Judgments Of Voice Quality Research Articles

Effect of Anchor Voices and Listener Expertise on Auditory-Perceptual Judgments of Voice Quality Using the GRBAS Scale

This study aimed to determine the effect of anchor voices and listener expertise on auditory-perceptual judgment of voice quality using the GRBAS scale. This study utilized a modified crossover design with counterbalancing. Anchor voices for each parameter of the GRBAS scale were chosen based on expert consensus. A total of 28 participants were divided into three groups based on their expertise. The first and second groups consisted of nine undergraduate (UG) and nine postgraduate (PG) students of speech-language pathology. The third group consisted of 10 practicing speech-language pathologists (SLPs). These participants carried out auditory-perceptual judgment of 60 dysphonic voice samples under two counterbalanced experimental conditions (with and without anchor voices). Each of the three groups was randomly divided into two subgroups to balance the experimental conditions. Interrater reliability for each subgroup was calculated using Krippendorff's α and 95% confidence intervals. For all the groups involved in the study, interrater reliability was higher when anchor voices aided perceptual judgment for most parameters of the GRBAS scale. For the different parameters of GRBAS, interrater reliability for the UG group varied from fair (20 < α ≤ 40) to moderate (40 < α ≤ 60). In contrast, it was fair (20<α≤ 40) to substantial (60 <α≤ 80) for the PG group and moderate (40 <α≤ 60) to substantial (60 <α ≤ 80) for the SLP group. Variations in reliability were the least for the SLP group compared to the UG and PG groups. However, there were overlaps in interrater reliability between the groups, as revealed by the 95% confidence intervals. Anchor voices help improve the auditory-perceptual judgment of voice quality, especially interrater reliability. Listener expertise is also shown to influence the interrater reliability of auditory-perceptual judgment of voice quality.

The Relationship Between the Stomatognathic System and Voice in Classical Singers

PurposeTo evaluate stomatognathic system’s structures and functions in classical singers, relating them to the auditory-perceptual judgment of voice quality and voice self-perception. MethodsA cross-sectional pilot study was conducted to evaluate the Stomatognathic System (SS) using orofacial myofunctional evaluation (MBGR Protocol). Voice handicap self-perception was assessed by the Classical Singing Handicap Index (CSHI) and the Voice Handicap Index (VHI-10). Voice samples, recorded according to the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol, underwent auditory-perceptual judgment by two voice experts. All statistical analyses adopted a 5% significance level. ResultsThe study included 15 classical singers (nine women and six men). Adequate assessments of lip and tongue functionality and mobility, upper and lower lip, mentum, and tongue tone were higher compared with altered assessments (P < 0.001). Nasal and oronasal breathing showed similar proportions among singers (P = 0.273). Participants reported greater pain in the masseter muscle (P ≤ 0.001), temporomandibular joint (TMJ) (P ≤ 0.001), and sternocleidomastoid muscle (SCM), especially on the left side (P ≤ 0.001). MBGR score showed no association with singers’ voice handicap and voice quality self-perception. ConclusionMBGR-evaluated SS items were not related to auditory-perceptual judgment of voice quality and voice self-perception. Singers reported more pain with palpation in the SCM, masseter muscle, and TMJ. Preference for a chewing side was higher than bilateral chewing. Assessing SS is paramount for the multidimensional evaluation of classical singers’ voice.

The Effect of a Climate Event on Voice-Related Processes in Seniors

Purpose: This project considered the relationship of harmful algal blooms, specifically red tide, to patient reports of respiratory diseases, use of respiratory medications, reflux symptoms, excessive coughing/throat clearing, water consumption, voice handicap scores, clinician judgments of voice quality, and voice therapy outcomes in senior voice patients in coastal Southwest Florida. Method: A retrospective chart review of 131 seniors receiving voice therapy during 2013–2019 was conducted. Patients formed two groups—those evaluated during periods of high versus low red tide. Patient reports, clinician ratings, and therapy outcomes were analyzed with nonparametric statistics to determine differences between patient groups. Results: No relationship was found between the presence of high red tide and reports of airway disorders, use of airway medications, coughing/throat clearing, Reflux Symptom Index scores, or voice therapy success. A significant relationship was found between high red tide months and ratings of voice severity and Voice Handicap Index scores. Conclusions: Harmful algal blooms may have negatively impacted the voices of seniors in this study, as shown by higher clinician voice severity ratings and higher patient perceptions of voice handicap during periods of high red tide. While voice success was still achieved by many of these seniors, speech-language pathologists should be aware of environmental issues and their possible negative impacts on voice.

