PERSPECTIVES
Viewpoint
COVID-19, Face Masks, and Social
Interaction: How a Global Pandemic
Is Shining a Light on the Importance
of Face-to-Face Communication
Tina M. Grieco-Caluba
Purpose: The purpose of this article is to discuss the impact of
COVID-19 mitigation strategies on face-to-face communication.
The article covers three main areas: the effect of face masks
and social distancing on aspects of communication, including
speech production, speech recognition, and emotion
recognition; the effect of face masks on access to visual speech
cues; and downstream effects of poor speech recognition on
language and cognitive abilities.
T
he SARS-CoV-2 (COVID-19) global pandemic
will be one of the defining events of 2020. At the
time of this writing, the primary mode of transmis-
sion of COVID-19 is through air molecules and, therefore,
primarily through person-to-person contact (Centers for
Disease Control and Prevention, 2020a). Some of the com-
mon symptoms experienced by infected individuals include
loss of taste, respiratory problems, fever, and/or digestive
issues (Centers for Disease Control and Prevention, 2020b;
World Health Organization, 2020). However, not all indi-
viduals infected with COVID-19 experience physical symp-
toms. Additionally, both symptomatic and asymptomatic
carriers of the virus can transmit the virus to other people:
a scenario that has likely negatively impacted communities’
ability to control the spread of the virus. Among the millions
of people who have been infected with COVID-19 world-
wide, more severe complications, including death, have been
observed. Individuals who are most vulnerable to these severe
a
Department of Psychiatry and Behavioral Sciences, Rush
NeuroBehavioral Center, Rush University Medical Center,
Chicago, IL
Correspondence to Tina M. Grieco-Calub: tina_griecocalub@rush.edu
Editor-in-Chief: Barbara Cone
Editor: Laura Dreisbach Hawe
Received February 19, 2021
Revision received June 4, 2021
Accepted June 15, 2021
https://doi.org/10.1044/2021_PERSP-21-00037
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SIG 6
Conclusions: The use of face masks and social distancing
are proven mitigation strategies to minimize the spread of
COVID-19 and other airborne diseases. However, these
strategies may place individuals with hearing, speech,
and language disorders at greater risk for communication
problems in their daily lives. Practitioners who work directly
with these patients should consider these issues when
discussing communication strategies with their patients.
complications include those with preexisting health conditions
and those who are elderly.
As the virus began to spread around the world in
early 2020, health officials in many countries closed busi-
nesses and ordered people to stay home. These extreme
mitigation measures were aimed at rapidly reducing the
transmission of the virus and protecting people. In mid-
2020, communities were allowed to reopen as the rate of
infected individuals decreased. Businesses welcomed cus-
tomers back, houses of worship opened their doors, and
people began to congregate in small groups. The key to
the successful reopening, while minimizing the spread of
the virus, was the implementation of safety measures known
to be effective at reducing transmission of airborne viruses,
such as wearing face masks, social distancing (i.e., maintaining
a 6-ft distance from other individuals), and minimizing the
size of social gatherings to a small number of people (e.g.,
Chu et al., 2020; Markel et al., 2007). Despite the benefits
of these mitigation strategies, they do present challenges
for the many people who rely on face-to-face conversations
and social interaction in their daily lives. Among these in-
dividuals are people who are deaf or hard of hearing,
second-language learners, children with speech and language
disorders, and older individuals whose social interactions sus-
tain their cognitive function and activity levels. Even with the
discovery of an effective vaccine against COVID-19 in late
2020 and an increase in the number of individuals being
Disclosure: The author has declared that no competing financial or nonfinancial
interests existed at the time of publication.
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SIG 6 Hearing and Hearing Disorders: Research and Diagnosis
vaccinated throughout 2021, there continue to be man-
dates for the use of face masks and social distancing to
mitigate the spread of the virus. The patient populations
served by audiologists and speech-language pathologists
are at greater risk for communication difficulties, and
the implementation of these mitigation strategies likely
exacerbates these difficulties. Thus, the purpose of this
article is to explore the myriad ways in which face masks
and social distancing impact face-to-face communication.
