Throughout the pandemic, many of us have observed how face masks have impacted people’s ability to hear clearly. Think about how many times you’ve needed a mask-wearing restaurant server to repeat the special of the day. Or, maybe you’ve caught yourself staring blankly at your child, friend or coworker when asked a question you couldn’t quite decipher through an N-95 or cloth mask. For many, these “every once in a while” occurrences may be annoying or frustrating.

For the 466 million deaf and hearing-impaired people in the U.S., face masks — while serving their safety functions — have led to lasting challenges. Communication barriers such as not being able to read lips, missing facial cues and mannerisms have compounded feelings of exclusion and declining mental and social health for people with hearing problems. Coinciding with the challenges of this existing hearing impaired and deaf population is another group: People who have come to learn that they may have yet-to-be diagnosed hearing impairments.

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An ah-ha hearing (or not) moment

“It’s a little bit hard to gauge if we are seeing a huge surge of people coming in because they’ve been wearing masks, or, in particular, because other people are wearing masks,” says Kory Castro, board-certified hearing instrument specialist and co-owner at Beltone West. “But I can say that it’s not a conversation I’ve ever had before with a patient before the pandemic in regards to masks.”

Castro goes on to explain that communication difficulty due to face masks, for many patients, has been more or less the straw that broke the camel’s back. “I noticed that people were starting to recognize that maybe they did have a problem before and now they’re starting to admit to themselves that it’s actually an issue that they need to get some help for,” he says.

Crash course: How face masks affect communication

When discussing hearing difficulties or loss, it’s common to focus on the ears, specifically on how well those ears process sound. But, Castro helps reveal that there’s more to the story. It’s important to link hearing loss with the ability to communicate effectively, and this includes observing how others speak.

“A lot of people don’t recognize that a big component of speech recognition is visual cues. If you aren’t receiving that kind of signal from somebody, then it can be a little bit more difficult understanding what somebody is saying,” Castro adds, “especially if you have hearing loss.”

And here’s where face masks make things complicated.

For deeper insight into how face masks affect communication, Castro offers a practical demonstration — and one you can try yourself. “If you were to take your hand and cover your mouth and talk, all those consonants that you hear just become more muffled. And that’s what masks are doing. Not as bad as me covering my mouth with my hand, but definitely to a point. And those masks or face coverings are affecting the speech range that covers high frequencies which cover the consonant sounds.”

Interestingly, consonants fall into a higher frequency range which also happens to be the range for moderate hearing loss.

“Most people with nerve damage hearing loss or sensory neural hearing loss — which is most common and is typically age-related or noise-related — have trouble processing high frequencies,” Castro says.

Hearing aids here we come?

If you have occasional to frequent difficulty understanding people wearing face masks does it automatically mean a hearing impairment diagnosis is in your future? Or, that hearing aids are on the way? Not necessarily.

One of the best things Castro advises, should you find yourself asking people wearing masks to repeat themselves several times and/or are age 55 and older, is to get a hearing test. This will at least set a baseline moving forward.

“There’s still definitely a stigma around hearing loss and hearing aids,” Castro says. “However, the technology has improved immensely over the last few years. And it’s not like it was for grandparents 50 years ago. It’s a much more sophisticated device. It’s definitely able to help a lot more people.”

According to the National Institute on Deafness and Other Communication Disorders, an estimated 28.8 million adults in the U.S. could benefit from using hearing aids. Among adults ages 70 and older with hearing loss that could benefit from using them, fewer than one in three ever have.

Additionally, when it comes to diagnosing hearing loss, it’s important to be proactive. “The longer it goes untreated for those people, the more difficult it becomes to treat later on in the future,” Castro explains.

While not all mask wearers will accommodate those with hearing loss and impairment, if you want to be supportive to a hearing-impaired family member or friend, there are things you can do.

Castro suggests wearing transparent face shields or masks with clear, plastic “windows” so your mouth is visible. It’s also helpful to speak slowly and enunciate your words. And try not to yell. “When you raise your voice, you’re really just raising the part that they already can probably hear just fine. And so to them, it sounds louder but it’s not any clearer,” he cautions.

And, if they haven’t already, you can gently suggest scheduling a hearing test (and maybe one for you too, it can’t hurt!).