title: The correlation between nasalance and a differentiated perceptual rating of speech in Dutch patients with velopharyngeal insufficiency.
abstract: OBJECTIVE
  The correlation between the nasalance score and the perceptual rating of several aspects of speech of speakers with velopharyngeal insufficiency (VPI) by six speech-language pathologists was evaluated.
  
  
  METHODS
  The overall grade of severity, hypernasality, audible nasal emission, misarticulations, and intelligibility were rated on visual analog scales. Speech samples with a normal distribution of phonemes (normal text [NT]) and those free of nasal consonants (denasal text [DT]) of 43 patients with VPI were used. Mean nasalance scores were computed for the speech samples, and Spearman correlation coefficients were computed between the mean nasalance score and the five parameters of the differentiated rating.
  
  
  METHODS
  The Institute of Phoniatrics, Utrecht University Hospital, The Netherlands.
  
  
  RESULTS
  The correlation coefficient between the mean nasalance and the perceptual rating of hypernasality ranged among judges from .31 to .56 for NT speech samples and .36 to .60 for DT speech samples. Only small differences were found between speech pathologists with and without expertise in cleft palate speech. The rating of the overall grade of severity appeared to correlate quite well with the rating of the intelligibility (r(NT) = .77, r(DT) = .79). Lower correlation coefficients, ranging from .34 to .71, were found between overall grade of severity and hypernasality, audible nasal emission, and misarticulations.
  
  
  CONCLUSIONS
  A low correlation between the nasalance and the perceptual rating of hypernasality was found. The parameter overall grade of severity appeared to be determined mainly by the parameter intelligibility. Expertise in rating of cleft palate speech does not guarantee a high correlation between instrumental measurement and perceptual rating.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, The Netherlands. k.h.keuning@amc.uva.nl
authors.forename: Kornelis H D M
authors.initials: KH
authors.lastname: Keuning
authors.forename: George H
authors.initials: GH
authors.lastname: Wieneke
authors.forename: Hans A
authors.initials: HA
authors.lastname: van Wijngaarden
authors.forename: Philippe H
authors.initials: PH
authors.lastname: Dejonckere
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001184:Articulation Disorders / Q000145:classification / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009426:Netherlands; D009666:Nose / Q000503:physiopathology; D010700:Phonetics; D012815:Signal Processing, Computer-Assisted; D013064:Speech Disorders / Q000145:classification / Q000503:physiopathology*; D013065:Speech Intelligibility / Q000502:physiology; D013067:Speech Perception / Q000502:physiology*; D013066:Speech-Language Pathology; D018709:Statistics, Nonparametric; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology*