AMA Criteria for Impairment Associated with Voice or Speech Disorders

Audibility

Percent Voice or Speech Impairment

speech intensity sufficient for most needs of everyday speech; may sometimes require effort; effort may sometimes be beyond the person's capacity

0 – 14%

speech intensity sufficient for many needs of everyday speech; sufficient to be heard under average conditions; may have difficulty being heard in noisy places

15 – 34%

speech intensity sufficient for some needs such as a close conversation; difficulty experienced with noisy places or conversations at a distance; voice may tire easily or become inaudible after a few seconds

35 – 59%

speech intensity sufficient for a few needs of everyday speech; can barely be heard by a close listener or over the telephone; may be able to whisper audibly if there is no background noise

60 – 84%

unable to meet any demands

85 – 100%

Intelligibility

Percent Voice or Speech Impairment

articulation sufficient for most needs of everyday speech; may be asked to repeat words; producing some phonetic units may be difficult or impossible

0 – 14%

articulation sufficient for many needs; can be understood by a stranger; may have many inaccuracies; may sometimes appear to have difficulty articulating

15 – 34%

articulation sufficient for some needs; can usually converse with family or friends; may be understood by strangers only with difficulty; may be asked to repeat words or phrases

35 – 59%

articulation sufficient for few tasks; can produce some phonetic units; may be able to produce approximations for a few words; unintelligible out of context

60 – 84%

unable to meet any demands

85 – 100%

Functional Efficiency

Percent Voice or Speech Impairment

speech articulation and phonation has adequate speed and ease for most demands; may occasionally hesitate or speak slowly

0 – 14%

speech adequate for many demands of everyday speech; sometimes may speak with difficulty or speech may be discontinuous; speech may be interrupted, hesitant, or slow

15 – 34%

speech adequate for some demands; consecutive speech limited to brief periods; speech may seem easily fatigued

35 – 59%

speech adequate for few demands; may be limited to single words or short phrases; unable to maintain uninterrupted speech; speech is labored and impractically slow

60 – 84%

unable to meet any demands

85 – 100%

Impairment in Voice or Speech

Impairment of Whole Person

0%

0%

5%

2%

10%

4%

15%

5%

20%

7%

25%

9%

30%

10%

35%

12%

40%

14%

45%

16%

50%

18%

55%

19%

60%

21%

65%

23%

70%

24%

75%

26%

80%

28%

85%

30%

90%

32%

95%

33%

100%

35%