As teachers return to the classroom, we want to emphasize the importance of vocal health and wellness to maintain a healthy voice throughout the demanding school year. Teachers are at high risk of voice disorders and often make up a large portion of the caseload for voice-specialized speech-language pathologists. However, voice disorders are preventable when utilizing functional strategies to help prevent vocal fatigue and vocal fold injury as well as science based vocal health prevention approaches. The definition of a voice disorder is any time the voice does not work, perform, or sound as it normally should so that it interferes with communication (Roy et al, 2007). International literature states that up to 20% of teachers report voice problems. Teachers are 3-5 times more likely to experience voice problems than the general population. Voice problems interfere with student learning, job performance, job satisfaction and cause absenteeism. Teachers report work, social and family life are restricted by their voice problems. (Pemberton et al, 2010). Da Costa and colleagues (2012) cross sectional survey study of primary school teachers with voice disorders revealed some of the barriers teachers have to accessing voice therapy. Barriers included lack of awareness about availability of voice therapy, lacking understanding of physician role in voice health and belief that voice problems are normal in teachers. The good news is “Providing teachers with voice education has been shown to be effective in helping to minimize voice symptoms.”(Pemberton et al, 2010). Evidence-based recommendations (Ziegler et al., 2010; Nanjundeswaran et al., 2012) to improve vocal wellness and care for your vocal mechanism begin with addressing factors that impact the physical environment of voicing to maintain adequate tissue health. In addition, it is critically important to plan for the amount and type of voice use so any negative changes of the vocal fold tissue from teaching are minimized. Below are strategies that can go a long way in helping teachers stay in the classroom so they can be effective in promoting student learning. Promote a healthy body and mind Engage in yoga and other body readiness approaches Keep the lungs healthy by washing hands and wearing a mask to avoid an upper respiratory infection Take time to focus on meditation and mindfulness Eat a diet that is healthy and balanced to limit exposure to refluxed stomach contents Undergo a baseline laryngeal examination with an ENT and an SLP Ensure superficial and systemic vocal fold hydration Use a nebulizer to hydrate the mucosa of the upper and lower airway Maintain your environmental humidity between 45-55% Incorporate nasal breathing whenever possible Drink enough non-caffeinated fluids such as water or herbal tea Maintain pliable vocal fold tissue Incorporate non-vocal classroom management such as a whistle or clapping Clean the classroom environment to be free of dust, chemicals, or mold Complete daily vocal warm-ups and vocal cool-downs Plan silent instructional activities and incorporating flipped classroom time Use amplification as well as optimize classroom acoustics and ergonomics Sources:Da Costa, V., Prada, E., Roberts, A., & Cohen, S. (2012). Voice disorders in primary school teachers and barriers to care. Journal of voice, 26(1), 69-76.Nanjundeswaran, C., Li, N. Y., Chan, K. M., Wong, R. K., Yiu, E. M. L., & Verdolini-Abbott, K. (2012). Preliminary data on prevention and treatment of voice problems in student teachers. Journal of Voice, 26(6), 816-e1.Pemberton, C., Oates, J., & Russell, A. (2010). Voice care education: Preliminary evaluation of the voice care for teachers package. Journal of Health, Safety and Environment, 26(5), 441–462.Roy, N., Merrill, R. M., Thibeault, S., Parsa, R. A., Gray, S. D., & Smith, E. M. (2004). Prevalence of voice disorders in teachers and the general population.Ziegler, A., Gillespie, A. I., & Verdolini Abbott, K. (2010). Behavioral treatment of voice disorders in teachers. Folia Phoniatrica et Logopaedica, 62(1-2), 9-23.
