Voice Care you are how you sound

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Voice Care you are how you sound

• Presented by
• Linda Linnan Speech-Language Pathologist-In-Char
  ge (Toowoomba, Darling Downs and Warwick
  Districts)
• Education Queensland

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Todays lecture

• understand how your voice is produced
• symptoms and causes of voice problems
• When to be concerned about your voice
• How to assess your own voice
• Voice care techniques
• understand the basic rules for voice care
• Identify and minimise harmful vocal habits
• Factors to consider in protecting your voice
• personal action plan to care for your voice
• understand what to do if you suspect you have a
  voice problem

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Fundamentals of voice production
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Breathing

• Intention to use voice signaled by brain
• Breath inhaled into lungs
• Ribcage expands, diaphragm flattens
• Lower rib area expands as lungs expand
• Elastic tissue recoils and air is exhaled
• Air passes up through trachea and larynx which
  contain vocal folds

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Phonation

•  produced in larynx by vocal folds
• Outer layers of folds is made of a mucous
  membrane covering a pliable layer filled with
  fluid
• Pressure from moving air causes vibration
• Vibration produces sound waves

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Pitch

• How high or low the voice sounds
• Determined by
• Speed of vibration of vocal folds
• Thickness of the edge
• Length of the folds
• Higher voice faster rate of vibration
• elongated/thinner edge

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Loudness

• Air pressure from lungs
• Muscle tension in vocal folds
• Lower pressure softer voice

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Quality

• Clarity of voice
• Determined by
• Tension in laryngeal muscles
• Moisture in cover of folds
• Smoothness of vibration
• Closure of vocal folds

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Resonance

• Amplification in throat, mouth and nose
• Depends on shape, size and muscle tension in
  these spaces
• All unique

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Other physical factors

• Body posture
• Relaxation of muscles of body and larynx
• Excess tension leads to strained, harsh voice

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Symptoms and causes of voice problems
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Throat discomfort symptoms

• a feeling of fatigue
• dryness
• scratchiness or a tickling sensation
• an ache, soreness or pain
• a feeling of tightness or pressure
• a feeling that talking is an effort
• shallow breathing
• a sensation of a lump in the throat
• burning sensation
• frequent need to clear the throat
•         

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Later symptoms

• Breath control problems
• audible inspiration or gasping on inspiration
• running out of breath
• shallow breathing
• using the shoulders and upper chest when
  breathing in
• Pitch impairments
• pitch is too high
• pitch is too low
• monotone voice inadequate variation in pitch
• Loudness impairments
• voice is too soft
• voice is too loud
• monoloud voice inadequate variation in loudness
•  

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Later symptomscont

• Voice quality impairments
• strained voice too much muscle tension in the
  larynx
• rough voice vocal folds do not vibrate smoothly
• breathy voice vocal folds do not close
  adequately and air escapes
• glottal fry or creaky voice vocal folds stay
  closed for too long and the pitch is too low
• falsetto immature, high pitched, breathy voice
  in adult male
• voice breaks or cracks
• voice loss voice disappears so that only a
  whisper is possible
• pitch breaks sudden, transient and dramatic
  rises in pitch
• loudness breaks sudden, transient and dramatic
  drops in loudness
• husky voice strained and breathy
• hoarse voice strained, rough and breathy

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Later symptomscont

• Resonance impairments
• weakness or difficulties projecting the voice
• muffled or throaty voice

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Structural changes to the vocal folds

• Caused by the mechanical impact of the vocal
  folds as they contact each other during strained
  or forceful voice production, coughing or throat
  clearing
• Damage occurs to the mucosal cover of the vocal
  folds

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Types of structural changes

• extra blood vessels appear on the vocal folds as
  a result of vocal abuse
• vocal nodules
• swelling or inflammation causes laryngitis
• Polyps

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Causes of voice problems

• Usually a combination of.
• the way the person uses the voice
• the physical environment in which the voice is
  used
•   increased levels of stress and tension
• unealthy lifestyle or illness such as hay
  fever, reflux and sinus problems

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When should you be concerned?

• no simple answer
• everyone experiences minor throat discomfort or
  small
• changes in breath control,
• voice quality, pitch, loudness,
• or resonance from time to time

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Usually nothing to be concerned about when

• problems are very slight, only last a few minutes
  and do not recur every day
• when changes associated with a viral infection of
  the throat or sinus, as long as the symptoms
  disappear when the infection resolves

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Use voice care strategies if symptoms are

•  
• more than very slight
• last for hours or days
• recur regularly
• do not result from viral infection

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ANY HOARSENESS OR VOICE LOSS WHICH PERSISTS FOR 2
WEEKS OR MORE SHOULD BE INESTIGATED BY A MEDICAL
DOCTOR, PREFERABLY AN EAR, NOSE AND THROAT
SPECIALIST
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Techniques to help maintain a healthy voice
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Use a good breathing technique

• silent inspiration of air
• quick inspiration and slow exhalation of air in a
  rhythmic pattern
• relaxation and expansion of the lower ribs and
  abdominal area on inspiration of air
• a focus on the lower part of the body for
  breathing during speaking
• a focus on exhalation of air rather than on
  inspiration so that inspiration is automatic and
  relaxed
• release of breath either simultaneously or just
  before the onset of voice not too early or too
  late
• pausing as soon as there are signs that you are
  about to run out of breath so that inspiration of
  air will occur automatically for the next phase
• regulation of breath supply to coordinate with
  the length of phrases take sufficient air in
  for the amount you wish to say in each utterance

