No AccessAmerican Journal of Speech-Language PathologyResearch Article17 May 2017

The Effect of Information and Severity on Perception of Speakers With Adductor Spasmodic Dysphonia


    The purpose of this study was to examine the effect of severity of adductor spasmodic dysphonia (ADSD) and information about it on unfamiliar listeners' attitudes about speakers' personal characteristics, perceived vocal effort, and listener comfort on the basis of ratings of speech recordings.


    Fifteen women with ADSD and 5 controls provided speech samples. Forty-five unfamiliar listeners were randomized into 3 groups. Listeners in Group 1 received no information, listeners in Group 2 were told that some speakers had voice disorders or had no voice concerns, and listeners in Group 3 were provided diagnostic labels for each speaker and information about ADSD. Listeners then rated speech samples for attitudes, perceived vocal effort, and listener comfort.


    Speakers with ADSD were judged significantly worse than controls for attitudes related to “social desirability” and “intellect.” There was no effect of severity on “personality” attributes. However, provision of a diagnostic label resulted in significantly more favorable personality ratings than when no label was provided. Perceived vocal effort and comfort became significantly more negative as ADSD severity increased. Finally, most listener ratings were unaffected by provision of additional information about ADSD.


    Listeners' perceptions about speakers with ADSD are difficult to change. Directions for counseling and public education need future study.


