Hearing access specialists
Hearing access specialists

Pippa sits on a sofa with phone and notebook in one hand and face mask in the other


Pippa Highfield of Ideas for Ears is searching for practical solutions to the barrier created by face masks

(Now with an update made 21 April 2020)


Hearing access when people are wearing masks

Regardless of Government recommendations at this time, it seems more than a little likely that wearing a mask, or some type of face covering, will become prevalent in many settings.

It is understandable that people will wish to protect themselves and do what’s best for their loved ones, but for people with hearing loss, this is a worrying development.

We are already dealing with the appearance of physical barriers at supermarket check-outs, intercoms at doctors surgeries and the 2 metre rule. All of which, though necessary, is making hearing more difficult.

But this latest development is a real game changer – and not in a good way.

I am uneasy about what it will mean for me personally as someone with significant hearing loss, and I am concerned that across the full population of people with hearing loss, all 11 million plus of us, it will lead to even greater feelings of isolation and exclusion.

Face masks block more than germs

The unintended consequence of masks is that they make life a lot harder for those of us with hearing loss.

People who have substantial hearing loss, like me, are probably well aware that, consciously or not, we use lip reading and facial expression to support our understanding of what is being said.

Among those with smaller levels of hearing loss, or with undiagnosed hearing loss, there might not be the same awareness that face and mouth movement provides a useful aid when they are listening.  It might well be a surprise when they discover how much not seeing someone’s mouth impacts on their ‘hearing’ and comprehension.

In the short-term at least, I suspect this is a situation that we are going to have to deal with as individuals.  It is not going to be easy.

It is likely to feel uncomfortable, for myself included, as we are forced to disclose our hearing difficulties more regularly, widely and repeatedly.  This could cause real anxiety for those feeling this to be undignified, exposing and upsetting.

Handling the unexpected consequences

I finally plucked up courage to use my speech to text app in the chemist yesterday. The pharmacist was standing behind a Perspex screen and was wearing a mask, and I had to stand 1 metre away from the counter – so a fairly challenging test.

I wasn’t intending to use the app as I thought it would be a fairly straight forward transaction, and I would manage without the necessity of hearing. I duly read out my list and, to my horror, was asked, what can only have been a question. I fumbled around for my phone and, explaining I couldn’t hear and needed to use a speech to text app, asked the pharmacist to repeat what he’d said.

After what seemed like an age, accompanied by acute embarrassment on my part, my app informed me that they didn’t have any ibuprofen – not really what I was expecting to hear in a chemist! I confirmed that I’d understood correctly, and moved on to the next item on my list.

Another question, another interminable silence. They didn’t have the brand of antihistamine I wanted, but had something with the same ingredients. This exchanged was cued by the pharmacist holding up two medicine packets. The app was definitely coming to my aid, but as a queue started to form behind me I began to lose my nerve. I couldn’t see the pharmacists expression so rather assumed he was getting as anxious about the queue as I was. At that point I cut my list, and my visit, short.

Was it easy? No. Was I glad I had a solution? Most definitely yes. Will I feel more comfortable using the app next time? Probably not, but needs must.

One final, practical, note. I was using the Otter.ai  app on iphone which needs wifi or mobile data to work, so had the added task of switching on my data. Not ideal when your brain is in an already anxious state. If, like me, you don’t automatically have your data switched on, you could downloaded Live Transcribe for iphone (£4.99 per month) as it has the facility to work offline, so no need for wifi or data. The offline transcription is not as accurate, but at least you only have to remember to open the app!

Advice at 21 April 2020

Frankly, few people will have thought about the implications of face masks on people with hearing loss, so the problems are (for the moment) rather hidden.  This is not surprising given the volume of change that has swept into all of our lives.

However, solutions do need to be found – and realistically, they need to be solutions that people can put in place themselves right now, in a quick and easy(ish) way.   Here’s what I’ve come up with:

1)  Old fashioned paper and pen!

Since we all rely so heavily on our ‘phones these days, I would imagine that fewer people actually carry a pen and paper with them. I do tend to carry a small notebook and pen with me, but rarely think to use it!

Writing important information down like dates, times and numbers can be a useful way to check understanding. This could work in a situation where you can follow the majority of what is being said, but just need to check a few facts.

2)  E-writer, ‘smart’ paper LED writing tablets

If you prefer a more technological version of pen and paper why not get an e-writer? They are inexpensive to buy, lightweight and easy to use. As with pen and paper though, you may need to sanitise your e-writer before and after use to avoid spreading the virus.

3)  Ask closed questions

In some situations, you don’t need to hear the conversation in full, as it is enough to simply ‘get the gist’ of what’s said.  For instance, you don’t need to hear everything at a check-out to be able to guess you’re being told how much you owe.

