Hearing and Believing: Some Limits to the Auditory-Perceptual Assessment of Speech and Voice Disorders

American Journal of Speech-Language Pathology • Vol. 5 • 1058-0360/96/0503-0007 © American Speech-Language-Hearing Association The ear is the essential tool of the speech-language pathologist. Auditory-perceptual judgments are typically the final arbiter in clinical decisionmaking and often provide the standards against which instrumental (so-called “objective”) measures are evaluated. Although it is difficult to know the exact degree of clinicians’ reliance on auditory-perceptual methods, surveys of selected clinical centers indicate that these methods are used frequently and valued highly (Gerratt, Till, Rosenbek, Wertz, & Boysen, 1991). In addition, for many disorders, or for some components of complex communicative disorders, auditory-perceptual judgment is the primary (if not singular) means for evaluating the outcome of an intervention program. As McCauley (1989) observed, measurement of some kind guides decisions at every step of the clinical process, including assessment, intervention, termination of treatment, and follow-up. Because of the critical importance of auditory perception in clinical practice, speech-language clinicians should be keenly aware of the strengths and weaknesses of auditoryperceptual judgments of speech. If shortcomings are identified, it is important to ask: