Background and objective:
The concept of “support” pervades much voice pedagogy and speech-language pathology in voice. This concept is typically linked to notions of “diaphragmatic/abdominal” action in phonation commonly thought to lay the foundation for effective and healthy voice production. A first concern is that descriptions of “support” vary widely across teaching studios and clinics. A second concern is that data are lacking regarding the actual effectiveness of this training. The purpose of this presentation is to review the literature on definitions of “support,” mine the literature for data, and present new findings from computer simulation.

Method:
A literature search was conducted to identify definitions of “support” in voice as well as data regarding putative effects. Findings regarding the role of breath support in vocal control and health were compared with results from recent computer simulations of voice production.

Results:
Some definitions of “support” that emerged from the literature review pointed to ribcage expansion, and thus a “checking” of expiratory pressures in phonation. Other definitions centered on vocal tract tuning. However, most commonly “support” was understood as “diaphragmatic/abdominal” action oriented to airflow management and also subglottic pressure control in phonation. However, empirical data were lacking. Simulation data showed that interestingly, subglottal pressure actually contributes to vocal fold impact stress, even more than vocal fold adduction, as well as to voice output intensity.

Conclusions:
Despite widespread claims about the importance of “support” for voice – in particular “breath support” — the nature of such “support” and its goals need to be better defined. Some caution should be exercised and some of our voice training methods may need to be revisited with respect to vocal health in particular. Subglottal pressure has the largest effects on both vocal intensity and vocal fold contact pressure compared to other parameters. Thus, vocalists may need to find a balance between intensity and risk of injury by relying more on resonance for vocal efficiency instead of increasing power alone.