The relationship between the Nasality Severity Index 2.0 and perceptual judgments of hypernasality

Publication date: Available online 26 May 2016
Source:Journal of Communication Disorders
Author(s): Kim Bettens, Marc De Bodt, Youri Maryn, Anke Luyten, Floris L. Wuyts, Kristiane M. Van Lierde
PurposeThe Nasality Severity Index 2.0 (NSI 2.0) forms a new, multiparametric approach in the identification of hypernasality. The present study aimed to investigate the correlation between the NSI 2.0 scores and the perceptual assessment of hypernasality.MethodSpeech samples of 35 patients, representing a range of nasality from normal to severely hypernasal, were rated by four expert speech-language pathologists using visual analogue scaling (VAS) judging the degree of hypernasality, audible nasal airflow (ANA) and speech intelligibility. Inter- and intra-listener reliability was verified using intraclass correlation coefficients. Correlations between NSI 2.0 scores and its parameters (i.e. nasalance score of an oral text and vowel/u/, voice low tone to high tone ratio of the vowel/i/) and the degree of hypernasality were determined using Pearson correlation coefficients. Multiple linear regression analysis was used to investigate the possible influence of ANA and speech intelligibility on the NSI 2.0 scores.ResultsOverall good to excellent inter- and intra-listener reliability was found for the perceptual ratings. A moderate, but significant negative correlation between NSI 2.0 scores and perceived hypernasality (r=−0.64) was found, in which a more negative NSI 2.0 score indicates the presence of more severe hypernasality. No significant influence of ANA or intelligibility on the NSI 2.0 was observed based on the regression analysis.ConclusionBecause the NSI 2.0 correlates significantly with perceived hypernasality, it provides an easy-to-interpret severity score of hypernasality which will facilitate the evaluation of therapy outcomes, communication to the patient and other clinicians, and decisions for treatment planning, based on a multiparametric approach. However, research is still necessary to further explore the instrumental correlates of perceived hypernasality.Learning outcomesThe reader will be able to (1) describe and discuss current issues and influencing variables regarding perceptual ratings of hypernasality; (2) describe and discuss the relationship between the Nasality Severity Index 2.0, a new multiparametric approach to hypernasality, and perceptual judgments of hypernasality based on visual analogue scale ratings; (3) compare these results with the correlations based on a single parameter approach and (4) describe and discuss the possible influence of audible nasal airflow and speech intelligibility on the NSI 2.0 scores.



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