Vocal Fatigue Index in Teachers Using Mokken Analysis.
Chaya Nanjundeswaran, Miriam van Mersbergen, Russell Banks and 1 others
PMID 33526304WHAT IT FOUND
Teachers with vocal fatigue report physical discomfort first, then need rest.
Those without fatigue do not show these patterns. The standard Vocal Fatigue Index may miss mild symptoms in teachers because it was designed for patients with voice disorders, not healthy voice users.
Key findings
01In teachers with vocal fatigue, physical discomfort items appeared at the lower end of the severity hierarchy, while symptoms improving with rest appeared at the higher end.
02Teachers without vocal fatigue did not show a clear hierarchical structure for tiredness and avoidance behaviors, suggesting the current scale may not capture their experience or that they do not engage in these behaviors.
03The Vocal Fatigue Index was originally developed for people with diagnosed voice disorders, and its factor structure may not be sensitive enough for professional voice users like teachers who have high vocal demand but no disorder.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The VFI was originally developed for people with diagnosed voice disorders, so it may not be sensitive to the specific experiences of healthy teachers. Teachers were grouped based on their scores on one factor of the VFI (Tiredness and Avoidance), which may have biased how they responded to other items. Some of the resulting scales had very few items, which limits the reliability of the hierarchy. The study relies on self-report and does not include objective measures of voice production or fatigue.
The easy way to misread this
Do not assume a teacher with a low VFI score is free from vocal fatigue risk. The study found that teachers without reported fatigue did not show the expected avoidance behaviors on the scale, which may mean they are not experiencing fatigue, or it may mean the scale fails to capture their specific experience because it was designed for patients with voice disorders.