Schaefer, Massey, Moore

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Vocal Health EducationA Program for High-School
Cheerleaders

• Ronald D. Schaefer, Ph.D.
• Tara Massey, Graduate Student
• Northeastern State University
• Tahlequah, OK
• Alli Moore, M.S.
• Warm Spring Hospital and Rehabilitation
• San Antonio, TX

Poster Session 2481
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Purpose

• A high prevalence of voice disorders among
  cheerleaders has been reported in the literature
  (Case, 2002). It is the purpose of this program
  to provide a simple method for increasing
  awareness and providing strategies for reducing
  vocal abuse associated with cheerleading by
  providing simple, easily-presented vocal hygiene
  instruction to high-school cheerleaders and their
  coaches.

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Method

• A one-hour Power Point presentation was developed
  for the purpose of providing basic information
  about voice production, vocally abusive
  behaviors, the effects of vocal abuse, and ways
  to reduce abuse while continuing with
  cheerleading activities.
• Instruction includes an introduction to anatomy
  and physiology of the vocal mechanism,
  recognition of vocal abuse, and 12 slides
  designed to help reduce the vocally abusive
  behaviors associated with cheerleading.

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Method (continued)

• In addition to the Power Point presentation,
  laryngeal models, humor, and question-and-answer
  time are used to provide information designed to
  reduce the vocal abuse associated with
  cheerleading.
• The presentation can be made by well-trained
  graduate students or any speech-language
  pathologist with an interest in and basic
  knowledge of vocal hygiene activities.

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• The following slides review the 12 steps of the
  program (with references). Much of the material
  is taken from other (non-cheerleading) vocal
  hygiene programs. Evidence of the usefulness of
  these suggestions from other areas is yet to be
  determined. Data will be collected as the
  program/study develops to determine their
  effectiveness on this extremely stressful and
  vocally abusive activity.

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The 12 Steps of Vocal Hygiene Activities for
Cheerleaders Presented in the Study

• Never cheer when your throat is sore or when you
  have a hoarse voice. (Colton, Casper,
  Leonard, 2006 Aaron Madison, 1991)
• Never scream or screech or cheer in a lower or
  higher than normal voice. (Case 2002)
• Maintain Hydration (water not caffeine).
  (Titze, 105 Case, 2002)

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12 Steps (continued)

• 4. Avoid tobacco, alcohol, and other drugs.
  (Colton, Casper, Leonard, 2006, Stemple, Glaze,
  Gerdeman, 1995)
• Breathe deeply and use plenty of air when you
  cheer. (Andrews, 1999)
• Avoid cheering in dusty conditions or when you
  are fatigued. (Case, 2002 Aaron Madison,
  1991)
• Warm up your voice, as well as your body, and
  allow a cool-down period after cheering. (Case,
  2002)

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12 Steps (continued)

• 8. Avoid hard glottal attacks. (Titze, 1994
  Case, 2002)
• Take frequent breaks during a game or practice,
  using that time to drink water and rest your
  voice. (Colton, et al., 2006)
• 10. As you workout to get your other muscles in
  shape, focus on keeping the vocal folds relaxed.
  (Andrews, 1999 Colton, et al. 2006)

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12 Steps (continued)

• With your coachs permission, work with your
  teammates to allow each member of the squad to
  take a 5-minute break from cheering (on a
  rotational basis) every 15 to 20 minutes.
  (Boone, McFarlane, Von Berg, 2005)
• 12. Use amplification whenever possible
  (controversial with some state athletic
  associations). (Roy, et al., 2002)
• Bonus Help your teammates recognize their
  vocally abusive behaviors and notify them if they
  are abusing their voice in any way. - Develop a
  buddy-system.

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• Throughout the presentation each of the program
  steps is discussed and opportunities for
  questions or comments are provided.
• Students and coaches are encouraged to share
  experiences and the moderator/presenter(s) help
  the group arrive at answers or solutions to
  problems.
• Prior to, and immediately following the
  presentation, a questionnaire designed to
  evaluate the effectiveness of the program is
  presented to the participants.

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• The next slide is the title page for the
  presentation at a local high school. School
  colors and school mascots are used, along with
  occasional cartoons to heighten interest among
  the students.
• Laminated copies of the 12 steps are made and
  left with the cheerleader coach to be hung in the
  practice facility.