Exploring The Validity of Acoustic Measurements and Other Voice Assessments

There are different parts of a battery of voice assessments to assess voice functions and voice quality. The objective assessment of voice quality using acoustics is recommended and two measurements such as the Acoustic Voice Quality index, 03.01 (AVQI) and the Acoustic Breathiness Index (ABI) are leading in this domain. The purpose of this study was to verify the validity between these two acoustic measurements and other dimensions of the voice assessments (the Voice Handicap Index-10 (VHI-10) and the laryngeal imaging evaluation of the larynx and vocal folds). We used a retrospective database of 150 participants (37 vocally healthy participants and 113 dysphonic patients). To test the validity between the acoustic measurements and the other voice assessments the concurrent validity and diagnostic precision were analyzed using Pearson correlation coefficient and the receiver operating characteristic (ROC) statistics with likelihood ratios. The VHI-10 score presented moderate-significant correlations with the AVQI and the ABI, r= 0.477, P < 0.001 (r2= 0.228) and r= 0.426, P < 0.001 (r2=0.181), respectively. The larynx alteration presented low-significant correlations with the AVQI (r= 0.362, P < 0.001, r2= 0.131), and ABI (r= 0.371, P < 0.001, r2= 0.138), respectively. The area under the curve (AUC) of ROC was almost reasonable ranging from 0.701 to 0.737; except between ABI and VHI-10 (AUC= 0.689). The highest AUC was between the AVQI and VHI-10 at a threshold of 2.10; the highest specificity was between the ABI and VHI-10 at a threshold of 3.77. However, the lowest sensitivity was between ABI and VHI-10 while the lowest specificity was between the laryngeal diagnosis and the ABI. AVQI and ABI presented significantly lower concurrent validity and diagnostic precision when the reference is not the auditory-perceptual judgment of voice quality. However, AVQI seems to be for some validity aspects a more reasonable classifier of vocal handicap and laryngeal alteration than ABI. Both AVQI and ABI values can broaden their range of assessment for the clinical user, thus showing more relationships between the individual voice examination methods.

Auditory Perception of Roughness and Breathiness by Dysphonic Women

To investigate the auditory perception of roughness and breathiness by dysphonic women. Twenty-two dysphonic native Brazilian Portuguese women participated in this research. All participants underwent audiological evaluation and laryngeal examination to confirm the diagnosis. During the tests, they recorded the sustained vowel /Ɛ/. A speech-language pathologist performed the auditory-perceptual judgment of voice quality for these vocal samples, categorizing the general degree of vocal deviation (mild, moderate, and severe degree) and the predominant type of deviation (roughness or breathiness). Thirty-two (32) stimuli were selected from a voice database, including twenty-four (24) dysphonic voice samples and eight (8) voice samples from vocally healthy women. The authors conducted five perception experiments, being three categorization tasks (normal vs. deviated, breathy vs. nonbreathy, rough vs. nonrough) and two tasks for discriminating the degree of deviation (roughness degree and breathiness degree). The experiments showed a difference between the answers for presence/absence of deviation, presence/absence of breathiness, and presence/absence of roughness in the stimuli, and a difference in the proportion of similar answers of dysphonic women (P < 0.001) regarding the identification of the deviation. Participants classified a large part of the deviated (57.9%), breathy (63.13%), and rough (65.31%) voices as normal. The degree of vocal deviation (P = 0.008) and the degree of roughness in the stimuli correlated positively with the proportion of similar answers of the participants. As for the discrimination of breathiness degrees, less deviated (normal and mild) voices were less discriminated, and more deviated (moderate and severe) voices were better discriminated. Regarding the discrimination of roughness degrees, only the voices with severe deviations showed good discrimination. Dysphonic women had a high rate of not similar answers in the identification of normal and deviated voices. They identified more than half of the deviated voices as normal. Samples with more severe deviations were proportionally more identified as deviated by the participants. The greater the vocal deviation of the participants' voices, the smallest the number of similar answers. Participants had a high rate of not similar answers in the identification of normal and breathy voices. Dysphonic women show less ability to perceive mildly and moderately breathy voices in the breathy category. Participants had a high rate of similar answers in the identification of normal and rough voices. Dysphonic women show less ability to perceive mildly and moderately breathy voices in the breathy category. Participants show less ability to perceive only mildly roughness voices with similar responses. Dysphonic women could discriminate between voices with adjacent degrees of roughness but had a low percentage of similar answers for discrimination between voices with adjacent degrees of breathiness.

