Toward Enhanced Voice-Related Self-Reports: Translation, Cross-Cultural Adaptation, and Validity

Charles J. Nudelman, Pasquale Bottalico, Miriam van Mersbergen, Chaya Nanjundeswaran

Research output: Contribution to journalArticlepeer-review


Purpose: This article provides a commentary on voice-related self-reports and presents various shortcomings endemic in the development and validation of these measures. Emphasis is placed on issues of construct validity, translation, and cross-cultural adaptation. Finally, a demonstration is provided to elucidate the importance of cross-cultural adaptation. Methods: An example of a voice-related self-report that lacks cross-cultural adaptation is provided, and a linguistic translation and cross-cultural adaptation process is outlined and demonstrated. A bilingual voice scientist, a bilingual speech-language pathologist (SLP), and two experts in voice-related self-reports completed a multistep linguistic translation and cross-cultural adaptation process and obtained back-translations from five SLPs native to the self-report's source culture. Results: Analyses of the back-translations demonstrated that the mean BiLingual Evaluation Understudy (BLEU) scores of the adapted items were higher overall than the back-translations of the original English items. Conclusions: Unvalidated translations of voice-related self-reports are commonly used as a baseline to further translate the measure, and this deteriorates cross-cultural health equity. Cross-cultural adaptation is a crucial, but often overlooked process when translating and adapting self-reports. The present article calls for standardized methodologies with an emphasis on the necessity of careful translation methods and cultural adaptation processes.

Original languageEnglish (US)
JournalJournal of Voice
StateAccepted/In press - 2024


  • Cultural adaptation
  • Self-reports
  • Translation
  • Voice assessment

ASJC Scopus subject areas

  • Speech and Hearing
  • LPN and LVN
  • Otorhinolaryngology


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