Perceptions of Voice Teachers Regarding Students' Vocal Behaviors During Singing and Speaking

ARTICLE IN PRESS Perceptions of Voice Teachers Regarding Students’ Vocal Behaviors During Singing and Speaking Shellie A. Beeman, Muncie, Indiana Summary: Objective. This study examined voice teachers’ perceptions of their instruction of healthy singing and speaking voice techniques. Methods. An online, researcher-generated questionnaire based on the McClosky technique was administered to college/ university voice teachers listed as members in the 2012–2013 College Music Society directory. Results. A majority of participants believed there to be a relationship between the health of the singing voice and the health of the speaking voice. Participants’ perception scores were the most positive for variable MBSi, the monitoring of students’ vocal behaviors during singing. Perception scores for variable TVB, the teaching of healthy vocal behaviors, and variable MBSp, the monitoring of students’ vocal behaviors while speaking, ranked second and third, respectively. Perception scores for variable TVB were primarily associated with participants’ familiarity with voice rehabilitation techniques, gender, and familiarity with the McClosky technique. Perception scores for variable MBSi were primarily associated with participants’ familiarity with voice rehabilitation techniques, gender, type of student taught, and instruction of a student with a voice disorder. Perception scores for variable MBSp were correlated with the greatest number of characteristics, including participants’ familiarity with voice rehabilitation techniques, familiarity with the McClosky technique, type of student taught, years of teaching experience, and instruction of a student with a voice disorder. Conclusion. Voice teachers are purportedly working with injured voices and attempting to include vocal health in their instruction. Although a voice teacher is not obligated to pursue further rehabilitative training, the current study revealed a positive relationship between familiarity with specific rehabilitation techniques and vocal health. Key Words: speaking voice–singing voice–voice disorders–McClosky technique–prevention–habilitation–rehabilitation.

INTRODUCTION Voice disorders have long been a topic of interest among speech communication professionals, performing artists, and medical practitioners. Research has indicated that professional voice users, including teachers, actors, broadcasters, preachers, sales workers, trained and untrained singers, and particularly women in such professions are at risk for vocal pathology because of hyperfunctional voice use.1 The wide gap, ranging from 11% to 81%, of teachers around the world experiencing some degree of voice dysfunction, whether past or current, raises cause for concern.2–11 If teachers in general education represent a population of professional voice users linked to poor vocal health, teachers of music should be especially concerned. Multiple researchers found music teachers to be more at risk than teachers in other professions, with voice teachers and choral directors indicated as those at higher risk for vocal pathology.1,11–21 Indeed, teachers and singers would find it difficult to communicate effectively with their students and audiences without a “well-functioning and enduring voice.”2 Yet a 1996 census revealed that teachers and singers represent the top two groups of professional voice users seeing otolaryngologists and speechlanguage pathologists for voice therapy.2 Researchers stated that “voice therapists claim to see some of the worst damage they are asked to treat in the larynges of music teachers (including

Accepted for publication February 9, 2016. From the School of Music, Ball State University, Muncie, Indiana 47306. School of Music, Ball State University, Muncie, IN 47306. E-mail: [email protected] Journal of Voice, Vol. ■■, No. ■■, pp. ■■-■■ 0892-1997 © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jvoice.2016.02.007

choral directors) and in those of young singers upon whom teachers have made impossible vocal demands. Such damage results from a lack of knowledge and understanding of how to develop healthy voices—a deficiency that often stems from a teacher’s college preparation for his or her career.”22 This statement comes more than 50 years following the establishment of standards, requirements, and recommendations given by the National Association of Schools of Music (NASM), which clearly states that all students (nonmajors, minors, and majors) and faculty and staff within the music program “must be provided basic information about the maintenance of health and safety within the contexts of practice, performance, teaching, and listening. . . . General topics include, but are not limited to, basic information regarding the maintenance of hearing, vocal, musculoskeletal health and injury prevention.”23 Yet research suggests that very few teachers were informed as to healthy speaking habits or preventive voice practices before entering a full-time career.24–30 Music teachers employ their voices much more than non–music teachers because of both teaching and singing responsibilities including general education and music classes, extra rehearsals, performances, and private lessons that persist throughout a day and week with little time for voice rest.13,31 Not only do music teachers use their voices to instruct, guide, and model correct singing and playing, but they also teach a significantly larger number of classes and class sizes.13,19,32 Schneider and Bigenzahn concluded, “a young adult though matured enough to begin a voice-intensive professional career still remains inexperienced in vocal use and prone to vocal misuse and overuse. The conversational demands and presentational phonatory use require great vocal flexibility, skill and endurance in these