Vocal quality of children with altered frenulum in the tongue

Children with a disordered lingual frenulum are said to be more prone to various difficulties in the development process. Although these children tend to present changes in chewing, swallowing and speech, it can be assumed that the voice is practically not focused, with few studies concerned on vocal function (Camargo et al, 2017, 2017a). With the aim of investigating voice quality in children with and without lingual frenulum disorder, 61 children were clinically evaluated regarding the characteristics of the lingual frenulum (Marchesan, 2012) and the perceptual judgments of voice quality in semi-spontaneous (audio) speech samples. Video samples of orofacial clinical examinations and semi-spontaneous (audio) speech samples were recorded in a soundproof room. 28 children presented altered lingual frenulum (19 boys and 09 girls) and 33 frenulum without alterations (20 boys and 13 girls). We adopted the phonetic description of voice quality model as the theoretical background (Laver, 1980) and the Vocal Profile Analysis Scheme – VPAS (Laver et al, 1981; adapted for brazilian portuguese: Camargo, Madureira, 2008) for perceptual data analysis. Voice quality settings regarding the position of lips, tongue (tip and body), jaw, pharyngeal cavity configuration and vocal tract muscle tension occurred in a greater proportion (in terms of number of the occurrences and the degree of manifestation) in children with lingual frenulum disorded. When observing the data differently by male and female subgroups, we estimate that the former accounted for most of the occurrences related to labiodentalization, retracted and lowered tongue body and pharyngeal constriction. In the girls' subgroup, pharyngeal constriction was also recurrent. With regard to our previous explorations on the topic (Camargo et al, 2017, 2017a), we were able to advance in terms of a broader understanding of children's voice quality profiles and, particularly, those related to congenital orofacial motricity limitations. The relationships between size and position of the hyoid bone in children with an altered frenulum of the tongue (Ardekani et al, 2016), especially the raised and posterior position of the hyoid bone and the posteriorization of the jaw compared to children without frenulum disorerss, seem to influence the voice quality findings reported in this study. The high incidence rates of dysphonia in childhood tend to make it difficult to associate the alterations of the lingual frenulum to phonatory settings, although they may, hypothetically, appear as aggravating factors for dysphonia.

Comparison of Pitch Strength With Perceptual and Other Acoustic Metric Outcome Measures Following Medialization Laryngoplasty

The diagnoses of voice disorders, as well as treatment outcomes, are often tracked using visual (eg, stroboscopic images), auditory (eg, perceptual ratings), objective (eg, from acoustic or aerodynamic signals), and patient report (eg, Voice Handicap Index and Voice-Related Quality of Life) measures. However, many of these measures are known to have low to moderate sensitivity and specificity for detecting changes in vocal characteristics, including vocal quality. The objective of this study was to compare changes in estimated pitch strength (PS) with other conventionally used acoustic measures based on the cepstral peak prominence (smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and clinical judgments of voice quality (GRBAS [grade, roughness, breathiness, asthenia, strain] scale) following laryngeal framework surgery. This study involved post hoc analysis of recordings from 22 patients pretreatment and post treatment (thyroplasty and behavioral therapy). Sustained vowels and connected speech were analyzed using objective measures (PS, smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and these results were compared with mean auditory-perceptual ratings by expert clinicians using the GRBAS scale. All four acoustic measures changed significantly in the direction that usually indicates improved voice quality following treatment (P < 0.005). Grade and breathiness correlated the strongest with the acoustic measures (|r| ~ 0.7) with strain being the least correlated. Acoustic analysis on running speech highly correlates with judged ratings. PS is a robust, easily obtained acoustic measure of voice quality that could be useful in the clinical environment to follow treatment of voice disorders.

