Voice and Lifestyle Behaviors of Student Actors: Impact of History Gathering Method on Self-Reported Data *Jeff Searl, †Troy Dargin, and ‡Erika Bailey, *East Lansing, Michigan, and yWeston, and zCambridge, Massachusetts Summary: Objectives. This study described voice use and lifestyle information about student actors and assessed whether different information is reported at study intake compared to data extracted from a 3-week voice Log. Methods. Twenty-five student actors estimated 14 voice and life style parameters at the start of the study. These included daily speaking time, performance time, vocal warm-up, and cool-down time; intake of water, caffeine, and alcohol; perceived voice effort (speaking and performance), among other items. The same parameters were tracked by the actor for 21 consecutive days. Nonparametric statistical comparisons of the estimates at intake to the median estimate from 21 days were applied. Results. Student actors reported frequent yelling (48%), frustration, anxiety, and depression about their voice (52%, 48%, and 16%), issues with breath support (56%), vocal fatigue (36%), and mild-moderate effort in the speaking (24%) and performance voice (70%). Estimates at study intake statistically overestimated daily speak- ing, performance, and vocal warm-up time compared to the 3-week Log. Intake reporting underestimated per- ceived effort in the speaking voice. Intake reporting of vocal fatigue and voice quality did not closely correspond to the Log data. Conclusion. Student actors reported a number of voice use and lifestyle behaviors that may increase their risk for voice problems. Additionally, the method of soliciting the history altered the information reported by the stu- dents for several parameters. The findings highlight the need to develop history gathering or other methods that optimize accuracy and reliability of the information sought. Key Words: Actor-Student-Voice-Clinical history-Voice Log. INTRODUCTION Stage actors face unique challenges placing their voice, and potentially their occupation or avocation, at risk. 1 Actors often engage in long rehearsals and performances during which extensive manipulations of pitch, loudness, quality, and effort may be required. 2,3 In addition, singing, danc- ing, and other physical activities while playing roles further increase the challenge to produce a healthy voice. 4 Com- peting crowd noise, suboptimal theater acoustics, environ- mental irritants such as dust or smoke, and restrictive costumes, among other influences, add even more to the vocal risk (eg, 5,6 ). The varied and challenging vocal demands of actors have been known for many decades with Brodnitz 7 offering one of the earliest descriptions in a scientific journal. However, the empirical literature regarding prevalence of vocal pathologies and problems among actors, as well as causative or associative factors, remains limited. In some studies, actors represent a small percentage of cases combined with other professional voice users, such as singers, so actor-specific data cannot be disentangled from the larger group. 8-10 This is not a criticism of such studies that often have a broader purpose, but it does hamper the understanding of issues specific to actors. Among actors, there are varying vocal demands depending on the work pursued, which might include voice over, film, musical theater, theater acting, among other options. 11 All can be elite vocal performers based on the classification scheme of Koufman and Isaac- son, 12 but the performance demands vary markedly. This study focused on theater actors in their graduate school training. The intent was to provide detailed informa- tion about lifestyle, voice use, and performance issues often queried in clinical assessments (eg, amount of voice use, fluid intake, smoking, etc). More informed understanding of actors, whether student or professional, appears war- ranted based on studies identifying vocal pathologies or complaints in this population. Table 1 summarizes findings from available studies assessing vocal complaints, voice behaviors, and lifestyle parameters for actors. Lerner et al 13 reported that among 30 stage acting students, indications of vocal hyperfunction were present stroboscopically in 59%, and reflux signs in 48%. Timmermans et al 11 reported organic (6%) and inflammatory (17%) stroboscopic findings for a group of 36 actors that included both stage and musi- cal theater students. They further reported 22% responded “yes” to the “vocal abuse” query. In another study, 35% of professional actors reported vocal complaints in general, and 50% noted vocal complaints after preforming. 1 Vocal fatigue has been reported in 23%-40% of professional and semiprofessional actors. 1,14 Not all studies report such high levels of vocal complaints among actors, however. Novak Accepted for publication July 26, 2019. Conflicts of Interest: None. Data Availability: The data derived from this study are deposited in Mendeley Data at https://data.mendeley.com/datasets/gs67mjccxt/draft?a=2ce97d5b-e73c-4397- ad28-5a188b460b02 (preview link with a reserved doi:10.17632/gs67mjccxt.1. From the *Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; yRegis College, Weston, Massachusetts; and the zHarvard University, Cambridge, Massachusetts. Address correspondence and reprint requests to Jeff Searl, Department of Commu- nicative Sciences and Disorders, Michigan State University, 1026 Red Cedar Rd, East Lansing, MI 48824. E-mail: searljef@msu.edu Journal of Voice, Vol. &&, No. &&, pp. &&-&& 0892-1997 © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.jvoice.2019.07.021 ARTICLE IN PRESS