Research Article| Volume 33, ISSUE 5, P801.e7-801.e16, September 2019

The Impact of Dysphonic Voices on Children's Comprehension of Spoken Language



      This study investigated the effect of teachers' dysphonic voices on children's listening comprehension.


      One hundred thirty-four grade three and four students were recruited from local primary schools in Hong Kong. They were required to listen to six passages, three in Cantonese and three in English, which were either read in normal, mildly dysphonic, or severely dysphonic voices. The students were required to complete six multiple-choice comprehension questions upon listening to each passage. Comprehension performance across languages, dysphonic severities, genders, and question types were examined.


      The results showed that listening comprehension was significantly poorer even when speaker's voice quality was mildly impaired. Performance in Cantonese was generally better than that in English but no significant difference in the pattern of decline was found. Both boys and girls suffered to similar extent under dysphonic situations. Differences in performance in various question types were discussed.


      These findings support the urgent need to implement voice care education for the teaching profession.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Roy N.
        • Merrill R.M.
        • Thibeault S.
        • et al.
        Prevalence of voice disorders in teachers and the general population.
        J Speech Lang Hear Res. 2004; 47: 281-293
        • Lee S.Y.Y.
        • Lao X.Q.
        • Yu I.T.S.
        A cross-sectional survey of voice disorders among primary school teachers in Hong Kong.
        J Occup Health. 2010; 52: 344-352
        • Tang P.K.
        Voice problems of secondary school teachers and the need for preventative education.
        • Aronson A.E.
        • Bless D.
        Clinical Voice Disorders.
        Thieme, New York2011
        • Sapir S.
        • Keidar A.
        • Mathers-Schmidt B.
        Vocal attrition in teachers: survey findings.
        Eur J Disord Commun. 1993; 28: 177-185
        • Chan K.M.K.
        • Li C.M.
        • Ma E.P.M.
        • et al.
        Noise levels in an urban Asian school environment.
        Noise Health. 2015; 17: 48-55
        • Yiu E.M.L.
        Impact and prevention of voice problems in the teaching profession: embracing the consumers' view.
        J Voice. 2002; 16: 215-228
        • Yiu E.M.L.
        • Ma E.P.M.
        Voice activity limitation and participation restriction in the teaching profession: the need for preventive voice care.
        J Med Speech Lang Pathol. 2002; 10: 51-60
        • Ma E.P.M.
        • Yiu E.M.L.
        Voice activity and participation profile: assessing the impact of voice disorders on daily activities.
        J Speech Lang Hear Res. 2001; 44: 511-524
        • Roy N.
        • Merrill R.M.
        • Thibeault S.
        • et al.
        Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices.
        J Speech Lang Hear Res. 2004; 47: 542-551
        • Chen S.H.
        • Chiang S.C.
        • Chung Y.M.
        • et al.
        Risk factors and effects of voice problems for teachers.
        J Voice. 2010; 24: 183-192
        • Morton V.
        • Watson D.R.
        The impact of impaired vocal quality on children's ability to process spoken language.
        Logoped Phoniatr Vocol. 2001; 26: 17-25
        • Rogerson J.
        • Dodd B.
        Is there an effect of dysphonic teachers' voices on children's processing of spoken language?.
        J Voice. 2005; 19: 47-60
        • Mullennix J.W.
        Voice adjustments.
        in: Johnson K. Mullennix J.W. Talker Variability in Speech Processing. Academic Press, San Diego, CA1997
        • Hazan V.
        • Barrett S.
        The development of phonemic categorization in children aged 6–12.
        J Phon. 2000; 28: 377-396
        • Crandell C.
        The effects of classroom amplification on children with normal hearing: implications for intervention strategies.
        Educ Audiol Monogr. 1991; 2: 18-38
        • Nabelek A.K.
        • Nabelek I.V.
        Room acoustics and speech perception.
        in: Katz J. Handbook of Clinical Audiology. 4th ed. Williams & Wilkins, Baltimore, MD1994
        • Heinrich R.
        • Molenda M.
        • Russell J.
        • et al.
        Instructional Media and Technologies for Learning.
        Prentice Hall, Englewood Cliffs, NJ1996
        • Benedict P.K.
        • Bauer R.S.
        Introduction to Cantonese Phonology.
        The University of Hong Kong, Centre of Asian Studies, Hong Kong1993
        • Cutler A.
        • Chen H.C.
        Lexical tone in Cantonese spoken-word processing.
        Percept Psychophys. 1997; 59: 165-179
        • Baudoin-Chial S.
        Hemispheric lateralization of modern standard Chinese tone processing.
        J Neurolinguistics. 1986; 2: 189-199
        • Chao Y.R.
        Cantonese Primer.
        Cambridge University Press, Cambridge1947
        • Fok-Chan A.Y.Y.
        A Perceptual Study of Tones in Cantonese.
        Centre of Asian Studies, University of Hong Kong, Hong Kong1974
        • Laures J.S.
        • Weismer G.
        The effects of a flattened fundamental frequency on intelligibility at the sentence level.
        J Speech Lang Hear Res. 1999; 42: 1148-1156
        • Berne J.E.
        Listening comprehension strategies: a review of the literature.
        Foreign Lang Ann. 2004; 37: 521-531
        • Blatchford P.
        • Burke J.
        • Farquhar C.
        • et al.
        Educational achievement in the infant school: the influence of ethnic origin, gender and home on entry skills 1.
        Educ Res. 1985; 27: 52-60
        • Davie R.
        • Butler N.
        • Goldstein H.
        From Birth to Seven Years.
        Longman, Harlow1972
        • McNiece R.
        • Jolliffe F.
        An investigation into regional differences in educational performance in the National Child Development Study.
        Educ Res. 1998; 40: 17-30
        • Smith E.
        • Lemeke J.
        • Taylor M.
        • et al.
        Frequency of voice problems among teachers and other occupations.
        J Voice. 1998; 12: 480-488
        • Massaro D.W.
        Preperceptual images, processing time, and perceptual units in auditory perception.
        Psychol Rev. 1972; 79: 124-145
        • Bistritsky Y.
        • Frank Y.
        Efficacy of voice and speech training of prospective elementary school teachers.
        Israeli J Speech Hear. 1981; 10: 16-32
        • Chan R.W.K.
        Does the voice improve with vocal hygiene education? A study of some instrumental voice measures in a group of kindergarten teachers.
        J Voice. 1994; 8: 279-291