Through The Mask

“The single biggest problem in communication is the illusion that it has taken place.”

–George Bernard Shaw

Under the best of circumstances, communication is an art form.  Misunderstandings, breakdowns, and unintended messages are common threats to an effective verbal exchange between two people.  Most people are able to identify the problem and repair it with clarifications, repetitions or with a rephrased statement. 

The verbal part of communication is typically where the meat of the message lies.  The non-verbal parts, including facial expressions, eye contact, tone of voice and gestures provide a wealth of additional information to support the verbal part. 

Not many people—including myself—ever thought that communication would take place between visual barriers—the face mask that is part of our new normal.  This takes away from the non-verbal aspect, as facial expressions are immeasurably harder to decipher when the speaker’s mouth is covered.

Most masks are cloth or disposable medical-grade materials, but some do feature clear plastic to enhance communication.  These are not very common, and they still do muffle speech.

COVID-19 has dictated that wearing a face mask is now normal.  Scientifically, it helps to prevent or at least hinder the transmission of the coronavirus that carries this novel disease.  This doesn’t mean, however, that many of us like to wear it.  I am willing to do my part and wear it where it is necessary, but it sure feels good to take it off when it is safe to. 

Like many people, I took for granted how easy it was to communicate verbally without a mask.  In my medical experience, I wore a mask only when I had a cold or another respiratory illness in order to protect my patients, or when my patient had other forms of highly contagious airborne illnesses.  This was very rare, but now wearing a mask is the norm. 

I am a speech-language pathologist, a.k.a. a speech therapist.  My work is primarily with adults in a hospital setting, as well as the home health setting.  It is imperative that I wear my mask in these situations, as most of my patients are compromised, and at higher risk for infection.   My effectiveness as a speech therapist behind a mask is an issue that I must take into account.  Some—but not all—of my work involves teaching people how to form words with their mouths, lips and tongue, all of which now have to be covered.  Most often I have to model the oral movements for my patients, and their job is to try to imitate them. 

For both of us, this is a challenge.  I am finding new ways to do my job.  Plexiglass, with other precautions in place, has been helpful.

In my 26 years of practice, I never dreamed it would come to this. 

As a communication expert, however, it is also part of my work to find creative solutions to communication problems when the old ways don’t work.  And the old ways of speaking without a face covering may very well be the old days.  I am hopeful that in the future, we can return to life without face masks in the medical setting, but at this time, like much of the future regarding COVID, this is uncertain. 

Until then, it is a new part of my job description to maximize communication effectiveness through the masks.  As most of us know, the following problems exist in speaking through a mask, and understanding through a mask:

  • Masks muffle sounds.  This is obvious, but bears consideration.
  • With the suggested minimum social distance of six feet, this can make speech sound quieter as the distance increases, and many people don’t adjust their volume accordingly.
  • The non-verbal part of communication—especially facial expressions and lip-reading, which we all do to an extent, are no longer effective behind a mask.
  • People with pre-existing communication disorders such as voice deficits or aphasia (the inability to produce the correct words and/or understand others, most often due to a stroke or other neurological deficits) adds another level of complexity to the challenges they already face to get their words out clearly and cohesively. 
  • People who wear hearing aids or have cochlear implants likely experience even greater discomfort than people who do not.
  • People with noise-induced hearing loss frequently struggle with higher-pitched voices, and this complicates the problem.
  • The social distancing requirements make it impossible to lean in closer when a communication breakdown occurs, or when the sound is too muffled due to the mask.

This is a partial list of the problems that masks pose in communication.  It is my job, however, to find new ways to communicate when the old ways don’t work, just as I have done for 26 years.  However, I didn’t learn anything in college all those years ago regarding this problem.  Like my colleagues, we have simply had to make the best of it, and use what we already know and apply it to this novel problem. 

Much of my advice is simple, and you likely have already been implementing some or all of the following tips in order to make communication work through the mask.  All of us, including myself, can benefit from reminders to put this information into practice:

  • As with any communication exchange with or without a mask, ensuring that you have the attention of your speaking partner is imperative.
  • Especially with greater distance in a social exchange, make sure your view is not obstructed, and you are facing each other directly.  A considerable degree of expression takes place through the eyes.
  • Slow down your rate of speech.
  • Increase your volume a bit, even if it feels like you are yelling.  You likely are not. 
  • Be aware of background noise.  It is a consideration in any verbal exchange, but with greater distance, there is an increased chance for interference from environmental noises such as television sound, music, other’s voices, wind and/or traffic if outdoors.  Adjust your volume accordingly, and repeat yourself if necessary. 
  • It is okay to ask if your message was received, and it is also okay to say that you did not understand someone.  These are unprecedented times, and even though this may have made many people uncomfortable pre-COVID, those old social norms are being necessarily challenged.  I find that if I have to ask for a repetition—or sometimes even two—injecting a bit of humor never hurts. 
  • Gestures and body language have heightened importance in the communication process.  Don’t be afraid to increase these in your expression. 
  • Some people, including my husband’s brother, rely upon lip-reading due to hearing loss.  Obviously, he is at a greater disadvantage.  He relies upon texting when he can, but if he is in an exchange with someone he does not know, he may need to have their message in writing.   The willingness to go this extra mile can make all the difference for him.  If you are in an interaction with someone who struggles like he does, writing your message can be a wonderful gift. 

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As with any ability that is compromised, it is appreciated even more when it is restored.  In my work, I try very hard NOT to take my communication abilities for granted, because I have learned they are not granted.  It is my hope that in time, the health risks we are all facing will lessen or even pass, these hard times will have come and gone, and we can all communicate without a mask. 

Until then, we all have to work a little harder to communicate.  No matter the reason, whether it is because of COVID or some other difficulty, the extra effort is always worth it when we can connect in communication.  It is what humans are meant to do.