you can do to facilitate communication when interacting with someone who has a hearing loss while wearing a mask. A good starting place would be to utilize positive communication strategies. Examples of such strategies include:
•Face the person you are speaking to.
•Ensure you are having a conversation in an area where there is good lighting so that the light falls on your face.
•Minimize background noise as much as possible
•Re-phrase what you are saying instead of repeating the same words.
•Do not shout or over-articulate – speak clearly and allow for occasional pauses in your speech
•Have information available in written form to prevent communication misunderstandings.
In addition to the above communication strategies, there are both free and pay-for apps available on the Apple App Store and Google Play that can be downloaded onto your phone that will transcribe speech-to text. These apps will use the microphone on your phone or iPad and transcribe what is being said into text on your screen in real-time. An example of such an app is Live Transcribe.
What Else is there?
Other suggestions include wearing a face mask that has a clear window allowing visualization of your lips. Many individuals are creating such masks and offering them to their communities at a small fee. If you are an individual who is deaf or has a hearing loss, some people are creating buttons to attach to their masks to let others know that they have a hearing loss6. Thanks to the recent research on the effects of face masks on speech clarity, hearing aid manufacturers are now starting to come out with a program in their hearing aids that boosts speech clarity when face masks are worn.
Although hearing aids do have some limitations, the good news is that with the use of positive communication strategies and patience from all sides, communication with masks is possible. Let us be kind to one another and help reduce the spread o COVID-19.
1. The Corporation of the City of St. Catharines. (2020, July). COVID-19 Mandatory Masks By-law.
2. Niagara Region. (2020, July). Niagara Regional Council adopts mandatory mask by-law to combat the spread of COVID-19.
3. Goldin A, Weinstein BE, Shiman N. How do medical masks degrade speech perception? Hearing Review. 2020;27(5):8-9.
4. Llamas C, Harrison P, Donnelly D, Watt D. Effects of different types of face coverings on speech acoustics and intelligibility. York Papers in Linguistics, 2(9): 80-104.
5. Palmiero AJ, Symons D, Morgan JW 3rd, Shaffer RE. Speech intelligibil
ity assessment of protective facemasks and air-purifying respirators. Journal of Occupational and Environmental Hygiene. 2016. 13(12): 960-968.
6. Zachariah, H. (2020, July 28). 'Please speak up': Mask buttons help those who wear hearing aids. USA Today.
Audiologist, M.CI.Sc., Reg. CASLPO
(For more information on the above subject matter or to book a hearing evaluation please contact Ears Canada.