Classification of speech nasality of individuals with cleft lip and palate with distinct ordinal scales.
Gisele Fonseca do Carmo, Jeniffer de Cássia Rillo Dutka, Flora Taube Manicardi and 3 others
PMID 39879425WHAT IT FOUND
Speech-Language Pathology students classified hypernasality more accurately and consistently using a 3-point scale than a 4-point scale.
The simpler scale yielded higher agreement with expert gold-standard ratings, suggesting it is better suited for training inexperienced listeners.
Key findings
01Students achieved a significantly higher mean percentage of correct classifications against the gold standard when using the 3-point scale compared to the 4-point scale.
02Intra-rater agreement was significantly higher for the 3-point scale, with students being more consistent in their own ratings across duplicate samples.
03The order in which the scales were presented to the students did not influence the classification results.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used pre-existing recordings rather than live speech, which may not fully capture the variability of clinical interactions. Other speech symptoms such as nasal air emission and compensatory articulations were not controlled for, which could have influenced the students' perceptions of hypernasality. The participants were students with no clinical experience, so the findings may not generalize to all inexperienced listeners or different levels of expertise. The gold standard was established by three experts, but the potential for expert bias or disagreement was not fully addressed beyond the initial selection.
Declared interests
The study was approved by the Human Research Ethics Committee. No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the 3-point scale as superior for all clinical contexts. The findings apply specifically to inexperienced listeners (students) who benefit from reduced complexity. Experienced clinicians may still require the granularity of the 4-point scale for precise diagnosis and treatment planning, and the study does not suggest replacing the 4-point scale in advanced practice.