    • Altenberg, E. P., & Ferrand, C. T. (2006). Perception of individuals with voice disorders by monolingual English, bilingual Cantonese-English, and bilingual Russian-English women.Journal of Speech, Language, and Hearing Research, 49, 879–887. doi:10.1044/1092-4388(2006/063)
    • American Speech-Language-Hearing Association. (2007). Scope of practice in speech-language pathology. Retrieved from
    • Amir, O., & Levine-Yundof, R. (2013). Listeners' attitude toward people with dysphonia.Journal of Voice, 27, 524.e1–524.e10. doi:10.1016/j.jvoice.2013.01.015
    • Anthony, W. A. (1972). Societal rehabilitation: Changing society's attitudes toward the physically and mentally disabled.Rehabilitation Psychology, 19, 117–126.
    • Bartlett, M. S. (1951). A further note on tests of significance in factor analysis.British Journal of Psychology (Statistical Section), 4, 1–2.
    • Baylor, C. R., Yorkston, K. M., & Eadie, T. L. (2005). The consequences of spasmodic dysphonia on communication-related quality of life: A qualitative study of the insider's experiences.Journal of Communication Disorders, 38, 395–419. doi:16/j.jcomdis.2005.03.003
    • Baylor, C. R., Yorkston, K. M., Eadie, T. L., Miller, R. M., & Amtmann, D. (2009). Developing the communicative participation item bank: Rasch analysis results from a spasmodic dysphonia sample.Journal of Speech, Language, and Hearing Research, 52, 1302–1320. doi:10.1044/1092-4388(2009/07-0275)
    • Bender, B. K., Cannito, M. P., Murry, T., & Woodson, G. E. (2004). Speech intelligibility in severe adductor spasmodic dysphonia.Journal of Speech, Language, and Hearing Research, 47, 21–32. doi:10.1044/1092-4388(2004/003)
    • Blackman, M. C. (2002). The employment interview via the telephone: Are we sacrificing accurate personality judgments for cost efficiency?.Journal of Research in Personality, 36, 208–223.
    • Blood, G. W., Mahan, B. W., & Hyman, M. (1979). Judging personality and appearance from voice disorders.Journal of Communication Disorders, 12, 63–67. doi:16/0021-9924(79)90022-4
    • Cannito, M. P., Burch, A. R., Watts, C., Rappold, P. W., Hood, S. B., & Sherrard, K. (1997). Disfluency in spasmodic dysphonia: A multivariate analysis.Journal of Speech, Language, and Hearing Research, 40, 627–641.
    • Cannito, M. P., Doiuchi, M., Murry, T., & Woodson, G. E. (2012). Perceptual structure of adductor spasmodic dysphonia and its acoustic correlates.Journal of Voice, 26, 818.e5–818.e13. doi:10.1016/j.jvoice.2012.05.005
    • Cannito, M. P., Murry, T., & Woodson, G. E. (1994). Attitudes toward communication in adductor spasmodic dysphonia before and after botulinum toxin injections.Journal of Medical Speech-Language Pathology, 2, 125–133.
    • Dampier, K., Dancer, J., & Keiser, H. (1985). Changing attitudes toward older persons with hearing loss: Comparison of two audiotapes.American Annals of the Deaf, 130, 267–271.
    • Duffy, J. R., & Yorkston, K. M. (2003). Medical interventions for spasmodic dysphonia and some related conditions: A systematic review.Journal of Medical Speech-Language Pathology, 11(4), 1–50.
    • Eadie, T. L., Kapsner, M., Rosenzweig, J., Waugh, P., Hillel, A., & Merati, A. (2010). The role of experience on judgments of dysphonia.Journal of Voice, 24, 563–573. doi:10.1016/j.jvoice.2008.12.005
    • Eadie, T. L., Nicolici, C., Baylor, C., Almand, K., Waugh, P., & Maronian, N. (2007). Effect of experience on judgments of adductor spasmodic dysphonia.Annals of Otology, Rhinology & Laryngology, 116, 695–701.
    • Eadie, T., Sroka, A., Wright, D. R., & Merati, A. (2011). Does knowledge of medical diagnosis bias auditory-perceptual judgments of dysphonia?.Journal of Voice, 25, 420–429. doi:16/j.jvoice.2009.12.009
    • Fairbanks, G. (1960). Voice and articulation drill book (2nd ed.). New York: Harper and Row.
    • Flamer, S. (1983). Assessment of the multitrait-multimethod matrix validity of Likert scales via confirmatory factor analysis.Multivariate Behavioral Research, 18, 275–308.
    • Funke, F., & Reips, U. D. (2012). Why semantic differentials in web-based research should be made from visual analogue scales and not from 5-point scales.Field Methods, 24, 310–327. doi:10.1177/1525822X1244061
    • Galacek, M. T., & Neiman, G. S. (1994, November). Listeners' perceptions of females with hoarse and normal voice quality. Paper presented at the meeting of the American Speech-Language-Hearing Association. New Orleans, LA.
    • Gilmore, S. I. (1974). Social and vocational acceptability of esophageal speakers compared to normal speakers.Journal of Speech and Hearing Research, 17, 599–607.
    • Gorenflo, C. W., & Gorenflo, D. W. (1991). The effects of information and augmentative communication technique on attitudes toward nonspeaking individuals.Journal of Speech and Hearing Research, 31, 19–26.
    • Hebl, M. R., & Kleck, R. E. (2002). Acknowledging one's stigma in the interview setting: Effective strategy or liability?.Journal of Applied Social Psychology, 32, 223–249.
