## 2 Methods  
Participant Speakers: The participant speakers included 20 male adults who had undergone total laryngectomy and TE puncture voice restoration (mean age = 62.6 years age, range 57 to 71); all were at least 12 months postlaryngectomy and had successfully used TE speech as their primary method of verbal communication for at least 12 months post-TE puncture at the time of speech sample collection. All participant speakers were native English speakers and none had used TE speech for longer than 8 years at the time of voice sample recording. Prior to their participation, all the speakers had passed a bilateral, pure-tone audiometric hearing screening at \(\leq\)30 dBHL for the octave frequencies 250-2000 Hz. Prior to consideration as potential participant speakers, all were judged by two independent raters who were familiar with this method of postlaryngectomy voice and speech rehabilitation to exhibit good-to-excellent levels of speech intelligibility as we desired to reduce any potential influence of poor speech intelligibility on assessments of OS and LC. Prior to obtaining voice sample recordings, all the participant speakers provided their informed consent as per the regulations of the research ethics board specific to this project. Participant Listeners: Fifty-one normal-hearing young adults (46 females, 5 males; mean age = 22.3 years; range = 20; 9 years to 31; 1 years) served as listeners; all participant listeners were considered to be naive based on the fact that none had any formal education about voice disorders or postlaryngectomy voice and speech rehabilitation, nor had they had prior exposure to this clinical population. Listeners were native English speakers and all indicated that they had no history of speech, language, and/or hearing difficulties prior to their participation in the study. All listeners passed a pure-tone hearing screening at 20 dB for the octave frequencies 500, 1000, and 2000 Hz prior to their participation. Potential participant listeners who were less than 20 years of age or older than 35 years of age, or those who failed the hearing screening were excluded from consideration. Prior to their participation in the auditory-perceptual phase, all the participant speakers provided their informed consent as per the regulations of the research ethics board. Auditory-Perceptual Stimuli and Stimulus Preparation: Each speaker recorded the experimental stimuli used in this study as part of a larger, standard voice sample recording protocol. All speaker samples were recorded digitally at a sampling rate of 44 KHz using _SonaSpeech II_ ([PERSON], Montvale, NJ, USA) under identical conditions in a professional recording environment that was free of ambient noise. Participant speakers represented a range of TE voice qualities and demonstrated substantial interspeaker variability to increase the likelihood that each perceptual dimension under study would be scaled along the breadth of its psychophysical continuum during the psychophysical experimental rating task [25; 26]. For the auditory-perceptual phase of the study, the second sentence of the Rainbow Passage [27] was extracted (i.e., _\"The rainbow is a division of white light into many beautiful colors\"_). Once these sentences were extracted, the experimental listening task was constructed to consist of 25 speech samples; these stimuli represented 20 original speaker samples plus five duplicated samples which were included to assess both intra- and inter-rater agreement. Listening Procedure. Two auditory-perceptual dimensions, OS and LO, were evaluated in this study. The order of speaker samples presented in all listening tasks (i.e., for both assessments of OS and LO), including the reliability samples, was randomized for both perceptual dimensions and for every participant listener. Ratings of the two dimensions were separated by 5-7 days to control for potential learning effects; thus, OS and LO were presented in a counterbalanced manner across two sessions.