Guzal Sultanova was an opera singer at the State Academic Theatre of Uzbekistan and a vocal teacher before she was employed by Westminster International University in Tashkent (WIUT), Uzbekistan. She is now occupying a position of Head of Social Engagement Sector at WIUT and leads the activities of the university Music Club. Email: gsultanova@wiut.uz

 

It is difficult to think of any other injury that individuals pay as little attention to as voice injury.
Martin and Darnley 1996 (in Maley, 2000).

 

Abstract

This article talks about teachers’ voice disorders from the point of view of a vocal specialist (an opera singer). There are solutions offered to the readers that can be helpful in any teaching context. These solutions will be further developed into a programme of study that may become a part of initial teachers’ training in any country.

 

Why the voice?

The choice of this topic is not accidental for me – the trigger was my mother, who worked as a schoolteacher.  Her husky voice cracked in the battles with her students. Her hoarseness can probably be explained by the fact that she never paid attention to this problem and this is true about so many people! I never cease to be amazed that people take their voices for granted. Having worked as an opera singer and vocal teacher for over 23 years, I know that most people’s attitude to caring for their voice is light-hearted, to say the least. In my experience, this is especially true for teachers.

 

Background

For the past nine years I have been working at the Student Support Services at Westminster International University in Tashkent (WIUT), I am the Head of the Social Engagement Section. My present job gives me an opportunity to communicate with different people but I also miss my work in the theater. That is why I organized the Music Club for university employees, where participants are learning to improve their singing skills and take part in university concerts and events. While working in the club I noticed that the voices of some teachers get tired very quickly, or they already have fatigued or hoarse voices. To my surprise, I discovered that my colleagues do not know how to use the capabilities of their voices and do not have any knowledge about the nature of the voice, structure of the speech apparatus and the dangers of professional diseases related to their voice. Teachers “… suffer more than most professionals from a number of voice-related symptoms. These may range from reduced vocal range or volume to chronic hoarseness or even total voice loss” Maley (2000, p vii). As it turned out later, our teachers had never undertaken a single training devoted to teacher’s voice management during their studies at a pedagogical university. Being immersed in their professional activities, teachers often pay little attention to the condition of their voice, and, unfortunately, the situation gets worse over time – the longer teachers work, the more serious are the voice problems they have. This caused me to revise the objectives of the club, so that staff members, especially teachers, can acquire the skills of proper breathing and voice hygiene tips as well as necessary relaxation techniques that can be practiced after hours of lectures.

I began to look for educational materials and professional literature in order to help me organize my lessons in the club I started studying the Inquiry Based Professional Learning (IBPL) module at the Post Graduate Course in Teaching and Learning (PGCert) at WIUT. Together with my module leader, an expert in developing presentation skills and a teacher with more than 30 years of experience, I began my research starting with identifying the problem and studying ways in which this problem is treated in other countries. After that my colleague, the head of the WIUT Labour Union and I conducted a survey among WIUT teachers in order to determine the level of importance of the issue related to the teacher’s voice. We intended to deliver training for teachers that would help them to use their voices in an optimal way.

 

The key role of the voice and voice disorders

The teacher's voice is one of their key resources. Regrettably, however, it is very fragile and does not "forgive" a negligent attitude. Information from medical examinations of teachers from different countries, reveals some very alarming statistics. According to Banks et al. (2017) among 2,500 teachers who were surveyed, more than 57% admitted to having experienced voice problems during their lives. By contrast, the survey also showed that only 28.8% of non-teachers experienced similar problems.

Taking into account the fact that in our country, according to the State Statistics Committee (2019), more than 30% of the population is made up of young people, who need quality education, teachers are in great demand.  This makes the problem of teachers’ voice disorders especially relevant.

Banks et al. (2017) also state that the data reveal that female teachers are more likely to experience voice problems than male teachers. In Uzbekistan, the majority of people who work in the education sector are women. They constitute 70.1% of the total number of teachers, according to the Asian Development Bank (2018) statistics. We can therefore assume that in our country the number of occupational diseases of teachers’ voices could be very high. Will (2016), in her article “Teachers, Especially Women, Are Prone To Vocal Damage, Research Finds”, agrees that female teachers are more likely to have voice problems than their male colleagues. She explains this phenomenon by differences in the anatomy of males and females.

It is essential to recognize the voice as the teacher's essential tool for conveying information to students, as well as maintaining class discipline. However, often insufficiently trained teachers suffer from a soft, or hoarse, or expressionless voice, with undeveloped speech expressivity. Will (2016) identifies the main symptoms associated with voice problems as:

• vocal tiredness,
• hoarseness,
• inability to speak at certain pitches
• a temporary loss of voice.

