*developed by the National Association of the Deaf (NAD) with input from other deaf, hard of hearing, and DeafBlind consumer advocacy organizations and subject matter experts
August 26th, 2020
General Guidelines with Masks
During a health threat such as a coronavirus, people should wear masks in public. Wearing masks gives people some protection. At the same time, many masks hide the lips and half of the face, which makes it harder to understand speech. It is also hard to understand sign language when the person is wearing a mask. Facial expressions are an important part of sign language. It is very important to wear masks to stay safe during a pandemic, but also very important that deaf and hard of hearing people can understand what everyone is saying.
Our guidelines explain the best ways to communicate with deaf and hard of hearing people while following health recommendations. Our guidelines do not explain how much each mask or face shield protects people from any virus.
The best way for people to use masks and communicate clearly with deaf and hard of hearing people is to wear clear masks and possibly clear face shields. Research is still ongoing about the safety of clear face shields to protect against spreading the virus. While not all deaf and hard of hearing people are able or want to read lips, clear masks and clear face shields may improve communication in some situations. Even though a clear mask still blocks some of the person’s face, it is still better than a non-clear mask. A clear mask will show lips, and a clear face shield will show enough of the face to understand facial expressions. You may see light reflected on the clear face shield that might cover up the lips and facial expression of the person wearing it. Both masks and face shields – clear or not – still cause muffled speech, which makes it harder for people who both listen and lipread. But clear masks and clear face shields are helpful in some situations.
If a deaf or hard of hearing person is food shopping or getting gas, they may need to ask an employee a simple question. Using a clear mask or clear face shield may be helpful for a short conversation at a public place. For other situations with longer discussions, the deaf or hard of hearing person has a right to understand what is being said. Those longer discussions might be at a hospital, court hearing, school, or at work. For those discussions, deaf or hard of hearing people may need American Sign Language (ASL) interpreters (including Certified Deaf Interpreters), Cued Language Transliterators, professional captioning (often referred to as CART), and/or assistive listening devices and systems.
Some people who wear masks and have difficulty communicating with deaf or hard of hearing people have tried to use children to interpret for their deaf and hard of hearing parents. It is never okay to use children to interpret for deaf and hard of hearing family members. Federal laws require that the interpreters be neutral.
Specific Protections for DeafBlind People
In any situation, DeafBlind people usually need a closer view, large print, or touch for communication access. Some DeafBlind people use ProTactile sign language which means interpreters and/or Service Support Providers (SSPs, otherwise known as “co-navigators”) communicate through touch. DeafBlind people have a right to ask for specific accommodations they need. Interpreters and SSPs/co-navigators should be given a clear mask/shield and personal protective equipment (PPE).
Best Face Protections for Communication Access
During a health threat, it is important to follow which face masks or covers health officials recommend. Most public places require people to wear a mask or something to cover their mouth but they don’t have any communication access policy. They should.
Again, our guidelines explain the best ways to communicate with deaf and hard of hearing people while following those recommendations. Our guidelines do not explain how much each mask or face shield protects people from any virus.
Today, people have three options to protect their face from a virus. These three options are: a clear face shield, a clear mask, and/or additional communication strategies. Explained below is how each option can best help deaf and hard of hearing people communicate.
Clear Face Shields
Clear face shields are one option for deaf and hard of hearing people. When a person wears a clear face shield, you can see that person’s facial expressions, which helps lipreading and sign language. Some clear face shields may become fogged during use. You can buy liquids to help prevent or reduce fogging. Some of those liquids are listed in Appendix A. Speech may be muffled or sound differently when wearing a clear face shield; remember to speak more clearly and carefully. Appendix A also includes a list of where you can buy clear face shields or learn how to make them at home.
For communication access, clear masks are better than masks such as cloth masks, surgical masks, or N-95 masks. Keep in mind, some clear masks still block parts of the face. Clear masks may also become fogged while wearing it. You can buy some liquids to help reduce the fogging. These liquids are listed in Appendix A.
There are several companies who make clear masks but we do not endorse any specific clear masks. Appendix A lists different clear mask brands.
Sometimes too many people want clear masks, and the companies in Appendix A may not have enough clear masks to sell. If there are no clear masks available, you can make your own at home. Appendix A shares different links that show how you can make your own .
A person wearing a clear mask may sound unclear or muffled while wearing a clear mask; remember to speak more clearly and carefully.
Non-Clear Masks with Other Communication Strategies
Cloth or surgical masks are the most common. Some people wear N-95 masks. Others use bandanas or other materials to cover their nose and mouth. These masks cover most of the face and are not see-through, which makes it harder to communicate.
