The role of experience on judgments of dysphonia.

Summary Objectives The objectives of the study were (1) to determine differences in judgments of overall severity (OS) and vocal effort (VE) of dysphonic speech when judgments were made by experienced and inexperienced listeners, and when self-rated by individuals with dysphonia; and (2) to determine relationships between auditory-perceptual judgments of voice and voice handicap. Study Design Prospective and exploratory. Methods Twenty speakers with dysphonia and four normal controls provided speech recordings. Participants judged their own speech samples for OS and VE and completed the Voice Handicap Index (VHI). Twenty-four inexperienced and 10 experienced listeners evaluated the same speech samples for OS and VE using 100-mm visual analog scales. Results No differences were found for judgments of OS and VE across the groups. However, relationships between judgments made by experienced and inexperienced listeners were strong, whereas those between individuals with dysphonia and other listeners were weak to moderate. All listeners' judgments of voice were moderate predictors of VHI scores, with patient-perceived VE and clinician-rated OS being relatively strongest. Conclusions Although there is no systematic effect of listener experience on judgments of dysphonia, individuals with dysphonia appear to self-rate their voices using different perceptual strategies than other listeners. Auditory-perceptual measures are only moderately related to voice handicap scores, indicating that they are complementary measures of voice.