ASHA refers to guidance from the Centers for Disease Control and Prevention (CDC) regarding mask use during the COVID-19 pandemic. ASHA prioritizes health and safety and recognizes that masks may make in-person schooling possible because mask use reduces infection.
Masks and Communication
Wearing masks can sometimes make communication more difficult, especially for people who have trouble speaking or hearing. Here are some ways in which wearing masks can be challenging:
- Masks muffle sound, making it more difficult to understand speech and some higher-pitched voices.
- Masks take away our ability to read lips and see facial expressions, which help us better understand what we’re hearing.
- Speaking with a mask can be hard for people with communication problems like aphasia or voice problems.
- Masks can be uncomfortable for people who wear hearing aids or cochlear implants (see tips below).
Ways to Improve Communication When Wearing Masks
ASHA strongly encourages parents and caregivers, day care providers, and preschool teachers to actively engage in the following strategies that support speech and language development in young children. These are good practices always—but especially during the pandemic because they can help address possible communication barriers by mask use:
- Make sure you have the child’s attention before speaking.
- Face the child directly, and make sure nothing is blocking your view.
- Speak clearly.
- Talk a little louder (but don’t shout) and a little slower than usual.
- Use your hands and your body language. Gestures add more information.
- Move to a quiet place, if possible.
- For older children, ask if they understood you; if not, say it a different way or write it down.
Masks and Speech-Language Development in Children
At this time, we are not aware of any research about mask use and speech and language development. Studies do exist showing that children can tune into different communication cues when an adult’s mouth is not visible. Children can listen to voices (e.g., inflection, tone) to understand words, and they can recognize emotions when looking at the eyes of adults wearing masks in photos.
Here are other points that may reassure families about the use of masks:
- Infants and toddlers spend much of their time interacting with people at home without masks.
- Typically developing children look at faces during the language learning period. However, they don’t stare at faces all the time. They run around and look at their toys. They learn to talk during many different social interactions. We know from eye movement studies that eyes are attended to first and longer and that eyes provide important communication cues.
- In some cultures, adults regularly wear face coverings without a detrimental effect on their child’s speech and language development.
- Children with visual impairments learn to talk at the same rate and following the same sequence of speech and language development as children without visual impairments.
Regardless of mask use, some children will take longer to reach speech and language milestones—and some may need help from a speech-language pathologist. Parents and caregivers, pediatricians, day care providers, teachers, and others are encouraged to continue contacting and/or referring children with possible speech or language delays/disorders to early intervention or private speech-language pathologists.
Mask Use and Hearing Loss
For people who are deaf and hard of hearing, a variety of approaches can help improve communication while wearing masks. Communication is the responsibility of both parties. Everyone can help people who are deaf and hard of hearing by doing the following:
- Slowing down your rate of speech and speaking clearly (but not shouting).
- Moving to a quiet location to talk, if possible.
- Using gestures and body language.
- Rephrasing your message using different words if you sense that the person does not understand.
- Using alternative forms of communication if needed (e.g., writing a message down).
- Facing the person directly as you talk.
- Using an amplifier or microphone.
- Being patient and helping find solutions to communication challenges. Understand that this is a very difficult listening environment for people with hearing difficulties.
People who are deaf and hard of hearing can take the following steps:
- Self advocate. Let people know that you are having trouble hearing. Don’t pretend that you understood the message.
- Bring along a family member or friend (if possible) to doctor’s appointments and other places where understanding a message is critical.
- Use other forms of communication, if needed, such as pen and paper or speech-to-text apps.
- Talk to your audiologist about needed hearing aid adjustments. Some hearing aids now have a “mask mode,” which can help.
In the Classroom
Students who are deaf and hard of hearing may have an added layer of difficulty due to masks. ASHA recommends the following strategies for parents and caregivers of children who are deaf and hard of hearing:
- Advocate for use of technology devices that improve the listening environment in the classroom. This technology may include classroom audio distribution systems (CADS), which involve the teacher wearing a microphone—thus distributing speech evenly throughout the classroom.
- Encourage effective teaching strategies, such as speaking while facing the class (versus speaking while writing on the chalkboard) and providing written instruction to supplement verbal instruction.
- Consult with an educational audiologist. These professionals can help teachers arrange classrooms for maximum effective communication, provide guidance on technological solutions such as microphones or captioning, and provide input on a student’s individualized education program (IEP) or 504 plan.
- Revisit the child’s IEP or 504 plan. It’s important to (a) include accommodations consistent with the learning environment and (b) assess a child to determine whether they require any additional services that address any communication and/or social skills that were lost during virtual learning.
See more: How to Help Children Who Are Hard of Hearing as They Return to In-Person Learning
Tips for Wearing Hearing Aids or Cochlear Implants With a Mask
- Secure your device with wig tape or other non-damaging material, like a cloth headband.
- Instead of looping the mask over your ears, use a button extender for the mask to attach it behind your head.
- Remove your mask in a safe place, then check your device to make sure it’s working.
- Choose a mask that has four string ties instead of ear loops.
Additional Tips for Children
- Practice taking masks off and on with their hearing aid or cochlear implant at home. This may be necessary at school during lunch or at other times.
- Use hearing aid clips, retainers, or cords to prevent the child from losing their hearing aid if it comes off when they remove their mask (or for any other reason).
From what we know right now, we don’t think there is cause for alarm. And there are things that parents and teachers can do in this challenging environment.
Audiologists and speech-language pathologists can help—find a professional on ASHA ProFind.