These types of masks should be a last resort when communicating with deaf and hard of hearing people. Clear face shields or clear masks should be used instead. Be prepared to also use other ways to communicate. For longer conversations, deaf and hard of hearing people should have ASL interpreters, captioning, or assistive listening systems. In other situations, like at a store or bank, there are different ways to communicate while wearing a non-clear mask.
People can type a message on their phone and show it to the other person. Some apps show large print. Other apps can do speech-to-text which automatically types out speech. Appendix A has a list of these apps. Keep in mind that speech-to-text may not be accurate because speech often is muffled by masks. You should hold the microphone as close to the speaker as possible without risking safety. We do not recommend sharing phones, each person should use their own to type and show their message. Your phone should be fully charged in case you need to use it to communicate.
Hard of hearing consumers may have portable FMs, portable hearing loops, or personal streaming devices with them and available to use.
With those fluent in English, you can also use a whiteboard and marker or paper and pens. Again, you should not share pens, each person should write with their own pen.
The last option would be to try to stand six feet away and ask the speaker to pull their mask down to try lipreading. Lipreading is not easy so the speaker should talk slowly and clearly. Again, this is a last resort and is not recommended unless the speaker is asked by the person to pull down their mask.
Businesses Must Provide Other Accommodations
Even with clear face shields or masks, deaf and hard of hearing people may need other accommodations for longer conversations. You may need interpreters or captioning at work, hospitals, courts, lawyers’ offices, and schools.
Employers should give clear masks or clear face shields to all employees who work with deaf or hard of hearing employees. Masks that block the mouth shouldn’t be used because they are a communication barrier.
Employers may need time to buy clear masks or clear face shields. Employers must also provide other accommodations, such as interpreters, captioning, typed or written communication, or assistive listening devices. If job duties permit, employers should allow Deaf employees to work from home until there are enough clear masks or clear face shields for all co-workers.
Allowing their employees to wear non-clear masks without any other access for deaf and hard of hearing employees puts employers at risk for a lawsuit. Deaf and hard of hearing employees can file a complaint with the Equal Employment Opportunity Commission (EEOC) if they do not have access at work. Deaf and hard of hearing federal employees can file a complaint with their agency’s EEO office.
Employers should work with each deaf or hard of hearing employee to understand what kind of accommodations they need. What works for one person may be different for the other person.
Schools and universities must make sure their deaf and hard of hearing students have access to education. For in-person classes, teachers should wear clear face coverings when working with deaf or hard of hearing students. Be sure to also follow the CDC guidelines for masks in schools. Schools must also provide other accommodations, such as interpreters, captioning, or assistive listening devices.
All staff (not just the teachers) should wear clear face coverings when communicating with deaf and hard of hearing students. This includes nurses, audiologists, therapists, interpreters, bus drivers, and others. Staff should also wear clear face coverings when communicating with deaf or hard of hearing employees or family members.
Teachers of the deaf and interpreters should wear clear face coverings to make it easy for deaf and hard of hearing students to understand what is being taught. In a program where there is more than one deaf student or in a deaf school where students need to understand each other, school administrators should consider which type of clear face covering works best for each deaf or hard of hearing student, depending on their age and/or comfort level.
Federal rules for masks are strict for hospitals and doctors. Those rules require FDA-approved medical masks. The FDA should prioritize approval of clear masks and clear face shields for medical use.
Hospitals and doctor’s offices should have medical clear masks and clear face shields available. Doctors and nurses should use these clear masks and clear face shields when they treat deaf or hard of hearing patients. These clear masks and clear face shields should also be used when communicating with deaf and hard of hearing companions. Hospitals that have deaf and hard of hearing employees should make sure other employees who work with them wear clear masks and clear face shields.
Hospitals and doctor’s offices should provide interpreters and SSPs/co-navigators with clear masks or clear face shields. If hospitals and medical offices have a limited supply of clear face shields and clear masks, they should follow this order for who should get these masks:
- Interpreters and SSPs/Co-Navigators should also get personal protective equipment (PPE).
- Medical staff and patient advocates that work with deaf, hard of hearing, or DeafBlind patients or employees.
- Medical staff and patient advocates that sometimes have contact with deaf, hard of hearing, or DeafBlind people.
We also have guidelines on telehealth for doctors that want to know how to best use telehealth with deaf and hard of hearing patients.
During a health threat, many legal meetings and court hearings are done remotely. For in-person meetings and court hearings, the lawyers and court staff that work with any deaf or hard of hearing person should wear clear masks or clear face shields. Clear masks or clear face shields should also be given to interpreters and SSPs/co-navigators.
Under federal law, police officers and sheriffs must provide effective communication to deaf and hard of hearing people.
Police officers should have clear masks to use with deaf and hard of hearing people during brief encounters like traffic stops. If police officers do not have any, then they should find other ways to communicate. At a traffic stop, the police officer should communicate using paper and pens. The police officer can also use their phone and use large print or speech-to-text apps (listed in Appendix A). Phones or pens should not be shared between people. As a last resort, if requested, the police officer can stand six feet away from a deaf or hard of hearing person and pull down their mask to talk.