It is important to stress that the forthcoming overview is
not an argument against these mitigation strategies that are
effective at minimizing the spread of the virus in communi-
ties. Rather, it is a summary of the potential communi-
cation barriers that arise because of these strategies so
that we, as speech, language, and hearing professionals,
can better serve the populations at risk for impaired
communication.
The Speech Communication Pathway
To better understand how COVID-19 mitigation
strategies pose barriers to communication, let us first con-
sider the speech communication pathway (see Figure 1).
During a conversation, a transmitter (i.e., talker) shares
content with a receiver (i.e., listener). To share this content,
the talker produces an acoustical speech signal, which con-
tains fluctuations in frequency and intensity. Speech pro-
duction is the result of coordinated oral motor movements
that are visible to the listener and, therefore, provide coin-
cident visual speech representations. For any given spoken
language, the changes in frequency and intensity of speech
reflect specific speech units that, when combined together,
form words. The listener then decodes the speech signal to
comprehend the meaning of the content. To do this, the
listener must map the speech units onto their own lexical
representations of speech to facilitate comprehension and
extract meaning.
Speech recognition is not always trivial given the
large variability in speech production both across and
within talkers due to differences in biological sex, age,
accent, or dialect of the talker (e.g., Magnuson & Nusbaum,
Figure 1. The speech communication pathway.
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2007; Trude & Brown-Schmidt, 2011). Additionally, access
to the speech signal may be disrupted by extraneous factors.
One such factor is background sound, such as environmen-
tal noise or background talkers, that masks target speech
or is distracting to a listener (Cherry, 1953; Festen & Plomp,
1990). Another factor is spectral filtering of the signal, which
can occur when it passes through an electrical device, a hear-
ing device, or a face mask. Finally, the amplitude of the
speech signal decreases as the distance between the talker
and the listener increases. In isolation or in combination,
these sources of signal degradation disrupt access to the
speech signal.
There are downstream consequences of poor access
to the speech signal regardless of the source of degradation.
Face-to-face conversations not only require that listeners
hear individual words but also often require that listeners
follow an ongoing speech stream, which is often rapid with
few pauses. Studies utilizing eye-tracking paradigms have
consistently shown that both children and adults have slower
recognition of speech when the speech has been degraded by
background noise or spectral filtering compared to when it is
unaltered (Grieco-Calub et al., 2009; McMurray et al., 2017;
Newman & Chatterjee, 2013). Degraded speech also impairs
verbal cognitive processes, such as working memory and, in
children, acquisition of new words (Newman et al., 2020;
Sullivan et al., 2015). Finally, not only does degraded
speech impact word recognition and linguistic processing,
it may also disrupt acoustic cues related to speech prosody,
such as intonation, pitch, and stress, all of which are criti-
cal for emotion recognition and processing (Everhardt
et al., 2020; Tinnemore et al., 2018).
One strategy that listeners employ to preserve recog-
nition when the acoustics of speech are degraded is to use
visual speech cues of the talker producing the speech dur-
ing face-to-face communication. A listener’s ability to ben-
efit from visual speech (i.e., lipreading or speechreading) to
facilitate speech recognition in children and adults when
auditory speech is degraded is well established (Erber, 1969;
Grant & Seitz, 2000; Kuhl & Meltzoff, 1982; Lalonde &
Holt, 2015; MacLeod & Summerfield, 1987; Ross et al.,
2011; Sumby & Pollack, 1954). Additionally, facial

expressions are helpful when attempting to understand
the emotional context of the speech signal (e.g., Busso
et al., 2004). Finally, the use of gestures, touch, or other
body movements can facilitate communication. Therefore,
although we often focus on the acoustics of a speech signal
and the ability of listeners to resolve those acoustics,
other verbal and nonverbal cues can support effective
communication.
