Wong Denise Wai-Man, Chan Roger W, Wu Chia-Hsin
Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taiwan.
J Speech Lang Hear Res. 2021 Apr 14;64(4):1136-1156. doi: 10.1044/2020_JSLHR-20-00214. Epub 2021 Mar 26.
Purpose Auditory-perceptual evaluation is essential for the clinical assessment of voice disorders. Unstable perceptual voice evaluation has been shown for inexperienced listeners as compared to expert listeners. We examined the effects of perceptual training with external auditory anchors with and without immediate feedback on the evaluation of roughness and breathiness of natural, nonsynthesized speech stimuli (reading of a standard passage) in speech-language pathology students. Method Perceptual voice evaluation and training with anchors using a visual analog scale was implemented with a computer software. Forty-eight speech-language pathology students were randomly assigned into three groups, feedback group (Group F), no feedback group (Group NF), and control group (Group C), attending one training session and four assessment sessions (before training, immediately after training, and 1 and 7 weeks after training). Group F received training with anchors with immediate feedback, Group NF received training without immediate feedback, and Group C received sham training (exposure session). Results Training with anchors significantly increased the rating accuracy (agreement with expert ratings) on both roughness and breathiness for Group F, with the effects lasting for 7 weeks. No significant changes in rating accuracy with training were observed for Group NF and Group C. No improvements in intra- and interrater reliability as well as intrarater agreement were observed in all three groups, whereas interrater agreement on breathiness (but not roughness) significantly increased for all groups, with the effect lasting for 7 weeks only for Group F. Conclusions These findings suggested that perceptual training with external auditory anchors and the use of immediate feedback could be effective for facilitating the development of perceptual voice evaluation skills in speech-language pathology students. Further studies involving more extensive training with stimuli covering a full range of dysphonia severity categories and improvements in design of the training protocol are recommended to verify these results.
目的 听觉感知评估对于嗓音障碍的临床评估至关重要。与专家听众相比，经验不足的听众在嗓音感知评估中表现不稳定。我们研究了使用外部听觉锚定并伴有或不伴有即时反馈的感知训练，对言语语言病理学专业学生评估自然的、非合成语音刺激（朗读标准段落）的粗糙感和气息声的影响。方法 使用计算机软件，通过视觉模拟量表对嗓音进行感知评估并进行锚定训练。48名言语语言病理学专业学生被随机分为三组：反馈组（F组）、无反馈组（NF组）和对照组（C组），参加一次训练课程和四次评估（训练前、训练后即刻、训练后1周和7周）。F组接受带有即时反馈的锚定训练，NF组接受无即时反馈的训练，C组接受假训练（暴露环节）。结果 对于F组，使用锚定训练显著提高了在粗糙感和气息声方面的评分准确性（与专家评分的一致性），且效果持续7周。NF组和C组在训练后评分准确性未观察到显著变化。三组在组内和组间信度以及评分者内部一致性方面均未观察到改善，而所有组在气息声方面的组间一致性（但粗糙感方面未观察到）显著提高，仅F组的这一效果持续7周。结论 这些发现表明，使用外部听觉锚定并伴有即时反馈的感知训练，对于促进言语语言病理学专业学生的嗓音感知评估技能发展可能是有效的。建议开展进一步研究，涉及使用涵盖全范围发音障碍严重程度类别的刺激进行更广泛的训练，并改进训练方案设计以验证这些结果。
