Toggle Main Menu Toggle Search

Open Access padlockePrints

Can we perceptually rate alaryngeal voice? Developing the Sunderland Tracheoesophageal Voice Perceptual Scale

Lookup NU author(s): Anne Hurren, Anthony Hildreth, Professor Paul Carding


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Objective: To investigate the inter and intra reliability of raters (in relation to both profession and expertise) when judging two alaryngeal voice parameters: 'Overall Grade' and 'Neoglottal Tonicity'. Reliable perceptual assessment is essential for surgical and therapeutic outcome measurement but has been minimally researched to date. Design: Test of inter and intra rater agreement from audio recordings of 55 tracheoesophageal speakers. Setting: Cancer Unit. Participants: Twelve speech and language therapists and ten Ear, Nose and Throat surgeons. Main outcome measures: Perceptual voice parameters of 'Overall Grade' rated with a 0-3 equally appearing interval scale and 'Neoglottal Tonicity' with an 11-point bipolar semantic scale. Results: All raters achieved 'good' agreement for 'Overall Grade' with mean weighted kappa coefficients of 0.78 for intra and 0.70 for inter-rater agreement. All raters achieved 'good' intra-rater agreement for 'Neoglottal Tonicity' (0.64) but inter-rater agreement was only 'moderate' (0.40). However, the expert speech and language therapists sub-group attained 'good' inter-rater agreement with this parameter (0.63). The effect of 'Neoglottal Tonicity' on 'Overall Grade' was examined utilising only expert speech and language therapists data. Linear regression analysis resulted in an r-squared coefficient of 0.67. Analysis of the perceptual impression of hypotonicity and hypertonicity in relation to mean 'Overall Grade' score demonstrated neither tone was linked to a more favourable grade (P = 0.42). Conclusions: Expert speech and language therapist raters may be the optimal judges for tracheoesophageal voice assessment. Tonicity appears to be a good predictor of 'Overall Grade'. These scales have clinical applicability to investigate techniques that facilitate optotonic neoglottal voice quality. Clin. Otolaryngol. 2009, 34, 533-538.

Publication metadata

Author(s): Hurren A, Hildreth AJ, Carding PN

Publication type: Article

Publication status: Published

Journal: Clinical Otolaryngology

Year: 2009

Volume: 34

Issue: 6

Pages: 533-538

ISSN (print): 1749-4478

ISSN (electronic): 1749-4486

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/j.1749-4486.2009.02034.x


Altmetrics provided by Altmetric