How Do Face Masks and Social Distancing
Influence Speech Transmission
and Speech Perception?
Given our knowledge about the speech communica-
tion process, it is unsurprising that individuals report
difficulty understanding the speech content of their com-
munication partner when face masks and social distancing
practices are implemented. There are three main issues re-
lated to these observations. First, given that COVID-19 is
transmitted via air molecules, the use of face masks reduces
the transmission of air from a talker’s mouth and into a lis-
tener’s nasal and mouth cavities. Although face masks are
effective at mitigating the transmission of the virus, they
concurrently reduce speech energy as it is transmitted out
of the talker’s mouth (Corey et al., 2020; Goldin et al.,
2020; Mendel et al., 2008; Vos et al., 2021). Specifically,
hospital-grade masks act as low-pass filters, effectively
reducing the intensity of the higher speech frequencies
(> 2 kHz) that are important for speech recognition. The
widespread use of face masks in the general public, how-
ever, has resulted in an increase in the variety of materials
and fabrics that are being used to construct the masks.
Given that different materials will have variable trans-
parency and thus different filtering properties, some masks
may degrade the signal more than other masks. Addition-
ally, some people may utilize additional filters under masks
or wear more than one mask at a time as additional pro-
tection from the virus. These factors all contribute to the
filtering effects of the speech signal. Less transparent mask
materials are expected to exert more filtering of the speech
output.
Second, social distancing creates a longer distance
for speech to travel between the talker and the listener.
Similar to the use of face masks, social distancing aims
to reduce the spread of the airborne pathogens. Close
contact in confined spaces increases the likelihood that
the listener comes into contact with air molecules that
are carrying the virus. When considering the relation
between distance and speech energy, the inverse square
law tells us that the sound pressure level of the speech
signal decreases by 6 dB for every doubling of the distance
between the talker and the listener. This can have an impact
on both the listener and the talker. From the perspective
of the listener, decreased energy of the speech signal may
result in parts of the signal being less audible or completely
unheard. In the former case, the listener would likely need
to exert greater cognitive effort to comprehend the speech
signal, which can have downstream consequences on their
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SIG 6 Hearing and Hearing Disorders: Research and Diagnosis
ability to comprehend or recall the content of the signal. From
the perspective of the talker, successful communication will be
achieved only if the content of their speech is received by
the listener. To overcome the intensity loss of the speech
signal due to the greater distance between the talker and
the listener, the talker will likely need to increase their vocal
effort (Fiorella et al., 2021; Michael et al., 1995). Sustained
increases in vocal effort can have negative downstream
consequences on the physical health of the talker.
Third, face masks limit access to the talker’s face,
which provides both verbal and nonverbal cues that en-
hance communication. Related to speech recognition,
disrupted access to the talker’s face limits access to visual
speech cues that appear coincidently with auditory speech.
Since the early work of Sumby and Pollack (1954), studies
have repeatedly shown that individuals across the life span
benefit from both hearing and seeing a talker (i.e., audiovisual
speech perception), particularly in situations when the auditory
components of speech are less accessible (Erber, 1969; Grant
& Seitz, 2000; Kuhl & Meltzoff, 1982; Lalonde & Holt, 2015;
MacLeod & Summerfield, 1987; Ross et al., 2011). Consistent
with this idea, in natural social interactions, listeners flexibly
shift their visual attention to a talker in situations when
the auditory components of speech are degraded or unfa-
miliar (Lewkowicz & Hansen-Tift, 2012; MacDonald
et al., 2020). The benefit of seeing the talker is realized
even when the listener has only partial access to the talker’s
face, suggesting that visual cues are accessible in the ab-
sence of seeing the talker’s lips (Fecher & Watt, 2013;
Jordan & Thomas, 2011; Schwartz et al., 2004; Swerts &
Krahmer, 2008; Thomas & Jordan, 2004). Given that ac-
cess to visual speech cues benefits a listener who has poor
access to the acoustics of a speech signal, a standard rec-
ommendation from audiologists to their patients with
hearing loss is to face their communication partners during
conversations. The widespread use of face masks, therefore,
has the potential to not only disrupt access to the speech
signal but also disrupt established communication strate-
gies implemented by individuals who already have poor ac-
cess to the speech signal. Specifically, face masks can reduce
the overall speech energy and obscure other cues that disam-
biguate speech information. The extent to which face masks
exert these effects will relate to the mask type, how much
the mask filters the acoustics of the speech signal, and how
much the mask obscures visual speech cues; therefore, peo-
ple may experience inconsistent difficulty with understand-
ing speech when the talker is using a face mask.
