title: Perceptual evaluation of severe pediatric voice disorders: rater reliability using the consensus auditory perceptual evaluation of voice.
abstract: The purpose of this nonrandomized prospective study was to quantify the inter- and intrarater reliability of experienced speech-language pathologist's perceptual ratings of voice in pediatric patients post-laryngotracheal reconstruction (LTR). Moderate to severe dysphonia is common in this population. Using the sentence portion of the Consensus Auditory Perceptual Evaluation-Voice (CAPE-V) rating scale, three experienced speech-language pathologists independently rated randomized voice samples of 50 participants ages 4-20 years, who had acquired or congenital airway conditions requiring at least one LTR on the six salient perceptual vocal attributes. Data collection and listening conditions were carefully controlled. Seventeen (34%) of the samples were randomly selected for rerating at a later time. Estimates of interrater reliability were strongest for perceptual ratings of breathiness (intraclass correlation coefficient [ICC]=71%), roughness (ICC=68%), pitch (ICC=68%), and overall severity (ICC=67%). Reliability was lower for ratings of loudness (ICC=57%) and strain (ICC=35%). For each rater, the intrarater reliability on all but one parameter (strain) was moderate to strong (ICC=63-93%). There was a strong interrater eliability for four of six vocal parameters rated using the CAPE-V in a population of children and adolescents with marked dysphonia. The parameter of strain, when rated by auditory sample alone and apart from the clinical context, was difficult to rate.
authors.affiliation: University of Cincinnati, Communication Science and Disorders, 202 Goodman Avenue G-65, French East, Cincinnati, OH 45267-0379, USA. kelchnl@email.uc.edu
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Kelchner
authors.forename: Susan B
authors.initials: SB
authors.lastname: Brehm
authors.forename: Barbara
authors.initials: B
authors.lastname: Weinrich
authors.forename: Janet
authors.initials: J
authors.lastname: Middendorf
authors.forename: Alessandro
authors.initials: A
authors.lastname: deAlarcon
authors.forename: Linda
authors.initials: L
authors.lastname: Levin
authors.forename: Ravi
authors.initials: R
authors.lastname: Elluru
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D032921:Consensus; D055154:Dysphonia / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007830:Larynx / Q000601:surgery; D008144:Loudness Perception; D008297:Male; D015588:Observer Variation; D010898:Pitch Perception; D011183:Postoperative Complications / Q000175:diagnosis*; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012720:Severity of Illness Index; D013066:Speech-Language Pathology / Q000379:methods* / Q000592:standards*; D014132:Trachea / Q000601:surgery; D014833:Voice Quality; D055815:Young Adult