Sounds of Silence: How the Pandemic Has Impacted Our Communication Skills

Every year since 1927, the month of May has been designated “Better Hearing & Speech Month” to promote awareness about communication disorders and the wide array of effective available treatment opportunities.

Though the month has long passed, the need this year is greater than ever – all year long.

Changes to Our Way of Life

The pandemic has turned our lives upside-down. In early 2020, we had to transition from brick-and-mortar to virtual systems overnight. We jumped from our business offices to working from home and from in-person medical visits to telehealth. We embraced streaming services, takeout from restaurants and virtual holiday celebrations.

The timing of the pandemic was uncanny. Americans actually had the infrastructure to support it; we had become accustomed to online banking, Amazon deliveries and FaceTime chats with our out-of-town friends and relatives.

What a different scenario from 2014, when I came up with my business plan to create a virtual speech therapy company, called Great Speech Inc. Before the pandemic, our ability to conceive life virtually was not on the public’s radar and was indeed groundbreaking. Today, telehealth and telemedicine are not only mainstream, but expected.

What we were not prepared for was the infectious nature and deadly capacity of this virus and how it affected face-to-face communication and in-person socialization. We sheltered in place, worked from home and Zoom-schooled our children. We found new ways to connect, share ideas around virtual conference tables and enjoy after-work activities. Our children were jolted from their daily school routines of sitting face-to-face in classrooms, participating in after-school activities and enjoying sleepovers, parties and play dates. With parks closed and field trips canceled, socialization and language development opportunities were unnaturally limited.

Face Coverings Complicate Connection

Beyond the day-to-day disruption, mandatory mask-wearing complicates our ability to communicate even further. Masks can make it hard to breathe, project our voices and use facial expressions to share our emotions.

As social creatures, we naturally crave connections and facial expressions are an essential part of non-verbal communication. It gives us the cues we need to promote conversation and establish and maintain social relationships.

We have all struggled to communicate with a mask. I personally have experienced the stress of making myself understood, particularly in a store with a lot of background noise. For the hearing-impaired, the combination of wearing a mask has been extraordinarily challenging. Unable to lip read, and without the visual cues of nonverbal communication, this segment of the population has been at an extreme disadvantage.

Communication Struggles Are a Universal Crisis

Most of us will bounce back from these challenges. The concern is for those who culturally, financially or geographically have limited access to health care services even during non-pandemic times.

Promoting better speech and hearing awareness is key in addressing these social determinants of health. Resources that enhance quality of life can have a significant influence on population health outcomes.

According to the Centers for Disease Control and Prevention, there are 34.2 million Americans diagnosed with diabetes. The National Institute on Deafness and Other Communication Disorders approximates 46 million Americans experience some form of communication disorder and 37.5 million Americans report having some form of hearing disorder. And these were the numbers before COVID. Yet, “diabetes is associated with substantial clinical and economic burdens” on patients and on the U.S. health care system, while communication disorders are not.

As a country, we spend billions of dollars treating diabetes which is the seventh leading cause of death in the U.S. Perhaps it’s the mortality factor which naturally garners more awareness. Though communication disorders may cost the U.S. up to 186 billion dollars per year and may impact an individual’s physical, social, educational and vocational health, the awareness is surprisingly limited.

What’s Next

We need to create awareness for those who are not in grave danger yet are medically impaired and give a voice to those who cannot effectively speak for themselves.

I strongly suspect we will see the number rise for post-pandemic communication disorders. I have personally seen a dramatic increase in the inquiries in my virtual speech therapy practice; other therapists are reporting a similar increase. Think of the havoc COVID-19 wreaked on the larynx and vocal cords of those who were intubated, the front-line workers who had to work with masks and overuse their voices. Let us not forget those students who were not diagnosed during this school year with a speech or language delay.

The needs for communication remediation are not just limited to COVID-related issues. With the medical advances and increased survival rates of stroke patients, victims of car accidents and others who have sustained traumatic brain injuries, the State of Texas alone has guesstimated a 32% increase in speech therapy demand by 2028.

Awareness and Advocacy Are Key

While promoting awareness is key in remediating the problem of lack of access and the lack of education about the efficacy of virtual speech therapy, advocacy is also needed. Health care professionals should be encouraged to ask questions about communication issues and patients need to be empowered to express their need for services. The addition of communication concerns to the health care provider-patient conversation may be the powerful advocacy tool needed to propel the awareness to the level needed for action.

We are making strides with insurance companies who have been reluctant in the past to cover telehealth services but rose to the occasion during COVID for two reasons:

• One reason was that traditional delivery of services was impossible.
• The other reason is that consumers did not accept denial as the final act, but used it as an opportunity to continue the conversation and broaden the coverage for services.

Demand is one of the driving forces for change. Awareness and advocacy are equal partners.

By raising awareness, increasing demand and promoting advocacy, we can address communication disorders – both those related and unrelated to the pandemic – and promote the promising opportunities available for remediation by the speech and language therapy community.