Auditory-perceptual Assessment of Healthy and Disordered Voices Using the Voice Deviation Scale

Objective. This study aims to (1) determine the cut-off values of the Global Severity of vocal deviation on the Visual Analog Scale (VAS) from the numerical scale ratings, and (2) identify the cut-off values according to different degrees of vocal deviation used by Voice-Specialized Speech-Language Pathologists (SLP). Study design. Prospective study. Methods. The auditory-perceptual assessment was performed by four SLPs using two protocols with different scales: the VAS and the 4-point numerical scale. Among the 211 voices analyzed, 147 corresponded to female participants, and 64 corresponded to males, plus 20% repeated voice samples. Participants were between 19 and 60 years. All of them were asked to count from 1 to 10 and were recorded in a sound-proof booth. For both protocols, the judges scored the overall severity. One SLP was excluded from the analysis due to inconsistency during the perceptual assessment. Results. For normal voice and mild deviations, overall severity cut-off score on the VAS was 21. For mild-moderate deviations, the cut-off was 55; and 81 points for moderate and severe deviations. The Area Under the Curve values correspond to 0.725, 0.905 and 0.851, respectively. Conclusions. Our results suggest that the VAS is a good instrument to be used during voice assessment performed by Chilean SLPs. However, it evidences possible differences in voice analysis perception with other cutoff scores performed in other countries, which can be compared to future studies.