Together, the use of face masks and social distancing
may significantly reduce the overall intensity and spectral
shape of speech for talkers and listeners. For some people,
the use of face masks and social distancing may simply re-
quire them to speak a little louder or to allocate more at-
tention to speech so that they can understand it. For other
people, the communication barriers resulting from the use
of face masks and social distancing may be more difficult
to overcome. For example, individuals who already have
difficulty with speech production, including people with
dysarthria, articulation errors, and dysphonia, may experience
1099
SIG 6 Hearing and Hearing Disorders: Research and Diagnosis
more frequent communication breakdowns because of the ad-
ditional effort that they need to exert. In addition, there are
many people who report hearing difficulty in complex listen-
ing situations who have not received audiological management.
Among these individuals are people with mild hearing loss
and who are able to navigate their daily lives by using com-
munication strategies, either overtly or covertly, to compen-
sate for their hearing loss. In addition, individuals with
“hidden hearing loss”—individuals who report difficulty
hearing in noise despite having audiometrically normal
hearing—may experience an increase in the number of sit-
uations where they have trouble understanding speech. What
does this mean for speech-language pathologists and audiolo-
gists? First, existing patients may report increased difficulty
with speech production or speech recognition. Second, clini-
cians may experience an increase in the number of referrals
that they receive for speech and hearing evaluations, espe-
cially from individuals who no longer are able to success-
fully implement communication strategies due to the
existence of COVID-19 mitigation strategies.
What Is Effortful Listening and How Does It
Relate to Face-to-Face Communication?
As we have discussed, effective social interactions
rely on the ability of a listener to perceive the speech of a
talker. Audiologists quantify this ability through standard-
ized speech recognition tests. In these tests, listeners hear
speech (words or sentences) and repeat what they hear to
the best of their ability. The accuracy with which patients
repeat the words is used to infer their ability to hear speech
in their everyday environments.
There is growing consensus, however, that typical
speech recognition tasks do not wholly capture what lis-
teners experience in their daily life. Clinically implemented
speech recognition tests typically occur in sound-treated
rooms, in the absence of visual distractions, and typically
at a suprathreshold intensity level. Real-world listening is
different from clinical assessments in multiple ways. First,
the listening environment is more complex than sound-
treated rooms. In contrast, real-world environments fre-
quently contain background sound (e.g., environmental
noise and other talkers) and reverberation, both of which
can mask or distort the target speech information. Second,
real-world listening often involves complex bottom-up sound
encoding and top-down cognitive processes as an individual
hears and processes speech in real time (McClelland &
Elman, 1986). Finally, real-world listening is a bit more
dynamic than speech recognition testing. In daily social
interactions, listeners need to not only recognize the speech
of a talker but also use that speech in a meaningful way
(i.e., comprehending or learning from the content of a
message).
Because real-time language processing contains both
bottom-up and top-down processes, a listener is able to en-
gage both overt and covert strategies to facilitate their
perception when access to speech is disrupted. To better
understand this, think back to a time when you were trying
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to have a conversation with a friend in a noisy environment.
