The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) is a standardized instrument used in voice assessment to assess voice quality. It has been translated and culturally adapted in several languages. This study aimed at developing and validating a Tamil version of CAPE-V through auditory perceptual evaluation of remotely recorded voice samples.
The Tamil version was adapted with permission from the American Speech-Language-Hearing Association to match the rationale in English CAPE-V. The sentences were constructed by the first author and validated for content by two panels of experts. Forty-five participants (15 cases and 30 controls) were included in the study. Data recording was conducted online (Zoom Video Communications, Inc., app) for all samples. Three raters participated in the auditory evaluation and scored all samples using Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale followed by CAPE-V with a week gap in between. Twenty percent of samples were repeated to assess intrarater reliability. The intrarater and interrater reliability measures for Tamil CAPE-V were established using intraclass coefficients (ICCs). To ensure construct validity, group differences were determined between the cases and controls. The concurrent validity was established by correlating Tamil CAPE-V with the GRBAS scale.
The intrarater reliability for Tamil CAPE-V ranged from moderate to excellent (ICC: .610-.998). The Tamil CAPE-V obtained moderate to good interrater reliability for all parameters (ICC: .525-.790) except pitch (ICC: .405). The differences between the cases and controls were statistically significant (p < .01). The correlation between CAPE-V and GRBAS was strong for overall severity, breathiness, and strain (r s = .725-.861) and moderate for roughness (r s = .678).
The Tamil CAPE-V is a reliable and valid tool for auditory perceptual evaluation in Tamil-speaking populations.
https://doi.org/10.23641/asha.21513885.

BACKGROUND: Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) is a widely used perceptual evaluation scale for voice assessment. It is adapted in many regional languages worldwide. This systematic review will help critically evaluate the methodologies used to adapt and establish CAPE-V as a valid and reliable tool.
METHODS: Authors reviewed literature in search engines (Scopus, Google Scholar, PubMed) to identify studies published in English between 2002-2020. The CAPE-V translated and adapted for linguistic or cultural variations were included for the review. The studies were compiled using the Mendeley Reference Manager and screened for title/abstract before shortlisting the studies.
RESULTS: The initial database had 3459 search results and after duplicates removal, 1535 articles were analysed. Thirteen studies were narrowed based on title/abstract screening. A final of ten studies were selected for the review.
CONCLUSIONS: This review provided a comprehensive understanding of the challenges encountered during cross-cultural adaptation and will help future researchers choose a suitable adaptation method.

Most patients with movement disorders have speech impairments resulting from sensorimotor abnormalities that affect phonatory, articulatory, and prosodic speech subsystems. There is widespread cross-discipline use of speech recordings for diagnostic and research purposes, despite which there are no specific guidelines for a standardized method. This review aims to combine the specific clinical presentations of patients with movement disorders, existing acoustic assessment protocols, and technological advances in capturing speech to provide a basis for future research in this field and to improve the consistency of clinical assessments. We considered 3 areas: the recording environment (room, seating, background noise), the recording process (instrumentation, vocal tasks, elicitation of speech samples), and the acoustic outcome data. Four vocal tasks, namely, sustained vowel, sequential and alternating motion rates, reading passage, and monologues, are integral aspects of motor speech assessment. Fourteen acoustic vocal speech features, including their hypothesized pathomechanisms with regard to typical occurrences in hypokinetic or hyperkinetic dysarthria, are hereby recommended for quantitative exploratory analysis. Using these acoustic features and experimental speech data, we demonstrated that the hyperkinetic dysarthria group had more affected speech dimensions compared with the healthy controls than had the hypokinetic speakers. Several contrasting speech patterns between both dysarthrias were also found. This article is the first attempt to provide initial recommendations for a standardized way of recording the voice and speech of patients with hypokinetic or hyperkinetic dysarthria; thus allowing clinicians and researchers to reliably collect, acoustically analyze, and compare vocal data across different centers and patient cohorts. © 2020 International Parkinson and Movement Disorder Society.

OBJECTIVE: This study was aimed at determining the internal and external responsiveness of the Persian version of the Consensus Auditory-Perceptual Evaluation of Voice (called ATSHA), Persian version of the Voice Handicap Index (VHI), and Praat scales among patients with vocal mass lesions and secondary muscle tension dysphonia.
METHODS: Prospective, within-participant repeated measures.
METHODS: Thirty patients with vocal fold nodules, polyps, and cysts related to secondary muscle tension dysphonia participated in the study. The measures of interest and videostroboscopy examination were used before and after treatment. The Global Perceived Effect questionnaire was used to separate those improved (moderately or greatly improved) and stable (slightly improved) patients.
RESULTS: The mean standardized response, standardized effect size, and Guyatt analyses indicated high internal responsiveness for the all target parameters of the ATSHA, total score of the VHI, and two parameters of the Praat (0.8<). There was poor correlation between the videostroboscopy and the other target scales (r Pearson = -0.1-0.1). The receiver operating characteristic analysis indicated that all the target scales did not significantly separate those improved and stable subjects (area under the curve = 0), except for the overall severity and roughness parameters of the ATSHA scale (area under the curve = 1).
CONCLUSIONS: This study recommends both the Consensus Auditory-Perceptual Evaluation of Voice and the VHI scales to show voice therapy changes. The target voice scale changes were not able to predict the videostroboscopy changes as external standard. Furthermore, we recommend that the overall severity and roughness may properly classify those improved and stable patients.