Perceptual Judgment of Voice Quality in Nondysphonic French Speakers: Effect of Task-, Speaker- and Listener-Related Variables

Several perceptual scales have been developed to assess voice quality in dysphonic voices, among which the Grade Roughness Breathiness Asthenia Strain and a Rate of Dysphonia scale is probably the most frequently used. However, this clinical tool has not been properly validated with a normophonic population yet. The aim of the present study was to provide a first set of reference data gathered from a normal population, to serve as a basis of comparison for vocologists and laryngologists working with French-speaking patients. A second goal was to investigate the influence on this normal voice dataset, of variables known to affect perceptual judgments of pathological voice. Sustained vowels and sentences produced by 80 healthy, normophonic French native speakers were perceptually assessed by a panel of 18 raters (nine students, nine experts) using the Grade Roughness Breathiness Asthenia Strain and a Rate of Dysphonia scale. The average overall grade was close to 1 on the (0 to 3) scale, questioning the notion of "normal" voice as opposed to dysphonic voice. Rating reliability as well as perceptual scores were affected by task-, speaker-, and listener-related factors: speech stimuli led to better rating reliability and were judged less severely than voice stimuli; experts were slightly more reliable and less severe than students; older speakers were unanimously considered as more dysphonic. Multiple interactions between these factors were observed, confirming the multidimensional nature of voice quality.

Measurement scales, psychophysical models, and reliability statistics in voice quality perception

Perceptual judgments of voice quality can be given on discrete or continuous scales. Discrete scales are typically described as consisting of “equal appearing intervals,” and continuous judgments may be given on visual analog scales (VAS) or via direct magnitude estimation. Interrater agreement on discrete scales is highly variable and often poor, though there is evidence that application of psychophysical principles (i.e., perceptual variability, response bias) can increase reliability. There is some evidence that interrater reliability may be higher with continuous scales, though the influences of psychophysical assumptions and measurement properties on the reliability of continuous scales has not been analyzed particularly thoroughly. The present work considers the effects of different assumptions about underlying perceptual and decisional processes on the measurement properties and reliability of perceptual voice quality scales. An adaptation of Stevens’ power law combined with different decision rules provide a model of the mapping between the acoustic properties known to influence voice quality (e.g., H1-H2, HNR) and discrete or continuous clinical judgment scales (e.g., “breathiness,” “roughness”). The effects of variation in model parameters on reliability and agreement statistics will be analyzed, and novel agreement statistics based on the properties of ratio-scale judgments will be explored.

Are Instructions to Manipulate Specific Parameters of Laryngeal Function Associated with Auditory-Perceptual Ratings of Voice Quality in Nondisordered Speakers?

This preliminary study investigated whether auditory-perceptual judgments of voice quality by experienced speech language pathologists were associated with instructions given to speakers to manipulate specific laryngeal postures. Experimental, within-subject design. Nine speakers were instructed and trained to manipulate three vocal parameters implicated in functional voice disorders-false vocal fold constriction, vocal fold mass, and larynx height-while reading a standard passage. Experienced judges rated these standard passages in terms of the widely used perceptual voice qualities breathiness, roughness, vocal strain, glottal fry, tone onset, tone color, loudness, and pitch. Between-subject factorial analysis of variance, controlling for judge unreliability, revealed some evidence that perceptual judgments are strongly associated with underlying laryngeal muscle activity that can then serve clinical planning of goals for intervention. Eta2 effect sizes were large for all dependent measures, ranging from 0.39 for pitch to 0.77 for strained. Although these results are encouraging, they were obtained under ideal conditions. Further research is warranted.

