Are Auditory-Perceptual Evaluations of Dysphonia by Experienced Voice Clinicians Affected by Knowledge of Speaker Race?

Purpose: The purpose of this study was to investigate implicit racial bias in auditory-perceptual evaluations of dysphonic voices completed by experienced voice-focused speech-language pathologists (SLPs).

Method: Thirty SLPs specializing in voice disorders listened to audio files of 20 Black speakers and 20 White speakers of General American English with voice disorders. The SLPs rated the overall severity of dysphonia (OS) of each voice heard using a 100-unit visual analog scale and then completed the Harvard Implicit Association Test (IAT) to estimate their implicit racial bias.

Results: There were no significant main effects of speaker race or labeled race on OS ratings; however, there was a small but significant interaction effect between them: Race labeling resulted in a minimizing effect for Black speakers, but not White speakers. No significant relationship was found between Harvard IAT scores and differences in OS ratings by race-labeling condition.

Conclusions: These findings suggest that experienced, voice-focused SLPs demonstrated a minimizing bias in their auditory-perceptual ratings of dysphonia of Black speakers. This bias is small and may not be clinically significant but, in some cases, could contribute to worse clinical care of Black people with voice disorders.