Voice Amplification Versus Vocal Hygiene Instruction for Teachers With Voice Disorders A Treatment Outcomes Study Research Article
Research Article  |   August 01, 2002
Voice Amplification Versus Vocal Hygiene Instruction for Teachers With Voice Disorders
 
Author Affiliations & Notes
  • Nelson Roy, PhD
    The University of Utah Salt Lake City
  • Barbara Weinrich
    Miami University Oxford, OH
  • Steven D. Gray
    The University of Utah Salt Lake City
  • Kristine Tanner
    The University of Utah Salt Lake City
  • Sue Walker Toledo
    The University of Utah Medical School Salt Lake City
  • Heather Dove
    The University of Utah Hospital and Clinics Salt Lake City
  • Kim Corbin-Lewis
    Utah State University Logan
  • Joseph C. Stemple
    The Blaine Block Institute for Voice Analysis and Rehabilitation Dayton, OH
  • Contact author: Nelson Roy, PhD, Department of Communication Disorders, 390 South 1530 East, Room 1219, Salt Lake City, UT 84112-0252. E-mail: nelson.roy@health.utah.edu
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   August 01, 2002
Voice Amplification Versus Vocal Hygiene Instruction for Teachers With Voice Disorders
Journal of Speech, Language, and Hearing Research, August 2002, Vol. 45, 625-638. doi:10.1044/1092-4388(2002/050)
History: Received August 10, 2001 , Accepted March 18, 2002
 
Journal of Speech, Language, and Hearing Research, August 2002, Vol. 45, 625-638. doi:10.1044/1092-4388(2002/050)
History: Received August 10, 2001; Accepted March 18, 2002
Web of Science® Times Cited: 72

Voice problems are common among schoolteachers. This prospective, randomized clinical trial used patient-based treatment outcomes measures combined with acoustic analysis to evaluate the effectiveness of two treatment programs. Fortyfour voice-disordered teachers were randomly assigned to one of three groups: voice amplification using the ChatterVox portable amplifier (VA, n=15), vocal hygiene (VH, n=15), and a nontreatment control group (n=14). Before and after a 6-week treatment phase, all teachers completed: (a) the Voice Handicap Index (VHI), an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders; (b) a voice severity self-rating scale; and (c) an audiorecording for later acoustic analysis. Based on pre- and posttreatment comparisons, only the amplification group experienced significant reductions on mean VHI scores (p=.045), voice severity self-ratings (p=.012), and the acoustic measures of percent jitter (p=.031) and shimmer (p=.008). The nontreatment control group reported a significant increase in level of vocal handicap as assessed by the VHI (p=.012). Although most pre- to posttreatment changes were in the desired direction, no significant improvements were observed within the VH group on any of the dependent measures.

Between-group comparisons involving the three possible pairings of the groups revealed a pattern of results to suggest that: (a) compared to the control group, both treatment groups (i.e., VA and VH) experienced significantly more improvement on specific outcomes measures and (b) there were no significant differences between the VA and VH groups to indicate superiority of one treatment over another. Results, however, from a posttreatment questionnaire regarding the perceived benefits of treatment revealed that, compared to the VH group, the VA group reported more clarity of their speaking and singing voice (p=.061), greater ease of voice production (p=.001), and greater compliance with the treatment program (p=.045). These findings clearly support the clinical utility of voice amplification as an alternative for the treatment of voice problems in teachers.

Acknowledgments
The authors wish to thank the school-based speech-language pathologists in the state of Utah who generously volunteered to serve as voice clinicians and without whose participation this research would not have been possible: Amy Anson, Lisa Higbee, Elaine Peterson, Julie Sorenson, Debbie Walton, Susan Williams, and Leslie Woods. The authors also gratefully acknowledge the assistance and support of Becky Almerico, Speech-Language Pathology Coordinator, Jordan School District; and Dale Sheld, Education Specialist for Communication Disorders and Learning Disabilities, of the Utah State Office of Education. This work was supported in part by the National Center for Voice and Speech through Grant R01-DC02285-01A1 (Voice abuse in teachers and the general population) from the National Institute on Deafness and Other Communication Disorders.
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