Communicating with a face mask is…difficult.
It is hard to convey emotions, like your happy face or your thinking face, when your mouth is covered up. Not only does your mouth convey emotions, it also helps people understand speech in difficult listening situations with lipreading. Lipreading is helpful for anyone, but it is even more important to people with hearing loss. Some individuals rely heavily on lipreading and a standard mask makes communicating with that person impossible. Here are some ways to help with communication in the coming months.
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Things a person with hearing loss can do to help others effectively communicate with them:
Be an advocate for yourself
Let the speaker know you didn’t hear them or you are having a difficult time understanding them, but do NOT ask them to take off their mask.
Clarify
If you are able to hear the speaker and just didn’t understand what was said, ask for the speaker to rephrase their statement.
Repeat what you heard
If you are able to hear the speaker and missed a part of what was said, repeat what you thought you heard when 
asking for repetition.
Be careful
If you are wearing a mask, BE CAREFUL to not lose your hearing aids or cochlear implants when removing the face mask. Try using otoclips or Ear Gear if you are concerned the hearing aids may fall off.
A few creative solutions for wearing traditional masks with hearing devices:
- These nurses used monkeys from the Barrel of Monkeys game to secure their masks on their heads, above the ears.
- Here’s a tutorial on how to make your own fabric ear savers, but we’ve also seen this successful with a simple scrap piece of fabric tied behind the head.
- This essential worker shares how she created an elastic-free mask that does not need to loop around the ears.
Things to keep in mind if you’re going to the hospital and have a hearing loss:
Make a statement
Bring signs to hang up stating you have a hearing loss and what people can do to communicate with you. You can print these ahead of time: Printable Communication Aids
Be prepared
Remember, if you are hospitalized for COVID-19, you will be in respiratory isolation and people will not be able to lower their masks.
The hospital may not be able to accommodate your hearing loss due to lack of resources – be prepared! Have a plan on how to communicate with someone who is masked. Make sure to bring all of your hearing care equipment.
Work with a care coordinator
Try working with the Patient Advocate/Accessibility Coordinator of the hospital to get communication needs met; ask the charge nurse or the nursing supervisor for help contacting this person.
Recruit help
Call a family member or close friend as a second listener when the health care providers complete check-ins with physicians and discharge planners.
Use available technology
Remote Communication Access Realtime Translation (CART) like this service: Care Captions
Simple ways to communicate non-verbally:
- Paper and pen
- Boogie Board, something like this
- White board with dry-erase markers
- Texting
Hearing aid and cochlear implant users should always try to remember to use any remote microphones and accessories that will connect to their devices, to make speech more accessible. If you have an iPhone and can connect to your hearing aids, but don’t have a remote microphone, try using Live Listen.
You can either give the speaker your microphone to wear on the upper chest or you can hold it out towards the speaker. Remember to sanitize the microphone between uses. Talk to your audiologist about what remote microphone option would work best with your devices.
We know, automated captioning isn’t always perfect. But using automated captioning with your mobile device or computer can help communicate effectively and avoid frustrating misunderstandings, especially when it comes to wearing masks.
If you’re speaking to someone with hearing loss and want to use live captioning on your own phone or device, hold your device under your chin while speaking, so they can read live captions while watching visible facial expressions.
If a person with hearing loss is using a live captioning service on their own device, they can point their device towards the speaker, while following best social distancing protocols.
Automated Captioning Options:
Click here to read Dr.Gowdy’s full blog post about captioning options.
Captioning on personal mobile device:
Otter.ai
- Available for iOS and Android devices as an app.
- 10 hours free for every 30 days, however there is a significant discount for pro-membership available to students and teachers.
- Only works with Google Chrome Web Browser on your computer as a split screen, or it can be run as an app for Android or iOS devices. You can save and edit transcriptions.
- If you are unable to access the internet, you can record the conversation and upload it to Otter once you are connected to the internet for full transcription.
Ava (includes language translation)
- Ava runs through iOS or Android devices as an application.
- There is a basic subscription with a time limit, but some schools have already paid for an unlimited subscription – check with your school district.
- The user can connect to the speaker via the app (after both have downloaded the app and signed in) so communication can take place at a distance.
Live Transcribe (includes language translation)
- Available only on Android devices.
- Provides automated captioning in many different languages
- Completely free!
Eyehear
- Available only on iOS devices.
- Uses Siri to transcribe what is being said, just press on the screen when using the app.
- Completely free!
Home button
- Siri is available on iOS devices and Google Assistant is available on Android devices.
- Quick availability – hold down the home button on your mobile device for quick transcription; however, it may complete a web search once the speaker is done.
- Completely Free!
No internet? No problem! Use your speak to text function in a note taking application to write out what you are saying! This is so easy and readily available! On iOS devices you can even add “Notes” to your Control Center for quick access. Here is how to get dictation or live transcription for your iOS device and your Android device.