The effect of visual feedback and training in auditory-perceptual judgment of voice quality

The aim of the present investigation was to evaluate the effect of visual feedback on rating voice quality severity level and the reliability of voice quality judgment by inexperienced listeners. For this purpose two training programs were created, each lasting 2 hours. In total 37 undergraduate speech–language therapy students participated in the study and were divided into a visual plus auditory-perceptual feedback group (V + AF), an auditory-perceptual feedback group (AF), and a control group with no feedback (NF). All listeners completed two rating sessions judging overall severity labeled as grade (G), roughness (R), and breathiness (B). The judged voice samples contained the concatenation of continuous speech and sustained phonation. No significant rater reliability changes were found in the pre- and posttest between the three groups in every GRB-parameter (all p > 0.05). There was a training effect seen in the significant improvement of rater reliability for roughness within the NF and AF groups (all p < 0.05), and for breathiness within the V + AF group (p < 0.01). The rating of the severity level of roughness changed significantly after the training in the AF and V + AF groups (p < 0.01), and the breathiness severity level changed significantly after the training in the V + AF group (p < 0.01). The training of V + AF and AF may only minimally influence the reliability in the judgment of voice quality but showed significant influence on rating the severity level of GRB parameters. Therefore, the use of both visual and auditory anchors while rating as well as longer training sessions may be required to draw a firm conclusion.

The Effect of Levels and Types of Experience on Judgment of Synthesized Voice Quality

The purpose of this study was to determine the effect of level and type of experience on the judgment of voice quality and to examine the correlation among acoustical measurements and perceptions of voice quality. This was a within-subjects group design. Speech-language pathologists, singing voice teachers (SVTs), speech-language pathology graduate students with and without experience with a voice client, graduate students who have completed a voice pedagogy course, and inexperienced listeners (IEs) rated stimuli with systematically altered measurements of jitter, shimmer, and noise-to-harmonics ratio (NHR) on a visual analog scale ranging from mild to severe for overall severity, roughness, breathiness, strain, and pitch. Results showed that the type of experience had an impact on judgments of voice quality more than the level of experience. Also, jitter/shimmer combination stimuli and shimmer only stimuli frequently correlated with the ratings of overall severity, roughness, and strain, and NHR stimuli correlated with ratings of breathiness across all groups. Only IEs, SVTs, and their students had significant correlations for ratings of pitch with jitter/shimmer combination stimuli having the highest correlations. The conclusion was that the level and type of experience affect judgments of voice quality.

Incorporating cepstral peak prominence as an acoustic method for assessing variation in voice quality

Cepstral Peak Prominence (CPP) has been proposed as a means of assessing breathiness from recordings (Hillenbrand et al., J. Speech and Hearing Res. 37(1994):769-78). CPP involves computing the deviation of the cepstral peak in a smoothed cepstrum from a regression function for the smoothed cepstrum. It has not been tested extensively, though the few evaluative studies, involving comparisons against auditory judgments of voice quality, have yielded positive results. Previous evaluations have not assessed the use of CPP for comparisons of inter-group or intra-individual variation. A reliable way to gauge breathiness is useful not only for therapeutic purposes, but also for informing researchers about a speaker’s repertoire and identity construction. This study examines the efficacy of CPP for analyzing social variables at the individual and group levels, using African American and European American subjects producing read and spontaneous speech under controlled conditions. Results show intra-speaker consistency across speaking tasks, but no consistent inter-ethnic differences. These findings suggest that some aspects of phonation may be more important for individual identity than for group identity.