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professional voice users.”25 Rather than completely restructuring existing music programs, Van Houtte et al8 and White22 recommended that current courses within the music education programs be reoriented to include increased awareness and instruction of efficient voice use. Their suggestions for voice training for the future music educator included not only the standard, single semester of voice class, but also the appropriate application of healthy singing in collegiate choral settings, courses in choral conducting and methods, a full course in voice pedagogy, and medical management instruction. Appropriate training during the college years is vital in helping music teachers attain competency in the voice area, enabling them to detect problems early. Multiple reasons were determined as to the prevalence of voice disorders among singers: artistic temperaments leading to emotional and psychological stress, “high vocal and physical effort,” and a poor understanding of voice care during rehearsal time and illness.2,33,34 Researchers also concluded that the focus of singing teachers was on the singing voice; thus, one should not necessarily expect to find intervention of the speaking voice as a result of a singing lesson.35 This statement supports findings that voice teachers rarely work with their students’ speaking voices.36 If a student’s speaking voice seemed to be affecting his or her singing voice, teachers cautioned the student, but neglected to give specific and accurate advice on how to make healthful changes. The only solutions, however faulty, given to voice students were to speak primarily in head voice or refrain from speaking.36 Because singing and speaking share multiple similarities, it should come as no surprise that voice lessons could potentially prevent voice pathology and rehabilitate vocal dysfunction.1 Researchers acknowledged that trained singers may have more vocal longevity than non-singers, and that there may be some effect on the speaking voice when singing teachers apply what is called “direct intervention” during a singing lesson.35 Sataloff37,38 stated that proper voice training of the speaking voice could cure most voice disorders resulting from misuse and abuse. Teachers of both speaking and singing employ similar techniques to achieve optimal voice production without harm. Thus, training either the singing voice or the speaking voice could aid in the training of the other. Sipley1 and Heurer et al39 likened proper speaking voice training to the classical singing approach. Yet research has found that most people, including singers, are not trained to use proper speaking habits. Classically trained singers are aware of the deleterious consequences of poor singing technique on the delicate tissues of the vocal folds. Even though they are usually conscientious in caring for their voices during singing, they often give little thought to how they use the same anatomy in speech, even though they may spend more time speaking than singing. Appropriate speaking technique is just as important for singers as for other professional voice users. They have much to gain from voice therapy. The elimination of vocal abuse during speaking can have a dramatic and positive effect on the singing voice. The process of acquiring good speaking technique often facilitates better singing, as well.39

Multiple researchers agree on the vital, active involvement of singing teachers in working with voice disorders alongside the voice care team.36–38,40,41 Knowledge, experience, and simple

awareness of voice disorders and how to prevent them could enable voice teachers to effectively collaborate with the voice care team, ensuring that the voice training and therapeutic exercises are being executed correctly and safely. Given that current and future music educators and singers are at high risk for voice problems, it would stand to reason that voice teachers adopt an active role in their students’ overall vocal health. The purpose of this study, then, was to examine voice teachers’ perceptions of their instruction of healthy singing and speaking voice techniques. As such, the following research questions were developed to provide direction for the study. 1. What is the perceived relationship between the speaking voice and the singing voice? 2. How do voice teachers perceive they teach healthy vocal behaviors to their students (TVB)? 3. How do voice teachers perceive they monitor their students’ singing (MBSi) and speaking (MBSp) voices? METHODS An online survey was designed and administered to examine voice teachers’ perceptions of their instruction of healthy singing and speaking voice techniques. Questions also examined the perceived relationship between the speaking voice and the singing voice. Three primary variables of interest were explored: TVB, MBSi, and MBSp. Using the McClosky technique as a guide, a survey containing Likert-type items, closed- and open-ended questions, and demographic characteristics was developed to quantify the participants’ perceptions and better understand differences among voice teachers (Appendix S1). The Likert-type items were grouped into three categories corresponding to the three primary variables. Each variable was measured by 10 Likert items, scaled from 1 to 6, which were summed to arrive at participants’ perception scores. Scores for each variable ranged between 10 and 60, with higher scores indicating a more positive perception regarding the instruction of healthy singing and speaking voice behaviors among students. Figure 1 illustrates the rubric used to classify the perception scores for each of the three variables. A panel of experts, including voice teachers, speech-language pathologists, and McClosky technicians, established content validity for the survey. Based on their expert opinions, the instrument was modified to increase its clarity and ensure content validity. A pilot test was then administered to a small, convenient sample of college/university voice teachers (n = 14). This group was asked to complete the survey and comment on its readability. The data obtained from the participants of the pilot test generated a Cronbach alpha coefficient of α = .88, indicating that the survey Perception Score

Classification

53-60

Extremely Positive Perception

45-52

Very Positive Perception

36-44

Somewhat Positive Perception

26-35

Somewhat Negative Perception

18-25

Very Negative Perception

10-17

Extremely Negative Perception

FIGURE 1. Perception classification rubric.

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Voice Teachers’ Perceptions of Students’ Vocal Behaviors

had very strong internal consistency. Following collection and analysis of data from the pilot test, additional changes were made to the survey before implementation. The study was administered through the College Music Society, following review and approval by the society’s survey committee. The survey was initially sent to 3895 voice professors, followed by a secondary distribution. A third and final distribution of the survey was sent to 4207 voice teachers as a result of an update to the College Music Society’s member database. Each distribution of the survey included a cover letter detailing the purpose of the study, instructions for the completion of the questionnaire, an indication of the time commitment needed to complete the survey, the researcher’s contact information, and response deadlines. Participants for the study were college/university voice teachers who were members of the College Music Society and listed in its Directory of Music Faculties in Colleges and Universities, U.S. and Canada, 2012–2013 Edition (N = 4207). These voice teachers taught in varied educational communities, including both large and small, public and private colleges and universities. Fifty-eight percent of the population was women, 41% was men, and 1% remained uncategorized. Because access to the directory was limited, and organizing an appropriate sample study would have been cumbersome, a census with this population of voice teachers was conducted. Three hundred four voice teachers participated in the study. Twenty-three voice teachers, however, failed to complete a significant portion of the questionnaire, and as such, were excluded from data analysis. The voice teachers who provided complete and usable data (n = 281) represent a 6.7% response rate and should be considered the data sample for the study. Data were collected from October 11 to December 2, 2013. Following the data collection period, reliability analyses were once again conducted to ensure that the changes made to the questionnaire after pilot testing did not compromise its internal consistency. On the contrary, analysis of the data provided by the true study sample yielded a Cronbach alpha coefficient of α = .94. Furthermore, reliability analysis for each primary variable of interest was conducted. The 10 Likert items related to TVB generated a Cronbach alpha coefficient of α = .81. The 10 Likert items related to MBSi produced a Cronbach alpha coef-