To caption video, voice recording, or video chat on some Android devices enable live caption:
Settings > Sound > Live Caption and switch to “On” position
For PC (could be used by healthcare provider, teacher, person providing service) if a microphone is available:
Otter.ai
Only works with Google Chrome Web Browser on your computer (PC), or it can be run as an app for Android or iOS devices. You can save and edit transcriptions.
Webcaptioner
Completely free! Works with Google Chrome web browser only.
Google Hangouts
Captions available for the viewer by clicking on the CC button at the bottom.
If communication is still difficult due to social distancing protocols and/or a face mask, consider having the person call you and using an app that provides captions for the phone call.
All of the applications listed below are free for anyone who is deaf or hard of hearing with the exception of Skype. For Skype you will need to register on the website first (linked below) then they will provide you with a special captioning-enabled phone number for callers to use.
Here are some options to receive captions with your call:
- Innocaption+
- ClearCaptions
- Hamilton Captel
- Skype (Here is how to add captions to your calls)
If you can anticipate what information you will need to give or questions that could be asked, you can use digital note cards to provide the information. For example, when going to an appointment, you can make a card beforehand that has your name, date-of-birth, time of appointment, etc., and another card with your current address so the receptionist can confirm your information without needing to hear.
Digital notecard applications available on your mobile device:
Things to keep in mind when communicating with someone who has a hearing loss while wearing a mask:
Visual cues
The person with hearing loss may have difficulty understanding you without verbal visual cues.
Muffled sound
Regular surgical masks and cloth masks will muffle speech slightly, and the N95 masks used with COVID-19 patients significantly muffle speech.
Enunciate and express
Slow down your speech and enunciate.Try using more body language such as shoulder movements and eyebrow raises to communicate as well as pointing and gestures.
Speak creatively
Try rephrasing your statement. If only one word is misunderstood, spell the word.
Check out the other options below for providing visual cues with a clear face mask or face shield, or by using some type of transcription application.
What to know about clear face masks:
- Homemade masks are not FDA approved and should not be worn in a medical setting or around those with COVID-19.
- Homemade clear face masks provide the same level of protection as cloth masks.
- The mask needs to fit well around the face and chin.
- The clear material for lipreading needs to be fog resistant.
- Fog resistant ideas:
- Wash clear material with soapy water and let air dry.
- Try anti-fogging wipes or spray, but this can be pricey.
- We’ve also heard that applying shaving cream to the clear window can prevent fog, but haven’t been able to test it out yet.
Mask-related Resources
- Connect-hear.com provides instructions for how to make a clear mask at home.
- Here is an article about clear masks from Hearing Like Me, if you would like to know more.
- FDA-registered Surgical Grade Mask (currently not accepting new orders).
- Available for pre-order: The Clear Mask
What to know about face shields:
(alternative option if medical face masks are not available)
- Shield will need to cover the entire front and sides of the face, extending to the chin or below.
- Some individuals prefer the face shield, saying they are more comfortable to wear than a mask.
- Can be disinfected and reused indefinitely, if it is not ripped or torn.
- Face shields will NOT filter air and should NOT be worn around anyone with COVID-19 symptoms.
- Here are the CDC Guidelines for using a face shield.
If you are unable to provide visual cues because you need to wear a mask, a quick fix is to provide captioning. You can use one of the applications listed in this post, or Dr.Gowdy’s blog post all about captioning. But if you have a quick question and haven’t downloaded an application beforehand – hold down the home button on your mobile device and use Siri (iOS) or Google Assistant (Android) to live transcribe what you are saying.
This can take away a lot of frustration and misunderstanding in what can be a chaotic moment like a noisy work environment or trying to place an order in a restaurant. If you will be frequently communicating with people who are deaf or hard of hearing, or you work in a noisy work environment, the following applications will work great to transcribe conversations. If it is a classmate or coworker that you are communicating with from further away, encourage them to download an app like Ava or discuss over Google Meet to get captioning with the conversation.
Jump to automated captioning options
If you can anticipate what information you will need to give or questions that could be asked, you can use digital note cards to provide the information. Consider using digital note cards to say frequently asked questions at work or at school, such as “Do you have your math assignment completed?” or “Will you confirm your phone number?”.
Digital notecard applications that are available on your mobile device:
One last option is calling the person over Skype. Here is how to add captions to your Skype calls. Let the person with hearing loss know about this option and then communicate over Skype.
Keep it simple! Try not to get frustrated. You can always turn towards these simple tools, if all else fails:
- Paper and pen
- Boogie Board, something like this.
- White board with dry-erase markers
- Texting
Last but not least, below are a few helpful videos for navigating the community while wearing a mask when you are deaf or hard of hearing:
Center for Hearing and Communication – Face Masks and Hearing Loss