Pitch strength of normal and dysphonic voices

Two sounds with the same pitch may vary from each other based on saliency of their pitch sensation. This perceptual attribute is called "pitch strength." The study of voice pitch strength may be important in quantifying of normal and pathological qualities. The present study investigated how pitch strength varies across normal and dysphonic voices. A set of voices (vowel /a/) selected from the Kay Elemetrics Disordered Voice Database served as the stimuli. These stimuli demonstrated a wide range of voice quality. Ten listeners judged the pitch strength of these stimuli in an anchored magnitude estimation task. On a given trial, listeners heard three different stimuli. The first stimulus represented very low pitch strength (wide-band noise), the second stimulus consisted of the target voice and the third stimulus represented very high pitch strength (pure tone). Listeners estimated pitch strength of the target voice by positioning a continuous slider labeled with values between 0 and 1, reflecting the two anchor stimuli. Results revealed that listeners can judge pitch strength reliably in dysphonic voices. Moderate to high correlations with perceptual judgments of voice quality suggest that pitch strength may contribute to voice quality judgments.

Acoustic Measures of Phonation during Connected Speech in Adductor Spasmodic Dysphonia

Objectives: This study examined acoustic measures related to voice production in connected speech of patients with adductor spasmodic dysphonia (ADSD) before and after boltulinum toxin (BT) treatment in comparison with speech of non-dysphonic healthy control (NHC) speakers. Correlations between acoustic measures and perceptual scaling judgments of overall voice quality were also examined. Methods: Ten patients with moderate-to-severe ADSD were audio-recorded prior to and following BT injection, as were age and gender matched NHCs. Signal processing algorithms were employed to extract fundamental frequency (f 0 ) and intensity (dB) of speakers’ digitized oral readings. Control procedures minimized the influence of severely aperiodic phonation and obstruent consonant production on the analysis of modal f 0 and related variables such as signal-to-noise ratio (SNR). Measures of severe aperiodicity, with f 0 < 80 Hz, were compared with modal f 0 data. Perceptual judgments of voice quality were obtained from expert voice clinicians under rigorously controlled listening conditions. Results: Acoustic measures of number of low frequency f 0 events, coefficient of variation of modal f 0 , and SNR demonstrated statistically significant differences for ADSD speech before and after treatment, and differentiated between ADSD and NHC speakers. Mean modal f 0 did not differentiate among speaker conditions. All other measures differentiated untreated ADSD speech from that of NHCs; however, only selected measures demonstrated differences between NHC and ADSD speakers following BT injection. Coefficient of variation of modal f 0 and SNR were moderately correlated with expert listener judgments of voice quality. Conclusion: Acoustic measures of connected speech derived from carefully edited modal f 0 tracks and intensity contours were effective for characterizing ADSD speech before and after treatment, and for differentiating it from that of NHCs. Acoustic measures were highly reliable and significantly related to voice quality scaling by expert listeners.

Perceptual characteristics of tracheoesophageal speech production using the new indwelling Provox Vega voice prosthesis: A randomized controlled crossover trial

The objective of this study was to determine if the design enhancements incorporated into the new Provox Vega Indwelling Voice prostheses result in any positive benefits in vivo. Using a randomized, crossover study design, 31 participants using tracheoesophageal speech postlaryngectomy completed a 3-week trial of the Provox Vega and a comparator device. Main outcome measures included patient perceptions of vocal effort and quality using each device, and perceptual judgments of voice quality produced. The majority of patients (72%) indicated the Provox Vega gave them overall better voice quality and 52% felt they required less effort to phonate. Voice samples produced with the Provox Vega were also perceived by listeners to be significantly (p < .05) less strained, easier to understand, produced with less effort, and the better speech sample overall. Results support that the aerodynamic improvements incorporated in the design of the new Provox Vega facilitate enhanced voice and speech qualities.