ficient of α = .89. Finally, the 10 Likert items related to MBSp bore a Cronbach alpha coefficient of α = .94. All research procedures and materials were submitted to, and approved by, the Internal Review Board for research conducted at Ball State University before beginning the study. The research was considered exempt, as it was conducted in an established or commonly accepted educational setting. Final approval for the study was granted on October 1, 2013 with the International Review Board protocol #505520-2. RESULTS Three primary variables of interest were explored: the perception scores of participants concerning the variable TVB were very positive (M = 49.6; SD = 6.6); the perception scores of the participants regarding the variable MBSi were extremely positive (M = 53.7; SD = 6.7); and the perception scores of the participants regarding the variable MBSp were somewhat positive (M = 44.6; SD = 9.7). The perception scores and classifications of all participants for variables TVB, MBSi, and MBSp can be found in Table 1. In addition to exploring the correlations among the primary variables of interest, a paired samples t test was also conducted to determine if the mean perception scores for each variable were significantly different. Although the mean perception scores for each of the variables were positive to some degree, Table 2 illustrates that the mean perception score was significantly greater for variable MBSi (M = 9.08; SD = 8.41; t = 18.11; df = 280; P = 0.000) than the mean perception scores for both variables TVB and MBSp (M = 4.95; SD = 7.841; t = 10.59; df = 280; P = 0.000). The following analyses explored whether participants currently, or had in the past, instruct(ed) a student medically diagnosed with a voice disorder, revealing point bi-serial correlations. Although no relationship was revealed between this characteristic and the participants’ perception scores for variable TVB, participants who had instructed students with voice disorders were likely to have more positive perceptions regarding their instruction of students’ singing behaviors (MBSi: rpb = 12) and speaking behaviors (MBSp: rpb = .21). The next set of analyses explored participants’ familiarity with voice rehabilitation techniques and also revealed point

TABLE 1. Frequency Distribution of Participants’ Perception Scores for Variable TVB

Perception Score 53–60 45–52 36–44 26–35 18–25 10–17 *f = frequency. †C% = cumulative %.

TVB

MBSi

MBSp

Classification

f (%; C %)

f (%; C %)

f (%; C %)

Extremely Positive Perception Very Positive Perception Somewhat Positive Perception Somewhat Negative Perception Very Negative Perception Extremely Negative Perception

98 (35%; 100%) 124 (44%; 65%) 52 (18.4%; 21%) 6 (2.2%; 2.6%) 1 (.4%; .4%) 0 (0%; 0%)

191 (68%; 100%) 62 (22%; 32%) 24 (8.5%; 10%) 2 (.7%; 1.5%) 1 (.4%; .8%) 1 (.4%; .4%)

66 (23.4%; 100%) 80 (28.5%; 76.6%) 80 (28.5%; 48.1%) 47 (16.7%; 19.6%) 7 (2.5%; 2.9%) 1 (.4%; .4%)

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TABLE 2. Paired Samples t Tests for the Primary Variables of Interest 95% Confidence Interval Pair 1 Variable TVB-Variable MBSi Pair 2 Variable TVB-Variable MBSp Pair 3 Variable MBSi-Variable MBSp

M Difference

SD

SE of M

Lower

Upper

−4.128 4.953 9.081

4.042 7.839 8.406

.241 .467 .501

−4.602 4.033 8.094

−3.653 5.874 10.068

bi-serial correlations. Those participants familiar with voice rehabilitation techniques were likely to have more positive perceptions related to all three primary variables, including teaching healthy vocal behaviors (TVB: rpb = .25), monitoring students’ singing behaviors (MBSi: rpb = .18), and monitoring students’ speaking behaviors (MBSp: rpb = .32). In addition to the preceding correlations, descriptive data were solicited from the participants. Ninety-eight percent of voice teachers acknowledged a relationship between the singing voice and the speaking voice. Seventy-eight percent of voice teachers (n = 217) indicated that they had instructed a student with a voice disorder, and one in five voice teachers had been personally diagnosed with a voice disorder. However, only 67% of voice teachers (n = 188) acknowledged a familiarity with voice rehabilitation techniques, specifically identifying Resonant Voice Therapy, the Wicklund approach, Vocal Function Exercises, and voice rest as rehabilitation techniques they used when working with students suffering from a voice disorder. Others mentioned voice rehabilitation techniques advocated by wellknown doctors and vocal pedagogues, including Ingo Titze, Morten Cooper, Richard Miller, Robert Sataloff, and Oren Brown. Some voice teachers admitted that they either did not know of any techniques or were not qualified to use voice therapy techniques. One voice teacher stated, “Singing teachers legally cannot do rehab. They can do HABILITATION (enabling the person with better use)” (Participant ID: 2886506283). Various others created unique instructional practices, derived from common sense and personal experience, to apply to the speaking voice. A few voice teachers relied on their personal experiences in therapy sessions as a result of their own voice disorders, whereas still others initiated observations of speech-language pathologists. Among the 67% of participants familiar with voice rehabilitation techniques, 4% acknowledged being degreed as a speechlanguage pathologist or certified as a singing voice specialist, Wicklund singing voice specialist, or McClosky technician. The next set of analyses explored the relationship between gender and the primary variables of interest. Female participants were likely to have more positive perceptions concerning their instruction of healthy vocal behaviors than their male counterparts (TVB: rpb = .24). Female teachers were also likely to have more positive perceptions concerning their monitoring of students’ singing behaviors (MBSi: rpb = .16). No relationship was found between participants’ gender and variable MBSp. The relationship between participants’ years of teaching experience and the primary variables was next to be explored. No relationship was found between participants’ years of teaching experience and variable TVB or MBSi. A Pearson correlation,

