Employer Detection of Spasmodic Dysphonia Across Varying Severity Levels

Document Type


Conference Title/Conference Publication

45th Annual Voice Foundation Symposium


The Voice Foundation


Philadelphia, PA

Conference Dates

June 1, 2016 - June 5, 2016

Date of Presentation



Objective: To determine the ability of human resources personnel (HRP) with experience in phone interviews to detect the presence or absence of adductor spasmodic dysphonia (ADSD) in potential applicants via auditory stimuli alone.

Methods/Design: Thirty HRP were exposed to a brief definition of ADSD. They subsequently performed an auditory-perceptual task in which they were asked to detect the presence of the voice disorder in 20 speakers with ADSD and 20 age- and gender-matched controls. ADSD samples were categorized a priori as perceptually within normal limits (WNL) to mild, moderate, or severe. Frequency counts and percentages were calculated for each speaker that was correctly and incorrectly identified as having ADSD. Mean accuracy ratings, and positive and negative likelihood ratios (LR+ and LR-) also were determined. Accuracy scores were grouped according to severity for ADSD speakers.

Results:On average, listeners were 78.83% accurate in discriminating ADSD speakers, and 90.17% in discriminating controls. Based on group averages, 16 speakers with ADSD were correctly identified as having ADSD, and 4 were incorrectly identified as control speakers (sensitivity = 0.80 or 80%). Based on group averages, 20 out of 20 control speakers were correctly identified as not having a voice disorder(specificity = 1.0 or 100%).HRP were accurate at determining ADSD from 87%-100% of the time for perceptually severe ADSD speakers. In moderate cases, accuracy fell between 77%-100%, and dropped between 10% to 87% accurate for mild speakers. Differences related to severity were statistically significant.

Conclusions: Results suggest that job applicants with more severe forms of ADSD may not be able to escape detection during phone interviews. However, those with mild symptoms may not be identified as having voice disorders.

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