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(No Transcript)
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References and suggested further reading Aaron,
V. L. Madison, C. L. (1991). A Vocal Hygiene
Program for High- School
Cheerleaders. Language, Speech and Hearing
Services in Schools, 22, 287-290. Andrews, M.
(1999). Manual of Voice Treatment. San Diego,
CA Singular. Andrews, M. L. (1996). Treatment
of Vocal Hyperfunction in Adolescents. Language,
Speech, and Hearing Services in School, 27,
251-256. Andrews, M., Shank, K. H. (1983). Some
Observations Concerning the Cheering Behavior of
School-Girl Cheerleaders. Language, Speech, and
Hearing in Schools, 14, 150-156. Boone, D. R.,
McFarlane, S. C., Von Berg, S. L (2005). The
Voice and Voice Therapy. Needham Heights, MA
Allyn Bacon. Bovo, R., Galceran, M.,
Petruccelli, Hatzopoulos, S. (2007). Vocal
Problems Among Teachers Evaluation of a
Preventive Voice Program. Journal of Voice, 12,
705-722.
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Campbell, S. L., Reich, A., Klockars, A. J.,
McHenry, M. A. (1988). Factors Associated With
Dysphonia in High School Cheerleaders. Journal
of Speech and Hearing Disorders, 53, 175-185.
Case, J. L. (2002). Clinical Management of Voice
Disorders. Austin, TX Pro-Ed. Colton, R. H.,
Casper, J. K., Leonard, R. (2006).
Understanding Voice Problems A Physiological
Perspective for Diagnosis and Treatment.
Baltimore, MD Lippincott Williams Wilkins.
Dworkin, J. P., Abkarin, G. G., Stachler, R. J.,
Culata, R. A., Meleca, R. J. (2004). Is Voice
Amplification for Teachers With Dysphonia Really
Beneficial? Journal of Speech, Language, and
Hearing Research, 47, 353-365. Gottliebson, R.
O., Lee, L., Weinrich, B., Sanders, J. (2007).
Voice Problems of Future Speech-Language
Pathologists. Journal of Voice, 21, 699-704.
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• Jacobson, B. H., Johnson, A., Grywalski, C.,
  Silbergleit, A., Jacobson, G., Benninger, M.S.,
  Newman, C. W. (1997). The Voice Handicap Index
  (VHI) Development and Validation. American
  Journal of Speech-Language Pathology, 6, 66-70.
• Kent, R. D., Ball, J. M. (2000). Voice Quality
  Measurement. San Diego, CA Singular.
• Klimas, N. (2002). Fine-Tuning the Instrument
  Prevention Strategies for Professional Voice
  Users. Advance for Speech-Language Pathologists,
  12, 6-8.
• Pannbacker, M. (1999). Treatment of Vocal
  Nodules and Outcomes. American Journal of
  Speech-Language Pathology, 8, 209-217.
• Pannbacker, M. (1998). Voice Treatment
  Techniques A Review and Recommendations for
  Outcome Studies. American Journal of
  Speech-Language Pathology, 7, 49-64.

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• Pasa, G., Oates, J., Dacakis, G. (2007). The
  Relative Effectiveness of Vocal Hygiene Training
  and Vocal Function Exercises in Preventing Voice
  Disorders In Primary School Teachers. Logopedics
  Phoniatrics Vocology, 32, 128-140.
• Reich, A., McHenry, M., Keaton, A. (1986). A
  Survey of Dysphonic Episodes in High-School
  Cheerleaders. Language, Speech, and Hearing
  Services in Schools, 17, 63-71.
• Roy, N., Weinrich, B., Gray, S. D., Tanner, K.,
  Toledo, S. W., Dove, H., Corbin-Lewis, K.,
  Stemple, J. C. (2002). Voice Amplification Versus
  Vocal Hygiene Instruction for Teachers With Voice
  Disorders A Treatment Outcomes Study. Journal
  of Speech, Language, and Hearing Research, 45,
  625-638.
• Stemple, J. C., Glaze, L. E., Gerdeman, B. K.
  (1995). Clinical Voice Pathology Theory and
  Management. San Diego, CA Singular.
• Titze, I. R. (1994). Principles of Voice
  Production. Englewood Cliffs, NJ
  Prentice-Hall.