My literature review included a book by Alan Maley, the author of many resource books for teachers, which discusses many aspects of voice problems, so I shall cite him often. In his book, “The Language Teacher’s Voice”, he provides a detailed list of voice problems experienced by teachers. From this list, I would single out such symptoms as “hoarseness and scratchy voice”, “chronic laryngitis”, “excessive throat clearing” and “voice fatigue” as the most common and noticeable for students. Banks et al. (2017) describes vocal fatigue as “an adverse reaction of voice users to extended periods of vocal load”. It is also worth noting that these symptoms can lead to a serious voice problem in the long term, namely, aphonia, which is a complete loss of voice.

If problems with the voice persist for three weeks or more a teacher should consult a therapist because this issue could lead to the aggravation of the situation. Since one of the main cures for voice problems is voice rest, this is bound to have an economic effect on educational institutions. Will (2016) mentions that “Teachers’ voice injuries alone cost the U.S. economy $2.5 billion per year”. When a teacher is ill and has to be absent in lessons, health care costs are increased, the administration will have to invite substitute teachers and pay them, in some cases it can lead to the teacher’s early retirement.

 

The main causes of voice problems

According to Maley (2000, p66), the main reasons for voice dysfunction can be divided into three groups:

1. environmental,
2. physical and
3. self-induced.

The environmental problems include air quality, fumes, smoke and humidity as "kind of stressors" that could affect the voice. Taking into account that Uzbekistan is ranked as the 16th most polluted country (AirVisual’s report 2018), this fact creates a “kind of stressor” for our citizens. Teachers are also forced to overcome noise that can be both internal (hum of voices in the classroom or the creak of chairs, for example) and external (construction work, traffic, radio, music, and so on). These can seriously interfere with the teachers’ work and increase their nervousness, fatigue and tension of the vocal folds. Maley (2000, p 68) describes some acoustic drawbacks of classrooms – too long or oblong spaces, too high or low ceilings – that are "dead" for speakers. In other rooms the sound of the voice can be completely or partially absorbed by carpeting, dense curtains and the materials from which the room was made. Rooms can also be too "sonorous" – where the sound is reflected from the walls and there are multiple. This also creates difficulties for both students and teachers.

Some physical causes of voice problems such as hormonal, age-related, asthma and allergies, throat infections and substance abuse (tobacco, alcohol and drug use) require special treatment and expert recommendations. I want to highlight fatigue, throat clearing and dehydration as the most common and underestimated physical problems that can seriously complicate the teachers work in the future.

Teachers, being engaged in professional activities, are forced to speak for several hours a day, explaining the material, often overcoming noise in the classroom. This cannot but affect the state of their voices. The coronavirus pandemic, when face-to-face education has been replaced with distance education, has worsened the situation because teachers have to talk even more due to the specifics of online communication. Stressing the vocal apparatus during five to six hours a day, educators frequently experience voice fatigue and dry throat, which often cause a desire to cough up and clear the throat, which can finally extinguish the voice. Throat clearing can cause greater voice problems than any other physical conditions, because strong “banging the vocal chords” and constant coughing can seriously damage the vocal cords. The main remedy for voice restoration is voice rest, but often the teacher cannot afford this because of the high degree of responsibility for the work performed, or, on the other hand, because of a lack of understanding of the danger to the health of her voice. Continuing to experience more and more new burdens on the vocal cords, the teacher finds herself in a vicious circle. Specialists in The British Voice Association (2020) note that the enormous consumption of alcohol, coffee, tea or coke may have a negative effect on the voice by drying up the throat, which in turn can cause dehydration of the body.

As one of the self-induced problems Maley (2000, p72) cites an unbalanced diet and irregular sleep patterns which can have a knock-on effect on the voice. He mentions that “Excessive level of stress will cause muscular tension, especially in the jaw, tongue and shoulders/throat, all of which have a negative effect on your voice” (ibid). He adds that muscular tension, uncontrolled and irregular breathing, overuse/misuse of the voice – when you talk too loudly/softly – might be harmful for the voice and fatigue the whole organism.

I would add problems such as insufficient awareness among teachers of how to maintain voice hygiene and prevent occupational voice diseases. Unreasonable voice demands, for example, when the teacher starts to conduct classes immediately after a previous illness, puts a lot of stress on her voice, frequently raises her voice, switching to shouting, and so on, can lead to disease. Moreover, with constant stress on the vocal cords, there is a risk of damaging them and can even cause voice loss for some time.

 

Our research findings

To identify the extent of the problem in our university, we conducted primary research among teachers using the online Google Forms questionnaire. In total, 37 people took part in the survey answering 14 questions regarding voice control and voice disorders.  The purpose of this survey was to find out how much WIUT teachers are aware of the possibility of injuring vocal cords, as well as the techniques that contribute to their recovery and improving the situation in the future.