OBJECTIVE: This study aims to analyze the Dysphonia Severity Index (DSI) in Brazilians with or without voice disorders and investigate DSI\'s correlation with gender and auditory-perceptual evaluation data obtained via the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol.
METHODS: A total of 66 Brazilian adults from both genders participated in the study, including 24 patients with dysphonia confirmed on laryngeal examination (dysphonic group [DG]) and 42 volunteers without voice or hearing complaints and without auditory-perceptual voice disorders (nondysphonic group [NDG]).
METHODS: The vocal tasks included in CAPE-V and DSI were performed and recorded. Data were analyzed by means of the independent t test, the Mann-Whitney U test, and Pearson correlation at the 5% significance level.
RESULTS: Differences were found in the mean DSI values between the DG and the NDG. Differences were also found in all DSI items between the groups, except for the highest frequency parameter. In the DG, a moderate negative correlation was detected between overall dysphonia severity (CAPE-V) and DSI value, and between breathiness and DSI value, and a weak negative correlation was detected between DSI value and roughness. In the NDG, the maximum phonation time was higher among males. In both groups, the highest frequency parameter was higher among females.
CONCLUSIONS: The DSI discriminated among Brazilians with or without voice disorders. A correlation was found between some aspects of the DSI and the CAPE-V but not between DSI and gender.

Adapting the built environment to the needs of nursing- or care-home residents has become common practice. Even though hearing loss due to ageing is a normal occurring biological process, little research has been performed on the effects of room acoustic parameters on the speech intelligibility for older adults. This article presents the results of room acoustic measurements in common rooms for older adults and the effect on speech intelligibility. Perceived speech intelligibility amongst the users of the rooms was also investigated. The results have led to ongoing research at Utrecht University of Applied Sciences and Eindhoven University of Technology, aimed at the development of acoustical guidelines for elderly care facilities.

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OBJECTIVE: To evaluate whether the overall dysphonia grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, and the Consensus Auditory Perceptual Evaluation-Voice (CAPE-V) scale show the same reliability and consensus when applied to the same vocal sample at different times.
METHODS: Observational cross-sectional study.
METHODS: Sixty subjects had their voices recorded according to the tasks proposed in the CAPE-V scale. Vowels /a/ and /i/ were sustained between 3 and 5 seconds. Reproduction of six sentences and spontaneous speech from the request \"Tell me about your voice\" were analyzed. For the analysis of the GRBAS scale, the sustained vowel and reading tasks of the sentences was used. Auditory-perceptual voice analyses were conducted by three expert speech therapists with more than 5 years of experience and familiar with both the scales.
RESULTS: A strong correlation was observed in the intrajudge consensus analysis, both for the GRBAS scale as well as for CAPE-V, with intraclass coefficient values ranging from 0.923 to 0.985. A high degree of correlation between the general GRBAS and CAPE-V grades (coefficient=0.842) was observed, with similarities in the grades of dysphonia distribution in both scales. The evaluators indicated a mild difficulty in applying the GRBAS scale and low to mild difficulty in applying the CAPE-V scale. The three evaluators agreed when indicating the GRBAS scale as the fastest and the CAPE-V scale as the most sensitive, especially for detecting small changes in voice.
CONCLUSIONS: The two scales are reliable and are indicated for use in analyzing voice quality.

OBJECTIVE: This study investigates the effect of consensus training of listeners on intrarater and interrater reliability and agreement of perceptual voice analysis. The use of such training, including a reference voice sample, could be assumed to make the internal standards held in memory common and more robust, which is of great importance to reduce the variability of auditory perceptual ratings.
METHODS: A prospective design with testing before and after training.
METHODS: Thirteen students of audiologopedics served as listening subjects. The ratings were made using a multidimensional protocol with four-point equal-appearing interval scales. The stimuli consisted of text reading by authentic dysphonic patients. The consensus training for each perceptual voice parameter included (1) definition, (2) underlying physiology, (3) presentation of carefully selected sound examples representing the parameter in three different grades followed by group discussions of perceived characteristics, and (4) practical exercises including imitation to make use of the listeners\' proprioception.
RESULTS: Intrarater reliability and agreement showed a marked improvement for intermittent aphonia but not for vocal fry. Interrater reliability was high for most parameters before training with a slight increase after training. Interrater agreement showed marked increases for most voice quality parameters as a result of the training.
CONCLUSIONS: The results support the recommendation of specific consensus training, including use of a reference voice sample material, to calibrate, equalize, and stabilize the internal standards held in memory by the listeners.

OBJECTIVE: This tutorial addresses fundamental characteristics of microphones (frequency response, frequency range, dynamic range, and directionality), which are important for accurate measurements of voice and speech.
METHODS: Technical and voice literature was reviewed and analyzed. The following recommendations on desirable microphone characteristics were formulated: The frequency response of microphones should be flat (i.e., variation of less than 2 dB) within the frequency range between the lowest expected fundamental frequency of voice and the highest spectral component of interest. The equivalent noise level of the microphones is recommended to be at least 15 dB lower than the sound level of the softest phonations. The upper limit of the dynamic range of the microphone should be above the sound level of the loudest phonations. Directional microphones should be placed at the distance that corresponds to their maximally flat frequency response, to avoid the proximity effect; otherwise, they will be unsuitable for spectral and level measurements. Numerical values for these recommendations were derived for the microphone distances of 30 cm and 5 cm.
CONCLUSIONS: The recommendations, while preliminary and in need of further numerical justification, should provide the basis for better accuracy and repeatability of studies on voice and speech production in the future.