Typical vs. atypical: Combining auditory Gestalt perception and acoustic analysis of early vocalisations in Rett syndrome.
Florian B Pokorny, Katrin D Bartl-Pokorny, Christa Einspieler and 6 others
PMID 29551600WHAT IT FOUND
Experts inconsistently rated early vocalisations from one infant with Rett syndrome.
Only 9 were unanimously atypical, but over half had at least one listener flagging them. Timbre was the most common perceived deviation, matching acoustic spectral analysis.
Key findings
01Only 9 of 363 vocalisations were unanimously rated as atypical by all five expert listeners, though more than half were flagged as atypical by at least one listener.
02Perceived atypicality was most strongly associated with timbre, which aligned with acoustic features describing spectral structure.
03Inter-rater reliability was low, indicating that expert concepts of vocal atypicality did not entirely overlap.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study analysed vocalisations from a single infant, so findings cannot be generalised to all individuals with Rett syndrome. The data came from retrospective home videos, which may miss behaviours not captured by parents, such as vocalisations during distressed states. Inter-rater reliability among experts was low, indicating that current auditory criteria for distinguishing typical from atypical vocalisations are not standardized.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that expert clinical judgment alone can reliably detect early vocal signs of Rett syndrome. The low agreement between listeners in this study shows that current auditory concepts of atypicality are inconsistent, even among specialists.