World Voice Day is an annual celebration of voice. The 2023 theme is “Your Voice Matters” – each individual voice is unique and special. Each voice is a tool to express ourselves, encompassing culture, identity, and artistry. Aaron, Jennifer, and Connor explore several of these facets below. Culture, Language, & Voice Aaron Ziegler, PhD, CCC-SLP (he/him/his)Director, Speech-Language Pathologist, Singing Voice Specialist Voice production is a complex human behavior influenced by factors such as genetics, age, disease, and emotion (Titze, I.R., 1997). Voice research has begun to encompass a wide range of speaker backgrounds in understanding the relationship between cultural-linguistic variations and voice production (Bryant, G.A., 2021). Indeed, vocal communication varies among the world’s different languages. While there are phonatory system constraints limiting the variance possible, for example, breath capacity or vocal tract shape, vocal modulation involves much cultural-linguistic variation (Matzinger T. & Fitch, W.T., 2021). The presence of voicing, pitch and intonation, nasal resonance, and voice quality are a few vocal parameters that vary among the languages. Whether or not voicing occurs shifts meaning in English and many other languages. Most of the 44 sounds in English are voiced; the remaining sounds are produced without vocal fold vibration. Some languages like Cantonese are tonal, that is, pitch inflection shifts meaning. In certain languages, changes in nasalence and vocal quality alter meaning. For example, use of nasal vowels versus oral vowels can shift meaning in French and the presence or absence of breathiness can shift meaning in Gujarati (Ladefoged, P., 2005). For multilingual speakers, shifting from one’s primary language to their second language can involve perceived vocal strain (Järvinen, K., 2017). In other words, listeners perceive increased vocal effort when a person speaks a second language. How would voice therapy differ among patients with different cultural-linguistic backgrounds? For multilingual speakers, voice therapy may benefit less than optimal voice production that occurs in their second language. Given such cross-cultural variances in vocal communication, consideration of the speaker’s cultural-linguistic background is an important part of culturally and linguistically affirming support of the voice. Your culture matters. Your language matters. Your voice matters. Sources:Titze, I.R. (1996). Introduction. In Workshop on acoustic voice analysis: Summary statement (pp. 4-5). National Center for Voice and Speech.Ladefoged, P. (2005). Vowels and consonants: An introduction to the sounds of languages (2nd ed.). Blackwell Publishing.Järvinen K, Laukkanen AM, and Geneid A.(2017). Voice quality in native and foreign languages investigated by inverse filtering and perceptual analyses. Journal of Voice, 31(2): 261.e25-261.e31.Bryant, G.A. (2021). Vocal communication across cultures: Theoretical and methodological issues. Philosophical Transactions of the Royal Society B: Biological Sciences, 377(1841): 1-11.Matzinger T. & Fitch, W.T. (2021). Voice modulatory cues to structure across languages and species. Philosophical Transactions of the Royal Society B: Biological Sciences, 376(1840): 1-11. Art, Performance, & Voice Jennifer Gill, MS, CCC-SLP (she/her/hers)Co-Director, Speech-Language Pathologist, Singing Voice Specialist The limbic system, the emotional center of our brain, has a direct connection to the larynx to create motor patterns for laughter, moans, screaming as well as for singing (Titze, 2010). The extraordinary use of the voice for singing can trigger emotional responses in both singer and listener. The timbre of one’s unique voice and the nuances of what is considered aesthetically pleasing or vocally and artistically viable can differ greatly across genres. One person’s perception of “noise” or an unpleasant sound may be another person’s desired art form. Voluntary artistic vocalizations can range from the operatic vibrato, melismas, and trills to utilizing extreme vocal range in head voice, whistle register, and chest voice, to rapping, beat boxing, riffing, screlting, screaming, and even vocal fry. Some musicians deliberately distort their vocal sound by putting their false vocal folds and other soft tissues above the vocal folds into vibration. “Most emotional responses from exposure to fine and performing arts are directly in response to a stimulus by an individual based on cultural, socio-economic, educational, and innate preferences (LeBorgne, 2021).” There is a song and a style for everyone. Effective singing support and vocal training to optimize on the artist’s specific style and genre can maximize one’s performance for vocal longevity. “A bird doesn’t sing because it has an answer, it sings because it has a song.” Maya Angelo Sources:Titze, I.R. (2010). Fascinations with the human voice. National Center for Voice and Speech.Leborgne, W.D., & Rosenberg, M.D. (2019). The vocal athlete. Plural Publishing. Gender Identity, Expression, & Voice Connor Mahon, BA (he/they)Communications Liaison, Speech-Language Pathology Graduate Student The perceived gender of one’s voice is an early and important part of identity development. Even before one’s first physical maturation affects the vocal mechanism, children demonstrate gendered voice differences (Zimman, 2018), which are perceptible as young as 2.5 years old (Munson, et al., 2022). Voice professionals most often interact with those who want something different from their voices. When the goal is alignment between voice and gender, the process is explorative, and requires a shift in mindset. Voice is more than a tool for verbal communication — it is also a meaningful facet of gender expression, and one that we can take ownership of. As this year’s World Voice Day theme puts it, “Your Voice Matters.” Sources:Zimman, L. (2018). Transgender voices: Insights on identity, embodiment, and the gender of the voice. Language and Linguistics Compass, 12(8), e12284.Munson, B., Lackas, N., Koeppe, K. (2022). Individual differences in the development of gendered speech in preschool children: Evidence from a longitudinal study. Journal of Speech, Language, and Hearing Research, 65(4), 1311-1330.