{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T17:01:13Z","timestamp":1774371673691,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["DC015570"],"award-info":[{"award-number":["DC015570"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["DC020349"],"award-info":[{"award-number":["DC020349"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["DC021080"],"award-info":[{"award-number":["DC021080"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Auditory\u2010perceptual evaluations of dysphonia, though essential for comprehensive voice evaluation, are subject to listener bias. Knowledge of an underlying voice disorder can influence auditory\u2010perceptual 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\u2010perceptual ratings for dysphonic speakers. The purpose of this work was to determine the impact of a foreign language accent on experts' auditory\u2010perceptual ratings of dysphonic speakers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twelve voice\u2010specializing 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\u2010effects models assessed the impact of a foreign language accent on expert auditory\u2010perceptual ratings of the overall severity of dysphonia, roughness, breathiness, and strain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The twelve raters demonstrated good inter\u2010 and intra\u2010rater reliability (ICC[3, <jats:italic>k<\/jats:italic>]\u2009=\u2009.89; mean ICC\u2009=\u2009.89). The linear mixed\u2010effects models revealed no significant impact of foreign language accent on ratings of overall severity of dysphonia, roughness, breathiness, or strain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite the possibility of increased listener effort and bias, foreign language accent incongruence had no effect on expert listeners' auditory\u2010perceptual evaluations for dysphonic speakers. Findings support the use of auditory\u2010perceptual evaluations for voice disorders across sociolinguistically diverse populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:2272\u20132276, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31160","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T11:33:43Z","timestamp":1699529623000},"page":"2272-2276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Foreign Language Accent on Expert Listeners' Auditory\u2010Perceptual Evaluations of Dysphonia"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5483-3794","authenticated-orcid":false,"given":"Katherine L.","family":"Marks","sequence":"first","affiliation":[{"name":"Speech, Language, and Hearing Sciences Boston University  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly L.","family":"Dahl","sequence":"additional","affiliation":[{"name":"Speech, Language, and Hearing Sciences Boston University  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara E.","family":"Stepp","sequence":"additional","affiliation":[{"name":"Speech, Language, and Hearing Sciences and Biomedical Engineering Boston University  Boston Massachusetts USA"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Boston University School of Medicine  Boston Massachusetts USA"},{"name":"Department of Biomedical Engineering Boston University  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"353","volume-title":"Bias in psychotherapy","author":"Lopez S"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2009.12.009"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0258-5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300621"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(00)00352-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejsp.862"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/002383099503800305"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2017.12.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0095-4470(19)30265-7"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000525649"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1006\/jpho.2001.0147"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.386168"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1075\/rllt.11.09kim"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000119746"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000518206"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000070726"},{"key":"e_1_2_9_18_1","unstructured":"American Speech\u2010Language\u2010Hearing Association.Code of Ethics [Ethics].2023. 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