Children and family members should never be used as interpreters. Federal law requires that interpreters be neutral and qualified. Family members of any age and skill cannot be neutral.
For longer conversations such as interviews at police stations, police officers should provide qualified interpreters (including Certified Deaf Interpreters) or captioning services. Interpreters should be given clear masks or clear face shields.
Many stores, restaurants, banks, and other businesses now have a large clear plastic shield guard for each cashier check-out lane. Employees who work behind these protective plastic shields should be ready to pull down their masks to talk with deaf or hard of hearing customers, if asked to do so. Employees should never ask deaf or hard of hearing people’s children to interpret.
These businesses should have clear masks or clear face shields available when they need to communicate with deaf and hard of hearing customers or employees.
Appendix B is a Communication Card for deaf and hard of hearing people to use. The Communication Card can be used anywhere at any time for deaf and hard of hearing people to share their communication needs.
1) Have clear masks or clear face shields available
2) Use your own phone and download large print or speech-to-text apps (listed in Appendix A). Make sure your phone is charged or have a portable battery charger with you. Do not share your phone.
3) Use a whiteboard, or pen and paper. Do not share the pens or markers.
4) Stand six feet apart at all times.
5) Only as a last resort, and if asked, the person can stay six feet away and pull down their mask for lipreading.
6) Deaf and hard of hearing people – bring your communication card with you everywhere (in Appendix B).
You can contact firstname.lastname@example.org for help.
Christopher J. Moreland, M.D., MPH, Associate Professor of Internal Medicine, Dell Medical School at the University of Texas at Austin
Michael McKee, M.D., MPH, Associate Professor of Family Medicine, University of Michigan
(*consumer advocacy groups that advocate for the rights of deaf, hard of hearing, and DeafBlind people)
Appendix A: Resources
We encourage companies that produce clear face shields and clear masks to increase production of their shield or mask and to continue innovating to meet the needs of deaf and hard of hearing people. Again, we do not endorse any of the products listed below but offer them as a resource.
Companies That Sell Face Shields
* availability of these masks may change as orders come in and raw materials are available, so please be sure to confirm mask availability with the company.
Companies That Sell Clear Masks
*availability of these masks may change as orders come in and raw materials are available so please be sure to confirm mask availability with the company.
- FaceView Mask (not yet in market but coming soon)
- LEAF N-99 Clear Mask
- People who live in Missouri may apply for a clear mask to be mailed to them
Tips for Keeping Clear Masks from Fogging:
Making Face Shields or Face Masks at Home:
*please consider the CDC’s guidelines on face coverings to make sure the shield/masks you make are safe
- Tutorial on Making Homemade Clear Acetate Face Shield
- Tutorial on Making Homemade Clear Visor Face Shield
- Face Shield DIY Tutorial
- Tutorials on Making Homemade Clear Masks
Typing Back and Forth with Large Print:
- Big Note (iOS, Android)
- Cardzilla (iOS, Android)
- Google Keep (iOS, Android)
- Make It Big (iOS, Android)
- Sorenson Buzz Cards (iOS, Android)
- Ava (can type back, many languages available) (iOS, Android)
- Google Live Transcribe (can type back, many languages available) (Android)
- iOS Dictation (works with any text app on iOS, must be enabled in settings)
- Microsoft Translator (can type back and translate, many languages available) (iOS, Android, Windows)
- Otter.ai (English only) (iOS, Android)
- Web Captioner (many languages available)
I DO NOT UNDERSTAND YOU WITH YOUR MASK ON.
I AM [choose one: DEAF/HARD OF HEARING/DEAFBLIND].
MY NAME IS [add your name here].
◻ I WILL HOLD UP MY PHONE FOR YOU TO SPEAK INTO MY SPEECH-TO-TEXT APP. Please do not touch my phone.
◻ PLEASE USE YOUR OWN PHONE TO TYPE IN BIG TEXT OR USE A SPEECH-TO-TEXT APP. I PREFER TO USE THIS APP: [add your preferred app for typing or speech-to-text]
CERTAIN COLORS MAY HELP ME READ THE TEXT BETTER.
MY PREFERRED BACKGROUND COLOR IS: [type your preferred background color]
MY PREFERRED TEXT COLOR IS: [type your preferred text color]
IF MY SMARTPHONE IS NOT WORKING WELL OR AT ALL, PLEASE WRITE DOWN WHAT YOU ARE TELLING ME. USE YOUR OWN PAPER OR WHITEBOARD.
[Add here any other communication needs you have.]
[For when you go to vote] HERE IS MY IDENTIFICATION CARD / DRIVER’S LICENSE.