Texas Speech Communication Journal

Communication teachers are sensitive to the role of vocal delivery in presentations. In fact, it is often an important component of the material taught in public speaking courses. But, how aware are communication teachers of their own voices? Teachers’ voices are among their most powerful tools. Teachers use their voices to motivate, to shape ideas, and to impart knowledge. Despite this fact, teachers belong to a profession that most frequently complains of vocal problems (Herrington-Hall, Lee, Stemple, Niemi, & Miller, 1988; Verdolini & Ramig, 2001). In turn, these problems have been reported to interfere with performance of professional responsibilities (Sapir, Keidar, & Mathers-Schmidt, 1993).

One particular vocal problem afflicting teachers has been called teacher’s nodules. Teacher’s nodules is another name given to vocal nodules. Vocal nodules is a condition in which benign growths develop on the vocal folds. Research shows that teachers may be at a greater risk for developing vocal nodules (Herrington Hall et al., 1988; Mattiske, Oates, & Greenwood, 1998; Schneider & Bigenzahn, 2005).

The value of maintaining good personal vocal health, or vocal hygiene, is often overlooked by teachers and teacher education programs (Russell, Oates, & Greenwood, 1998). Good vocal hygiene includes practices for healthy and continued voice use. Observing vocal hygiene recommendations may be useful in avoiding vocal problems, like vocal nodules. Suggestions for good vocal health practices by teachers will be presented here. As a background for understanding the relationship between vocal health and voice problems, a short description of normal voice production and voice production with vocal nodules is provided. This is followed by a discussion of behaviors that may contribute to the development of vocal nodules and ideas for better vocal health.

Normal voice production

Voice production utilizes as a power source the air that rises from the lungs during breathing. The passage of rising air is partially obstructed by the vocal folds, or voice box (Sasaki & Isaacson, 1988). To produce voice we use our muscles to bring the vocal folds together. Air builds up below them and when enough air pressure has been built up, air flows through the space between the vocal folds causing vibration of the tissue that covers them. Voice is the result of a balanced relationship between several body systems (Prater & Swift, 1984). Even minor variations in the complex process that occurs to produce voice may result in noticeable differences in voice quality. For example, the size and shape of the vocal folds will vary systematically relative to gender and age (e.g., Hollien & Shipp, 1972), contributing to general vocal differences between individuals.

Voice production with vocal nodules

Vocal nodules may be associated with a breathy, hoarse voice as well as alterations in pitch. Vocal nodules are benign growths on the vocal folds. They are the result of tissue reaction to biomechanical stress (Arnold, 1962; Sataloff, 1991). When the vocal folds are forcefully brought together, like when we speak loudly, vocal fold tissue may be traumatized. Vocal fold trauma results in localized swelling on the vocal fold edges that over time may develop into hardened masses called vocal nodules (Greene, 1980; Sataloff, 1991). Individuals with vocal nodules may experience voice problems, as complete closure of the vocal folds may be affected by the presence of the callous-like masses called nodules. Muscular adjustments may subsequently be required in order to achieve adequate closure of the vocal folds; in turn, these adjustments may further aggravate the damage (Prater & Swift, 1984).

Vocal behaviors associated with vocal nodules

Vocal nodules have also been referred to as “screamers nodes” (Nemec, 1961). Vocal nodules are the product of vocal abuse/misuse. While teachers are not necessarily screamers, some teachers may engage in vocal behaviors like screaming or raising their voices that are abusive and can contribute to the development of vocal nodules. Other behaviors that bring the vocal folds together in a forceful manner are also abusive. These include habitual excessive loudness and habitual throat clearing, as well as yelling. Speaking in back ground noise is also abusive as speakers often raise/over-exert their voices in the presence of background noise. Over-use of the voice may also be abusive; excessive voice use is one behavior reported by individuals with vocal nodules (Goldman, Hargrave, Hillman, Holmberg & Gress, 1996). Untrained singing may promote vocal fold trauma (Greene, 1980). Excessive coughing may contribute to the development of vocal nodules as well (Prater & Swift, 1984). Heavy lifting, including weight lifting, is done via forced closure of the vocal folds in order to stabilize the torso/trunk; these behaviors are also consequently potential vocal abuses.