t

df

−17.11 280 10.59 280 18.11 280

Sig. 2-Tail .000 .000 .000

however, did exist between participants’ years of teaching experience and variable MBSp, indicating that participants with more years of teaching experience were likely to have more positive perceptions of their monitoring of students’ speaking behaviors (r = .12). The final set of correlations explored whether participants were familiar with the McClosky technique. Participants familiar with the McClosky technique were likely to have more positive perceptions of their instruction of healthy vocal behaviors to their students (TVB: rpb = .13). Although no relationship was found between participants’ perception scores for variable MBSi and whether they were familiar with the McClosky technique, a relationship did exist between variable MBSp and familiarity with the McClosky technique. Participants familiar with the McClosky technique were likely to have more positive perceptions of their monitoring of students’ speaking behaviors (MBSp: rpb = .18). Relative to the issue of how specific groups of participants may differ, a one-way Analysis of Variance was conducted to compare the effect of type of student taught on participants’ perception scores for each primary variable of interest. Although the type of student taught did not have a significant effect on participants’ perception scores for variable TVB, the type of student taught did have a significant effect on participants’ perception scores for variable MBSi (F[3, 277] = 5.03, P = 0.002). Scheffé post hoc comparisons indicated that the mean perception score for variable MBSi among participants who taught current/future performers (M = 54.1, SD = 7.7) was significantly greater than the mean perception score for participants who taught casual singers (M = 48.4, SD = 6.8). Likewise, the mean perception score for variable MBSi among participants who taught current/future music educators (M = 54.5, SD = 5.6) was significantly greater than the mean perception score for participants who taught casual singers (M = 48.4, SD = 6.8). Those participants who taught choral singers (M = 51.7, SD = 6.2) did not have significantly different perception scores for variable MBSi from their counterparts. Results of these analyses are illustrated in Tables 3 and 4. The type of student taught also had a significant effect on participants’ perception scores for variable MBSp (F[3, 277] = 8.32, P = 0.000). Scheffé post hoc comparisons indicated that the mean perception score for variable MBSp among participants who taught current/future performers (M = 46.7, SD = 9.9) was significantly greater than the mean perception score for participants who taught choral singers (M = 39.7, SD = 8.6) and participants who taught casual singers (M = 36.9, SD = 6.9). Likewise, the mean perception score for variable MBSp among participants who taught current/future music educators (M = 45.1,

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Voice Teachers’ Perceptions of Students’ Vocal Behaviors

TABLE 3. Summary Data and ANOVA for the Effect of Type of Student on Variable MBSi Type of Student Taught N M SD Source Between groups Within groups Total

C/F Performers

C/F Educators

Choral Singers

Casual Singers

98 54.1 7.7

134 54.5 5.6

35 51.7 6.2

14 48.4 6.8

SS

df

Mean Square

F

641.735 11,782.706 12,424.441

3 277 280

213.912 42.537

5.029*

* P = 0.002. Abbreviation: ANOVA, analysis of variance.

TABLE 4. Scheffé Post Hoc Comparisons for the Effect of Type of Student on Variable MBSi

Student Type (I) C/F PERFORMERS

C/F EDUCATORS

CHORAL SINGER

CASUAL SINGER

95% Confidence Interval

Student Type (J)

Mean Difference (I-J)

Lower Bound

Upper Bound

C/F EDUCATORS CHORAL SINGERS CASUAL SINGERS C/F PERFORMERS CHORAL SINGERS CASUAL SINGERS C/F PERFORMERS C/F EDUCATORS CASUAL SINGER C/F PERFORMERS C/F EDUCATORS CHORAL SINGERS

−.38578 2.43469 5.7346* .38578 2.82047 6.1204* −2.43469 −2.82047 3.30000 −5.7346* −6.1204* −3.30000

−2.8241 −1.1777 .4933 −2.0526 −.6619 .9678 −6.0471 −6.3028 −2.5012 −10.9761 −11.2731 −9.1012

2.0526 6.0471 10.9761 2.8241 6.3028 11.2731 1.1777 .6619 9.1012 −.4933 −.9678 2.5012

* The mean difference is significant at the 0.05 level.

