"You do a lot of talking and you do it at a loud level," said Pinaglia, who teaches boisterous 4th and 5th graders at Reavis Elementary School in Kenwood, a Chicago suburb. "The kids can get loud. Sometimes you want to talk over them.
" Teaching is a high-risk occupation for voice disorders. Yet unlike singers and actors, who also give their vocal cords strenuous workouts, teachers are less likely to properly care for and protect their voices, experts say. To help teachers save their voices the Chicago Institute for Voice at the University of Illinois at Chicago hosted its first Midwest Voice Conference last month.
Under the theme "A Focus on the Classroom," teachers learned how the voice works and how to protect it as they prepared to head back to school after summer hiatus. For starters, don't drink too much caffeine. It dries up the vocal cords.
And don't yell at the kids too much. It strains the voice. Constant stress on the vocal cords can cause permanent damage and produce wart-like growths called nodules, which sometimes require surgical removal.
That chronic croaky voice isn't always soothed by lemon and honey. "A lot of people don't look at it, but the number of times that they call in sick, the number of days that they're unable to effectively communicate, really does create a detriment to education," says Dr. Steven Sims, voice institute director and assistant professor of otolaryngology at UIC.
Teachers are vocal athletes who are often required to speak loudly in noisy classrooms or one-on-one with pupils for hours without much time to rest. On any given day, they might battle the cacophony of hallways, go head-to-head with the din of car traffic from nearby streets or shift within a split second from talking to shouting in a classroom. Strain on the vocal cords is worse for some teachers than others.
Bilingual teachers repeat instructions over and over again first in English, then in Spanish. Coaches have periods of motivational yelling. And music instructors often perform a series of do-re-mi warm-ups.
Classroom environments aren't larynx-friendly either. Chalk dust. Dusty ventilation systems.
Low humidity. Coughs and colds of pupils. Irritating fumes in the chemistry and shop classes.
All of it takes a toll. At least 18 percent of the nation's roughly 3.5 million elementary and high school teachers will miss at least one day of work a year because of their voice, according to University of Utah language pathology professor Nelson Roy.
That represents about $2.5 billion in annual losses to the educational system, said Roy, a national expert on teacher vocal abuse. In the largest investigation of its kind, a 2004 study on the prevalence of voice disorders in teachers conducted by Roy and colleagues found that 11 percent reported having a current voice problem compared to just 6 percent of the general population.
Last winter, the pain in Margaret Pinaglia's throat was so severe, she thought it was strep. It turned out to be strain. Her doctor told Pinaglia, a self-described "loud talker," to drink tea and try not to, well, talk.
The fall is particularly bad, experts say, because teachers have to readjust to daily teaching after summer break. "Autumn vocal meltdown" is how it is described by the Voice Academy, a Web site developed by the University of Iowa's Department of Speech Pathology and Audiology and the National Center for Voice and Speech to help teachers prevent and treat voice problems. UIC speech pathologist Bonnie Smith said a teacher's best prevention is to learn to project the voice without strain or effort.
"For teachers, ministers and actors, the voice really is their livelihood," Smith said.
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