Mask on or off? Study uncovers effects of face masks on stuttering

A study by Charles Darwin University (CDU) has leveraged the unique context of mandatory mask-wearing during the COVID-19 pandemic to explore the relationship between stuttering, anxiety-related safety behaviours, and the challenge of maintaining open communication.  

Led by CDU lecturer and speech pathologist Dr Hamid Karimi, the research highlights how the fear of negative evaluation by listeners influences adults who stutter (AWS), leading some to conceal their stuttering behind a mask, while others choose to communicate openly despite it.

Most respondents reported masks interfered with non-verbal cues they would otherwise rely on to signal they were experiencing a speech block, leading to negative self-perception and reduced ability to engage with fluency-shaping techniques.

Fluency-shaping techniques assist with the management and severity of symptoms in AWS and include slowed speech rate, gentle speech initiation, soft voice onset and diaphragmatic breathing.

While some study participants saw masks as a plausible short-term means to conceal stuttering and anxiety, Dr Karimi noted most preferred open communication long-term without the challenges posed by masks.  

“Masks can function as a subtle shield, obscuring the outward signs of stuttering and providing a sense of solace from the anxiety and societal scrutiny often associated with these behaviours,” Dr Karimi explained.

“This concealment comes at a cost, however; disrupting speech and hindering essential non-verbal communication elements such as facial expressions, critical for effective communication."

With up to 60 per cent of those seeking stuttering treatment meeting the criteria for social anxiety disorder, Dr Karimi said the research underscored the need for comprehensive therapeutic interventions addressing both the physical and cognitive-emotional aspects of stuttering in AWS.

“Recognising the role of safety behaviors and self-focused attention in perpetuating social anxiety underscores the importance of an integrated therapeutic approach for AWS,” Dr Karimi continued.

“Addressing speech fluency alone, without considering pertinent cognitive-emotional factors, falls short in providing adequate stuttering treatment.”

Behind the mask: Stuttering, anxiety, and communication dynamics in the era of COVID-19 was published in the International Journal of Language and Communications Disorders.