The trouble here though, is that you don’t know if you’ve misheard! If in doubt use a closed question to confirm your understanding. Something like, ‘ Did you say 40?’ rather than ‘ Did you say 40 or 14?’.

We’d love to hear how you are getting on in the new world of mask wearers and please share your own tips and advice in the comments section below.

4) Speech to text apps (STT)

If you’ve not come across speech-to-text apps before, they simply use the microphone on your smart phone, tablet or other device, to pick up the speaker’s voice and they then translate it into text on your screen.

My experience with various apps like Ava, Google Transcribe and Otter.ai has been mixed, sometimes good, sometimes poor.

I’ve recently been doing more experimenting with Otter, which seems to work best for me, to explore how well it will work in face-to-face situations at a 2m distance from the person speaking.

I haven’t yet tested it in a supermarket or somewhere with background noise, but in quiet locations, I have had some encouraging results.

In my first ‘experiment’, I simply stood 2m away from the speaker and found that the app adequately translated the conversation to text for me.  There was no need to hand the phone over, so no risk of contamination.  I just held it in the direction of the speaker and slightly away from me.

In a second ‘experiment’, I gave a wired lapel microphone to the speaker and found that the accuracy of the translation was improved.

Whilst obviously there may prove to be a few practical issues with using a wired microphone, I can see this set up working well in a doctors surgery, for example, where a longer and more accurate conversation may be necessary.

I should add that the Otter app does record the conversation, so it is important to make the other person aware of that fact before you start using it. 


Update: 21 July 2020

I finally plucked up courage to use my speech to text app in the chemist yesterday. The pharmacist was standing behind a Perspex screen and was wearing a mask, and I had to stand 1 metre away from the counter – so a fairly challenging test.

I wasn’t intending to use the app as I thought it would be a fairly straight forward transaction, and I would manage without the necessity of hearing. I duly read out my list and, to my horror, was asked, what can only have been a question. I fumbled around for my phone and, explaining I couldn’t hear and needed to use a speech to text app, asked the pharmacist to repeat what he’d said.

After what seemed like an age, accompanied by acute embarrassment on my part, my app informed me that they didn’t have any ibuprofen – not really what I was expecting to hear in a chemist! I confirmed that I’d understood correctly, and moved on to the next item on my list.

Another question, another interminable silence. They didn’t have the brand of antihistamine I wanted, but had something with the same ingredients. This exchanged was cued by the pharmacist holding up two medicine packets. The app was definitely coming to my aid, but as a queue started to form behind me I began to lose my nerve. I couldn’t see the pharmacists expression so rather assumed he was getting as anxious about the queue as I was. At that point I cut my list, and my visit, short.

Was it easy? No. Was I glad I had a solution? Most definitely yes. Will I feel more comfortable using the app next time? Probably not, but needs must.

One final, practical, note. I was using the Otter.ai  app on iphone which needs wifi or mobile data to work, so had the added task of switching on my data. Not ideal when your brain is in an already anxious state. If, like me, you don’t automatically have your data switched on, you could downloaded Live Transcribe for iphone (£4.99 per month) as it has the facility to work offline, so no need for wifi or data. The offline transcription is not as accurate, but at least you only have to remember to open the app!


5)  Communication masks with a clear panel

As you may be aware, there are surgical masks on the market that have a clear panel that allow the wearers’ mouth to be seen. These seem like an excellent solution for those of us who rely on lipreading and something to ask for in situations where it feels like we could expect them to be used e.g. a medical setting.

Even though they might not currently be available, by asking about them we can play our part in building awareness that they can help.

Perhaps in time, we will be able to request the use of these types of mask in the same way that we would request communication support like a lip speaker or a BSL interpreter.  This is in line with the Patients’ Rights Act  (Scotland) and the Accessible Information and Communication Policy (England and Wales).

What do you think?

So that’s my thoughts on how we might overcome the practical challenges that face masks create.  To me, it very much seems that the onus will be on us, as people who have hearing loss, to explore, learn and use whatever method possible we can to ensure we are ‘hearing’ the conversation.

What do you think?  Please share your comments or ideas by replying below or sending Ideas for Ears an email.

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17 responses to “Face masks & communication: How to hear someone who is wearing a mask”

  1. I found the suggestion about using a Text to speech app interesting and will try these out as I am very anxious about the future when it seems likely that everyone will be wearing face masks in some form.

