1. Professional Voice Users
Presented by: Nikki Tessari

2. Professional Voice Users
Anyone who requires a certain voice quality to have an effect on others
This includes public speakers and singers
If voice is damaged within these professionals: it can be detrimental to their careers and how they are perceived by those around them

3. Professional Voice Users
Professional speaking voice falls into two categories:
Normative
Emotive
More likely to have problems related to abuse from overuse
Often use their voices to motivate or encourage others to engage in some kind of activity
Includes: Telephone operators, telemarketers, TV and radio broadcasters, executives, and teachers
Includes: Conductors, actors, ministers, politicians, aerobic instructors, drill instructors, and athletic coaches

4. Common Problems They put ridiculous demands on their voices
Little tolerance for illnesses and unrealistic expectations: “the show must go on”
Many have inadequate and inappropriate training
Singers and Actors may have two jobs: leads to excessive vocalization
Posture issues

5. Demands of Various Careers
Telemarketers
Boredom and fatigue along with psychological problems of constant rejection
Poor posture from sitting in inappropriate chairs with no headset
No training in breath support
Broadcasters
Worked in fixed head/body position
Lower-pitched voice to sound forceful
In dirty and dusty studios for long stressful hours
Don’t take many sick days
Salesmen
Perform under pressure: no sales=no income
Carry heavy bags through the airport
Spend hours in airplanes with dry air and loud background noise
Teachers
Work in old musty environment
No amplification
Often present to a nonreceptive audience=stress

6. Bogart-Bacall Syndrome James A Koufman, M.D.
Named after Humphrey Bogart and Lauren Bacall
Condition most common in singers, actors, and radio and TV personalities
These people speak with a fundamental frequency that is too low, poor breath support, and laryngeal muscle tension
Causes muscle tension dysphonia
Distinguishing characteristics: Walter Cronkite to Peter Jennings
More common in women: social pressure to compete with men

7. Vocal Abuse, Misuse, and Overuse
Yelling, screaming, and singing loudly
Causes nodules, contact ulcers, and vocal fold swelling
Avoid screaming at all times: when performing and not performing
Abuse with professionals is inappropriate and neglectful
Misuse
More habitual: speaking out of range and character voices (BBS)
If they sound like they are straining, they are: point out the obvious
Overuse
Can happen to anyone: individuals must know their limit
Most common when suffering from infection/virus

8. General Voice Problems
Aging
Takes more effort to stay fit as you age
Pressure to work later in life: living longer, social security, breakdown of family
Dentures, tongue thinning, TMJ, posture, hearing loss
Accidental Injuries
Be safe: use seatbelts and common sense
Abusive Injuries
Drinking, smoking, drug use

9. General Voice Problems (cont’d)
Infections/Diseases
Head colds, tonsillitis, laryngitis, sinusitis, bronchitis, pneumonia all can damage a career
Limit exposure by avoiding closed, crowded, poorly ventilated spaces: such as elevators
Alter lifestyle to prevent lung cancer and high blood pressure
Medication
Can have effects such as: drying, sedation, mood changes, and anxiety
Drink lots of water

10. Treatment for the Professional Voice User
Preventative care/ Vocal hygiene
Instructional care for maximal performance
Reversal of dysfunction and pathology

11. Vocal Hygiene
Proper care and use of the vocal mechanism: preventatives
Increased vocal cord lubrication
Nasal breathing: so air can be filtered, purified, and properly humidified by the nose and sinuses
Avoid irritants, smoking, heavy drinking, and dust
Use diaphragm breathing
Maximize relaxation throughout body
Identify and avoid vocal abuse
Use easy on-set phonation

12. Instructional Care
This is for the professional who wants to maximize his/her vocal function: range, pitch, loudness
Inform about all aspects of:
Vocal hygiene
Normal phonatory process/ vocal mechanism
Breathing techniques
May obtain information from a SLP for goals and techniques to work on

13. Reversal of Dysfunction and Pathology
Must first see laryngologist to rule out a laryngeal pathology
The SLP will be working with hyperfunctional/ hypofunctional activity in the vocal mechanism
Must identify the poor vocal behaviors and work to eliminate them
If therapy is not effective, the client may develop nodules or polyps

14. A Team Approach
May all work together to preserve a career: despite less than perfect health
Professionals include
Primary Physician
Otolaryngologist
Speech-Language Pathologist
Voice Coach
Job Supervisor

15. The Speech-Language Pathologist’s Role
After the client has been examined by the laryngologist, the SLP must:
Take baseline voice documentation
Do an acoustical voice analysis
Perform therapeutic manipulation: “unloading”
Therapy done to remove any temporarily compensatory vocal behaviors
Obtain optimal breath support
Soften the hardness of glottal attack
Reduce the rate of speaking
Reduce laryngeal and neck muscle tension
Make an independent diagnosis
Perform speech/voice therapy
Determine dismissal criteria

16. What the Patient Needs
A caring professional who understands that their voice is their career
An understanding of their weaknesses, their diseases, and their medications
Should be encouraged to take as few risks as possible, exercise regularly, get plenty of rest, and minimize stress
This information and treatment should lead to a long career as a professional voice user!!

17. Resources
Mitchell, S.A. (1996). Medical problems of professional voice users. Comprehensive therapy, 22,
Koufman, J.A., Blalock, D.P. (1988). Vocal fatigue and dysphonia in the professional voice user: bogart-bacall syndrome. Laryngoscope, 98,
Neely, J.L., Rosen, C. (2000). Vocal fold hemorrhage associated with coumadin therapy in an opera singer. Journal of Voice, 14,
Rarnalingam, R. (1997). Care of the professional voice. Help, Health Library. Retrieved on April 19, 2003 from,
Watts, C.R., Clark, R., & Early, S. (2001). Acoustic measures of phonatory improvement secondary to treatment by oral corticosteroids in a professional singer: a case report. Journal of Voice, 15,
Wate Forest University Baptist Medical Center. Center for Voice Disorders. Retrieved on April 19, 2003, from