If someone were to tell you that wearing a mask negatively affects your ability to hear, you would probably give them the “Are you serious” look.

In fact, masks are shown to negatively impact our natural ability to read lips and use visual cues to aid in hearing. With the threat of COVID-19 around every corner, however, wearing a mask is essential to many people.

How do we accommodate the necessity of wearing protective face masks during the coronavirus pandemic without making it more difficult to hear each other? This question is especially applicable to people over the age of 50.

Age is the strongest predictor of hearing loss among adults; 91% of adults with hearing loss are aged 50 and older. Adult men in their 50s are three times more likely to have hearing loss than women of the same age. As they age, however, hearing loss rates become similar among both sexes.

As of November 2019, Johns Hopkins Cochlear Center for Hearing and Public Health estimated 38.2 million Americans, or 14% of the total population, have some degree of hearing loss.

Listening Fatigue

Trinity Health Clinic Audiologist Tricia Nechodom stated: “Hearing loss creates what we call listening fatigue, and our brains use a lot of our mental energy in the day working at listening and understanding. Lip reading cues help fill in the gaps in speech and help our brains hear. The ‘f’ sound, for example, has a very distinct visual cue that makes it different from the ‘k’ or the ‘s.’ ‘Kit’ looks different than ‘fit’ looks different than ‘sit’” and this helps all of us, but especially people with hearing loss, piece together speech information.”

Nechodom continued: “Masks not only reduce access to visual cues, but they also muffle and distort speech information and further degrade the volume of the person’s voice they are trying to hear. Some masks create more of a ‘barrier’ than others and muffle speech more.”

Nadine Hagen, Speech Therapy manager at Trinity Health, advised: “Visual supports are needed to improve comprehension of messages. We have had issues when assessing a patient’s cognitive or language skills being affected by the mask in place. This has skewed results negatively. The patient likely misses important information throughout the day and could appear to be confused as a result. This also affects a patient’s safety due to missing important recommendations following evaluations and treatments throughout the medical visit.”

Social Distancing

Nechodom said, “Our best ‘listening bubble’ for talking with people with hearing loss is about three to five feet. Speech information gets quieter over a distance, so the farther we are away, the softer the message is and the harder it is to understand clearly.

“Even by being another foot away,” Nechodom continued, “crucial speech information is lost. And then to add in masks makes it even more challenging by taking away the visual information. This is true for speech overall, and down to the phonemic level. The softer, higher-pitched sounds like ‘s,’ ‘th,’ etcetera, are quieter sounds that are more easily lost by being farther away.”

Nechodom added: “Distance and masks affect not only people with hearing loss, but patients with overall pretty good hearing may find themselves struggling more to hear clearly.”

Self Advocate

If you are having problems hearing a person who is wearing a face mask, make them aware. Ask them to speak slowly and to repeat what they said. Be sure to face the person so their voice is projecting toward you.

“Do not pretend you understood something when you did not,” Nechodom said.

If you are in the presence of someone who is having difficulty hearing you, be cognizant of how they react. Then, adjust your speaking accordingly. Slow down your speech, pause and articulate your words carefully.

“Observe the signs of the person you are speaking with and be aware of how they are ‘listening’ to you,” said Hagen. “Monitor your pitch, volume and rate of speech. Use visual supports when able.”

Suggested visual supports include pointing to the object or direction, and using gestures.

“Do not yell!” said Nechodom. “Get as close to the person as safely as possible to negate the effect of distance.”

Help for Impaired

There are various types of masks and technology available to help those with hearing loss. Some face masks have clear shields in front of the lips to allow access to visual cues. These are a good option if you’re around a friend or family member who has difficulty hearing.

“There are many devices available to increase the volume of speech for listeners who are having difficulty hearing and understanding,” Nechodom said. “One example of a low-cost, over-the-counter device is a Pocket Talker. The person who has difficulty hearing uses a set of headphones attached to a small box where they can control the volume of the sound in the headphones. They give a small microphone to the person they are talking to. Some of these microphone cords are 6 feet or longer, which allow for good social distancing. Some of the systems are even wireless, so there are no cords to worry about.”

Other high-tech devices, such as Roger systems or companion microphone accessories to hearing aids, work in the same way, Nechodom said. However, the devices employ background noise reduction technology or increased amplification of the signal to the person’s hearing aids.

Some apps can turn smartphones into microphones, capable of transmitting an amplified signal to headphones that are plugged into the smartphone.

“I am happy to help provide guidance to anyone in need,” said Nechodom.

Privacy Matters

Be careful using smartphone apps for listening devices. It is illegal in most states, including Montana, to record a conversation without the expressed consent of the person being recorded. People who use their smartphones to amplify sound should check to make sure they are not recording their conversations illegally. –Editor

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