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Masked Challenges for People who are Deaf and Hard of Hearing

Christine Anthony, a cochlear implant recipient from Bloomfield Hills, Michigan, recently found herself almost in tears after a lunch outing with her mom and daughter.

Written By: Lisa A. Goldstein

Christine Anthony, a cochlear implant recipient from Bloomfield Hills, Michigan, recently found herself almost in tears after a lunch outing with her mom and daughter. The inability to answer and understand the cashier herself was frustrating, and then the situation was compounded by her own family not understanding her struggles. When she was having difficulty ordering, her family members were busy talking and didn’t notice her distress. When they did, Anthony’s mom thought it was her turn ordering, which made things more confusing. This exemplifies several challenges, she says.

“The first being the obvious, wearing a mask with hearing loss and trying to understand others wearing a mask,” she says. “But the second is a little surprising, [which] is that people around me who are used to me being very capable and self-sufficient are having to recalibrate themselves to me with mask wearing. The second is much more difficult than the first, since it comes from a source that I usually consider my ‘rock’ and ‘safe people’ that totally get me and understand how to communicate with me and even they are having to re-learn things. It’s very isolating.”

COVID-19 has changed life as we know it. For those who are deaf and hard of hearing, everyday routines and methods of communication were suddenly challenged—from missing in-person discussions with co-workers or teachers to trying to comprehend speech muffled behind a mask. Here are some of the situations that people who are deaf and hard of hearing have had to endure since the beginning of lockdown.

Common Denominator

Most difficulties can be traced to one thing: face masks. After years of hard work to function independently in society, those who rely on lipreading to communicate are feeling frustrated and isolated. Think about all the scenarios in which face masks may be required, which is, basically, anything that involves the public. Whether going for a haircut, doctor’s visit, or even grocery shopping, whoever you interact with will likely be wearing a mask.

Some states, like California and Pennsylvania, have exemptions. Pennsylvania’s reads: “Individuals who are communicating or seeking to communicate with someone who is hearing impaired or who has another disability, where the ability to see the mouth is essential to communication, are not required to wear a mask; however, individuals should consider using another type of face covering such as a plastic face shield.”

The problem is obvious: removing one’s mask for lipreaders means increasing the lipreader’s risk of contagion, even if the lipreader is wearing a mask.

Other states have made attempts to provide access for people who are deaf and hard of hearing, but the exemptions are backwards. For example, Washington exempts people who are deaf and hard of hearing from wearing a mask, but not the people who need to communicate with them.

“Masks not only make it harder to hear, people communicate less,” says Dr. Chad Ruffin, a cochlear implant surgeon who has bilateral cochlear implants. “Add hearing loss and the need for lipreading into the mix, and COVID-19 has really worsened the social isolation. It’s imperative that people with hearing loss consciously plan for ways to safely decrease feelings of isolation.”

Clear Masks

There are clear face masks on the market, but they don’t completely solve the issue. When the mask-wearer speaks, the clear panel will fog up, thus defeating the purpose of making it easier to lipread. Many are unaware of and don’t address the fog issue. There are defogging tricks, like putting a little dishwasher detergent on the panel, but they don’t always work well enough. Soap could make the panel blurry, for instance.

Many hospitals use the Communicator Mask, or the Safe’n’Clear, though the clear panels are small. Another mask on the market is the ClearMask, which has full face visibility. The FaceView is expected to be available soon.

Needless to say, the support network for people who are deaf and hard of hearing is invaluable right now. People keep each other appaised of the latest clear mask possibility, even if it’s downright silly, like the ShieldPod, which resembles a giant clear birdcage that covers a person’s head and torso. More realistic ones are the HelloMask —made with biomass-based material—and the Leaf, the first UV-powered clear mask.

Even mainstream news outlets are promoting the use of clear masks, because they go such a long way in improving human interaction. They also benefit children who are learning to pronounce words and the elderly, many of whom are struggling with decreased hearing. All of us rely on facial expressions for clear understanding of speech and thus anyone can benefit from clear masks.

It’s also important to note that these masks only work if everyone else is wearing them, which isn’t realistic in a public situation.

At least one state is doing its part to get them to the right people. The Arizona Commission for the Deaf and Hard of Hearing received 10,000 ClearMasks to distribute throughout the Maricopa County community. This was through a partnership with the Maricopa County Board of Supervisors and the Arizona Association of the Deaf, Inc.

The American Speech-Language-Hearing Association (ASHA) recently applauded the 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.

Accessories

Putting masks on and off isn’t always easy if someone is wearing one or two hearing devices. Taking the mask off could mean inadvertently also taking off the hearing devices. Wearing the mask may also be uncomfortable because of what’s already behind the ears. People have suggested various accessories like attaching straps around buttons on a headband elastic, wearing a hat with buttons on which to attach the straps, or wearing a strap clip. A quick web search for “ear savers” will yield a host of solutions.

Face Shields

Theoretically, face shields make more sense than masks, but the jury is out on their effectiveness. The Journal of the American Medical Association, the American Association of Retired Persons, and The New York Times have addressed the topic.  The bottom line is that research is limited, but promising. Face shields have many benefits that masks don’t, including the ability to cover eyes and offer more face protection. They’re also more comfortable, easier to use in warmer weather, reusable, and easier to breathe in, and they prevent people from touching their faces. Some shields have limits to the amount of protection they can offer, but if there are openings on the sides and bottom, does this even matter because of gravity? More research has to be conducted in terms of efficacy.

At least one state is vouching for face shields. If you’re an Illinois resident, you’re in luck. The Illinois Deaf and Hard of Hearing Commission is distributing a free pack of five clear face shields to anyone who is a state resident. The shields were provided by the Illinois Emergency Management Agency.

One trick Christine Anthony has found to cope with being in public places with people wearing masks is to wear her hair in a ponytail with her hearing devices visible. “In almost every case where there are communication challenges, people either already notice or take note when I point and understand my situation. I have found that once people understand why I am struggling, they are more than happy to work with me, which makes me feel hope about our country’s citizens.”

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