You may have physically arranged yourself to hear her better
(i.e., decreased the social distance between you). You may
have focused more on her face (i.e., gathered visual speech
information). You may have found yourself exerting more
effort to focus on what she was saying (i.e., allocated more
of your attention to her while simultaneously inhibiting at-
tention to the noise around you). You may recall that you
were able to follow the conversation just fine.
What you may not have realized is that your accu-
rate speech perception in this complex listening environment
came at a cost. The additional overt and covert strategies
that listeners employ to maintain accurate recognition of
degraded speech require a reallocation of cognitive resources.
In other words, recognizing words and processing ongoing
speech are “effortful,” as evidenced by physiological, behav-
ioral, and subjective measures. For example, individuals
who exert more effort during a listening task tend to show
increased physiological activity, including changes in skin
conductance, cardiovascular function, and pupil dilation
(as reviewed in Francis & Love, 2020). Additionally, be-
havioral studies have implicated that processing degraded
speech requires greater attentional resources. Given that in-
dividuals have a finite set of attentional resources (Kahneman,
1973), allocating more attention to understanding speech
means that a listener has fewer cognitive resources to multi-
task or to manipulate the speech content in a meaningful
way. Support for this idea has been provided by studies
implementing dual-task paradigms. Specifically, both chil-
dren’s and adult’s performance on secondary tasks decline
as the target speech of the primary speech recognition
task becomes more degraded (Grieco-Calub et al., 2017;
Pals et al., 2013; Ward et al., 2017). Additionally, there is
growing evidence that lexical access in both children and
adults is slower when the auditory input is degraded by
spectral filtering, background noise, hearing loss, or soft
speech (Grieco-Calub et al., 2009; Hendrickson et al., 2020;
McMurray et al., 2017; Newman & Chatterjee, 2013). The
results from this work suggest that listeners who are slower
to recognize words in these situations may be at risk for
missing speech content during a social interaction, where
speech is spoken rapidly with few pauses.
Simply put, there are downstream consequences of
needing to work harder to understand degraded speech. In
the last decade or so, our field has attempted to model the
cognitive and communicative costs related to this “effort-
ful” listening. Theoretical models, such as the ease of lan-
guage understanding model (Rönnberg et al., 2013) and
the framework for understanding effortful listening
(Pichora-Fuller et al., 2016), provide ways to consider
the strategies that listeners use to achieve good speech
perception when their access to speech is disrupted due
to hearing loss, background noise, or other forms of
spectral filtering. Work in this area suggests that language
knowledge, cognitive capacity, and cognitive function are
important components in this process. For example, lis-
teners who score higher on standardized measures of inhib-
itory control (i.e., executive function) and verbal working

memory tend to perform better in adverse listening condi-
tions than listeners who score lower on comparable mea-
sures (e.g., Ng & Rönnberg, 2020; Pichora-Fuller et al.,
1995). Additionally, the ability of listeners to use existing
knowledge to “fill in the gaps” of missing speech will likely
influence their performance. Specifically, better language
skills promote better speech processing (Benichov et al.,
2012; Lash et al., 2013).
Another consideration is how effortful listening influ-
ences downstream language processing and language
learning. If a listener is allocating more cognitive effort
into processing speech and their ability to comprehend
is slower, it is reasonable to expect that their compre-
hension will be impaired and their ability to remember
or learn from the speech input will be disrupted. Consis-
tent with this idea, school-age children perform more
poorly on comprehension tasks when speech is presented
in background noise (Sullivan et al., 2015). Additionally,
younger children learn fewer words when the target
speech is degraded by background noise (Avivi-Reich
et al., 2020; Han et al., 2019; McMillan & Saffran, 2016).
These issues are particularly relevant for children who are
attending in-person school, either full-time or part-time
(e.g., as in some hybrid academic models), where the teacher
and all of the students are required to wear face masks.
Classrooms typically contain significant amounts of back-
ground noise and reverberation, which negatively impact
speech perception and verbal working memory tasks
(Crandell & Smaldino, 2000; Klatte et al., 2013). In sum-
mary, the myriad sources of speech degradation in class-
rooms, including environmental noise and background
talkers, and the use of face masks may negatively impact
the extent to which children can access and retain speech
content.
