It’s one of the toughest (yet most important) conversations a singing teacher can have.

And, according to speech pathologist and singing teacher Elle Holiday, many teachers don’t go about it the right way.

So, how should you tell a student that you’ve noticed an irregularity or change in their voice that should be checked out by an ENT?

What not to say

Whatever you do, don’t blurt out your unproven diagnosis.

“What I’d say to singing teachers out there is please do not diagnose your students,” Elle says. “You can’t know if someone has a nodule unless you put a camera down their nose.

“But one of the things that I hear often from singers is that their singing teacher has said to them: ‘I think you have nodules’. 

“It’s very wrong because that can cause panic and concern on the singer’s part; they get worried that they have a voice injury when it’s not been proven. 

“I know of many occasions when that has happened, and they go to the ENT, and their voice is fine – it’s muscle tension dysphonia and something to do with a change in environment.”

There’s also a risk that our clumsy words frighten students so much that they don’t seek further medical help. 

And given that, in the worst-case scenario, the problem may be cancer or a degenerative illness such as Parkinson’s, that is the last thing we want. 

What you should say

Here are Elle’s suggested ways of raising the issue.

•  I can hear that your voice is doing this [and then explain the symptom or voice change that you’ve observed].
  
  
• I’ve noticed you can’t sing as high as you used to.
  
  
• You’ve said for me over the past couple of weeks everything’s feeling sore or it’s starting to get tired.

Elle says: “You can use these examples as proof to say: ‘I think it would be a great idea for you to get checked out by an ENT and a speech pathologist’.”

In the meantime, while the student waits for an appointment, it’s important not to try to rehabilitate the singer based on what you think the problem is.

“It’s about keeping things safe until an ENT can see them,” Elle says. “We can’t say ‘do these things and you will get better’ if we don’t know what the problem is. 

“Until you know the actual diagnosis, you cannot safely and correctly create a rehabilitative voice program for an individual. It’s just not ethical.”

Learn more

Listen to our full-length interview with Elle on the Singing Teachers Talk podcast, where she also discusses:

• How to assess speaking voice.
  
  
  
• A vocal exercise called the Swell Test, which she uses to identify swelling on the vocal folds.
  
  

Read more

For more on having difficult conversations with students, read this blog.