The Impact of Foreign Language Accent on Expert Listeners' Auditory-Perceptual Evaluations of Dysphonia

Introduction: Auditory-perceptual evaluations of dysphonia, though essential for comprehensive voice evaluation, are subject to listener bias. Knowledge of an underlying voice disorder can influence auditory-perceptual ratings. Accented speech results in increased listener effort and delays in word identification. Yet, little is known about the impact of foreign language accents on auditory-perceptual ratings for dysphonic speakers. The purpose of this work was to determine the impact of a foreign language accent on experts' auditory-perceptual ratings of dysphonic speakers.Methods: Twelve voice-specializing SLPs who spoke with a General American English (GAE) accent rated vocal percepts of 28 speakers with a foreign language accent and 28 with a GAE accent, all of whom had been diagnosed with a voice disorder. Speaker groups were matched based on sex, age, and mean smoothed cepstral peak prominence. Four linear mixed-effects models assessed the impact of a foreign language accent on expert auditory-perceptual ratings of the overall severity of dysphonia, roughness, breathiness, and strain.Results: The twelve raters demonstrated good inter- and intra-rater reliability (ICC[3, k] = .89; mean ICC = .89). The linear mixed-effects models revealed no significant impact of foreign language accent on ratings of overall severity of dysphonia, roughness, breathiness, or strain.Conclusion: Despite the possibility of increased listener effort and bias, foreign language accent incongruence had no effect on expert listeners' auditory-perceptual evaluations for dysphonic speakers. Findings support the use of auditory-perceptual evaluations for voice disorders across sociolinguistically diverse populations.