How Do Face Masks Influence the Social
Components of Face-to-Face Communication?
Face masks not only disrupt access to the acoustic
and visual aspects of speech, but they also disrupt the so-
cial aspects of face-to-face communication (smiles, frowns,
smirks, etc.) that serve as subtle nonverbal cues, context
for verbal content, and emotion. Individuals use a variety
of facial and bodily cues to both communicate and perceive
emotion (Bänziger et al., 2009; Planalp, 1996). The face,
however, provides particularly salient cues about the emo-
tional state of a communication partner. Although the eyes
and mouth are both able to communicate aspects of emo-
tion, both static and dynamic mouth positions tend to do a
better job (Blais et al., 2012). Thus, during times when
social interaction involves the use of face masks, emotion
perception may be altered.
It is important to note, however, that emotion is also
communicated through nonverbal prosodic cues, which in-
clude the intonation, pitch, and stress of the talker’s vocal
production (e.g., Juslin & Laukka, 2003). For example, dif-
ferent types of emotions have different prosodic profiles
that listeners use to determine the emotional state of the
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SIG 6 Hearing and Hearing Disorders: Research and Diagnosis
talker. Because emotion can be communicated by talkers
across auditory and visual modalities, listeners may be able
to flexibly alter their attention on the most salient cues. Thus,
one might suspect that emotion perception may not be dis-
rupted when a talker uses a face mask. There is evidence to
suggest, however, that unimodal perception reduces emo-
tion perception variability across different emotions. For
example, De Silva et al. (1997) showed that individuals
were more accurate at identifying emotions, such as anger,
happiness, surprise, and dislike, when provided with a
visual-only (vs. auditory-only) cue. In contrast, individuals
perceived sadness and fear with higher accuracy with an
auditory-only (vs. visual-only) cue. Listeners are the most
accurate, however, when they have access to both acoustic
and visual markers of emotion (Busso et al., 2004; Chen
et al., 1998). In summary, face masks and social distancing
may alter a listener’s perception of a talker’s emotion, which
could have consequences on their perception of a social
interaction or the intent of the communication act.
Strategies on How to Overcome the Negative
Effects of the COVID-19 Mitigation Strategies
on Face-to-Face Communication
Understanding the existing and potentially cascading
negative effects of wearing face masks and social distancing
on communication is critical for both speech-language
pathologists and audiologists. As discussed, there may be
patient complaints about vocal effort and complaints about
difficulty with understanding speech. There are, however,
strategies that can be implemented to potentially overcome
these negative effects.
One strategy implemented by individuals, especially
those who interact with patients or students who have hear-
ing loss, has been to use transparent masks and face shields.
Both pieces of equipment offer protection against airborne
pathogens and provide the listener with access to visual
speech. Given the benefits of visual speech cues on speech
recognition when acoustic speech is degraded, it is reason-
able to expect that access to visual speech via transparent
masks and face shields can counteract the acoustic filtering
properties of the mask. Consistent with this idea, recent
studies show that access to a talker’s mouth (i.e., access to
visual speech) through a transparent mask improves listeners’
speech recognition (Lalonde et al., 2021; Thibodeau et al.,
2021). It is important to note, however, that the materials
used to make transparent masks and face shields have vari-
able acoustic filtering properties and variable transparency
due to reflections or fogging (Corey et al., 2020; L. Hunter,
personal communication, June 3, 2021). Thus, the benefits
observed with transparent equipment—and thus access to
visual speech—may be limited if the material itself causes
too much degradation to the speech signal.
