BACKGROUND This study examined relationships between communicative participation and post-laryngectomy speech outcomes including: a) listener-rated speech intelligibility and acceptability; and b) patient-rated speech acceptability and voice handicap. METHODS Thirty-six laryngectomized individuals completed the Communicative Participation Item Bank short form and the Voice Handicap Index-10. They provided recordings from the Sentence Intelligibility Test (SIT) and a reading passage, and rated their own speech acceptability. Forty-eight inexperienced listeners transcribed the SIT sentences to derive intelligibility scores. Eighteen additional listeners judged speech acceptability using rating scales. RESULTS Listeners judged tracheoesophageal speakers significantly more intelligible and acceptable than electrolaryngeal speakers (p < .05). Speech acceptability was significantly more acceptable to speakers than listeners (p < .05). Weak, non-significant relationships were found between communicative participation and listener-rated outcomes. Stronger, significant relationships were found between communicative participation and self-rated speech acceptability and voice handicap (p < .05). CONCLUSIONS Patient-reported communication outcomes are complementary to listener-rated outcomes.

Speech intelligibility in quiet is a weak predictor of self-reported communication measures in tracheoesophageal speakers. Speech intelligibility in noise may be a better metric of self-reported communicative function for speakers who demonstrate higher speech intelligibility in noise.