Effects of Face Masks on Perception of Emotion from Facial Expression and Voice in Preschool-age Deaf and Hard-of-Hearing Children

Objectives: Emotional cues in speech communication are delivered in several sensory modalities, including the auditory and the visual modality. Since the onset of the COVID-19 pandemic, masking wearing has become ubiquitous internationally. In this study, we investigated the effects of face masks on the perception of emotional speech in deaf and hard of hearing children (DHH) compared to children with normal hearing (NH). Methods: Thirteen children with DHH participated in the study. Six children were cochlear implant (CI) users and 7 children used hearing aids (HAs). Thirteen children with NH were involved as the control group. They completed the emotion perception tasks, based on stimuli presenting three emotional expressions (happiness, sadness, and anger). Results: There were no significant differences between the DHH and NH groups in mask-wearing and unmasked conditions. The CI group showed lower emotion perception scores than the HA group in unmasked-sad and unmasked-anger conditions. Among communication-related factors, speech perception scores at the sentence level were highly related with the emotion perception scores in the DHH group. Conclusion: These results indicate that children with DHH can accurately perceive emotions even in situations when facial expressions are limited. Children with CIs have more difficulty perceiving emotions than children with HAs. This endeavor will help an optimized treatment plan for children with CIs who have relatively poor emotion perception skills.