ASPO076 - Validation of Perceptual Speech Assessment in the Evaluation of Velopharyngeal Insufficiency
Sunday, May 1, 2022
8:55 AM – 9:55 AM CT
Location: Landmark C
Madeleine A. Drusin, MD, MSc1, Kathleen C. Y. Sie, MD1, Sara Kinter, PhD, CCC-SLP2;
1Division of Pediatric Otolaryngology – Head & Neck Surgery, Seattle Children's Hosp. / Univ. of Washington, Seattle, WA, 2Division of Craniofacial Medicine / Craniofacial Center, Seattle Children's Hosp. / Univ. of Washington, Seattle, WA.
Seattle Children's Hospital - University of Washington
Introduction: Velopharyngeal insufficiency (VPI) impacts pediatric quality of life and speech intelligibility. Perceptual speech evaluation is the gold standard for the diagnosis of VPI and is often the primary outcome of interest. Establishing the reliability of perceptual speech assessment scores is therefore critical to the diagnosis and treatment of VPI. Our study aims to assess the inter- and intra-rater reliability of perceptual speech ratings commonly used in the evaluation of VPI.
Methods: Fifty de-identified audio recordings of patients undergoing perceptual evaluation of velopharyngeal function were reviewed. Three speech language pathologists (SLPs) specializing in the evaluation of velopharyngeal function evaluated each recording to assign VPI severity, hypernasality (HrN) and hyponasality (HoN) ratings. They then re-evaluated 15 randomly selected audios from the original 50 two weeks after the initial ratings to assess intra-rater reliability. Single-measures intra-class correlation coefficients (ICC) and weighted kappa determined inter-and intra-rater reliability respectively.
Results: Correlation coefficients for inter- and intra-rater reliability revealed “good” to “excellent” reliability for both HrN and VPI. For inter-rater reliability, the ICCs were 0.752 (CI 0.639-0.841) for HrN and 0.768 (CI 0.661-0.852) for VPI. For HoN, inter- and intra-rater reliability fell into the “fair” range of agreement, with an ICC of 0.5 (CI 0.334-0.654).
Conclusion: Standardized perceptual speech ratings for hypernasality and velopharyngeal insufficiency severity demonstrate good to excellent inter- and intra-rater reliability among speech language pathologists specializing in the evaluation of velopharyngeal function.