title: [Changes in behavior associated to the use of voice after a speech therapy intervention with professionals of child day care centers].
abstract: BACKGROUND
  preventive programs have been used with teachers with the purpose of lowering the number of risk factors for voice disorders. However, few studies have focused on the effectiveness of these programs.
  
  
  OBJECTIVE
  to assess changes in behaviors that are considered, according to the specific literature, as having a negative impact on the voice, during a speech therapy intervention program offered to educators.
  
  
  METHODS
  an experimental study where a theoretical-practical program involving the professional use of voice was developed with 26 educators from two day care centers of São Paulo. This program involved five monthly meetings, working up to a total of twelve hours. During the program, topics concerning negative behaviors that affect the voice were discussed. On four of the meetings the educators filled in a protocol, making it possible to analyze the frequency on which they presented those specific behaviors. Later on, scores were given to the answers on the protocol in order to compare the findings during the program. For this comparison the statistical test of Wilcoxon and the linear tendency chi-square test were used.
  
  
  RESULTS
  the gradual decrease in the use of voice out of work was observed, as well as in speaking with a very low or high pitch voice and in eating excessively before sleeping. There was an increase in the occurrence of coughing in the third application of the protocol. As for the overall monthly averages, statistically significant differences were not found when comparing the four applications of the protocol. The overall average score was of 11.75, which was considered moderately abusive.
  
  
  CONCLUSIONS
  the changes that were observed during the program were interesting, but very restrict which makes one wonder about the real effects of this kind of practice and how much broader changes rely on small individual changes. Actions that involve information about vocal well-being exclusively should be revised.
authors.affiliation: Faculdade de Saúde Pública, Universidade de São Paulo, SP, Brazil. marciasz@usp.br
authors.forename: Marcia
authors.initials: M
authors.lastname: Simões-Zenari
authors.forename: Maria do Rosário Dias de Oliveira
authors.initials: Mdo R
authors.lastname: Latorre
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002656:Child Day Care Centers; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control*; D015397:Program Evaluation; D013070:Speech Therapy / Q000592:standards; D018709:Statistics, Nonparametric; D013663:Teaching; D014705:Verbal Behavior / Q000502:physiology*; D014832:Voice Disorders / Q000209:etiology / Q000517:prevention & control*; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult