###### Abstract  
Speech intelligibility (SI) tests under realistic acoustic scenarios are complex tasks to perform. Optimal acoustics, in terms of reverberation and noise, are thus needed. This is particularly true in the presence of young hard-of-hearing (HoH) children equipped with cochlear implants who need speech to be highly intelligible to learn. During the COVID-19 pandemic starting in early 2020, wearing face masks became common to avoid the spread of infection, mainly impacting the increasingly challenging task of listening for HoH listeners. This study investigated the influence of different types of face masks on speech intelligibility and listening difficulty under competitive noise scenarios. Fourteen children with cochlear implants were involved, as well as six children with typical hearing. Three types of face masks with different acoustic, filtration, and breathability characteristics were considered; three signal-to-noise ratios (SNR) of +10 dB, +5 dB, and 0 dB were used. As expected, lower SNRs corresponded to lower speech intelligibility, and SI without a mask was similar to that obtained with a mask at the lowest acoustic attenuation, albeit with a low filtration efficiency. These preliminary outcomes help improve speech communication strategies in classrooms to support optimal listening conditions. face masks; speech intelligibility; listening difficulty; cochlear implant; children; noise +
Footnote †: journal: Medical  
* They act as filters that alter the speech signal in terms of amplitude frequency responses [3];
* They lead to excessive vocal effort for the talker and increased listening effort for the listener [4; 5];
* The physical presence of masks limits the secondary communication strategies for hard-of-hearing (HoH) listeners, who usually benefit from lip-reading and who are further hampered from an emotional point of view [6; 7; 8];
* The signal degradation implies a reduction in speech intelligibility, and it is further worsened in the case of dysphonic voices [9];
* Speech is intrinsically variable due to communication intent, e.g., spontaneous or clear [8; 10; 11], as well as by the use of a voice-amplification system [12], by the activity carried out [13], and therefore the presence of a face mask can alter its characteristics;
* The degree of speech understanding under competitive conditions, such as in the presence of face masks, can be decreased in non-native listeners [14]. Face masks represent a barrier to communication. Their negative effects are emphasized for a vulnerable population of listeners who are HoH and wear hearing aids (HAs) or have cochlear implants (CIs). The effects are both on their performance and their mental well-being. [PERSON] and [PERSON] [15] delivered an online questionnaire about the effects of face masks on the speech communication process of adults wearing CIs. The main outcome of the study consisted of evidence that up to 80% of the people who answered the questionnaire reported considerable problems, which turned into psychological distress, such as an increased feeling of loneliness. From an objective point of view, when the degrading effect of face masks on speech is combined with a poor acoustic environment in terms of a high level of reverberation and noise, the speech communication process, which implies the quality of speech understanding, too, can be also strongly degraded. This is a major problem in environments where communication plays an essential role such as school and for younger listeners who should be supported in the learning process [16; 17]. Accounting for the presence of HoH listeners, when a CI or a HA is well fitted, young listeners may achieve in quiet conditions high speech intelligibility levels similar to their peers with typical hearing (TH); vice versa, the presence of noise and reverberation does not enable them to reach comparable performances [18; 19].