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Pediatric Auditory-Perceptual Evaluation of Voice Part 2: A Protocol
Robert Brinton Fujiki1, Sijia Huang2, Rebecca Johnson3
1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.
Journal of Speech, Language, and Hearing Research : JSLHR
|August 14, 2026
Summary
The Pediatric Auditory-Perceptual Evaluation of Voice (PAPE-V) protocol offers reliable voice assessments for children. This validated tool uses either visual analog scales or Likert scales, enhancing pediatric voice evaluation efficiency.
Area of Science:
- Speech-language pathology
- Pediatric audiology
- Voice science
Background:
- Auditory-perceptual voice assessments are vital for children's voice evaluation.
- No standardized protocol currently exists for pediatric auditory-perceptual voice assessment.
- Establishing a reliable protocol is crucial for consistent and accurate diagnosis.
Purpose of the Study:
- To create and validate the Pediatric Auditory-Perceptual Evaluation of Voice (PAPE-V) protocol.
- To assess the influence of scale type (visual analog vs. Likert) on rating reliability.
- To examine the impact of child demographics on voice rating reliability.
Main Methods:
- Ten specialist speech-language pathologists rated voice samples from 102 children (ages 3-17).
- Ratings included overall quality, breathiness, roughness, strain, pitch, and loudness using visual analog scales (VASs) or Likert scales.
- Interrater and intrarater reliability were calculated using intraclass correlation coefficients (ICCs) and Krippendorff's alphas, comparing scale types and demographics.
Main Results:
- High interrater and intrarater reliabilities were observed across all conditions for the PAPE-V protocol.
- Overall voice quality demonstrated the highest reliability (Likert ICC = .97, VAS ICC = .96).
- Reliability was significantly higher for children with voice disorders and those younger than 6 years.
Conclusions:
- The PAPE-V protocol provides a reliable method for auditory-perceptual voice assessment in children.
- Both visual analog scales (VASs) and Likert scales are effective for use with the PAPE-V protocol.
- The PAPE-V protocol enhances the reliability and efficiency of pediatric voice assessments.
