Cairo Association of Teachers - Newsletter

CAT Tracks for June 24, 2008 TEACHER VOICE

Hours of lessons leave teachers with voice-related problems.

By Tom Avril
Inquirer Staff Writer

Leah Chadwick's job left her speechless - literally.

Every fall, her voice felt a bit worn out after a few months of teaching ninth-grade social studies in Mount Holly. Then, in November, she'd take on the extra job of swim-team coach, shouting to the kids underwater:

Streamline off the wall!

Don't breathe off your turn!

By midwinter, some days her voice was entirely gone.

"I'd get it back by Friday," Chadwick says, "and then Saturday we'd have a swim meet."

Scientists have gained a good understanding of how we produce sound only in the last few decades, and that knowledge has found its way to singers, politicians, and others who speak a lot on the job. But new research suggests that teachers place unique demands on their voices, and that they may tend to gut it out, not seeking help until too late.

Chadwick didn't know it, but her vocal cords were so swollen they could not open properly. Each one had a nodule - a bumpy growth similar to a callus that sometimes is even called a "teacher's nodule."

It didn't have to happen. The human voice is a workhorse of an instrument, equally capable of lofty operatic arias and repeated shouted commands, but not if it is used improperly.

"Teachers are near the top of the list," says Robert T. Sataloff, a Philadelphia physician and voice specialist who treats patients from around the world. "They allow themselves to get more and more hoarse."

He says teacher-training programs ignore the subject of voice care, except at music schools - and even then, the knowledge is sometimes outdated. To top it off, classroom acoustics are often poor, says Sataloff, who is chairman of the ear, nose and throat department at Drexel University College of Medicine. "Either they're very dead, or they're very echoey," he says.

Teachers are about twice as likely as nonteachers to suffer from a voice problem at some point - nearly 58 percent vs. less than 29 percent, according to a 2004 study in the Journal of Speech, Language and Hearing Research.

Scientists have started to ask why. Sure, teachers talk a lot, but so do people in some other professions.

Lubrication

A key difference may be that teachers do not take breaks, says Eric J. Hunter, a researcher at the National Center for Voice and Speech, in Denver. The theory is that four hours of speaking in a near-monologue may be more taxing than the same amount of speech spread out over eight hours, he says. And sometimes teachers must speak loudly - using what Arlene Ackerman, the new Philadelphia schools superintendent, referred to recently as her "teacher voice."

Research at the University of Wisconsin has shown how the forces applied to the vocal cords cause the redistribution of the organ's internal lubricants. During a pause in speech, these fluids resume their natural place.

Hunter says failure to allow this can cause problems. He likens it to what happens when a construction worker uses a vibrating power tool for too long.

"The blood just stops flowing to the hand or whatever's holding on to it," Hunter says. "You give it these little breaks just to allow fluid to redistribute, to allow blood to come back in."

One solution, he says: drink water. But teachers sometimes forget to drink, or don't want to, because they can't leave their class unattended to hit the bathroom.

And they talk a lot. In a 2007 study, scientists at the Denver center placed special sensors on teachers' throats and found they had 1,800 episodes of "voicing" per hour at work - compared with just 1,200 per hour when off-duty.

Scientists' understanding of the voice has changed dramatically in the last three decades.

Start with the name vocal cords. The term arose from the old belief that these bands of tissue generated sound by vibrating like the strings on a violin, says Sataloff, who is also a professional opera singer and chairman of the Philadelphia-based Voice Foundation.

Researchers now say the sound is produced in a way that more closely resembles two hands clapping - typically hundreds of times a second - and they prefer the term vocal folds. The Denver scientists estimate that a teacher's vocal cords open and close a half million times a day.

The folds open because air is forced through them. When they snap shut, the interruption in the airstream creates sound.

"The more robustly they blow apart and snap together, the louder you get," Sataloff says. But if people don't breathe properly, heavy use of the voice can lead to a range of problems: cysts, hemorrhages or nodules.

Surgery is an option, but while Sataloff is a surgeon, he says this is sometimes not the best approach.

Learning to breathe

Maryann Cembor, a kindergarten teacher in Bayville, Ocean County, suffered from chronic raspiness. She thought she simply had recurring colds or allergies; one doctor prescribed antibiotics. Some of her lessons required her to sing to the children, and at times she could barely get through it.

The real culprit, she eventually learned, was a pair of cysts. An ear, nose and throat doctor referred her to Sataloff, whose practice takes an unusual interdisciplinary approach. Singing teachers, speech pathologists and nurse specialists are all on staff; he consults with a range of physician specialists and a voice scientist as well.

"They actually made me stop and think about my breath control," Cembor says. "I needed to give my voice more support."

Even when Sataloff recommends surgery, he makes his patients do weeks of therapy and exercises first, lest the problems come right back.

For example, patients are taught to breathe out with muscles in the abdomen, back and chest, rather than straining from the neck.

"Most people's breathing is too tense, too shallow," Sataloff says. "I want them to speak correctly as soon as they open their mouth after surgery. . . . You can do anything you need to do with your voice, including yell and scream, if you know how."

Cembor still has cysts on her vocal folds, but they have shrunk. Her voice sounds normal.

Chadwick, who teaches at Rancocas Valley Regional High School in Mount Holly, also avoided surgery by undergoing therapy, and she has tried to recraft her lessons so she is not speaking for long periods at a time. This year, she had an added boost:

The school district purchased a surround-sound amplification system for Chadwick's room, for a little less than $1,000. She wears a wireless headset, and her voice is projected from seven small speakers mounted high on the classroom walls.

"I kind of look like a drive-through person, taking your order," she jokes.

No summer break for Chadwick's voice, though. Today, she starts coaching a 200-person swim team. Her solution?

She'll be using a megaphone.