Compared to the general population, teachers are between three and five times more likely to suffer vocal problems and 32 times more likely to report a vocal problem than other professions (Voice Care Australia, 2014).
Kirsten Geraghty, an experienced speech pathologist and voice coach who has been practising for more than 30 years, said teachers have a vocally demanding profession and their vocal loads are extremely high, which puts them at increased risk of a voice injury.
“Given how frequently and the length [of time] teachers are required to use their voices for, speaking in front of the class and over competing noises, using it during lunch time duty outdoors and shouting to communicate during events like sports carnivals, it all adds up,” Geraghty said.
“Their high vocal load coupled with a good dose of stress, which we know teachers often experience, contributes to the prevalence of voice problems they experience,” she said.
Women disproportionately impacted
Previous research indicates there are gender differences in the laryngeal system and pulmonary usage that make women more prone to voice problems (Will, 2016).
According to Geraghty, female teachers who are at the beginning of their teaching career or nearing the end and approaching retirement are more prone to experiencing voice problems.
“It seems to be the trend that voice injuries occur most frequently during the first few years of teaching or at the other end of a teacher’s career, particularly during transition to retirement,” she said.
“Obviously, voice problems can occur at any stage of a teacher’s career, although it seems to be heavily weighted to those cohorts and affects mostly the female population.”
“Going from not talking as much being a student to then being in front of a class teaching and talking all day is a drastic change,” she said.
Geraghty said stress levels and voice problems are intrinsically linked too, as the vocal anatomy is highly sensitive to stress, hormones and mood changes.
“That’s why when for example, if someone is really upset, tired or angry, you can tell by the sound of their voice and hear something is wrong,” she said.
“Voices are really sensitive to mood and how we are feeling, so will close over to protect your lungs, that’s what our vocal cords are there for, so it can get ready to shut down very easily,” she said.
Initial teacher education lacking
Geraghty believes universities need to do much more in terms of ensuring early career teachers are taught about voice injuries as an occupational hazard and how to protect themselves and minimise risk.
“There is still not enough done in initial teacher education to ensure teachers know how to look after themselves and their voice,” she said.
“All beginning teachers, before they enter a classroom, should be taught to recognise the warning signs, how to warm up their voices safely, how to use their voices effectively and project it safely as well as knowing their limitations.
“It really beggars belief that in 2021, the approach to voice injury is still very reactive, rather than proactive.
“Although courses in university might touch on it and there is slightly increased awareness, it’s nowhere near as good as it could be, given that between 20 and 30 percent [of teachers] experience problems.
“That figure is not necessarily reflective of the true number either, because many teachers don’t seek help or report their voice problems, because there seems to still be a slight stigma attached to teachers saying I need help with my voice, as though it’s a sign of weakness,” she said.
Unsurprisingly, health and physical education (HPE) teachers are susceptible to sudden voice injuries, given the nature of their work.
“HPE teachers are prone to more of an acute injury, generally from yelling while outside and having a sudden blowout on the voice fold, or a polyp, a really sudden injury,” Geraghty said.
With many teachers now wearing protective masks in the classroom due to the COVID-19 pandemic, voice strain and vocal fatigue are becoming increasingly common.
“It is really disempowering for teachers to have problems with their voice, because they don’t feel like they’re being heard and it can become a very stressful ordeal,” Geraghty said.
“That is why it is crucial for teachers to have flexible voices and be educated on how to protect their voices, know their limitations and project safely,” she said.
There are several warning signs teachers should look out for that indicate a potential voice problem, and Geraghty said teachers should monitor themselves and be familiar with their voices.
“One of the common signs of a voice problem can be huskiness or hoarseness in the voice at the end of a working day or working week,” she said.
“If you notice a pattern of your voice being fine at the beginning of a day or week but then fatiguing by the end, that’s a sign something isn’t right.”
Loss of range of volume and loss of range of pitch of the voice are further examples of symptoms commonly reported by teachers suffering voice problems.
“Loss of power and loss of the ups and downs, the melodies of your voice, indicates a problem,” Geraghty said.
“A lot of teachers I have treated would say they can’t sing anymore with their class whereas once they used to, which is a sign something isn’t normal,” she said.
If a teacher has returned to work following absence due to an illness but their voice has not fully recovered, Geraghty said that should be monitored.
“Use your sick leave when necessary, take the full two days off to fully recover from conditions like laryngitis and even longer for colds and flu,” she said.
“While you might not feel overly sick, you still lose your voice so teachers do often soldier on and continue to talk over swollen folds, which can lead to chronic and more serious problems.
“If you’ve been coughing lots, your vocal cords have been slamming together repeatedly, which can affect your voice, and some medications dry up the mucous in your nose and vocal folds, which means your voice is like a car running without oil,” she said.
Geraghty said some medical conditions like reflux can also impact on voices.
“Stress can manifest through reflux and if you’ve got stomach acid coming up and sitting at the back of where your vocal folds are, it creates problems,” she said.
“There’s also silent reflux, where people don’t experience the burning sensation, but the damage can be happening without you knowing it.
“Usually with reflux, you wake up with a husky voice and it clears up as the day progresses.
“Again, if you experience this, go see your General Practitioner (GP) or an Ear, Nose and Throat specialist (ENT) who will be able to help and prescribe medication to manage the reflux which can help your voice improve.
“Know your voice, don’t push it too far and understand the impact stress can have on your voice.
“As a rule of thumb, you know you have a voice problem when you’re sucking up your own energy to get your voice out as opposed to energising others with your voice,” she said.
Seek help for voice issues
Geraghty said teachers who have concerns related to their voice should seek help promptly.
“If in doubt, go to your GP and get it checked out,” she said.
“They will then examine you and refer you to an ear, nose and throat specialist if necessary, or advise you to see a speech pathologist.
“It’s wise to have it looked at and certainly if you’re going to try and make a claim, or get some financial support, because it can be expensive over time.
“You don’t necessarily have to have a pathology, or nodules or something sinister to lodge a claim and get some help,” she said.
The other piece of advice Geraghty has for teachers is to invest in learning how to use your voice correctly and safely by attending a relevant workshop or course.
“Sign up to do a voice course, if there is one available near you, because it’s like a form of protection or insurance,” she said.
“Take the opportunity to learn about your voice, because it’s the main tool of your trade and has to be in top form for many years throughout your career.
“Learning how to warm up, warm down, maintain and project safely are really important.
“Doing a voice course is great because it’s professional development but also self-care,” she said.
Geraghty said to support colleagues if you notice issues with their voice and encourage them to get help.
“If you hear a teacher struggling, don’t be afraid to ask them how their voice is going or let them know it sounds a bit dodgy and encourage them to seek help,” she said.
“If you’re experiencing issues with your voice, know that you’re not alone.
“Don’t let it snowball into something out of your control, get on top of it quickly,” she said.