SD = 9.2) was significantly greater than the mean perception score for participants who taught choral singers (M = 39.7, SD = 8.6) and participants who taught casual singers (M = 36.9, SD = 6.9). Perception scores for variable MBSp among participants who taught current/future performers and participants who taught current/future educators were not significantly different. Per-

ception scores for variable MBSp among participants who taught choral singers and participants who taught casual singers were not significantly different. Tables 5 and 6 outline the results of these analyses. The effect of highest music degree earned, type and size of institution, and age of student was also explored. Although

TABLE 5. Summary Data and ANOVA for the Effect of Type of Student on Variable MBSp Type of Student Taught n M SD Source Between groups Within groups Total

C/F Performers

C/F Educators

Choral Singers

Casual Singers

98 46.7 9.9

134 45.1 9.2

35 39.7 8.6

14 36.9 6.9

SS

df

Mean Square

F

2,162.830 24,012.323 26,175.153

3 277 280

720.943 86.687

8.317*

* P = 0.000. Abbreviation: ANOVA, analysis of variance.

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TABLE 6. Scheffé Post Hoc Comparisons for the Effect of Type of Student on Variable MBSp

Student Type (I) C/F PERFORMERS

C/F EDUCATORS

CHORAL SINGERS

CASUAL SINGERS

95% Confidence Interval

Student Type (J)

Mean Difference (I-J)

Lower Bound

Upper Bound

C/F EDUCATORS CHORAL SINGERS CASUAL SINGERS C/F PERFORMERS CHORAL SINGERS CASUAL SINGERS C/F PERFORMERS C/F EDUCATORS CASUAL SINGERS C/F PERFORMERS C/F EDUCATORS CHORAL SINGERS

1.61803 7.03061* 9.88776* −1.61803 5.41258* 8.26972* −7.03061* −5.41258* 2.85714 −9.88776* −8.26972* −2.85714

−1.8628 1.8737 2.4054 −5.0989 .4413 .9140 −12.1875 −10.3838 −5.4244 −17.3702 −15.6254 −11.1386

5.0989 12.1875 17.3702 1.8628 10.3838 15.6254 −1.8737 −.4413 11.1386 −2.4054 −.9140 5.4244

* The mean difference is significant at the 0.05 level.

observable differences were sometimes apparent, none of these aspects had a significant effect on participants’ perception scores or the primary variables. DISCUSSION The current study provided valuable information concerning the perceptions of voice teachers regarding their teaching and monitoring of students’ vocal behaviors. Data suggested that differences exist among variables TVB, MBSi, and MBSp. The nature of these differences is noted by the paired samples t tests for each primary variable of interest. The mean perception score for each variable was classified as being positive to some degree. Considering that self-evaluation research results have the potential to be inflated, this result may be expected. Still, each perception score remained significantly different from the others, despite their common, positive nature. Also worth noting is the obvious ranking of perception scores. Participants’ perception scores were the most positive for variable MBSi. Participants’ perception scores for variables TVB and MBSp ranked second and third, respectively. This, too, should not come as a surprise, as each item was ranked according to what most voice teachers might perceive their primary job to be—training the singing voice. Further differences in how voice teachers managed the singing and speaking voices of their students can be gleaned from the many correlations between various characteristics and the three primary variables. Perception scores for variable TVB were primarily associated with three items: participants’ familiarity with voice rehabilitation techniques, gender, and participants’ familiarity with the McClosky technique. The perception scores for variable MBSi were primarily associated with four items: familiarity with voice rehabilitation techniques, gender, type of student taught, and whether participants had instructed a student(s) with a voice disorder. Finally, the perception scores for variable MBSp were primarily associated with five items: participants’ familiarity with voice rehabilitation techniques, familiarity with the McClosky technique, type of student taught, years of teaching experience, and whether participants had in-

structed a student(s) with a voice disorder. The only characteristic correlated with each of the primary variables was voice teachers’ familiarity with voice rehabilitation techniques. This common characteristic may provide insight into the prevention and intervention of voice disorders within the voice studio. Descriptive data revealed that many voice teachers, whether familiar with specific voice rehabilitation techniques or not, were already implementing many common techniques into their students’ singing lessons. Although working with students with voice disorders influenced teachers’ perceptions of how they monitored that student’s singing and speaking behaviors, it did not seem to affect their perception of whether they taught that student a healthy vocal regimen. Teachers, however, who were familiar with voice rehabilitation techniques reported teaching their students healthy vocal behaviors and also monitored students’ behaviors during singing and speaking. Teachers familiar with voice rehabilitation techniques believed themselves to be more aware of the benefits of teaching well-rounded, healthy, vocal behaviors and applying them to both the singing voice and the speaking voice. As a matter of fact, data analysis revealed that the ranking of monitoring vocal behaviors with familiarity of voice rehabilitation techniques was the exact opposite to that found in the paired samples t tests concerning the three primary variables. Purportedly, teachers familiar with voice rehabilitation techniques were more likely to monitor the speaking behaviors of their students, followed by teaching them healthy vocal behaviors, and then monitoring their singing behaviors. Specific to the current study was the inclusion of the McClosky technique within its survey. Twenty-nine percent of participants (n = 82) indicated familiarity with the McClosky technique, which was correlated with variables TVB and MBSp. Participants’ descriptive data offered insight as to how teachers used the McClosky technique with their students. Familiarity with the technique ranged from having only heard of it to being fully certified in the technique. Some participants indicated that they used McClosky’s book, Your Voice at Its Best, requiring students to purchase the book and practice the technique as part of their

