According to the CDC, “Masks should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance” (CDC Guidelines). However, speech language pathologists are in a unique position. Our job is based on communication and our clinics are pediatric based. The American Speech and Hearing Association (ASHA) states, “Although critical to infection control, masks may negatively affect audiology and speech language pathology services”. Below are many reasons how wearing a mask can negatively impact the efficacy of speech therapy sessions:

  • Increased difficulty in understanding speech: Masks attenuate sound by 3–12 dB and also result in low-pass filtering of high-frequency sounds, making it more difficult to understand speech and some higher-pitched voices (Goldin et al., 2020). Listening to masked speech can be especially hard for people with hearing loss. 
  • Reduced discrimination of speech signal among competing noise: For example, reduced discrimination may occur in the presence of traffic or noisy yard work like lawn mowing. 
  • Reduced intelligibility of the wearer’s speech: Listeners may perceive speech as muffled or lower in volume. 
  • Loss of visual cues: Masks remove the ability to speech read and see facial expressions, which augment communication.
  • Increased difficulty of verbal communication: Speaking and understanding language while wearing a mask can be hard for people with communication problems like aphasia, voice problems, and autism. 
  • Reduced ability to provide appropriate cues to the client/student: Masks can reduce one’s ability to provide communication cues—for example, in the case of speech sound production. 
  • Noncompliance of mask wearing: Masks can be uncomfortable for young and school-aged children, and for people who wear hearing aids or cochlear implants. Noncompliance with mask use can also be an issue for those with cognitive or sensory deficits. 

Based on ASHA’s guidance, we will take the following approach on mask wearing.

  • Clinician and all children over 2 wear masks WHEN POSSIBLE.
  • Any child over 2 who cannot or will not wear a mask will try Telehealth services first (or resume them)
  • If 1 & 2 do not support optimal therapy opportunities, a face shield and/or mask with clear cut out will be worn by the clinician.


Many of our kids have various sensory aversions to different textures of cloth or wearing new clothing. This makes it a challenge to expect them to wear a mask in this new world we’re living in. This summer, we used social stories in our mini-camp this summer to talk about mask wearing with our campers. There are many variations out there but we found this one to be child-friendly, printable, and free! Please feel free to check it out and share it with your child if wearing a mask is a challenge. Talk with your SLP or OT about any recommendations for brands and techniques that might be useful to try. We look forward to ensuring the safety of our clients and staff as well as providing the best therapeutic services possible.

*Our therapists reserve the right to cease in-person services and resume telehealth services at their discretion.