    • Fully empathise – we’re anxious about it too. We’ll share the results of the survey on 30 April. Best wishes, Sally & the Ideas for Ears team

  2. Thank you for this review of our options, it is fantastic and I am going to try them all out.
    I failed the first hurdle speaking with the assistant at the pharmacy who was wearing a mask (quite correctly so). I was prepared and gave my name and address but, as we all queue on the pavement and a huge lorry was just starting up at the lights behind me SHE didn’t hear! I knew what had happened but she nipped inside and a colleague with a harder voice (and no mask) came out to speak (loudly) to me. I collected my prescription and left quickly in the opposite direction to the queue! Next time I will have it all written out to show them.
    Our HCA prepared in the opposite corner of her consulting room and spoke her piece prior to slipping her mask into place to treat me – all sensitively done.
    Entrance to the surgery was by speaking to the receptionist through the window, I disclosed my hearing problem and she spoke really clearly and indicated where I should wait to be admitted. I could lipread so communication was good.

    • Hi May, so glad you found the post helpful. It is also really interesting to hear about your experiences with communication at this time. I wonder how it contrasts with the experiences of others e.g. speaking with a GP receptionist or mask use by healthcare staff. We have a survey running at the moment to capture data on the impact of face masks – some good insights coming through already. We’ll share the results when it closes (midday 30 April). Best wishes to you, Sally & the Ideas for Ears team

  3. Hi Pippa,

    An excellent article and very valid observations relevant to all of the hard of hearing. ‘Otter’ was one of the ‘Speech to Text’ apps that one of our MK Hard of Hearing Support Group members had tried with reasonable success. Also, I was at a recent meeting at ‘The Stables’ where a ‘Powerpoint, presentation projected on to a large screen which worked very well for all the attendees including BSL users.
    Perhaps there needs to be a common approach nationally from all the organisations and support groups if, as looks likely, we are all instructed to wear masks for the duration.

    Best regards,

    Norman
    l

    • Thank you Norman. If you become aware of any other experiences anyone has had with speech-to-text apps, we’d be pleased to know. Best wishes to you.

  4. I have an Alead livemic2 which connects by bluetooth to the iphone or ipad as well as to bluetooth ear buds/headphones and through an easytek to my hearing aids. I use it for yoga classes, talks and outings with friends. It costs £59.99. After pairing the mic, I opened ‘notes’, pressed the microphone option, and, talking all the time, walked from the lounge, through the kitchen and out into the garden. Came back and everything I said had been typed. I covered the mic with an antibacterial wipe and also a plastic bag and it still worked. I think if you stop talking then you have to press the mic option again. So, no wire connection, no problem with social distancing or physical transmission of the virus. Doctor could clip it to a pocket, it’s very small.
    I’ve only just discovered Ideas for Ears and am really grateful for what you are doing.

    • Hi Bridget,
      Great to get this practical information about your experiences of a speech transcription app and the testing of a wireless mic when it is protected by plastic. We’d love to know how people react when you try it out in real situations. Are they surprised? Accepting? Unsure? Please stay in touch.
      Best wishes, Sally, Pippa & the rest of IFE team

      • People seem pleased to be given something to help. They quickly forget that they have the microphone as it doesn’t need to be held near the face. The first time we used it, a friend and I walked to a department store. She got used to speaking without having to look at me and we both enjoyed being less likely to trip over. Thinking about it, I guess the doctor, for example, could put the mic on the desk. I haven’t used it to get text – only started thinking about it after receiving your email. I’ll let you know how I get on.

        • Thanks Bridget. We’re based in Scotland where face masks are now actively being encouraged for use by everyone, so perhaps we’re not far away from remote microphones becoming an essential and more widely used tool.

          That’d be great if you could get back to us about your experiences in testing the speech to text app. 🙂

  5. I work at a clinic and I’m wearing my mask all the time, but is hard for people to understand me over the phone while I wear my mask. Do you have any ideas on how to fix this problem? A patient just yelled at me because he walked in while I was talking to another patient on the phone and I had to remove my mask so the person on the phone can understand and the person that was walking in got so mad. That’s frustrating and seriously very annoying, as an essential worker I had deal with all kind of complains. People if you are so scare to go out. STAY AT HOME.

    • Hello Aliza, there are a huge range of difficult and sensitive issues arising because of the way masks hinder how easily people can hear and follow what’s being said. The scenario you outlined is a tricky one – you removed your mask so the person you were speaking with on the phone could hear you but that then caused a negative reaction from someone else who was in the room with you. I suspect the most practical way to avoid future issues like that would be to introduce a protocol (and ensure people are aware of it) that establishes your right to temporarily remove your mask in order to allow a phone call to take place with someone who would otherwise not easily hear you. If others know that is the case then they will be able to safeguard themselves by waiting outside the room until the call is completed. As you may have seen elsewhere on our website, phone calls are notoriously difficult for people with hearing loss and masks will only make them harder. All good wishes with your work. Sally & team

    • I’m glad you found the ideas useful.

      You make a good point, I think everyone is finding it difficult, not just those of us who have hearing loss.

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