The American Speech-Language-Hearing Association (ASHA) applauds the US Centers for Disease Control and Prevention (CDC) for issuing newly updated COVID-19 mask considerations that include adaptations and alternatives for people with hearing loss and other communication disorders, according to an announcement issued July 14.

In a June 8 letter to CDC Director Robert Redfield, ASHA asked the agency to emphasize the need for clear face masks and use of other communication aids to protect people with hearing loss and other communication disorders. ASHA noted that this was a pressing public health issue, given the large segment of the US population that has a communication disorder. Solid face masks and coverings reduce the effectiveness of spoken communication in numerous ways, including dampening and filtering sound, degrading speech intelligibility, and removing visual cues.

In written correspondence to ASHA informing the association of its revised recommendations, Redfield stated, “We appreciate ASHA raising this important issue, and CDC recognizes the unique challenges that individuals with communication disorders encounter when wearing solid face coverings or when interacting with essential workers, such as healthcare providers, who communicate through solid face coverings.” He further acknowledged the critical work being done by ASHA members at this time. 

“We greatly appreciate the CDC’s updated recommendations,” said Theresa H. Rodgers, MA, CCC-SLP, ASHA 2020 President. “They allow for modifications that can improve communication success for everyone—including those with communication disorders. It bears noting that breakdowns in communication can be far more than a nuisance. They can result in real harm, particularly in medical settings where it’s imperative that communication between patients and healthcare providers is clear.” 

In its updated, “Considerations for Wearing Cloth Face Coverings,” the CDC states: “Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading if it is not possible to wear one.” 

In a May 2020 article in Hearing Review, authors Alexander Goldin, Barbara Weinstein, and Nimrod Shiman presented research that showed medical masks (including N95s) served as “low-pass filters” that weakened high-frequency speech tones by the wearer. In combination with background noise and the absence of visual cues, the authors conclude that speech was “close to unintelligible for many.”

The health agency cites specific populations in its revised recommendations, including those with hearing loss: “People who are deaf or hard of hearing—or those who care for or interact with a person who is hearing impaired—may be unable to wear cloth face coverings if they rely on lipreading to communicate,” the CDC states. “In this situation, consider using a clear face covering. If a clear face covering isn’t available, consider whether you can use written communication, use closed captioning, or decrease background noise to make communication possible while wearing a cloth face covering that blocks your lips.”

In its June letter, ASHA stated that clear face masks and other flexible communication methods—such as shared computer screens, notepads, whiteboards, voice-to-speech applications, personal sound amplifiers, use of plexiglass barriers, and other related resources can assist in making communication more effective, most critically for imparting one’s medical needs and preferences. 

“In this challenging environment, ASHA remains committed to continued advocacy to realize its vision of making effective communication, a human right, accessible and achievable for all. We are very pleased to work with CDC to make progress on this front, and we look forward to our continued engagement with the agency,” said Rodgers.

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Source: ASHA