All Masked Up: On World Voice Day, Solutions to COVID-19 Voice Challenges

Masks, face shields, and respirators all aid in preventing COVID-19 transmission. They also make communication more difficult.

Often, we struggle to hear each other, or we find our voices tiring out more quickly after speaking through masks. Vocal fatigue can also lead to persistent hoarseness or other voice changes, which in turn can cause compensatory muscle tension and discomfort in the face, jaw, neck, and shoulders. Some people also feel short of breath with a mask, making it more difficult to speak for prolonged periods of time.

Note: If you or a client experience hoarseness or voice changes lasting more than two weeks, an evaluation by a multidisciplinary voice team including a laryngologist and SLP specializing in voice is recommended. Likewise, if you suspect you have hearing loss, schedule an evaluation with an audiologist. 

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These issues—along with the ongoing need for physical distancing and heightened challenges experienced by people with hearing loss—can cause  a communication conundrum. Here are some simple solutions to common voice and communication issue associated with mask use.

Problem: Masks interfere with our ability to read lips and see facial expressions, which makes understanding more challenging.

Why it’s a problem: When we communicate with others, we often rely on additional information, beyond what we can hear, to better understand what a speaker is saying. Lip or speech reading, which incorporates speech patterns and mouth movements in the listener’s processing, helps us interpret what someone says. Nonverbal communication also provides additional information about a speaker’s message. Masks create visual obstruction of these two components of communication.

Solutions: Increase the precision of your articulation and slightly exaggerate the movement of your lips when speaking.  To augment communication, use other nonverbal body language, such as hand gestures and pronounced facial expression with your eyes and eyebrows.

Problem: Your voice becomes fatigued or hoarse after speaking while wearing a mask.

Why it’s a problem: Certain masks can muffle or interfere with the sound of our voices, potentially making it more difficult to be heard and understood—especially during physical distancing. To compensate for this sound distortion, a speaker often exerts more vocal effort and increases volume beyond comfortable and sustainable levels. This results in vocal fatigue or voice changes that can persist.

Solutions: To help keep your voice healthy while speaking through a mask.

• Adopt general vocal hygiene recommendations: Stay well hydrated, avoid smoking and alcohol, manage reflux or allergies, avoid excess throat-clearing and coughing, and avoid laryngeal irritants (such as fumes and harsh chemicals).
• Monitor your daily voice use by not speaking too loudly and for too long at a time.
• Use “clear speech” or slightly exaggerated articulation when speaking.
• If you speak quickly, try slowing your rate slightly. This will help you pause to take breaths to “power” your voice with minimal effort.
• Reduce any upper body tension by periodically stretching throughout the day.
• Consider using voice amplification for online sessions (headset or USB microphone) to help preserve the voice for in-person use with a mask.
• Ensure your mask sits comfortably on your face and doesn’t significantly contribute to jaw and neck tension.
• Maintain a comfortable, neutral posture when speaking.

Problem: With masks and physical distancing, you have difficulty being understood by people with hearing loss.

Why it’s a problem: Someone who has hearing loss  can’t use typical strategies—like getting closer—to help fix a communication breakdown. The listener also loses visual cues of lip-reading and facial expressions, as discussed above.

Solutions:

• Use slower and more articulated speech.
• Face your communication partner directly.
• Avoid loud background noise and move to a quieter place if possible.
• Used your hands and body language to augment your message.
• If you are speaking with someone new, ask them what you can do to make communication easier for them.
• Make sure hearing loss and use hearing assistive devices are turned on and functioning.
• Consider using masks with clear panels and face shields made of clear plastic.

While the COVID-19 global pandemic physically distances us, we’re often wanting safe social interaction probably now more than ever. As schools, clinics, and private practices start reopening—and restaurants and shops allow more consumers—most everyone can benefit from optimizing communication without compromising vocal health and safety.

Editor's note: The theme for World Voice Day this year is "One World Many Voices!" Join ASHA SPecial Interest Group 3: Voice and Upper Airway Disorders, for an online discussion next week. Beyond Hard Conversations: Responding to Racism, Sexism, Transphobia, and Ableism in Our Settings

Date: Thursday, 4/22/2021

Time: 8:00–9:00 p.m. EDT/5:00–6:00 p.m. PDT 
 
 

Jennylee Diaz, MS, CCC-SLP, is a bilingual speech-language pathologist specializing in the evaluation and treatment of voice, swallowing, and upper airway disorders in the Department of Otolaryngology at the University of Miami. She is an affiliate of ASHA Special Interest Group 3, Voice and Upper Airway Disorders. j[email protected]