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Voice Teachers’ Perceptions of Students’ Vocal Behaviors

warm-up routines. Some participants used the technique solely with hyperfunctional singers and/or disordered voices. Five percent of the participants indicated that they had studied with David Blair McClosky himself, and 30% of participants reported attendance at a McClosky seminar and/or study with a McClosky technician. Participants also commented that although they were familiar with the technique in some way, many of the McClosky techniques were naturally implemented into what they believed were healthy teaching practices. Three percent of participants indicated a resistance to the McClosky technique. Some participants combined the methods of the McClosky technique with various other practices in an effort to further benefit their students. “While there are many aspects of the McClosky Technique I think are beneficial, I am not a ‘single method’ teacher. I have found it most helpful to my students to be aware of a broad range of approaches and to bring the best of each to them. Not all students are the same.” (Participant ID: 2857596329) “It is the duty of every voice teacher to know as many techniques as possible to be able to relate to as many students as possible.” (Participant ID: 2884023626)

When you consider the previously mentioned rankings for the primary variables and the most likely perceived job of voice teachers to train the singing voice, these data suggest that it might be beneficial if voice teachers were familiar with specific rehabilitation methods. Familiarity with rehabilitation techniques may encourage voice teachers to include the direct teaching of healthy vocal behaviors and the monitoring of students’ speaking voices within a voice lesson. Ninety-eight percent of voice teachers believed there to be a relationship between the singing voice and the speaking voice, indicating shared similarities of posture, breathing, and resonance. Voice teachers also believed that proper and improper use in one voice could directly influence the other. Many participants perceived that the root cause of voice disorders among students was not improper singing technique, but rather improper speaking habits, and believed that using techniques of singing as a means to rehabilitate a disordered speaking voice could facilitate the healthy production of both singing and speaking voices. Some participants suggested that singing is merely an extension or exaggeration of speaking, stating that the quality of students’ speaking voices indicated the likely quality or condition of their singing voices. “As a singer, I say sing like you speak; however, I have noticed that a large majority of people don’t speak correctly, and therefore, as a teacher of singing, it is most important to get a student to speak correctly at the same time as learning to sing. The connection between speech and singing is quite simple: both are produced using the same organs—the larynx and the lungs. Speech and singing also rely on the same resonators; in (classical) singing, however, we tend to use these resonators more efficiently.” (Participant ID: 2895942044) “As a voice teacher, I’ve coached many students back to ‘vocal health’ through singing. The singing acts as ‘therapy’ for the students. Focusing on the fundamentals of posture, breath-

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ing, onset/phonation, articulation, and projection [sic].” (Participant ID: 2930500100) “If one speaks in a manner that is unhealthy for their [sic] larynx (too low, too loudly without breath support, too high, etc.), it will tire and thus will the singing voice. Most singers’ vocal problems result from their misuse of their speaking voices, rather than the way they sing.” (Participant ID: 2924675286) “Voice disorders most often arise as a result of speaking, not singing. Abusive speech habits compromise the instrument, and then when you sing on a compromised instrument you compromise it further. When one approaches the act of singing one must begin from a standpoint of vocal health if one wishes the singing act to perpetuate vocal health. Voice use can either be self-limiting or self-perpetuating. If you begin with compromised vocal health you will most likely progress down the self-limiting path. If you begin with sound vocal health you will have a better chance of achieving self-perpetuating vocalism, which should be the goal in the development of vocal technique.” (Participant ID: 2924448715) “The speaking voice constantly, consistently, informs the singing voice (mostly at a subconscious level). While the singing voice might be ‘healthier’ in its production, speaking voice issues will keep a singer from fully developing (at the very least), and/or cause vocal damage (in the worst cases).” (Participant ID: 2924218368)

Another result of the study indicated that voice teachers were more likely to monitor students’ singing and speaking behaviors when the student suffered from a medically diagnosed voice disorder. There was no correlation between students diagnosed with voice disorders and the teaching of healthy vocal behaviors. Based on these results, one might assume that a voice teacher will monitor the singing and speaking habits of students exhibiting voice disorders, but may not necessarily teach them appropriate, healthy vocal behaviors to avoid such disorders. Although voice teachers perceive that they are teaching healthy vocal behaviors merely by teaching proper singing technique, many students fail to see a connection between what they do in voice lessons and their everyday speaking habits. Certainly, voice teachers in the current study indicated that when a student was diagnosed with a voice disorder, changes were made in the students’ lessons concerning technique, literature, singing range, and lesson duration. Many participants reported that they would send their students to voice specialists and might focus more on the basic singing techniques of posture, breath, resonance, and articulation in an effort to have their students apply these techniques to their speaking voices. Voice teachers also focused on vowel alignment and position, easier onsets, humming, lip and tongue trills, sighs and sirens, and speaking habits in an effort to help their students. “I move more slowly into full-blown singing. I consult with the voice specialist at the voice care center where the student is a patient for guidance. I spend more time on the speaking voice and health problems according to the need.” (Participant ID: 2938942414) “Several applied voice students have been instructed to take complete vocal rest after scoping. The student’s [sic] lessons