In addition to abusive vocal behaviors, various conditions are also potentially aggravating/predisposing factors. Prolonged/excessive use of the voice when the vocal folds are vulnerable is also potentially abusive (Mowrer & Case, 1982). In fact, teachers with disordered voices report more speaking effort when teaching (Lowell, Barkmeier-Kraemer, Hoit, & Story, 2008). The vocal folds may be more vulnerable when individuals are suffering from sore throats or upper respiratory infections, as well as during portions of the menstrual cycle (Prater & Swift, 1984). Allergies may also aggravate the condition; in fact, De Bodt and colleagues found that allergies may be a factor in the persistence of vocal nodules from adolescence (De Bodt et al., 2007). As a professional hazard, teachers may be exposed to colds and other illnesses more frequently and consequently develop sore throats more often (Greene, 1980). Additional contributory factors may include use of/exposure to dehydrating agents, like caffeine, antihistamines, tobacco, and chalk dust (Prater & Swift, 1984). Lastly, alcohol use may directly or indirectly aggravate vocal nodules (Arnold, 1962; Greene, 1980).

Suggestions for better vocal health

Voice treatment is a common recommendation for vocal nodules and a voice treatment program will often include vocal hygiene training (Pannbacker, 1999). Vocal hygiene includes practices for healthier and continued voice use. Vocal hygiene recommendations are frequently made for numerous vocal conditions, not only vocal nodules. Recent research indicates a benefit of vocal hygiene along with behavior modification on teachers’ reported vocal problems (Hackworth, 2007). Vocal hygiene has furthermore been a part of several successful research studies on treatment for vocal nodules (e.g., Glancer, Syder, Jones and Le Boutillier, 1988; Glaze, 1996; McFarlane & Watterson, 1990). The recommendations presented here are among those that would contribute to achieving better vocal health overall. Medical consultation should always be undertaken if you detect any vocal changes. Furthermore, while the preceding following may be useful for individuals with vocal nodules, they in no way replace the utility of a full course of voice therapy. Voice therapy would include assistance in identifying and modifying vocal abuse patterns, learning to produce voice in ways that are not consistent with vocal abuse, and training in vocally favorable behaviors that include speaking at a proper pitch and loudness with easy onset of voice, as well improved breath control.

One major aspect of healthy voice use is avoiding vocal abuses (Colton & Casper, 1996). Many vocally abusive behaviors may be modified or eliminated. However, changing long-standing behaviors may be a challenge; the help of a voice therapist can be indispensable as a result. Teachers are probably guilty of at least one prime vocal abuse that may be avoided: SPEAKING LOUDLY. Avoiding other abusive behaviors like yelling/screaming, excessive loudness, excessive throat clearing, whispering, singing, talking in background noise, and excessive talking would also be useful. Teachers can consider replacing vocally abusive behaviors with other behaviors. For example, in order to gain students’ attention in class, one might drop a heavy book to the floor instead of raising their voices. You might clap or snap your fingers. Using extended pauses, repetitively turning classroom lights on and off, miming, ringing a bell, and developing a system of hand signals are other behaviors that might replace vocal abuses. In addition, to avoid speaking loudly, prudent use of audio equipment as provided by the school’s facilities is recommended. Alternatively, if such equipment is not available, a personal amplification device might be purchased to help avoid vocal abuse during class time. Research shows that a treatment program that focuses on use of one such device has been associated with vocal improvements for teachers (Roy, Weinrich, Gray, Tanner, Toledo, Dove, Corbin-Lewis, & Stemple, 2002).

In addition, adopting other behaviors may be useful in improving and supporting overall vocal health. Teachers with vocal problems should consider using their voices judiciously and engaging in rest periods during the day as teaching schedules allow. Keeping the body well hydrated by adequate water intake is also frequently recommended and has been found to be useful in some cases (Verdolini-Marston, Sandage, & Titze, 1994). Use of a humidifier at work/home may also be considered. Furthermore, reducing caffeine intake and excessive exposure to dust/fumes/chalk/smoke can contribute to healthier vocal folds. Smokers should quit smoking. Occasionally, individuals who suffer from voice problems like vocal nodules complain of increased stress and somatic problems (Goldman et al., 1996). Relaxation and stress reduction exercises may therefore also be useful.

Conclusion

Teachers of communication are aware of how powerful and valuable a tool the voice is as it relates to the delivery of student speeches in classes. This paper aimed to increase their awareness of the voice to include the use and abuse of voice by teachers themselves. Vocal problems in general are a hazard often associated with teaching. Vocal nodules are one such vocal problem experienced by teachers. Improved vocal hygiene that includes reducing vocal abuses is highly recommended. Several suggestions have been presented here that could be useful in reducing the risk of developing vocal problems.

References

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