It can start with a “frog” in the throat or laryngitis. It can end a career as a teacher.
Whether it’s called “teacher’s voice,” hoarseness (dysphonia), voice disorder, voice fatigue or vocal harm, the condition is quite common among teachers and others working with students. Yet, it’s unlikely to be on a list of job-related hazards.
Vocal music teachers are most likely to suffer, followed by others with activities that really depend on the voice, such as drama and performing arts. Those with the smallest classes face fewer problems.
That’s from a 2004 study. Teachers’ voice problems have been studied internationally for at least 35 years. In 1987, the British Voice Care Project started workshops for teachers. Later, the organization found that teachers were eight times more likely to have voice-related health conditions than other those in other jobs. Half of newly qualified teachers experienced voice loss in their first year at work in a Greenwich University study.
U.S. studies in the 1990s showed “teacher’s voice” interferes with job satisfaction, performance and attendance. In 2010, Johns Hopkins School of Medicine said up to 47% of American teachers had “some degree of voice abnormality on any given day,” 20% reported missing work thanks to voice problems, and the condition forced some to leave the profession. The American Academy of Otolaryngologists says more than half of all teachers develop a voice disorder at some point.
It’s also expensive. A 2001 Harvard University study conservatively estimated therapy, surgery and substitute teachers alone cost $2 billion just in the U.S.; the study excluded workers’ compensation, job loss and other results. A 2016 study of 14,256 Miami teachers found absenteeism costs from voice disorders were about
Students also have an interest. Studies show their learning and academic performance is negatively affected by teachers’ voice problems.
What are the symptoms?
Your voice depends on two vocal cords—folds of tissue inside the larynx (voice box) sitting atop the windpipe (trachea). They vibrate as air passes over them, producing sounds.
An overworked voice sounds different. It can be hoarse or strained, tire easily, break occasionally. It’s harder to talk. Pitch can become lower, the singing range reduced and overall voice quality lessens. The throat can be sore. There may be polyps or nodules on the vocal cords themselves.
What’s causing these problems?
Like other tissues, our vocal cords need rest.
Yet teachers talk for a full work day. They also often have to raise their voice, thanks to room acoustics (often overlooked), room or class size, or projection distance. It’s also common for noises from inside or outside the classroom (e.g., ventilation, class bells, traffic) to cause “speech interference.”
There are other hazards too. Low humidity increases throat irritation and infection risk. Changing room temperatures, upper respiratory infections and airborne hazards—like mold and dust—also contribute, along with muscle tension in and around the larynx. A 2021 Finnish study linked poor school air quality to teachers’ “voice disorders.”
How can vocal harm be prevented?
Like any health and safety hazard, prevention is possible.
Health and safety committees should have this topic on their to-do list. Start with conversations or surveys of members, followed by acoustic surveys as needed (with outside help). These surveys go beyond measuring noise levels to include how sounds travel in a particular space. Consider voice-related harm in air quality discussions. Encourage and support anyone with “teacher’s voice” to tell the committee and employer and make a workers’ compensation claim.
Effective solutions eliminate the hazard. They require looking at classroom size, design and layout. For example, some materials—on walls, ceilings, furniture, floors —absorb sound better than others, some reflect it more. Ceiling acoustical materials can help, especially with high ceilings. Movable screens and furniture can reduce sound reflections. Ventilation equipment noise can be reduced with special duct inserts, checking for and fixing vibration sources and installing quieter fans. Classroom layout matters. Long lines of desks make it hard to project; circular arrangements make it easier.
For new construction or renovations, there are national standards and guidelines about classroom acoustics and ventilation, another reason for committees to be involved in planning.
Portable microphone-amplifier devices let users be heard without raising their voice. Stick to wired ones that can be used anywhere, not just in a room with speakers.
Those with a voice problem need assessments and/or treatment from health care professionals (e.g., medical specialists, speech-language pathologists). Committees and local associations should support easy access.
While “vocal hygiene” is less effective than other methods, individuals still can:
- Rest their voice whenever possible (e.g., between classes).
- Use gestures to illustrate and emphasise points.
- In physical education, give instructions by gathering students together and avoid screaming/shouting (use gestures).
- Drink water regularly during the day (avoid caffeine).
- Move around the room to talk to students.
- Increase/decrease/vary intonation, voice intensity, with pauses.
The American Speech-Language-Hearing Association also recommends these strategies:
- Get students’ attention before delivering information.
- Pay attention to visual communication for complex information.
- Review key points.
- Help students learn about and practice active listening.
- Involve students in managing noise levels.
Dorothy Wigmore is a long-time health and safety specialist and WEC consultant. She has worked in Canada, the U.S. and Mozambique, focusing on prevention and worker participation to solve job-related hazards. These days, she is writing Transmission Truth?, a book about the pandemic.
American Academy of Otolaryngology
“Clinical practice guideline: hoarseness (dysphonia) update” (and patient handouts):
Acoustical Society of America
Classroom acoustics booklets
American Speech-Language-Hearing Association
Classroom acoustics (with links to U.S. standards)
British Voice Association
Voice care articles
Institute of Acoustics and Association of Noise Consultants
Acoustic design of schools, 2015
“Noise harms a lot more than our ears”
Science and Literacy
The 9 best voice amplifiers for teachers to be heard in any size classroom and outdoors [2023 Edition]