Case Study 1: Voice Therapy for a Teacher

with Vocal Nodules

The following case study outlines how Voice Science™ achieved leading care and service in providing voice therapy for a teacher with early stage bilateral vocal nodules.

voice rehabilitation for teacher


The Problem

A 24 year old female teaching professional was experiencing ongoing voice loss and difficulties. She first noticed a voice problem after entering the teaching profession full-time earlier in the year and described her voice as “very rough and scratchy, even after I clear my throat.” The teacher felt “incredibly frustrated in the classroom because my voice does not project over the background noise.” She also reported changes in her singing voice- “I don’t know why, but I can’t sing as high anymore when leading the praise and worship at my local church on weekends.” 

After 3 months of voice difficulties, the teacher sought out Voice Science for an initial diagnostic voice assessment.

Diagnostic Assessment of Voice

The clinician took a case history to obtain further insight into:

  • the nature of the voice problem
  • the client’s voice needs pre-injury
  • medical, environmental, behavioural and psychosocial factors impacting on the voice condition
  • the client’s current vocal status: Are they presently fit for work? Do work modifications need to occur?

Sound recordings of the client’s voice were also taken for subsequent acoustic analysis.

The clinician provided the client with information on the foundations of voice production as well as insight into compensatory strategies to protect voice while awaiting ongoing voice treatment.

A diagnostic report was then written and provided to the client within 5 business days .

Barriers to Vocal Rehabilitation

The clinician noted several barriers to vocal rehabilitation. These barriers were identified as potentially impeding a return to healthy voice production.

Voice therapy for teachers

Referral to an Ear, Nose and Throat Surgeon

The client was referred to an Ear and Nose Throat Surgeon in light of suspected vocal fold nodules (click to read more about nodules here)

An endoscopy confirmed the presence of bilateral early stage vocal nodules. The surgeon recommended trialling a period of voice therapy.

Voice Treatment

Voice treatment was provided across a course of 6 sessions. Each session was tailored to restore vocal function and repair the integrity of the vocal muscle.

The voice therapy encompassed the following aspects to address the client’s needs:

Voice therapy for teachers 2

A follow up perceptual and acoustic assessment was completed after the 6 treatment sessions. The post treatment assessment indicated pronounced voice quality improvements suggestive of vocal repair. The teacher reported she could “finally produce consistent and clear voice once more.” She stated that she had acquired some “really powerful strategies to manage vocal fatigue and damage. I now know what to do to protect my voice even though my job teaching is really demanding.”

The speech pathologist recommended a follow up appointment with the Ear Nose and Throat Surgeon. The teacher reported that she was content with her vocal recovery. She stated she would attend a follow up ENT appointment if she experienced further concerns.



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Voice Science™ treats from Melbourne to Bangkok, New York, Sydney, Perth … wherever you are via our global service. Our chief, Sarah Lobegeiger de Rodriguez is a senior voice clinician, certified practicing speech pathologist and professional opera singer. She offers face to face voice therapy and voice treatment in Melbourne at the Collins St clinic.

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