As we embark on a new school year still in the throes of a global pandemic, parents have hundreds of questions and concerns about the safety and growth of their children.  As speech and language pathologists at Speech Sisters, one of the biggest concerns we hear is how will my child communicate while wearing a mask?  And as a parent, should we be concerned? The truth is, we are concerned about the impact that masks may have on language learning for babies and toddlers, but we also believe that parents can compensate by making a language-rich home (mask-free) environment. As this continues to be a novel situation, the evidence and research are lacking to determine the specific impact that masks may or may not have on a child’s speech and/or language development. But here is what we do know based on several relatable research studies and sources…

• “Lip reading is the act of using visual cues to understand and interpret speech in the absence or presence of sound. Normal hearing individuals process some speech information from the sight of the moving mouth” (“Lip Reading”, 2019, para.1).
• Research shows that humans are most successful in interpreting language when both auditory and visual information are accessible during everyday listening. (Peelle and Sommers, 2015).
• One study wanted to determine why children look in the direction of a speaker's mouth versus a speaker’s eyes? The results show that children tend to focus on different facial features depending on their age and stage of development (ranging from infancy through preschool). However, regardless of a child’s age, the findings reveal that most children tend to rely and focus on both the mouth and eyes of a speaker to assist in the interpretation of oral messages. (Morin-Lessard et. al., 2019).
• Face masks can be an obstacle in watching facial expressions and determining empathy toward a communication partner. (Wong et.al., 2013).
• Surgical Masks can affect one’s speech perception from a masked communication partner. (Wittum et. al., 2013).
• AVT (Auditory Verbal Therapy) teaches an individual to use solely hearing to comprehend a verbal message. An individual learns to rely on listening rather than visual cues to comprehend a spoken message. Many children with cochlear implants improve communication development with the use of the AVT treatment method. This proves that when necessary, children are capable of succeeding in comprehending a spoken message using only auditory and verbal sources (Stith, 2014).

As you can see, related research shows that comprehending oral language is improved with the addition of visual cues (watching a speaker’s mouth movements and facial expressions). But here's the thing, in many places at this time we can’t control the facial covering regulation. But, the good news is YOU CAN CONTROL how you communicate to others and to your child when you are wearing a mask. You can also share this article with your child’s caregivers or teachers if needed.

Here are 8 tips on how to improve communication while wearing a facial mask covering:

1. Speak clearly. Make it a point to enunciate words and sentences
2. Exaggerate speech sounds if needed
3. Speak in a slow, unhurried way
4. Decrease background noise if possible
5. Turn up your speaking volume. Use a deep breath to help project your voice
6. Be expressive with your eyes (our eyes show happy, sad, and scared emotions) and tone of voice
7. Use gestures or body language to support your verbal message (act out action verbs)
8. Show the child objects as you speak about them

One more option is that you can purchase a mask that has a clear covering over the mouth, this will allow your child to continue to see your mouth movements as you speak. You can also purchase these as gifts for teachers! In the past, these masks have been commonly used for communication partners who interact with a person who is deaf or hard of hearing and they are wonderful masks that allow one to continue to rely on lip-reading.

And guess what? You can control something else too! You can make a HUGE, positive impact on your child's speech and language development when you are at home (or outside) and not wearing a mask. This is SO important! Your next thought may be, how can I do this in addition to everything else that I am taking on right now? Our online courses will teach you how you can maximize communication opportunities at home during the everyday routines that you are already doing. You don't need to carve out extra time in your day “to do” speech therapy. You can make up a lot of face to face “talk time” at home. You got this!

To learn simple and effective strategies to help get your little one talking, check out our Talk on Track (newborn-14 months) and Time to Talk: Toddler Course (15-36 months). We’d love to equip you to experience the joy of your little one talking to you!

REFERENCES

“Cloth face coverings,” 2020. ( June 5, 2020). Cloth face coverings for children during COVID-19. American Academy of Pediatrics. Retrieved from https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Cloth-Face-Coverings-for-Children-During-COVID-19.aspx

Copithorne, D (2020). Seeing is Believing—And Hearing. Hearing Tracker. Retrieved from https://www.hearingtracker.com/news/clear-window-surgical-masks-are-a-lifesaver-for-patients-with-hearing-loss#a-where-to-buy-clear-window-mask

Katz, R. & Hadani, H.S. ( April 21, 2020). Are you happy or sad? How wearing face masks can impact children’s ability to read emotions. Brookings. Retrieved from https://www.brookings.edu/blog/education-plusdevelopment/2020/04/21/are-you-happy-or-sad-how-wearing-face-masks-can-impact-childrens-ability-to-reademotions/

N.A. (2020). Ideas to make children become comfortable with mask wearing. Retrieved on 5/30/20 from https://llatherapy.org/wp-content/uploads/Mask-Wearing.pdf

“Lip Reading.” Wikipedia, Wikimedia Foundation, 27 Oct. 2019, en.wikipedia.org/wiki/Lip_reading.

Morin-Lessard, E., Poulin-Dubois, D., Segalowitz, N., & Byers-Heinlein, K. (2019). Selective attention to the mouth of talking faces in monolinguals and bilinguals aged 5 months to 5 years.

Developmental psychology, 55(8), 1640–1655. https://doi.org/10.1037/dev0000750

Peelle, JE; Sommers, MS (2015). "Prediction and constraint in audiovisual speech perception". Cortex. 68: 169–81. doi:10.1016/j.cortex.2015.03.006. PMC 4475441. PMID 25890390.

Stith, Joanna L. (2014). What is Auditory-Verbal Therapy? Retrieved on 6/2/2020 from http://www.rchsd.org/documents/2014/04/what-is-auditory-verbal-therapy-cochlear-implant.doc

Wittum K.J., Feth L., Hoglund E. 2013. The Effects of Surgical Masks on Speech Perception in Noise. Presented at the ICA 2013 Montreal; p. 60125. Montreal, Canada.

Wong, C. K., Yip, B. H., Mercer, S., Griffiths, S., Kung, K., Wong, M. C., Chor, J., & Wong, S. Y. (2013). Effect of facemasks on empathy and relational continuity: a randomised controlled trial in primary care. BMC family practice, 14, 200. https://doi.org/10.1186/1471-2296-14-200