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Influences on Vocal Health

Jack Pickering, Ph.D., CCC-SLP
Speech-Language Pathologist
Capital Region Ear, Nose, and Throat
Department of Communication Sciences and Disorders
College of Saint Rose

There are many potential influences on our voice and vocal health. Some of the influences, like constant yelling and screaming, may have a clear, negative effect on the voice by causing irritation to the vocal cords and a sore throat. There are other, more subtle influences that can get in the way of achieving adequate, on-going vocal health, as well. For example, numerous substances can leave our “voice box” (larynx) and vocal cords dry, like the caffeine in coffee and medications for congestion. Unfortunately, we can sometimes inadvertently damage the voice by speaking when our throat and larynx are extremely dry.

The following information provides a brief overview of key influences on vocal health and the ways in which they can negatively affect the voice. It is important to note that multiple influences frequently affect us simultaneously, but infrequently cause permanent damage to the voice. Nonetheless, those of us who use our voice for professional, educational and/or social reasons, need to protect this valuable resource from the potential negative effects associated with the influences. If we do not protect our voice, we increase the risk of developing a voice disorder that will require professional attention.

Biological Influences – There are several biological influences on the voice, one of the most important being general health. Illness, allergies, and gastrointestinal reflux may cause inflammation in the throat and larynx, and result in a damaged voice if excessive talking takes place under these circumstances. One of the most significant biological influences on the voice is the maintenance of adequate moisture (hydration) in the mouth and throat. There are a surprisingly large number of substances that dry out the larynx and vocal cords, including certain medications, caffeine, alcohol and smoking. As noted earlier, we can sometimes damage the voice by speaking when the throat and larynx are extremely dry. Finally, hormonal changes may also influence the voice, the most obvious associated with puberty and its accompanying normal voice change.

Environmental Influences – In addition to internal, biological influences on the voice, there are also environmental influences. For example, when speaking in a dry place, the chance of harming the voice increases. In addition, air quality is an important influence, since breathing smoke, dust or chemicals in places where we work, study or socialize can have a negative impact on the voice. Additional negative influences include speaking in noisy environments or speaking to others at a distance, particularly if the noise and distance requires an increase in loudness. Finally, certain demands are placed on the voice depending on occupation and/or recreational activities. Generally, the greater the vocal demands, the greater chance of voice problems. Fortunately for singers and other vocal performers, voice training is an effective way of protecting the voice when there are very high vocal demands.

Psychological Influences – A third group of potential influences on the voice is considered psychological. For example, emotional state can have a significant effect on the voice, especially an extreme emotional response to an event or experience. Stress is frequently a component of voice disorders, whether it causes one or maintains it. In addition, a change in work role or family situation may increase stress, producing a negative effect on the voice. Finally, family dynamics may influence the voice, even when things are going well within the family. If we are constantly raising our voice or competing for attention the likelihood of hurting the voice increases.

Physiological Influences – Of all the potential influences on the voice, the physiological influences may be the most obvious, because they relate directly to how we use the vocal cords. Muscular tension, for example, can have a significant impact on the voice, whether the tension is in the whole body, in the throat or in the mouth. Additional influences include excessive talking, yelling and pushing the voice out when beginning to speak (hard glottal attack). Each of these behaviors, if extreme or frequent, can damage the voice. Speaking in an unusually high or low pitch can also affect the voice, particularly if the pitch is produced regularly. Interestingly, there are other, non-speech behaviors that can negatively affect the voice, the most significant being coughing and throat clearing, which require the tense closing of the vocal cords. Finally, posture and physical limitations can affect voice, in that poor posture and limitations in breathing or movement of speech muscles can make the voice less effective.

This handout briefly addressed the influences on vocal health. The attached list of practical tips may be useful in achieving good vocal health. If you want to learn more, the following resources are worth exploring:

Remember that voice disorders require professional help, which means a medical examination by an otolaryngologist (ENT), as well as voice assessment and treatment from a licensed and certified speech-language pathologist.

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