The survey showed that 65.7% of respondents are not familiar with the anatomy of the voice and the respiratory system in general. However, it was found that more than 57% of respondents feel tired and experience voice fatigue after speaking for the duration of a lecture or a seminar. Moreover, 54% of surveyed teachers also confirmed that they often face problems related to the sound of their voice during lectures. However, respondents argued that this problem mainly occurs during times of stress. It is also worth noting that more than 54% of respondents are aware that the improper use of vocal cords can lead to more serious problems in the future. At the same time, the rest of the respondents, namely 45.7, are not aware of or have never thought about this. More than 91% of the teachers agreed that it is essential to have an agreeable sounding voice and an ability to control it. Notwithstanding this, from 68% to 77% of respondents were unaware of methods or techniques that help develop voice production. In addition, 42.9% of respondents do not use any vocal techniques to improve or maintain the condition of their voice, while only 20% of teachers do so. Thus, from this particular research, we can conclude that it is necessary to provide specific information and organize training sessions aimed at studying the work of the vocal cords and practical ways to prevent occupational diseases. It is also worth noting that more than 85% of the interviewed respondents confirmed their desire to acquire necessary techniques for the development of expressive, eloquent and emotional speech.

Maley (2000, p vii) notes that actors unlike teachers, who have much less stress on the voice while working on the stage, study for at least 3 years to master the skills of voice production. By contrast, no one explains to future teachers the basics of correct voice control. This is especially true for those universities in Uzbekistan which prepare future teachers. In this light, I consider it especially important that vocal trainers or elocution experts are involved in future teachers’ learning.

Accordingly, I propose to start working on a possible training course and share information and techniques with participants that can help teachers to keep their voices in good condition.

 

Recommendations

Here are some recommendations which could be useful in training sessions.

• The first and main recommendation to avoid the problems with voice can be proper and frequent hydration of the whole organism. For example, the proper amount of water for proper hydration is at least 6–8 glasses per day. In countries with a very dry and hot climate, like Uzbekistan, it can be necessary to install coolers with drinking water and air humidifiers in staff rooms and classrooms in schools and higher educational institutions. These improvements in classroom ergonomics could significantly influence teachers’ productivity. Lecturers cannot solve this problem on their own but they can negotiate with the administration of their educational institutions. To maintain vocal health it is important to keep the water balance in the body and limit the carbonated and coffeine drinks consumption.  
• The next recommendation for keeping the voice in good condition is to plan controlled breaks for the voice during teaching classes or similar activities. Taking small breaks during the working day should become a daily habit, not just when the voice is hoarse or tired (teachstarter.com, 2020). In order not to overload the voice during the day, it is necessary to correctly alternate the time when the voice needs tension and the moments when the intonation can be lowered and the voice can be given a short rest.
• If a voice problem has already occurred, the teacher needs to take remedial actions as early as possible. Dr. Kayes (2018) in his article “Vocal care and warm-up exercise for teachers” advises to give voice a rest for at least 72 hours. “That means no talking, no whispering, no throat-clearing and extra hydration of up to 10 glasses of water a day”. Unfortunately, nothing better than rest for saving the voice has been invented yet. The crucial thing is for the teacher to realize the importance both of having breaks while working in class, or rest, if she feels her voice is strained, to keep it in good condition.

Gentle methods like sipping water and swallowing should be used instead of throat clearing with pressure to clear the throat (teachstarter.com, 2020). As a vocal specialist, I would also recommend using an artificial yawn to relax the walls of the larynx as an alternative of frequent throat clearing.

