Perceptual Evaluation of Dysphonic Voices: Can a Training Protocol Lead to the Development of Perceptual Categories?

Abstract

The purpose of this study was to develop and test a training protocol for the perceptual evaluation of dysphonia. A group of 38 inexperienced listeners participated in a three-phase experiment: a pretest to evaluate their initial performance on categorization of dysphonic voices, a training phase, and a posttest to detect training-related changes in performance. In parallel, a different group of 14 listeners who were experts in voice assessment took a test that was identical to the posttest taken by the inexperienced subjects. The corpus used for the tests was made up of recordings of 142 voices of women reading aloud, with a sampling of voice qualities ranging from normal to severely degraded. The learners' performance on judgments of moderate and severe dysphonia improved between the pretest and the posttest. No improvement was observed for normal voices, whose initial detection was already good, nor for slight dysphonias, which appear to be the most difficult to learn. The improvements were still present on a delayed posttest taken a week later. Unexpectedly, the inexperienced listeners' initial performance was similar to that of the experts. After the training phase, their scores for severely deteriorated voices were even better than the experts'. In conclusion, our training protocol seems to be effective and could therefore be proposed to voice therapists. However, judging intermediate degrees of dysphonia remains fragile and therefore needs to be reinforced by repeated training.

The Effect of the Speech Task Characteristics on Perceptual Judgment of Mild to Moderate Dysphonia: A Methodological Study

“…The controversy also concerns the impact of speech task on the interrater reliability since some authors did not find significant differences in interrater reliability between dysphonia severity ratings of sustained vowels and continuous speech [13, 20, 21], while others supported that the counting task and/or sustained /a/ phonation are the optimal tasks for perceptual voice judgment with regard to interrater reliability [17]. Most of the studies selected perceptual moderate or severe dysphonia samples to demonstrate a task’s effect, but they did not compare the absolute agreement, intra- and interrater reliabilities of mild or moderate dysphonia that often remain harder to grade than severe dysphonic voice [22, 23]. …”

The influence of motor production experience on voice perception

“…Research studies on vocal perceptual evaluations looked further into why perceptual ratings were less reliable and what could be done to improve them. These studies found that reliability was better for the least and most severe voice samples (Ghio et al, 2014;Kreiman, Gerratt, & Ito, 2007), listener experience influenced reliability (De Bodt, 1997;Ghio et al, 2014;Karnell et al, 2007;Kreiman, Gerratt, & Precoda, 1990;Sofranko & Prosek, 2014) and training programs for naïve listeners were effective in improving reliability (Awan & Lawson, 2009;Chan & Yiu, 2006;Eadie & Baylor, 2006;Ghio et al, 2014;Iwarsson & Reinholt Petersen, 2012;Yamaguchi, Shrivastav, Andrews, & Niimi, 2003).…”

“…This makes it challenging for students to become proficient and reliable in evaluating voices. Even the reliability of judgments made by experienced raters is often variable; however, perceptual training programs for experienced and inexperienced raters have reduced intra-and inter-rater variability (Chan & Yiu, 2002;Eadie & Baylor, 2006;Ghio et al, 2014;Yamaguchi et al, 2003). Some training literature and practices in speech-language pathology suggested that imitation of disordered speech or voice quality can be useful for developing perceptual judgment skills (DeBoer & Shealy, 1995;Duffy, 2013), but this premise has not been evaluated by the research literature on perceptual voice evaluations.…”

“…Subjective perceptual evaluations are a staple of clinical voice assessment procedures and are used widely for describing the quality of the patient's voice and quantifying the severity of the disorder (Ghio et al, 2014). Standard perceptual assessments, like the Consensus Auditory-Perceptual Evaluation -Voice (CAPE-V) (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009), the Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale (Hirano, 1981) and its derivative the Grade, Instability, Roughness, Breathiness, Asthenia, Strain (GIRBAS) scale (Dejonckere et al, 1996), use general descriptors of voice quality.…”

“…Additionally, professional background, SLP versus singing teacher, was more influential than the number of years in the profession, with singing teachers rating voices as more severely dysphonic than the SLPs (Sofranko & Prosek, 2014). Listener self-perception created bias in perceptual ratings because listeners often used their own voice as a baseline (Ghio et al, 2014;Kreiman et al, 1990;Kreiman, Gerratt, Precoda, & Berke, 1992) and did not objectively evaluate their own voice in comparison to others (Haskell, 1987).…”