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2. Posture

• Do
• align the head with your spine (ears over
  shoulders)
• keep posture symmetrical
• balance your weight evenly when standing
• keep arms relaxed
• keep the shoulders level and relaxed and in a
  slightly forward-sloping position
• keep knee joints loose and legs relaxed
• keep the feet directed forward and approx 20 cm
  apart where possible
• keep the rib cage relaxed and lifted
• keep the shoulders relaxed and lowered
•  

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Posture cont

• Dont
• thrust the chin forward or up
• throw the head back
• clench the teeth
• push the tongue against the teeth
• clench the hands or toes
• round the shoulders
• slump the spine
• lean excessively forwards or sideways
• tilt the pelvis excessively
• hold a rigid posture
• try to keep the spine straight
• lock the knees
• keep thigh muscles braced
• raise or hunch the shoulders
• narrow the back
• stand or sit with an asymmetrical posture

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3. Effective vocal fold vibration

• Pitch use a pitch within the comfortable range
  for you
• Relaxation of the vocal fold muscles - Laryngeal
  constriction/tension is strongly linked to voice
  problems.
•  

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4. Relaxation of the larynx

• Yawn-sigh technique
• Silent giggle technique

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5. Voice Projection

• Head resonance focus project your voice from
  your head instead of from your throat
• Imagine your voice making the bones and skin of
  your face and head vibrate as you speak
•  open mouth posture, mouth as megaphone

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6. Articulation

• Say every sound in your words

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7. Warming up your voice

• five minutes of practising the breathing,
  laryngeal relaxation and humming exercises can
  allow your voice to function better for the whole
  day.

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8. Minimising vocal misuse
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What constitutes vocal misuse?

• speaking or singing with excess loudness levels
• speaking or singing with excessively low or high
  pitch levels
• speaking or singing with excessive muscle tension
  in the larynx, throat, jaw, tongue and neck
• speaking with hard glottal attacks abrupt and
  forceful beginnings to the first sounds in words
• crying, laughing and sneezing with excessive
  muscle tension in the larynx, throat, jaw, tongue
  and neck
• shouting, yelling and screaming
• coughing or clearing the throat excessively
• speaking or singing extensively or loudly during
  a throat infection
• producing voice during effort closure of the
  vocal folds in non-speaking activities eg.
  Weightlifting/ serving in tennis
• whispering or speaking in an excessively breathy
  or airy voice

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What activities/situations contribute to vocal
misuse in your day as a Teacher?
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Some examples

• speaking or singing over background noise
• speaking loudly to attract childrens attention
  or to discipline children
• speaking over large distances without effective
  amplification
• speaking to large groups without effective
  amplification
• speaking in an unnatural pitch or voice quality
  when reading to children or directing plays
• singing in a style or vocal range which is
  appropriate for the children but uncomfortable
  for the teacher
• cheering at sporting events

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Strategies for minimising vocal misuse

• Placement of teacher classroom
• Furniture placement
• Arrangement of students
• Behaviour management
• Background noise
• External noises
• Focus on voice feeling
• Non verbal communication
• Pauses and variations in intonation
• Talk only when children are quiet
• Give instructions to small numbers of children
• Signal changes in activities in creative ways not
  involving the voice
• Use an amplifier or megaphone

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Minimising vocal misuse cont

• When you feel the need to clear your throat or
  cough try swallowing hard, yawning, a sip of
  water, sucking sweets (non medicated) or push air
  up from you lungs in short, quiet bursts
• Improve awareness of throat clearing or coughing
• Restrict speaking when you have a throat
  infection
• Avoid whispering or using a breathy voice

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How to reduce the effects of vocal misuse

• sip water frequently
• Massage under chin
• Steam inhalations
• Alternate listening and speaking activities
• Use alternatives mediums eg. Video/tapes
• Plan voice rest times throughout the day
• Use effective voice production techniques

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Other factors to consider

• Physical and emotional health
• Medical problems
• smoking and high caffeine intake
• Medications
• Stress
• Anxiety or depression
• The physical environment

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The physical environment

• Environmental acoustics
• Environmental conditions including
• Very dry air
• Dusty environments
• Polluted air
• Fumes from paint, markers
• Smoky environments
• Plant pollens

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Maximising the physical enviornment

• Stand where students can easily see and hear you
• Arrange furniture for short-distance
  conversations
• Demanding students at the front
• Minimise background noise
• Encourage students to use normal voice
• Shut out external noise sources
• Amplifiers in noisy environments
• Sip water frequently to minimise effects of dry
  air, dust, pollution
• Avoid dusty chalk
• Heating at low levels
• Fresh air breaks often
• Balance voice use throughout the day vary
  activities using voice and resting voice eg.
  Videos
• Rest voice during day

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Take action to care for your voice!!
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HOW?

• identify which of your voice care behaviours and
  environmental factors need to be changed
• set your own goals for changing your voice care
  behaviours and your voice environment
• devise strategies for changing your voice care
  behaviours and voice environment
• monitor your progress

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Examples of goals

• by the end of term 3, I will have reduced the
  number of times I raise my voice in the classroom
  to once per day by using non-vocal methods of
  attracting students attention such as gesture,
  hand clapping, noise makers, musical instruments,
  bell
• by learning breathing techniques I will use an
  efficient breathing pattern every time I project
  my voice when I am on playground duty during the
  last 3 weeks of term and thereafter
• by the end of term 1, I will reduce my stress
  levels due to the disruptive behaviour of
  students by participating in the upcoming
  workshop on behaviour management and applying the
  strategies I learn to my classroom

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Questions???

• Good Luck!!!
• Thanks for listening.

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Acknowledgements

• The information presented today was gathered from
  a variety of sources including the Voice Care
  Program for Teachers compiled by the Department
  of Education, Employment and Training, Victoria,
  2000. www.sofweb.vic.edu/hrm/ohs/hlthwell/voice.ht
  m