Voice Problems - Prevention And Correction

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As part of a recent seminar at my company on voice recognition (using DragonDictate), I outlined my experiences with voice problems, and what I have learned about correcting and preventing such problems. I realize that many have seen much of this information before. In particular, Duncan A. Buell's comments in "nosore.txt" on the Dragon Systems BBS highlight some of the same problems that I experienced. However, such listings usually encompass a relatively narrow focus -- I have tried to more broadly outline the problems and solutions, with admittedly narrow depth. I am providing this information to the Dragon Systems BBS and to the mailing list "SoreHand" (SOREHAND% This e-mail address is being protected from spambots. You need JavaScript enabled to view it ), in the hope that most people will find something useful in it, and to help convince those with difficulties that they can be overcome!

First and foremost, I ELIMINATED MOST OF MY VOICE PROBLEMS, INCLUDING VOCAL CORD NODULES, BY SPEAKING TO DRAGONDICTATE! Below, I provide expanded notes, based on my seminar.

John J. Staudt

Senior Statistician

Research Information Technology

Rohm and Haas Company

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(I will only be at this Internet address until early June, 1995. If this is posted on the Dragon Systems BBS, I should be able to provide a new address by July 31, 1995.)

PERMISSIONS

This document may be copied and distributed freely, so long as it is copied in its entirety, with no modifications. -- John J. Staudt

DISCLAIMER

I am not an expert in voice recognition technology or voice therapy. This material represents my perceptions and opinions only, based on my own experiences with DragonDictate and voice therapy. If you experience voice problems, you should consider consulting with a physician and a voice therapist for professional diagnosis and voice training.

This is also not intended as an endorsement of DragonDictate. Although I believe that DragonDictate for Windows is the product best suited to meet my needs, other products might be more suitable for other people. I believe that my comments regarding voice problems should apply to users of most voice recognition systems.

Finally, these are my opinions; they are not opinions of Rohm and Haas Company. -- John J. Staudt

Voice-Related Injuries

Sore throat
Laryngitis
Vocal cord nodules

PROPER TREATMENT IS USUALLY VOICE THERAPY, NOT VOICE REST!

Without correction, problems get worse!

I had horrible speaking habits (with frequent laryngitis) prior to using DragonDictate. When I decided to use DragonDictate, I obtained a copy of Change Your Voice, Change Your Life by Dr. Morton Cooper (full reference below), which addresses common voice problems. I hoped to prevent problems by using the exercises and techniques in Cooper's book. However, I found my voice became worse in the first three months of using DragonDictate. Upon seeing my physician, I found I had vocal cord nodules.

I obtained voice therapy, and in the course of the next few months, I ELIMINATED MY NODULES BY SPEAKING TO DRAGONDICTATE!

I found that I was better able to practice good speaking techniques while speaking to the computer (as opposed to during normal conversation). Eventually, I was better able to carry over the newly developing habits (other than the pauses) to other speaking situations.

Following are some of the items that have seemed most important in my case.

Correct Speaking Techniques

Breathe from diaphragm - (Stomach moves out with inhalation, in with exhalation -- speak while exhaling)
Speak during exhalation - (Referred to as using proper breath support. Do not continue to speak when you have completed exhaling -- take a new breath. One of my voice instructors recommended a maximum of 8 syllables per breath.)
Use appropriate pitch (not too low)
"Place" voice correctly (not in the throat). (Low voices are often associated with "authority" in our society. Many people speak with a lower than natural pitch by speaking with their voice centered in their throat, rather than in their mouth.)
Use "easy onset" when speaking. (As opposed to a sudden burst of the word accompanying the beginning of the exhalation. I try to think of beginning the exhalation before starting a word. Duncan A. Buell gives a good description of this in the file "nosore.txt", which I found on the Dragon Systems BBS.)
Use a low volume (but do not lower the pitch!). Higher volume = more stress/strain = greater risk of injury.
Relax -- avoid tensing up -- stretch/relax neck and shoulders with appropriate exercises
Avoid, ahem, throat-clearing (or coughing for that purpose)

Why Does Voice Recognition Seem so Hazardous?

All you do is talk, talk, talk
You speak while sitting. This makes diaphragmatic breathing difficult
You speak with discrete utterances. The tendency is to speak words as sharp commands, without "easy onset"
You may tend to use a monotone. This is a REPETITIVE use of vocal cords
Stress. Concern about recognition, speed, etc.
- Congestion -- colds and allergies
- Dry air

Contributing Factors

Additional Injury Prevention

Drink heavily (water). (If you use a straw, you can take sips every few words or sentences without pausing DragonDictate or repositioning the microphone.)
Take frequent breaks (especially for water/restroom)
Possibly raise pitch (as if talking to a young child)
Introduce variation (sing-song)
Use proper breath support, breathing from the diaphragm. For diaphragmatic breathing, sit upright with shoulders back -- not hunched over. If necessary, stand to speak. Take good breaths and limit the number of words per breath. (I often try to take a breath every one to two words or macros -- but it is important to maintain low volume, with easy onset.)
Control cold/allergy symptoms (or rest voice during active symptoms)
Humidify room (but not to the point where it gets moldy)
Be aware! Get help if needed.
Don't worry, be happy!

I found it less stressful for me to dictate when I eliminated automatic display of the DragonDictate "choice list". Instead, I usually dictate words at a somewhat set pace, starting the next word before I really know whether the previous word was correctly recognized. Rather than worrying about whether to say "Spell Mode" or "Oops", I set up macros (Oops 1) -- (Oops 10), which move me to the appropriate word in the Word History, where I can make the correction(s).

To successfully use DragonDictate, plan on working SLOWLY and producing less for at least the first 2-4 weeks. Do not work extra hours to make up lost time. Take the time to play with the DragonDictate Options and develop macros that will enable you to work more efficiently with a style that suits you, and you can greatly reduce stress and achieve reasonable productivity in the long run. (You may find it worthwhile to write macros that help you write or modify macros in the "Add Word" and "Modify Word" dialogues. I did.)

In my case, those who have attended my seminar or observed an impromptu demonstration in my office have expressed amazement at my speed, even when dictating straight text. (Most have expressed the opinion that they could not type as quickly. I doubt this, although I will admit that my use of macros allows me to write program code more quickly and accurately than I could when typing.)

Resources

Cooper, Dr. Morton. Change Your Voice, Change Your Life. Harper and Row, New York, 1984.

Easy to read

About 5 pages of instructions/exercises summarized at the end of the book

Remainder is "motivational"

This was not sufficient to prevent problems for me -- I needed to have a professional voice therapist help me identify continuing problems and correct them. However, the book gave me a good start, and likely minimized the number of sessions needed with a voice therapist. This book does not address some of the issues specific to using discrete speech, notably "easy onset" and monotone speech.

Dragon Systems Bulletin Board: 617-332-7371

Source for "nosore.txt" by Duncan A. Buell