Special Education Teachers' Self-Assessed Voice Health Regarding Voice Use Habits

OBJECTIVES

Special education teachers (SETs) work with students with disabilities. To get and keep these students' attention during the lesson, they may use their voices with high loudness and frequent pitch changes. These situations can be tiring for their voices and affect their vocal health. This study aimed to compare SETs' voice fatigue, reflux symptoms, and self-assessments according to their voice use habits in their work and social lives.

METHODS

A total of 208 SETs were included. A Teacher Voice Use Habits Questionnaire was developed by considering the literature, taking expert opinion, and conducting a pilot study. In addition, the Vocal Fatigue Index (VFI), Voice Handicap Index-30 (VHI-30), and Reflux Symptom Index (RSI) were used. One-way ANOVA, Mann-Whitney U, Kruskal Wallis-H, and Pearson correlation analyses were performed.

RESULTS

Of SETs, 37.5% reported frequent hoarseness, and 65.4% reported voice fatigue during/at the end of the day. Those who answered "yes" to the questions about talking loudly at home, having the television on at home, feeling stressed in the work environment, eating and drinking before going to bed at night, smoking, having frequent colds, talking loudly during the day, and voice fatigue during/at the end of the day had significantly higher scores in all scales. Those who used their voice for more than 6hours were found to have significantly higher scores on the VFI and RSI. In all scales, the scores of those who made very frequent long phone calls were significantly higher.

CONCLUSION

According to the SETs' reports, it was concluded that they did not comply with the rules of vocal hygiene, although they used their voices for a long time. This situation should be considered an occupational health problem in schools, and it may be helpful to screen this group's voice disorders and design preventive programs.

Modes of Educating Teachers About Vocal Hygiene: A Comparative Study

OBJECTIVES

Educating teachers about vocal hygiene can be a means of alleviation or prevention of voice problems in this population. The present study aimed to compare four modes of educating teachers in India (n = 80) about vocal hygiene.

METHOD

Four groups of 20 teachers were exposed to educative material on the vocal hygiene program created for the present study. Each group received it either in audio mode delivered by the researcher posing as a voice therapist (VA); in audio mode delivered by a researcher posing as a teacher (TA); in written mode delivered by the researcher posing as a voice therapist (VW); or in written mode delivered by a researcher posing as a teacher (TW). The improvement in the knowledge of teachers before and after vocal hygiene education was gauged by administering a written questionnaire before and after the content that the teachers received.

RESULTS

Results revealed that all four modes were effective in vocal hygiene education. However, no significant difference (P > 0.05) in the improvement of knowledge in teachers across the four modes was seen although the relative mean difference was observed higher for TW mode than other modes. Individual item analyses revealed that some concepts were conveyed more effectively than others. This gave insights into improving the quality and efficacy of vocal hygiene programs in the future.

CONCLUSION

Findings have implications in reaching out to remote areas and employing peer-to-peer teaching as an effective way of vocal hygiene education among teachers.

Prevalence of Voice Disorders in Indian Female Secondary School Teacher Population-A Cross Sectional Study

Teachers are the backbone of any civilized society as they are the keepers of knowledge, wisdom and values. Lack of infrastructure, manpower and resources makes voice the most important tool for a teacher. Teachers need to speak loudly for long periods often under unfavourable circumstances. Increased vocal effort and incorrect phonation techniques can lead to vocal fold tissue damage and vocal fold pathologies and hence voice problems producing adverse effects on teaching performance. To study the prevalence of voice disorders in Indian female secondary school teacher population. To identify the risk factors for the development of voice disorders. A multicentric, cross-sectional observational study of 200 teachers were conducted in 4 schools over a period of 2 years. Female teachers who gave consent and were willing for follow up were included in the study. Details were collected using a structured questionnaire. Subjective analysis by VHI, perceptual analysis by GRABS score, acoustic analysis and direct visualization using Hopkins 70° rigid laryngoscope were done.The prevalence of voice disorders was 18.5%. Risk factors identified were age group 41-60 years, repeated respiratory allergies, comorbidities, constitutional symptoms, increased number of years of teaching and number of lecture hours per week. VHI, GRABS, Acoustic analysis findings were consistent with Rigid Laryngoscopic finding making them effective tools in the assessment of voice.

Impact of Classroom Determinants on Psychosocial Aspects of Voice Among School Teachers of Indore, India: A Preliminary Survey

Teaching voice is the professional voice; often different in quality from our day-to-day speaking voice, and is supposed to be subjected to vocal abuse, misuse and overuse. This paper aims towards highlighting  the various classroom determinants that may impact teacher's voice and how these impacts can affect the daily activities in terms of functional emotional and psychosocial aspects. To understand the same, a cross sectional prospective study was conducted across eight English medium institutions of Indore (a city in central India) region. The study was carried out in three phases: formulation of a questionnaire, data collection (through administration of the questionnaire and VHI among sixty school teachers) followed by data analysis, to determine whether any association exists between the various classroom determinants and voice impairment. Significant association was found between determinants like teaching experience; number of classes, duration of breaks, use of any alternate method of teaching and alternate use of any amplification device with physical, emotional and functional aspects of life. The findings holistically indicate that various factors within the classroom environment only has a significant bearing on the voice disturbances of a school teacher's life thus deteriorating their quality of life. Thus it is substantial to begin a training programme by speech language pathologists in order to heighten awareness among teachers. After all voice disturbances are a real and treatable condition and with the right amount of training can be avoided.

