Project Summary/Abstract Schoolteachers' voice problems are significant, not only because these problems occur so frequently but also because they undermine education in the classroom. Research has suggested a number of associated physiological, environmental and behavioral risk factors. However, there remains a fundamental gap in understanding how these factors affect a teacher's vocal health over an academic year, how teachers accommodate to the vocal demands they face, and how current occupational policies (including the financial and attitudinal constraints of educational policy makers) impact teachers' vocal health for better or worse. The continued presence of this gap represents a barrier to the long-term objective of proactive vocal health education and treatment programs. The current proposal will move this effort forward by exploring how teachers' voices are impacted by vocal risks, vocal demands, vocal accommodations, and vocal health policies. Grounded on strong foundational work and a track record of productivity, this experienced research team proposes 3 specific aims: [1] determine the interactions between risk factors related to the occurrence of teacher voice problems by collating cross-sectional and longitudinal (year-long) survey data with standard voice assessments; [2] quantify teachers' perceptual acuity of and accommodations to classroom vocal demands that increase the risk of vocal health issues by conducting analyses in classrooms and simulated classroom environments; and [3] investigate current and potential school-based policies to improve vocal health by reviewing administrative responses to teachers' voice issues and quantifying the costs of both solutions and non-interventions. The proposal is innovative in part because it [1] merges virtual reality technologies with previously tested acoustic simulations and real-time auralization systems to replicate classroom risk factors and interventions, eliciting “teacher voice” in controlled settings; [2] uses tools from a unique interdisciplinary research team (i.e. Voice Science, Acoustical Engineering, Communication, Economics, and Education) to approach a significant public health concern in an effectively innovative way; and [3] combines reliable survey instruments (developed using focus groups) with standard clinical assessments to accurately track how a teacher's voice changes over the course of a full academic year. While not a clinical trial, these data are clinically significant because patterns may emerge, including when voice problems occur, how they progress over an academic year, and why they improve or worsen. Thus, this ambitious approach will help preserve teachers' vocal health, improve the response when problems present, and indirectly improve the classroom learning environment. The results of this study will also provide school administrators and other policy makers with practical and economically feasible information that can be used to support teachers' ...