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Journal of Voice, Vol. ■■, No. ■■, 2016 [then] involved extensive work with rhythms, IPA, and characterization/analysis of assigned repertoire.” (Participant ID: 2924876755) “I work closely with the student’s laryngologist (or surgeon, if applicable), and the speech pathologist who is supervising or consulting in the rehabilitation. If no surgery has taken place, I try to make sure the student has at least seen a qualified ENT to get a clear picture of what the vocal folds look like, and that there is no swelling or hemorrhage present. I also prefer to work with a speech pathologist so that I may adapt my vocalizes to support the student’s needs. All the vocal exercises I do with the student during the lesson are to encourage ease of production, with easy free tone, and good breath support.” (Participant ID: 2924890629) “When this occurs, we develop a variety of vocal rest and vocal-preservation protocols to assist in the rehabilitation of the voice. This restricts the time and behaviors of the use of the singing and speaking voice.” (Participant ID: 2924120320)

These strategies, however, are reactive. When you consider that 78% of voice teachers indicated instruction of a student with a voice disorder, and that one in five voice teachers had been personally diagnosed with a voice disorder, redirecting teachers’ attention toward the speaking voice may have profound, positive effects. The direct teaching of healthy vocal behaviors, including concrete connections to how such behaviors should apply to the speaking voice before the development of a voice disorder, represents a proactive approach to the prevention of voice disorders among students. Adopting a more proactive approach toward one’s teaching could spare many students the dangers and discomforts of a voice disorder. Gender was positively correlated with primary variables TVB and MBSi. Female voice teachers were more likely than their male counterparts to teach healthy vocal behaviors to their students and monitor those vocal behaviors when their students were singing. This perhaps is because of the overwhelming research indicating that women are more susceptible to vocal dysfunction due to laryngeal and physiological differences, teaching field dominance, and hormonal effects.4,7–9,14,42–47 Also of interest were the correlations concerning years of teaching experience and the primary variables. Although no correlations were found between years of teaching experience and variables TVB and MBSi, a positive correlation was found as related to variable MBSp. It might be assumed that voice teachers, whether early in their careers or with years of experience behind them, are well aware of their duties concerning singing voice training. Teaching singing is their job. However, years of working with students entering or leaving their studios with voice disorders might have a direct effect on teachers’ desires to prevent or intervene in such situations. The majority of voice teachers indicated that they primarily taught undergraduate current or future music educators. Interestingly enough, although results of the current study indicate that teachers instructing performers and music educators are more likely to monitor healthy singing and speaking behaviors, many music education majors admit anecdotally that they are unprepared for the heavy voice use of their student-teaching semesters and early full-time teaching careers. Research indicates that music teachers use their voices more than

50 hours a week, teaching, advising, and modeling for as many as 475 students for more than 46 different class settings in a week.13,19 With these statistics, it would behoove voice teachers to gain experience earlier in their careers concerning voice rehabilitation techniques and speaking voice training to help these future music teachers maintain vocal longevity. Results of the type of student taught revealed a disturbing relationship to the primary variables. Although type of student taught did not affect participants’ instruction of healthy vocal behaviors, it did have an impact on their monitoring of students’ speaking and singing voices. Purportedly, teachers instructing current and future performers and music educators were more likely to monitor students’ singing and speaking habits. However, teachers were less likely to monitor the singing and speaking habits of casual singers and choral singers. Many concerns were revealed because of the implications of these results. Casual and choral singers—students in various degree plans who may be taking lessons for personal enjoyment and further learning—are less likely to be aware that potential dangers exist concerning their voices and careers before it is too late. Within this group called the casual and choral singer, one might find those involved in sales, reception work, TV and broadcasting, general education, acting, and preaching— professionals already identified as being highly at risk for vocal dysfunction.1 If a voice teacher, who is on a weekly, one-on-one contact with these individuals, is not actively teaching them healthy singing and speaking behaviors, who will help them? The National Association of Teachers of Singing Code of Ethics clearly states the responsibilities of the teacher to each and every voice student: “Members will treat each student in a dignified and impartial manner; Members will offer their best voice and music instruction and career advice to all students under their instruction.”48 Many participants indicated that they either did not feel qualified or did not have time to pursue additional education to aid in rehabilitation of the singing voice and the speaking voice. Although acquiring additional certifications and degrees to aid in the rehabilitation process is not required, voice teachers may want to reconsider their role in the prevention and habilitation of the speaking voice and the singing voice within the voice studio by teaching healthy vocal behaviors. Prevention is something the voice teacher can do now. Descriptive data, however, revealed that many voice and music education teachers did not necessarily receive this education within their degree plans. This is a surprising contradiction when one considers again the standards and requirements of NASM.23 Students enrolled in music unit programs and faculty and staff with employment status in the music unit must be provided basic information about the maintenance of health and safety within the contexts of practice, performance, teaching, and listening. For music majors and music faculty and staff, general topics include, but are not limited to, basic information regarding the maintenance of hearing, vocal, and musculoskeletal health and injury prevention. For non-majors enrolled in courses offered by the music unit, including performing ensembles, or other curricular offerings of the music unit, topics chosen in addition to the maintenance of hearing health are

ARTICLE IN PRESS Shellie A. Beeman

Voice Teachers’ Perceptions of Students’ Vocal Behaviors

directly related to health and safety issues associated with their specific area of study or activity in music.23

