Background: To date, research has primarily focused on the subjective and objective measurement of vocal fatigue in professional voice users such as teachers and singers. However, these studies have not examined the effects of psychosocial factors (e.g., lack of sleep, emotional distress) leading to vocal fatigue in depth. Much like the professional voice users, students seeking to be professional voice users may face several psychosocial difficulties, may also experience similar vocal demands, and may develop vocal fatigue. Goal: The purpose of this study is to identify the relationship between psychosocial factors and vocal fatigue in students majoring in Communication Sciences and Disorders. Methods: During this study, graduate and undergraduate students completed a survey consisting of questions on employment, general health, vocal demands, and several standardized measures, (e.g., Beck’s Depression Inventory, Perceived Stress Scale, and the Vocal Fatigue Index). Vocal fatigue was induced using an adapted LingWAVES vocal loading task (~30-min duration) where participants had to meet a specific intensity goal as well as modify their pitch and voice quality. Recordings of phonation and passage reading were also made pre- and post-loading to evaluate the effects of vocal exertion. The VFI score and two objective measures (fundamental frequency and sound pressure level) were acquired and analyzed in addition to the scores from the surveys. Results: Results revealed that all students were moderately stressed, while graduate students reported more depression. All students demonstrated vocal fatigue in both subjective and objective outcome measures. Moderate-high correlation between total psychosocial scores and VFI as well as phonation Sound Pressure Level (SPL) were observed.

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Purpose The purpose of this document is threefold: (a) review the uses of the terms “vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading” (as found in the literature) in order to track the occurrence and the related evolution of research; (b) present a “linguistically modeled” definition of the same from the review of literature on the terms; and (c) propose conceptualized definitions of the concepts. Method A comprehensive literature search was conducted using PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. Four terms (“vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading”), as well as possible variants, were included in the search, and their usages were compiled into conceptual definitions. Finally, a focus group of eight experts in the field (current authors) worked together to make conceptual connections and proposed consensus definitions. Results The occurrence and frequency of “vocal load,” “vocal loading,” “vocal effort,” and “vocal fatigue” in the literature are presented, and summary definitions are developed. The results indicate that these terms appear to be often interchanged with blurred distinctions. Therefore, the focus group proposes the use of two new terms, “vocal demand” and “vocal demand response,” in place of the terms “vocal load” and “vocal loading.” We also propose standardized definitions for all four concepts. Conclusion Through a comprehensive literature search, the terms “vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading” were explored, new terms were proposed, and standardized definitions were presented. Future work should refine these proposed definitions as research continues to address vocal health concerns.