Relationship between Voice Complaints and Subjective and Objective Measures of Vocal Function in Iranian Female Teachers

Abstract

Teachers are at high risk of developing voice problems because of the excessive vocal demands necessitated by their profession. Teachers' self-assessment of vocal complaints, combined with subjective and objective measures of voice, may enable better therapeutic decision-making. This investigation compared audio-perceptual assessment and acoustic variables in teachers with and without voice complaints. Ninety-nine teachers completed this cross-sectional study and were assigned to one of two groups: those "with voice complaint (VC)" and those "without voice complaint (W-VC)." Voice samples were collected during reading, counting, and vowel prolongation tasks. Teachers were also asked to document any voice symptoms they experienced. Voice samples were analyzed using Dr. Speech program (4th version; Tiger Ltd., USA), and labeled "normal" or "abnormal" according to the "grade" dimension "G" from GRBAS scale. Twenty-one teachers were assigned to the VC group based on self-assessment data. There were statistically significant differences between the two groups with regard to self-reported voice symptoms of hoarseness, breathiness, pitch breaks, and vocal fatigue (P < 0.05). Fourteen participants in the VC group and 40 from the W-VC group were determined to demonstrate "abnormal" vocal quality on perceptual assessment. Only harmonic-to-noise ratio was significantly higher for the W-VC group (ES = 0.55). Teachers with and without voice complaints differed in the incidence, but not type of voice symptoms. Teachers' voice complaints did not correspond to perceptual and acoustic measures. This suggests a potential unmet need for teachers to receive further education on voice disorders.