    • Isetti, D., & Eadie, T. L. (2016) The Americans with Disabilities Act and voice disorders: Practical guidelines for voice clinicians.Journal of Voice, 30, 293–300. doi:
    • Isetti, D., Xuereb, L., & Eadie, T. L. (2014). Inferring speaker attributes in adductor spasmodic dysphonia: Ratings from unfamiliar listeners.American Journal of Speech-Language Pathology, 23, 134–145. doi:10.1044/2013_AJSLP-13-0010
    • Jenkins, J. J., Russell, W. A., & Suci, G. J. (1958). An atlas of semantic profiles for 300 words.American Journal of Psychology, 71, 688–699.
    • Kaiser, H. F. (1958). The varimax criterion for analytic rotation in factor analysis.Psychometrika, 23, 187–200.
    • Kaiser, H. F. (1970). A second generation little jiffy.Psychometrika, 35, 401–415.
    • Karnell, M. P., Melton, S. D., Childes, J. M., Coleman, T. C., Dailey, S. A., & Hoffman, H. T. (2007). Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders.Journal of Voice, 21, 576–590. doi:10.1016/j.jvoice.2006.05.001
    • Kempster, G. B., Gerratt, B. R., Verdolini Abbott, K., Barkmeier-Kraemer, J., & Hillman, R. E. (2009). Consensus auditory-perceptual evaluation of voice: Development of a standardized clinical protocol.American Journal of Speech-Language Pathology, 18, 124–132.
    • Lallh, A. K., & Rochet, A. P. (2000). The effect of information on listeners' attitudes toward speakers with voice or resonance disorders.Journal of Speech, Language, and Hearing Research, 43, 782–795.
    • Lass, N. J., Ruscello, D. M., Bradshaw, K. H., & Blankenship, B. L. (1991). Adolescents' perceptions of normal and voice-disordered children.Journal of Communication Disorders, 24, 267–274. doi:16/0021-9924(91)90002-Z
    • Lopez, S. (1989). Patient variable biases in clinical judgment: Conceptual overview and methodological considerations.Psychological Bulletin, 106, 184–203.
    • Ma, E. P.-M., & Yu, C. H.-W. (2013). Listeners' attitudes towards children with voice disorders.Journal of Speech, Language, and Hearing Research, 56, 1409–1414. doi:10.1044/1092-4388(2013/11-0242)
    • Nagle, K. F., Eadie, T. L., & Yorkston, K. M. (2015). Everyday listeners' perceptions of speech produced by individuals with adductor spasmodic dysphonia (ADSD).Journal of Communication Disorders, 58, 1–13. doi:10.1016/j.jcomdis.2015.07.001
    • Nunnally, J. C. (1970). Psychometric theory. New York, NY: McGraw Hill.
    • O'Brian, S., Packman, A., Onslow, M., Cream, A., O'Brian, N., & Bastock, K. (2003). Is listener comfort a viable construct in stuttering research?.Journal of Speech, Language, and Hearing Research, 46, 503–509.
    • Osgood, C. E., Suci, G. J., & Tannenbaum, P. H. (1957). The measurement of meaning. Urbana: University of Illinois Press.
    • Panico, J., Healey, E. C., Brouwer, K., & Susca, M. (2005). Listener perceptions of stuttering across two presentation modes: A quantitative and qualitative approach.Journal of Fluency Disorders, 30(1), 65–85.
    • Pearson, E., & Sapienza, C. (2003). Historical approaches to the treatment of adductor-type spasmodic dysphonia (ADSD): Review and tutorial.NeuroRehabilitation, 18, 325–338.
    • Pitman, M. (2011). Spasmodic dysphonia. Retrieved from
    • Rankin, G., & Stokes, M. (1998). Statistical analysis of reliability studies.Clinical Rehabilitation, 12, 187–199.
    • Rosenthal, R. (1966). Experimenter effects in behavioral research. New York, NY: Appleton-Century-Crofts.
    • Ruscello, D. M., & Lass, N. J. (1996, November). Attitudes toward dysarthria: Examination of an educational training program. Paper presented at the meeting of the American Speech-Language-Hearing Association, Seattle, WA.
    • Ruscello, D. M., Lass, N. J., & Podbesek, J. (1988). Listeners' perceptions of normal and voice-disordered children.Folia Phoniatrica, 40, 290–296.
    • Silverman, F. H., & Hummer, K. (1989). Spastic dysphonia: A fluency disorder?.Journal of Fluency Disorders, 14, 285–291. doi:16/0094-730X(89)90011-9
    • Smith, E. S., Verdolini, K., Gray, S., Nichols, S., Lemke, J., Barkmeier, J., & Hoffman, H. (1996). Effect of voice disorders on quality of life.Journal of Medical Speech-Language Pathology, 4, 223–244.
    • Titze, I. (1995). Workshop on acoustic voice analysis.National Center for Voice and Speech, 1–36.
    • Triandis, H. C. (1971). Attitude and attitude change. New York, NY: John Wiley & Sons.
    • Verhagen, T., van den Hooff, B., & Meents, S. (2015). Toward a better use of the semantic differential in IS research: An integrative framework of suggested action.Journal of the Association for Information Systems, 16, 108–143.
    • Wright, B. A. P. (1960). Physical disability—A psychological approach. New York, NY: Harper.
    • Yuker, H. E., & Block, J. R. (1979). Challenging barriers to change: Attitudes towards the disabled. Albertson, NY: Human Resources Center.
    • Zacharias, S. R., Kelchner, L. N., & Creaghead, N. (2013). Teachers' perceptions of adolescent females with voice disorders.Language, Speech, and Hearing Services in the Schools, 44, 174–182. doi:10.1044/0161-1461(2012/11-0097)

    Additional Resources