无需参考语音即可评估发音严重程度，且抗噪能力强。

Speech severity evaluation is becoming increasingly important as the economic burden of speech disorders grows. Current speech severity models often struggle with generalization, learning dataset-specific acoustic cues rather than meaningful correlates of speech severity. Furthermore, many models require reference speech or a transcript, limiting their applicability in ecologically valid scenarios, such as spontaneous speech evaluation. Previous research indicated that automatic speech naturalness evaluation scores correlate strongly with severity evaluation scores, leading us to explore a reference-free method, SpeechLMScore, which does not rely on pathological speech data. Additionally, we present the NKI-SpeechRT dataset, based on the NKI-CCRT dataset, to provide a more comprehensive foundation for speech severity evaluation. This study evaluates whether SpeechLMScore outperforms traditional acoustic feature-based approaches and assesses the performance gap between reference-free and reference-based models. Moreover, we examine the impact of noise on these models by utilizing subjective noise ratings in the NKI-SpeechRT dataset. The results demonstrate that SpeechLMScore is robust to noise and offers superior performance compared to traditional approaches.