Although NASM does not specify who within the institution imparts this knowledge or how it may be conveyed, the Handbook 2013–201423 clearly states that the health and prevention of the instrument is the responsibility of the institution and must be communicated to the student. Descriptive data from the current study indicated that voice teachers are not fully aware of their appropriate role within the voice care team, nor do they always take the appropriate means necessary to help students evidencing voice disorders. As guided and recommended by NASM,23 music institutions should be involved in helping students and teachers alike access the resources necessary to promote vocal health. Normally, institutions or music programs (1) have policies and protocols that maintain strict distinctions between the provision of general musicians’ health information in the music program, and the specific diagnosis and treatment of individuals by licensed medical professions, and (2) identify for the benefit of students and other personnel as appropriate or as requested, resources that will enable them to make contact with such professionals for specific treatment or other medical cares. Normally, institutions and music programs develop their specific methods for addressing the maintenance of health and safety in consultation with qualified professionals, for example, licensed medical personnel and/or authoritative sources providing information to students and faculty regarding the maintenance of professional health and the prevention of performance injuries.23

Voice teachers have multiple opportunities to actively pass on this education to the plethora of nonmajors, music minors, and music majors who come through private lessons, methods courses, and pedagogy classes. Past research concerning the speaking voice indicated a need for methods that might aid in the proper use and rehabilitation of the speaking voice and the singing voice. Participants in the current study identified voice rest, Vocal Function Exercises, Resonant Voice Therapy, the Wicklund approach, and the McClosky technique as rehabilitation techniques used when working with students suffering from a voice disorder, all of which share multiple similarities.11,49–51 Familiarity with or training of specific rehabilitation techniques could provide teachers with the resources necessary to fulfill their role within the voice care team as managers of their students’ speaking voices while still meeting the needs of a successful yet healthy singing technique. CONCLUSIONS The majority of voice teachers participating in the current study believed there to be a relationship between the health of the singing voice and the health of the speaking voice. Furthermore, thorough analysis of participants’ descriptive data revealed that voice teachers are purportedly working with injured voices and attempting to include vocal health in their instruction. Although a voice teacher is not obligated to pursue a speechlanguage pathology degree or voice specialist certification, the current study does reveal a positive relationship between familiarity with specific rehabilitation techniques and vocal health. As clearly stated by NASM, “Health and safety depend in large

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part on the personal decisions of informed individuals.”23 Teachers and students alike should take the time to become personally informed of healthy singing and speaking voice habits, in turn, applying that knowledge to their own voices and those of their students and implementing it within the college atmosphere and teaching studio. This knowledge can be acquired through multiple resources including, but not limited to, such events as the Oberlin Symposium for Voice Performance and Pedagogy, The Voice Foundation, American Speech-Language Hearing Association (ASHA) conventions, National Association of Teachers of Singing (NATS) forums, National Association for Music Educator’s (NAfME) conventions, McClosky Certifications, and Wicklund Singing Voice Specialist Training. Further research is encouraged, including direct observation of what teachers actually do in their voice studios as compared with what they perceive they do in teaching and in monitoring healthy vocal behaviors of students’ speaking and singing voices. Acknowledgments This study was conducted as a part of a dissertation and would not have been possible without the help and encouragement of Drs. Kevin Gerrity and Meryl Mantione of Ball State University. APPENDIX: SUPPLEMENTARY DATA Supplementary data related to this article can be found online at doi:10.1016/j.jvoice.2016.02.007. REFERENCES 1. Sipley K. Training the speaking voice through singing. [Abstract]. 1997: 1–14. Retrieved 2012, Available at: http://www.eric.ed.gov/; http:// www.eric.ed.gov/PDFS/ED439462.pdf. 2. Titze IR, Lemke J, Montequin D. Populations in the U.S. workforce who rely on voice as a primary tool of trade: a preliminary report. J Voice. 1997;11:254–259. 3. Smith E, Gray SD, Dove H, et al. Frequency and effects of teachers’ voice problems. J Voice. 1997;11:81–87. 4. Smith E, Kirchner HL, Taylor M, et al. Voice problems among teachers: differences by gender and teaching characteristics. J Voice. 1998;12:328–334. 5. Phillips DE, Gillespie AA, Thompson JD. Voice Problems and Teachers, Voice Problems of Classroom Teachers: Incidence, Symptoms, and Associated Factors. Richard W. Waguespack M.D.: Ear, Nose & Throat. 2004 Available at: www.drwag.com/939.html. Retrieved September 6, 2013. 6. Munier C, Kinsella R. The prevalence and impact of voice problems in primary school teachers. Occup Med. 2007;58:74–76. 7. Bermúdez de Alvear RM, Barón FJ, Martínez-Arquero AG. School teachers’ vocal use, risk factors, and voice disorder prevalence: guidelines to detect teachers with current voice problems. Folia Phoniatr Logop. 2011;63:209– 215. doi:10.1159/000316310. 8. Van Houtte E, Claeys S, Wuyts F, et al. The impact of voice disorders among teachers: vocal complaints, treatment-seeking behavior, knowledge of vocal care, and voice-related absenteeism. J Voice. 2011;25:570–575. 9. Behlau M, Zambon F, Guerrieri AC, et al. Epidemiology of voice disorders in teachers and nonteachers in Brazil: prevalence and adverse effects. J Voice. 2012;26:665. doi:10.1016/j.jvoice.2011.09.010. 10. Charn TC, Mok PKH. Voice problems amongst primary school teachers in Singapore. J Voice. 2012;24:141–147. 11. Ziegler A, Gillespie AI, Abbott KV. Behavioral treatment of voice disorders in teachers. Folia Phoniatr Logop. 2010;62:9–23. 12. Roy N, Merrill RM, Thibeault S, et al. Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices. J Speech Lang Hear Res. 2004;47:542–551.

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