• When they cannot be heard in classrooms, teachers often unconsciously increase the volume of their voice, even switching to shouting. This situation should be avoided because both shouting and whispering are vocal extremes, which cause stress and over-straining of vocal folds. It is important to note that acoustic problems, which lead to the problems with voice, cause not only physical but also psychological harm to the teacher. While studying at the conservatoire, as future singers, we were taught the basics of acoustics. Later, working in the theatre, I always took into account the peculiarities of the rooms in which I performed. I would recommend that the administration of educational institutions or Labour Union invite professional vocal trainers or elocution experts to demonstrate and teach the staff how to "control" acoustics, where and how to project the voice so that it sounds lighter and louder. If acoustic problems are difficult to overcome, TeachStarter (2020) recommends the use of “personal amplification products designed specifically for teachers” that are becoming more common in classrooms. Devices, such as a microphone and voice amplification systems may help teachers to avoid the vocal strain, overcome acoustic issues and conduct classes in a comfortable environment for both teachers and students.
• Professional vocal teachers or elocution experts know well how to master and control the vibrations of voice. This skill is called voice projection. For example, when someone shouts, the voice often comes from the strained or closed throat, while the voice projection skill helps to produce the sound from an open throat which, in turn, decreases the stress on the vocal folds. One of the ways to learn how to project voice effectively is practicing the “forward resonance”; that means making the voice resonate in the hollow parts of the face (the so-called "mask"). Being able to direct the voice into the “mask” or support the voice with conscious breath, teachers can make their voice more sonorous so that it reaches the farthest corners of any lecture room with less effort. Another important step in maintaining the voice efficiency, which helps to relieve vocal cords tension and makes the voice more sonorous, is properly tuned and controlled breath. When the effort comes from the muscles in the abdomen instead of more gentle muscles of the throat, it reduces the pressure of the vocal chords and the voice strain on the whole. By practicing these particular techniques, the strain on the vocal cords and especially throat can be significantly reduced. Correct voice projection can help teachers keep the audience's attention longer while helping to boost their self-confidence as a speaker.
• Working online, educators should be especially attentive to the condition of their voice because they have to talk more than during regular offline lectures. I would like to quote Rod Bolitho, an ELT specialist from the UK, who wrote (personal communication): “Modern insights into teaching and learning... almost all point towards the need for more active participation by students in their learning events, whether lessons or lectures.  This means that teachers may need to set up more student-centered tasks during a class, thereby cutting down considerably on the use of their own voice.  This requires careful preparation for online teaching, but it is perfectly possible”. In our rapidly changing times, we must become more flexible following delivered goals but we should not forget about a reasonable usage of such a valuable teachers’ tool as vocal cords.
• For opera singers it is important to master the ability of overcoming anxiety and stress, to preserve internal energy that will send a clear and strong message, and this will make their performance special and memorable. Teachers, like actors and singers, are also on a kind of stage in front of students every day; they have to cope with nervousness and fatigue, filling their speeches with energy and inner light. Among all the remedies, I consider yoga, pranayama and meditation as the best ways to work on breathing techniques, relaxing the tone of the abdominal and pharyngeal muscles. All this may help to quickly restore and conserve the inner energy.
• The last but not the least important point to bear in mind is to regularly visit a physician. When certain voice symptoms, such as a hoarse or abnormal voice, do not disappear after more than three weeks, only the professional advice of a physician can help to cure the problem.

When creating my future training, I propose to involve an elocution specialist and a yoga trainer as co-trainers so that they teach participants the basics of eloquent speech as well as some pranayama and meditation practices. Expressive skills will add dynamics and color to the teacher's voice, and some yoga, pranayama and meditation exercises can help them to cope with stress, nervousness and tiredness. As for my participation, I will try to convey to trainees the idea of the importance of supporting vocal hygiene and developing voice projection skills. I consider this training should last at least two months, because the development of such skills as forward resonance and voice projection require multiple repetitions before they become habitual.  I hope my efforts will be useful, and my small contribution will raise teachers’ awareness about the importance of maintaining voice hygiene and prevention of voice disorders, as well as enhancing the effective use of their voices.

 

References

Banks, R., Bottalico, P. and Hunter, E., 2017. The Effect Of Classroom Capacity On Vocal Fatigue As Quantified By The Vocal Fatigue Index. [online] https://www.ncbi.nlm.nih.gov/. Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336191/> [Accessed 16 December 2020].

Britishvoiceassociation.org.uk, 2020. Your Voice Is A Very Valuable Resource. [ebook] British Voice Association, p.1. Available at: <https://www.britishvoiceassociation.org.uk/downloads/free-voice-care-literature/Take%20care%20of%20your%20voice.pdf> [Accessed 15 December 2020].

Kayes, D., 2018. Vocal Care And Warm-Up Exercises For Teachers. [online] Sec-ed.co.uk. Available at: <https://www.sec-ed.co.uk/best-practice/vocal-care-and-warm-up-exercises-for-teachers/> [Accessed 15 December 2020].

Maley, A., 2000. The Language Teacher’s Voice. 1st ed. Oxford: Macmillan Heinemann English Language Teaching, pp. vii, 53, 66-72.

Neu.org.uk, 2018. VOICE CARE NEU Guidance For Members, Reps And Local Officers. [ebook] National Education Union, p.1. Available at: <https://neu.org.uk/media/6981/view> [Accessed 15 December 2020].

Teach Starter, 2020. Voice Care For Teaches Important! How To Stop Losing Your Voice As A Teacher | Teach Starter. [online] Teach Starter. Available at: <https://www.teachstarter.com/au/blog/voice-care-for-teachers/> [Accessed 15 December 2020].

Will, M., 2016. Teachers, Especially Women, Are Prone To Vocal Damage, Research Finds. [online] Education Week. Available at: <https://www.edweek.org/teaching-learning/teachers-especially-women-are-prone-to-vocal-damage-research-finds/2016/05> [Accessed 15 December 2020].

 

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