Face Masks Can Mean Extra Challenges for the Hard of Hearing


Though face masks are critical for slowing the spread of coronavirus, they also make life—and medical care, specifically—more difficult for people who are hard of hearing. Professor Barbara Weinstein (The Graduate Center) has written extensively about these challenges and possible solutions in recent months, including in an editorial published in The BMJ, articles in Speech Pathology and The Hearing Journal, and a post on the Audiology Blog.

Masks, whether homemade, disposable, or N-95, reduce the volume of people’s speech and muddle their words. They especially muffle high frequencies, Weinstein says, which are essential to understanding speech. Moreover, a face mask covers up facial expressions and lip movements, taking away a crucial part of sign language and communication in general. This presents hurdles in day-to-day life but in a health care setting, the repercussions are more serious.

To be clear, the larger problem is nothing new, Weinstein says. In a Q&A with Audiology Online, Weinstein pointed out that “inaccessible and inadequate patient-clinician communication has always jeopardized care of persons with sensory disabilities.” Now, the pandemic has made things worse.

The authors suggest trying low-tech solutions, like using notepads or whiteboards. Personal amplifiers, while not a replacement for hearing aids, could help patients who have a full range of hearing but need a little boost. Remote sign language interpretation is another potential option. And in general, health practitioners should face the patient when communicating, be sure that they have the patient’s attention, speak slowly and slightly louder, and always check for understanding.

Many of the higher-tech solutions should make things easier but need more work, the authors say. Speech transcription tools and closed captioning have lags and inaccuracies, and masks made with clear plastic often fog up or make it hard to breathe. There is only one FDA-approved mask with a non-fogging transparent window. As a result, the company has experienced sky-high demand and supplies were on back order for part of the summer.

Taking down these barriers will take awareness, activism, and innovation, the authors say.