Three Treatments for Teachers With Voice Disorders A Randomized Clinical Trial Research Article
Research Article  |   June 01, 2003
Three Treatments for Teachers With Voice Disorders
Author Affiliations & Notes
  • Nelson Roy, PhD
    The University of Utah Salt Lake City, Utah
  • Barbara Weinrich
    Miami University Oxford, Ohio
  • Steven D. Gray
    The University of Utah Salt Lake City, Utah
  • Kristine Tanner
    The University of Utah Salt Lake City, Utah
  • Joseph C. Stemple
    The Blaine Block Institute for Voice Analysis and Rehabilitation Dayton, Ohio
  • Christine M. Sapienza
    University of Florida Gainesville
  • Contact author: Nelson Roy, PhD, Department of Communication Disorders, University of Utah, 390 South 1530 East, Room 1219, Salt Lake City, Utah 84112-0252. E-mail:
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   June 01, 2003
Three Treatments for Teachers With Voice Disorders
Journal of Speech, Language, and Hearing Research, June 2003, Vol. 46, 670-688. doi:10.1044/1092-4388(2003/053)
History: Received August 15, 2002 , Accepted October 31, 2002
Journal of Speech, Language, and Hearing Research, June 2003, Vol. 46, 670-688. doi:10.1044/1092-4388(2003/053)
History: Received August 15, 2002; Accepted October 31, 2002
Web of Science® Times Cited: 89

Voice problems are a common occupational hazard of teaching school, yet few studies exist that have objectively evaluated treatment approaches aimed at rehabilitating these occupation-related voice disorders. This randomized clinical trial used patient-based treatment outcome measures to evaluate the effectiveness of three treatment programs. Sixty-four teachers with voice disorders were randomly assigned to 1 of 3 treatment groups: voice amplification using the ChatterVox portable amplifier (VA; n = 25), resonance therapy (RT; n = 19), and respiratory muscle training (RMT; n = 20). Before and after a 6-week treatment phase, all teachers completed (a) the Voice Handicap Index (VHI; B. H. Jacobson et al., 1997), an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders, and (b) a voice severity self-rating scale. Both intention-to-treat and as-treated analyses revealed that only the VA and RT groups reported significant reductions in mean VHI scores and in voice severity selfratings following treatment. Furthermore, results from a posttreatment questionnaire regarding the perceived benefits of treatment showed that compared to RT and RMT, teachers in the VA group reported significantly more overall voice improvement, greater vocal clarity, and greater ease of speaking and singing voice following treatment. These findings replicate previous results from an earlier clinical trial confirming the efficacy of VA and provide new evidence to support RT as an effective treatment alternative for voice problems in teachers. The results are discussed in the context of uneven levels of self-reported compliance and disparate dropout rates among the treatment groups.

This article is dedicated to the memory of Steven D. Gray, MD, our dear friend and colleague who passed away in September 2002. It was a privilege to have known and worked with Steve. His deep commitment to his family, his faith, and science served as a model and inspiration for all of us. Steve's wisdom, sense of humor, and truly unselfish character will be missed more than words can convey.
We wish to thank the truly dedicated speech-language pathologists in Utah and Ohio who generously volunteered to serve as voice clinicians and without whose unselfish participation this clinical trial would not have been possible: Chad Bingham, Ashley Berg, Lillian Clark, Charlene Dean, Heather Dove, Susie Durr, Julie Early, Amberlie Fackrell, Cherie Fallon, Janet Goldstein, Shanna Guymon, Lisa Higbee, Paige Jackson, William (Bill) Liston, Krista Melani, Miette Murphy, Luanne Nielsen, Pat Parkinson, Suzan Patton, Jeanne Sorensen, Annie Steller, Becky Stookey, Kristine Tanner, Christine VanderBent, John Wald, and Sandy Wright. We also gratefully acknowledge the support and assistance of District Speech-Language Pathology Coordinators: Cheri Cornaby (Nebo), Lisa Holmstead (Salt Lake City), Ginger Pierce (Alpine), Joan Durfee (Tooele County), and Dale Sheld, Education Specialist for Communication Disorders and Learning Disabilities, of the Utah State Office of Education. We also wish to acknowledge the important contribution of Carla Briggs, research assistant, who tirelessly coordinated important aspects of participant recruitment and enrollment.
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