Keeping Teachers in the Classroom: Recommendations for Vocal Health and Wellness

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.