Vocal Health Practices Among School Teachers: A Study From Chennai, India

INTRODUCTION

A healthy vocal system is a prerequisite to produce a serviceable voice for any vocal profession. The concept of vocal health (VH) among teachers is worth exploring considering their known risk of developing voice disorders.

AIM

To provide socioculture-specific information on VH practices and nature of voice problems in teachers.

METHOD

A VH questionnaire was developed to elicit opinions toward one's own voice health and factors that indicated and contributed to impaired/poor VH from 384 school teachers.

RESULTS AND DISCUSSION

'Flexible voice' (23%), 'enduring voice' (22%), and 'good voice' (22%) were descriptions to indicate good VH by teachers. 'Vocal fatigue' (13%), 'dry throat' (9.4%), 'throat irritation' (4.7%), and 'pain while swallowing/speaking' (3.1%) were frequently reported throat sensations to indicate poor VH. For 30.2% of the teachers, voice mattered for professional needs. However, most of them managed to cope with voice problems through several home remedies and 'intentional/self-imposed neglect' despite their vocal difficulties. Sociocultural factors influencing these findings and scope to escalate voice problems in teachers as a public health issue are discussed.

CONCLUSION AND IMPLICATION

Insight and perception of VH based on self-reports and information on voice practices among teachers pertinent to this geographical location provide scope to develop models for counseling and preventive treatment for voice problems.

Multi parametric voice assessment: sri ramachandra university protocol

Emergence of "Voice specialty clinics" in ENT and Speech Language Pathologist (SLP) practice in India necessitates development of standard protocols for assessment and management of voice disorders. Based on recommendations from European Laryngological Society in Dejonckere (Eur Arch Otorhinolaryngol 258:77-82, 2001), a comprehensive voice assessment protocol was adapted for Indian population. This study aimed at verifying the face validity and feasibility of using the developed voice assessment protocol in a multi specialty tertiary care hospital. It included: history, clinical examination, visual analysis, perceptual analysis, aerodynamic measures, acoustic analysis and patients' self assessment of voice. The developed protocol was administered on 200 patients with voice concerns and problems. Correlation of self assessment with the assessment by the professionals was done using Kendaul tau_b correlation test. The scores of self assessment did not correlate significantly with acoustic measures. Differences in lab findings and self percept of voice indicated that these two were complementary measures in the protocol. Further, diagnosis and management decisions were arrived through a consensus discussion involving the ENT surgeon, SLP and the patient. Vocal hygiene and voice conservation were advised to all patients. Recommendations for voice therapy and/or surgery were provided based on findings from the protocol. The study demonstrated feasibility of using a comprehensive protocol for effective documentation, comparisons, review, training and treatment planning.

Interventions for preventing voice disorders in adults

BACKGROUND

Poor voice quality due to a voice disorder can lead to a reduced quality of life. In occupations where voice use is substantial it can lead to periods of absence from work.

OBJECTIVES

To evaluate the effectiveness of interventions to prevent voice disorders in adults.

SEARCH STRATEGY

We searched MEDLINE (PubMed, 1950 to 2006), EMBASE (1974 to 2006), CENTRAL (The Cochrane Library, Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006) and the Occupational Health databases OSH-ROM (to 2006). The date of the last search was 05/04/06.

SELECTION CRITERIA

Randomised controlled clinical trials (RCTs) of interventions evaluating the effectiveness of treatments to prevent voice disorders in adults. For work-directed interventions interrupted time series and prospective cohort studies were also eligible.

DATA COLLECTION AND ANALYSIS

Two authors independently extracted data and assessed trial quality. Meta-analysis was performed where appropriate.

MAIN RESULTS

We identified two randomised controlled trials including a total of 53 participants in intervention groups and 43 controls. One study was conducted with teachers and the other with student teachers. Both trials were poor quality. Interventions were grouped into 1) direct voice training, 2) indirect voice training and 3) direct and indirect voice training combined.1) Direct voice training: One study did not find a significant decrease of the Voice Handicap Index for direct voice training compared to no intervention.2) Indirect voice training: One study did not find a significant decrease of the Voice Handicap Index for indirect voice training when compared to no intervention.3) Direct and indirect voice training combined: One study did not find a decrease of the Voice Handicap Index for direct and indirect voice training combined when compared to no intervention. The same study did however find an improvement in maximum phonation time (Mean Difference -3.18 sec; 95 % CI -4.43 to -1.93) for direct and indirect voice training combined when compared to no intervention. No work-directed studies were found. None of the studies found evaluated the effectiveness of prevention in terms of sick leave or number of diagnosed voice disorders.

AUTHORS' CONCLUSIONS

We found no evidence that either direct or indirect voice training or the two combined are effective in improving self-reported vocal functioning when compared to no intervention. The current practice of giving training to at-risk populations for preventing the development of voice disorders is therefore not supported by definitive evidence of effectiveness. Larger and methodologically better trials are needed with outcome measures that better reflect the aims of interventions.