Female Teacher's Voice During Teaching

Study Overview
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Brief Summary
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Two voice therapy methods are compared. Activity noise levels and vocal load of teachers during teaching in primary school classrooms are evaluated. Acoustic and Workshop Interventions are implemented in order to reduce noise level during lesson.

Detailed Description
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Due to the voice disorders, teachers are a major customer group for voice therapy. The main part of the study is comparison of two voice therapy methods. There are several factors in the classroom that increase teacher's risk of voice disorders. One of the most significant is high noise level during lessons. This study explores the noise conditions the teachers are working in and how these conditions are related to the voice parameters and symptoms. Finally, the study aims to determine whether classroom noise level can be lowered by improving classroom acoustics and by noise reducing workshops for teachers and pupils.

Official Title
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The Well-being of Female Teacher's Voice During Teaching

Conditions
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Functional Voice Disorder

Intervention / Treatment
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* Behavioral: Voice therapy
* Behavioral: Voice therapy with carryover strategies
* Other: Control group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female teachers or teachers of special needs children from elementary schools Voice symptoms and willingness to participate in voice therapy Mother tongue Finnish No hearing loss, no need to use a hearing aid Non-smoking No neurological diseases No voice therapy during past year Successful phoniatric examination with rigid laryngoscopy or nasal endoscopy Exclusion Criteria: Mother tongue other than Finnish Need to use a hearing aid Need for medical treatment in the larynx Abnormalities of the larynx Vocal cord paresis Laryngitis Posterior hypertrophy
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants are randomly divided into three groups. Group 1: Voice therapy. Group 2: Voice therapy with carryover strategies (supplementary tasks and reminders). Group 3. Controls. No treatment during control period. After the control period participants are having Voice therapy or Voice therapy with carryover strategies.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Voice therapy<br>An individually tailored voice therapy where the order and length of voice treatment methods will depend on the nature of each subject's voice problems. The intervention will take eight weeks and average of eight sessions (a' 45 min). | Behavioral: Voice therapy<br>* Voice therapy with direct and indirect therapy elements.<br>|
| Experimental: Voice therapy with carryover strategies<br>A voice therapy as described above and an enhanced carryover program. By carryover we mean the process of extending new vocal skills outside the clinic. It includes supplementary tasks and reminders that will be tailored individually out of those direct and indirect methods that the subjects have adopted during therapy sessions. Additionally, the teachers will be doing vocal warm-up and relaxation exercises together with their pupils int the beginning and in the middle of a school day. The intervention will take eight weeks. | Behavioral: Voice therapy with carryover strategies<br>* Voice therapy with direct and indirect therapy elements and supplementary tasks and reminders.<br>|
| Other: Control group<br>No intervention during eight weeks since this group will act as a temporary control group. After eight weeks, half of the participants in this group will be provided with Voice therapy and half with Voice therapy with carryover strategies. | Other: Control group<br>* No therapy during eight weeks. After the control period half of the group will be provided with Voice therapy and half with Voice therapy with carryover strategies.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The change of the well-being of the teachers' voice. | Subjective evaluation.Data collected with a questionnaire (Voice Activity and Participation Profile, VAPP) from the participants, answers given on a visual analogical scale (VAS) of 100 mm (0 = no disorder, 100 = extreme disorder). | Up to one week before the interventions, up to one week after the interventions, 6 months after the interventions, 1 year and 2 years after the interventions and up to one week after the control time (concerning control group). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Voice disorder, Teacher's voice, Voice SPL (Voice sound pressure level), Voice F0 (Voice fundamental frequency), Voice therapy, Voice accumulator, Activity noise, Classroom