Identifying when medical advice may be needed

Consulting your Doctor

Teachers should be alert to the signs of vocal difficulties. These may occur at any time and may be due to overuse of the voice, or to infection or illness. As a first step, teachers who experience any of the following symptoms should consult their GP:

• Regular and/or unexplained voice loss.

• A change in voice quality (e.g. hoarseness or croakiness) for more than 10 days.

• A weak and tired sounding voice.

• A voice and/or throat that feels consistently painful or as if there is a lump in the throat.

• Frequent throat clearing.

• Loss of vocal power or ability to project.

Doctors will usually consider any underlying infection, illness or allergic response and prescribe treatment accordingly.

Referrals to E.N.T. Consultant

If the problem persists, teachers should make a further appointment with their GP and discuss whether referral to an ENT consultant or laryngologist would be appropriate

Referrals to Speech and Language Therapist

Following a consultation with an ENT specialist, a referral to a Speech and Language Therapist may be deemed appropriate.

Support from your Employer

Advice and assistance should also be made available by employers through the occupational health service. Steps which employers might take to assist might include a voice therapy and also, for example, the provision of voice amplification equipment in appropriate circumstances.

Checklist for using the Voice

Set out below is a brief summary of points to consider about the way teachers use their voices, possible problems which they may be causing for themselves and the way in which their working environment may contribute to these.

More detailed advice on these areas, in particular on speaking techniques, is available from the Voice Care Network.

Voice and Speech Patterns

It is important for teachers to:

• warm up their voice at the start of the day;

• focus their thoughts and make good use of key words;

• consider the effect their voice needs to have on the listener and aim for flexibility to reflect the changing moods they wish to convey;

• make use of pauses and silences to emphasise their meaning; and

• be aware of the symptoms of vocal fatigue and consult their doctor accordingly.


Teachers may find it helpful to:

• practise relaxation techniques to ease whole body tension;

• before lessons, stretch and relax their facial muscles to release tension from their face and jaw; and

• take time to relax and let their voice recover after prolonged speaking, use "cooling down" exercises and have a warm drink.


Teachers should be aware of their posture when speaking and consider how their postural alignment and degree of muscular tension affect the tone and resonance of their voice.


Shallow "upper chest breathing" can affect the tone and resonance of the voice. Teachers may find it useful to practice slower "centred breathing" using the diaphragm, which will help their vocal quality and also release tension and recharge energy.


It is a useful exercise for teachers to seek to find their optimum or natural pitch. by making a sound of agreement in their most relaxed state ("hm, hm"). The second sound is most likely to be very close to their optimum pitch. Practicing speaking flexibly on and around this level can be helpful.

Although this may be hard to achieve, teachers should try not to pitch outside their comfortable range or shout to get attention. Instead, they should try using agreed signals and develop "getting attention" routines using sound, visual and vocal signals.

Your Working Environment (Acoustics, Layout and Air Quality)

Teachers need to be aware of acoustics, space and classroom layout and how these can impact upon their voice and should consider how best to group their class for the task they are undertaking with regard to the acoustics and layout of the room.

• Wood, stone, ceramics, pottery, brick, metal and glass all reflect sound, while some large spaces produce echoes. Teachers should aim to speak more slowly with clear pronunciation rather than increasing the volume in such surroundings.

• A heavily furnished room with low ceilings and containing many people will absorb sound, meaning that voices have to work much harder, so teachers will need to maintain good posture and articulate words using the front of the mouth.

• Dust and fumes or dry atmospheres can affect the voice as well. Poor standards of cleaning, particularly in areas such as art or D&T rooms where particular materials such as clay, solvent-based glues etc are used, can affect air quality. Rooms need to be well ventilated. Humidity can be increased by introducing a few houseplants or by placing bowls of water near radiators.

Self Help for Vocal Fatigue

• It is important to drink water frequently. Drinking six or eight glasses a day will help to keep the larynx moist, especially in hot dry atmospheres. Keeping a glass of water to hand during lessons will help as will a reduction in caffeine intake.

• For a mild sore throat, sucking fruit pastilles can help. Strong throat sprays, lozenges etc, which dry the larynx, should be avoided. It is important to rest the voice as much as possible and avoid whispering, as it is stressful for the larynx. Breathing steam rising from hot - but not boiling! - water can also be of benefit.

From NUT's Voice care guide.

Full NUT health and safety briefing: Keep the noise down

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