Another strategy that is effective at improving speech
recognition in the presence of acoustic signal degradation
is the use of FM systems or remote microphones (e.g., Roger
microphone from Phonak). These systems are designed to
improve the intensity of the talker’s voice relative to other
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SIG 6 Hearing and Hearing Disorders: Research and Diagnosis
sounds present in the environment. They are frequently
utilized in classrooms to provide children who are deaf
or hard of hearing with better access to their teacher’s and
classmate’s voices. If masks and social distancing continue
to be mandated within schools, FM systems and remote
microphones may be essential to ensure that children are
able to hear talkers in the classroom.
If listeners are better able to recognize speech because
they have access to visual speech or because they have access
to an improved signal-to-noise ratio, then the onus on the
talker to overcome the acoustic filtering of face masks and
social distancing is less. Consistent with this idea, Beechey
et al. (2020) showed the benefit of hearing amplification to
both the adult users with hearing loss and their communi-
cation partners. Together, the data suggest that finding ways
to improve the fidelity of the speech signal may be critical
to ensuring communication efficiency for people who use
face masks and execute social distancing.
The Long-Term Effects of Social Isolation
on Cognitive and Social Functions
The COVID-19 mitigation strategies have not only
impacted face-to-face communication. It would be remiss
to not address the effects of reduced social interaction in
individuals across the life span. Social interaction is funda-
mental to the human experience. It is critical in infancy to
promote language, cognitive, and social development.
Social interaction promotes vocabulary development and
social emotional learning throughout childhood. As we
age, even small doses of social interaction improve our
cognitive function (Evans et al., 2018; Glei et al., 2005;
Ybarra et al., 2008).
In the early days of the global pandemic, people
were instructed to isolate, and shelter-in-place orders were
issued across the country. For family units, this meant more
time together. In contrast, for individuals living alone, this
meant reduced human, face-to-face contact. Older adults
were especially impacted by shelter-in-place orders given
that they were viewed as a population more vulnerable to
the fatal effects of the virus. Routine social activities, such
as going to religious services, having lunch with friends, or
celebrating holidays with extended family members, were
strongly discouraged and, in some areas, no longer permit-
ted. There has been increasing evidence that reduced social
interaction, or social isolation, is linked to cognitive decline
in older adults (Lin et al., 2013; Maharani et al., 2019).
Therefore, the shelter-in-place orders throughout the
COVID-19 pandemic may have long-lasting effects on
the elderly population within communities.
One strategy to combat social isolation has been the
implementation of videoconferencing technology, which
has enabled continued connection to families, friends, and
work colleagues. For many people, work, school, and so-
cial networking simply pivoted to an online format. The
reality of the situation, however, was that the availability
of videoconferencing technology has not been equitable.
Despite the widespread success of videoconferencing to
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connect people, there have been disparities in individuals’
accessibility to this technology. Reasons for these dispar-
ities range from lack of devices that are capable of video-
conferencing, unstable wireless access, and/or lack of
technical knowledge of the end user. A pre-COVID study
by the Pew Research Center (2019) showed that Internet
access and technology use vary widely based on household
income and age, with lower income and older adults hav-
ing less access. The immediate effects of this disparity have
resulted in inequitable education, health care, and social
connectedness. The longer term effects of technology dispar-
ities and social isolation related to COVID-19 on communi-
cation health in individuals across the life span, however,
will likely not be realized for some time.
Summary
Face masks and social distancing have been proven
to be successful at mitigating the spread of COVID-19.
Despite this success, they may create challenges to effective
communication, which can have negative downstream
effects on speech production, speech recognition, language
processing, and cognition. Individuals with preexisting com-
munication disorders may be at a higher risk for these nega-
tive effects. Understanding the mechanisms that underlie
communication challenges associated with face masks and
social distancing will improve our ability to serve these
patients.
Acknowledgments
This work was supported by National Institute on Deafness
and Other Communication Disorders Grants R01DC018596 and
R01DC017984 and National Institute of Child Health and Human
Development Grant R01HD100439. The author would like to
thank Natalie Krasuska, Diana Cortez, Samuel Shipley, and Kelsey
Sherry for helpful comments on the article.
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