Abstract
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. © 2023, American Cleft Palate Craniofacial Association.