Vocal strain: Educators at risk

Have you ever strained your voice? Well, you’re not alone. Local and overseas studies have shown teachers are at a higher risk of vocal strain than many in the general population and early childhood educators need to be aware of their own vocal health and how to minimise risks in their daily activities.

A survey by the University of Auckland in 2015 showed voice problems are a concern for teachers and there is limited awareness among teachers about vocal health, potential risks, and specialised health services for voice problems.

While participants in the survey were primary and secondary teachers, the risk of vocal strain for early childhood educators would be similar. The study of 1,879 New Zealand teachers found:

• A third of participants developed a voice disorder during their teaching career with around 13 per cent having a vocal issue on the day of the survey
• 47 per cent reporting voice problems were moderate to severe
• More than a quarter of teachers had stayed away from work for 1-3 days due to a vocal problem.

Early childhood educators depend heavily on their voice for work. It is an essential tool for the daily delivery of teaching, care and communicating. From singing to reading through to raising your voice to be heard above a noisy classroom, heavy use of the voice can lead to vocal fatigue, which makes educators more susceptible to losing their voice, hoarseness and a disorder such as vocal fold nodules.

It’s important for educators to understand key aspects of their voice, be aware of risk factors and to focus on prevention through managing their speaking environment where possible and taking care of vocal health. Educators need their voices to be flexible, resilient and clear for teaching, so they need to take extra steps to care for their voice.

What is voice strain?

There are many reasons why the voice can be strained, it can be brought on by a viral infection, irritants in the environment or by the overuse or misuse of your voice. Voice strain or fatigue is characterised by hoarseness, soreness and, if not rested or treated, can lead to the gradual loss of your voice. Other symptoms can include loss of intonation or expression, constant throat clearing, dryness in the throat and excessive mucous and pitch breaks on words.

While mild voice loss can be common, if the strain is ongoing and painful it can lead to a more serious condition such as laryngitis or nodules. Continuing to work with untreated severe voice strain can cause long-term voice damage and educators should visit a GP for an assessment and treatment.

Understanding voice production

It’s important to understand key aspects about our voice to be able to care for it. Firstly the sound of your voice is produced by vibration of the vocal folds, these are two bands of smooth muscle tissue that are positioned opposite each other in the larynx. The larynx is between the base of the tongue and top of the trachea, which is the passageway to the lungs.

When not using your voice, the vocal folds open so you can breathe. When it’s time to speak the vocal folds snap together while air from the lungs blows past, making them vibrate. The vibrations produce sound waves that travel through the throat, nose and mouth, which act as resonating cavities to modulate the sound.

Managing vocal health

Vocal injuries are best treated by prevention. Vocal health is about practices that enable educators to keep their voice in an optimal condition and prevent injuries associated with overuse or abuse. Here are some strategies to manage your vocal health:

Speaking environment:

Noisy environments can cause you to increase your vocal effort and volume in an attempt to lift your voice above the noise. While you may not be able to avoid being in a noisy space try setting up a system of non-vocal signals to get the attention of the children. This could include clapping, hand signals, a tambourine or playing music.

Stay hydrated:

Keep a bottle of water handy and sip it at regular intervals. Even though water doesn’t have direct contact with our voice box, it hydrates the cells in our body and works on your body as a total system. Limit your caffeine intake as it dehydrates and can make your larynx and vocal folds dry too.

Avoid vocal extremes:

Obviously shouting isn’t great for anyone’s voice and neither is whispering, both of these vocal extremes can cause stress to your vocal chords. There’s a difference between whispering and speaking quietly. It’s best explained by identifying that a whisper contains more breath. This extra breath puts pressure on your vocal folds in a more acute way than when you are just speaking in your normal voice at a low volume.

Use your voice wisely:

Avoid any vocally abusive behaviours, such as persistent throat clearing, prolonged loud talking or keeping your voice low in a croaky tone, the latter can cause vocal fatigue problems and lead to more serious vocal injuries.

Plan regular vocal naps throughout the day. This is a voice rest or around 5-20 minutes and can be taken during breaks or quiet time. Also learn how to project your voice as this can reduce the stress placed on vocal folds. While the volume of sound made from shouting often comes from a closed and strained throat, the volume created when projecting your voice comes from an open throat.

Good posture:

Posture helps everything: breathing, pain management, digestion and yes, it’s good for your speaking voice. Poor posture can make you feel more fatigued because the body must work harder to keep you upright. This causes more energy to be expended, which results in more fatigue. This tiredness can affect voice quality, breathe support, and vocal pitch.

How you hold your body affects the quality of the sound, the degree of vocal freedom, the clarity of your voice and your ability to take supporting breaths.

The areas to focus on for maintaining good posture are:

1. Alignment of your head, neck and shoulders
2. Lengthened spine
3. Comfortably high chest – ribs up and out
4. Weight distributed evenly across the feet or sit bones

Simple voice exercises:

Just as bodies are warmed up as part of exercising, it’s no different for the voice. Here are some warm-ups to try:

1. Hum to loosen up your vocal chords. Start by doing one long “hmmmm” and hold it, then alternate between descending and ascending hums.
2. Lip buzz or trill, just make a motorboat sound by making your lips vibrate as you blow air through your mouth and nose
3. Tongue trill engages your breathing and voice. Pace your tongue tip behind your upper teeth and exhale while vibrating your tongue tip in a trill. Hold the sound steady and keep the breathing connected.  Try to vary the pitch up and down the scale but don’t push beyond what is comfortable.

Focus on your wellbeing:

Maintain your general health with a focus on sleep, nutrition and exercise. Ensure a good sleep routine, fatigue has a negative effect on the voice. Exercise promotes good posture and breathing which are necessary for good speaking practice. And a balanced diet will nourish your body so that it can regenerate and repair cells – your voice is part of this system.

Ensuring early years educators are aware of how to manage their own vocal health is essential. The value of a voice training session extends beyond the individual and can deliver benefits to your community of children, families and the early education centre.

Resources and further reading

National Institute on Deafness and Other Communication Disorders: Taking care of your voice

Croner-i: Voice strain and loss in teaching and early years

Total Voice Studio: Coping with vocally-demanding jobs