Hearing and Believing: Some Limits to the Auditory-Perceptual Assessment of Speech and Voice Disorders

Abstract

Speech-language pathology relies on auditory-perceptual judgment as a central tool for classifying and measuring a variety of disorders of communication. Over the history of the field, a great deal has been written about the use of perceptual judgments for research and clinical practice. Auditory-perceptual methods carry strong advantages of convenience, economy, and robustness, but it is also clear that these judgments are susceptible to a variety of sources of error and bias. Awareness of these threats to validity and reliability is a major step in the effective and refined use of perceptual methods. Several common themes are evident in contemporary research on the perceptual assessment of voice disorders, stuttering, dysarthria, aphasia, and apraxia of speech. These five disorders are taken as primary foci in a discussion that (a) identifies threats to reliability and validity, and (b) offers suggestions for the improvement of auditory-perceptual methods, whether used alone or in combination with instrumental techniques.