Assessing the Agreement of Hypernasality and Audible Nasal Emission Ratings Between Audio-Recordings and a Clinic Setting

Objective Assess agreement of hypernasality and audible nasal emission (ANE) ratings between audio-recordings and a clinic setting. Design/Setting Cross-sectional study using retrospective clinical recordings. Participants/Intervention Audio-recording ratings by two trained speech language pathologists. Main Outcome Measures Percent agreement and intra- and inter-rater reliability of perceptual ratings. Results Intra-rater reliability (AC2) of 167 audio-recorded speech samples for the primary and secondary raters, respectively, was 0.82 and 0.79 for hypernasality; for ANE, it was 0.57 and 0.75. Inter-rater reliability was 0.77 for hypernasality and 0.63 for ANE. When comparing ratings made from audio-recording versus the original clinical ratings, intra-rater reliability was 0.85 and 0.61 (primary and secondary rater, respectively) for hypernasality and 0.21 and 0.34 for ANE. Conclusions Ratings for hypernasality made from audio recordings were consistent with clinical evaluation, while ratings of ANE were not. ANE ratings made from audio recordings may not be a valid measure of velopharyngeal insufficiency speech characteristics.