Carmo Gisele Fonseca do, Dutka Jeniffer de Cássia Rillo, Manicardi Flora Taube, Geremias Beatriz Campanine, Pegoraro-Krook Maria Inês, Marino Viviane Cristina de Castro
Programa de Pós-Graduação em Fonoaudiologia, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil.
Pós-Graduação em Ciência da Reabilitação, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - USP - Bauru (SP), Brasil.
Codas. 2025 Jan 27;37(1):e20240044. doi: 10.1590/2317-1782/e20240044pt. eCollection 2025.
To investigate whether there is a difference in the classification of speech hypernasality by inexperienced listeners using different ordinal scales; to verify the agreement of the listeners in the analyses when using these scales; and to verify whether the order in which the scales are presented influences the results.
Twenty Speech-Language Pathology students classified the degrees of hypernasality of 40 (oral) samples from patients with cleft lip and palate. Ten performed the classifications using a 4-point scale (absent, mild, moderate, and severe) and, after two weeks, using a 3-point scale (absent, slightly hypernasal, and very hypernasal). Other ten students performed the same classifications, but in reverse order. The classifications were made remotely and documented on a form.
The average percentage of correct responses by the students, in relation to the gold standard, was significantly higher for the 3-point scale. There was no significant interaction between the order of presentation and the scale for the percentage of correct classifications. The students' agreement with the gold standard assessment was fair (3-point scale) and moderate (4-point scale). The mean percentage of agreement of the intra-rater analyses was significantly higher for the 3-point scale. There was no significant interaction between presentation order and scale for the percentage of intra-rater classifications. The Kappa coefficient index showed more favorable intra-rater agreement for the reduced scale.
The reduced scale favored the classification of speech hypernasality by listeners and can be considered an important strategy to favor the initial evaluations of students in Speech Therapy during their training.
调查没有经验的听众使用不同的顺序量表对言语鼻音过重进行分类时是否存在差异；验证听众在使用这些量表进行分析时的一致性；并验证量表呈现的顺序是否会影响结果。
20名言语语言病理学专业学生对40例唇腭裂患者的（口腔）样本的鼻音过重程度进行分类。其中10名学生使用4分量表（无、轻度、中度和重度）进行分类，两周后，使用3分量表（无、轻度鼻音过重和重度鼻音过重）进行分类。另外10名学生进行相同的分类，但顺序相反。分类通过远程方式进行，并记录在表格上。
与金标准相比，学生正确回答的平均百分比在3分量表中显著更高。正确分类百分比在呈现顺序和量表之间没有显著交互作用。学生与金标准评估的一致性在3分量表中为中等，在4分量表中为一般。评分者内分析的平均一致百分比在3分量表中显著更高。评分者内分类百分比在呈现顺序和量表之间没有显著交互作用。kappa系数指数显示，简化量表的评分者内一致性更优。
简化量表有助于听众对言语鼻音过重进行分类，可被视为在言语治疗专业学生培训期间促进其初步评估的一项重要策略。
