GRBAS Scale GradeRoughnessBreathinessAstheniaStrain The 5 categories above are used to grade voice. Each category is given a score where 0 = normal, 1 = mild, 2= moderate, and 3 = severe. Original article by Hirano 1981. Nemr K, Simões-zenari M, Cordeiro GF, et al. GRBAS and Cape-V scales: high reliability and consensus when applied at different times. J Voice. 2012;26(6):812.e17-22.