The Effect of Listener Experience and Anchors on Judgments of Dysphonia

To determine the effect of auditory anchors on judgments of overall severity (OS) and vocal effort (VE) in dysphonic speech when judgments are made by experienced and inexperienced listeners, and when self-rated by individuals with dysphonia (speaker-listeners). Twenty individuals with dysphonia and 4 normal controls provided speech recordings. Speaker-listeners judged their own speech samples for OS and VE without auditory anchors, and then in the presence of anchors, using 100-mm visual analog scales (VAS). Twenty inexperienced and 10 experienced listeners evaluated the same speech samples for OS and VE in similar rating conditions. Twenty inexperienced listeners also made judgments of the speech samples solely in anchored conditions. All listeners judged the speech samples as significantly less severe and effortful in the anchored conditions. No significant effects of anchors or experience were found for intrarater agreement within 7.14 mm on the VAS. Both inexperienced and experienced listeners were significantly less variable and showed improved interrater agreement in the anchored conditions. Anchors significantly improved agreement across groups of listeners, particularly between inexperienced and speaker-listeners. Listeners systematically shift judgments of voice quality in response to auditory anchors. Anchors reduce interrater variability and may improve agreement across some types of listeners.

Establishing Validity of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)

The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) was developed to provide a protocol and form for clinicians to use when assessing the voice quality of adults with voice disorders (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kramer, & Hillman, 2009). This study examined the reliability and the empirical validity of the CAPE-V when used by experienced voice clinicians judging normal and disordered voices. The validity of the CAPE-V was examined in 2 ways. First, we compared judgments made by 21 raters of 22 normal and 37 disordered voices using the CAPE-V and the GRBAS (grade, roughness, breathiness, asthenia, strain; see Hirano, 1981) scales. Second, we compared our raters' judgments of overall severity to a priori consensus judgments of severity for the 59 voices. Intrarater reliability coefficients for the CAPE-V ranged from .82 for breathiness to .35 for strain; interrater reliability ranged from .76 for overall severity to .28 for pitch. Although both CAPE-V and GRBAS reliability coefficients varied across raters and parameters, this study reports slightly improved rater reliability using the CAPE-V to make perceptual judgments of voice quality in comparison to the GRBAS scale. The results provide evidence for the empirical (concurrent) validity of the CAPE-V.

Perceptual Distances of Breathy Voice Quality: A Comparison of Psychophysical Methods

Experiments to study voice quality have typically used rating scales or direct magnitude estimation to obtain listener judgments. Unfortunately, the data obtained using these tasks are context dependent, which makes it difficult to compare perceptual judgments of voice quality across experiments. The present experiment describes a simple matching task to quantify voice quality. The data obtained through this task were compared to perceptual judgments obtained using rating scale and direct magnitude estimation tasks to determine whether the three tasks provide equivalent perceptual distances across stimuli. Ten synthetic vowel continua that varied in terms of their aspiration noise were evaluated for breathiness using each of the three tasks. Linear and nonlinear regressions were used to compare the perceptual distances between stimuli obtained through each technique. Results show that the perceptual distances estimated from matching and direct magnitude estimation task are similar, but both differ from the rating scale task, suggesting that the matching task provides perceptual distances with ratio-level measurement properties. The matching task is advantageous for measurement of vocal quality because it provides reliable measurement with ratio-level scale properties. It allows the use of a fixed reference signal for all comparisons, thus allowing researchers to directly compare findings across different experiments.

The Effect of Musical Background on Judgments of Dysphonia

The objectives of this study were to determine the effect of musical background on both pitch discrimination abilities and the reliability of judging voice quality in dysphonic speakers, and to determine the relationship between pitch discrimination abilities and the reliability of voice quality judgments. Twenty musicians and 20 nonmusicians performed pitch discrimination tests. They also made judgments of dysphonic vowels and speech samples for breathiness and roughness using 100-mm visual analog scales. Musicians demonstrated significantly smaller pitch discrimination thresholds than nonmusicians. For measures of intrarater agreement, musicians were significantly more consistent than nonmusicians for judgments of breathiness in both vowels and speech produced by dysphonic speakers. Musicians also showed significantly better interrater agreement for judgments of breathiness in vowels. Weak to moderate relationships were found between pitch discrimination abilities and agreement values for voice quality judgments. Results suggest that musical background may affect a listener's reliability in making judgments of dysphonia, particularly for judgments of breathiness. However, simple pitch discrimination skills of pure tones do not explain these differences. More complex stimuli should be used in future investigations to help determine the nature of underlying differences.