It was then that she was seen in my office, describing what the voice was like at the start, and then at the end of a school day. Even if she didn't speak at all in the evening after a teaching day, the voice was hoarse upon first use in the morning. Barbara's return to her laryngologist, shortly before our first session, also showed the beginning of vocal nodules- tiny bumps on each vocal cord, opposing one another, which can become larger and interfere increasingly with normal voicing if they are not treated. Her physician explained that surgery was a possible option, but that even when vocal nodules are removed surgically, the areas along the vocal cords where they had developed can be weaker and give rise to more vocal nodules, unless vocal habits and voice use change. The laryngologist recommended that Barbara first try voice therapy, before considering surgery, and that is how she came to my office.
Voice disorders occur with alarming frequency among school teachers.
The exact incidence is unknown, but it is an occupational hazard of considerable importance. It is not hard to understand why teachers as an occupational group are prone to the development of voice disorders. Their most important teaching tool is the voice. Vocal use often occurs in less than ideal circumstances with poor acoustics, noisy students and a tense atmosphere. Large classes and discipline problems add to the teacher's vocal demands.