Voice Education/Prevention Programs
Linked to the lack of advice and support is the need for early intervention in the workplace in the form of vocal education programs. Our study reported that 93% of teachers did not receive any voice training for their work. We have cited studies that have reported on the efficacy of voice training/education and vocal hygiene programs for teachers.44, 45, 46, 47, 48 Improvement was observed in vocal symptoms, fundamental frequency, ease of phonation, and voice quality. Leao et al have reported on the need for voice training/education programs given the association between low hours of voice training/education and higher frequency of reported voice problems. She suggests that training can be effective in reducing problems.40
On the basis of studies on the efficacy of reported vocal education programs, it seems likely that the introduction of such programs in the schools for teachers would have similar benefits. They would be a form early intervention and as such would have a preventative role. In an earlier article, using a subset of data from the same questionnaire, this author reported that the symptoms, vocal fatigue, dry throat, and reduced vocal range, were statistically significant, and may be the early signs of a developing voice disorder. Therefore, they should not be ignored.20 Bermudez de Alvear et al31 also propose intervention for individuals reporting vocal effort and the presence of frequent symptoms.
Vocal Education Programs in the workplace would help to identify vocal symptoms when they first appear and may help prevent the development of a voice disorder. They can include a combination of voice care (indirect approaches) and direct voice training (prevention of voice problems). Both have been reported to have positive results. The opinions of teachers in this study on what should be included in an educational voice care program are reported in Table 4.
Early intervention in the workplace can play an important role in the detection and prevention of the development of voice problems in teachers. We normally see voice patients including teachers in hospital voice clinics. By this stage, the voice problem has been present for several weeks, months, or even longer. We rarely see primary school teachers when the early symptoms first appear. Early intervention in the workplace would take the pressure off hospital voice clinics, as the client would be seen earlier in the evolution of the voice disorder. In turn, it would reduce the negative impact of a voice problem on the work and personal life of the individual and would have huge economic benefits, in terms of reduction in absenteeism and costly medical and surgical treatments for advanced stage voice problems.