No abstract

Teachers commonly report voice problems and often seek medical assistance for voice-related complaints. Despite the prevalence of voice disorders within this occupation, there are no studies evaluating the effectiveness of treatment programs designed to remedy the voice problems of teachers. To assess the functional effects of two voice therapy approaches, 58 voice-disordered teachers were randomly assigned to 1 of 3 groups: vocal hygiene (VH, n = 20), vocal function exercises (VFE, n = 19), and a nontreatment control group (CON, n = 19). Subjects completed the Voice Handicap Index (VHI)-an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders-before and following a 6-week treatment phase. The VFE and VH subjects also completed a posttreatment questionnaire regarding the perceived benefits of treatment. Only the group who adhered to the VFE regimen reported a significant reduction in mean VHI scores (p <.0002). Furthermore, when compared to the VH group, the exercise group reported more overall voice improvement (p < .05) and greater ease (p < .02) and clarity (p < .01) in their speaking and singing voice after treatment. These findings suggest that the VFE should be considered as a useful alternative or adjunct to vocal hygiene programs in the treatment of voice problems in teachers.

Voice problems are common among schoolteachers. This prospective, randomized clinical trial used patient-based treatment outcomes measures combined with acoustic analysis to evaluate the effectiveness of two treatment programs. Forty-four voice-disordered teachers were randomly assigned to one of three groups: voice amplification using the ChatterVox portable amplifier (VA, n = 15), vocal hygiene (VH, n = 15), and a nontreatment control group (n = 14). Before and after a 6-week treatment phase, all teachers completed: (a) the Voice Handicap Index (VHI), an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders; (b) a voice severity self-rating scale; and (c) an audiorecording for later acoustic analysis. Based on pre- and posttreatment comparisons, only the amplification group experienced significant reductions on mean VHI scores (p = .045), voice severity self-ratings (p = .012), and the acoustic measures of percent jitter (p = .031) and shimmer (p = .008). The nontreatment control group reported a significant increase in level of vocal handicap as assessed by the VHI (p = .012). Although most pre- to posttreatment changes were in the desired direction, no significant improvements were observed within the VH group on any of the dependent measures. Between-group comparisons involving the three possible pairings of the groups revealed a pattern of results to suggest that: (a) compared to the control group, both treatment groups (i.e., VA and VH) experienced significantly more improvement on specific outcomes measures and (b) there were no significant differences between the VA and VH groups to indicate superiority of one treatment over another. Results, however, from a posttreatment questionnaire regarding the perceived benefits of treatment revealed that, compared to the VH group, the VA group reported more clarity of their speaking and singing voice (p = .061), greater ease of voice production (p = .001), and greater compliance with the treatment program (p = .045). These findings clearly support the clinical utility of voice amplification as an alternative for the treatment of voice problems in teachers.

A 0 S T R A C TA survey of telephone use by 66 patients fitted with the lneraid cochlear prosthesis revealed that 51% initiate telephone calls (most calls are to family or friends) and that 66% answer the telephone. Of the patients who answer the telephone, 49% indicated that they could identify the gender and/or age of the caller most of the time, 27% could identify a familiar caller most of the time, and 48% indicated that they could understand a conversation most of the time if speaking to a familiar speaker about a familiar topic. Understanding dropped rapidly as the speaker and topic became unfamiliar (Ear Hear 12 5368-369).IN THIS REPORT, we describe the results of a questionnaire study of telephone use by patients who hear by means of the Richards/Ineraid cochlear implant (Eddington, 1980; for a recent review, RESULTSThe results are shown in Table 1 DISCUSSION The responses to the questionnaire leave no doubt that many Ineraid patients use the telephone. About half of the sample initiate calls and about two-thirds answer the telephone. Of the 66% who answer the telephone, 48% indicated that they could understand a familiar caller and a familiar topic most of the time. Thus, about one-third of the total sample claimed to understand a telephone conversation with a familiar speaker and a familiar topic. As the speaker and message uncertainty increased, the number of patients who claimed to understand a caller decreased to a lower limit of only 5%, who claimed to understand an unfamiliar caller and an unfamiliar topic.A relationship between CID sentence intelligibility and telephone use, suggested first for hearing-impaired students at the National Technical Institute for the Deaf (NTID), and which held for a small sample of Nucleus patients (Cohen et al, 1989), holds for Ineraid patients. That is, patients with scores greater than 50% on the CID sentences are significantly more likely to initiate calls than patients with scores less than 50% (z = 3.8, p < 0.001). Eighty five percent of patients with CID scores greater than 60% initiate calls, whereas only 3 1% of patients with scores less than 40% initiate calls.