Daily Papers

Parameter-efficient fine-tuning (PEFT) for personalizing automatic speech recognition (ASR) has recently shown promise for adapting general population models to atypical speech. However, these approaches assume a priori knowledge of the atypical speech disorder being adapted for -- the diagnosis of which requires expert knowledge that is not always available. Even given this knowledge, data scarcity and high inter/intra-speaker variability further limit the effectiveness of traditional fine-tuning. To circumvent these challenges, we first identify the minimal set of model parameters required for ASR adaptation. Our analysis of each individual parameter's effect on adaptation performance allows us to reduce Word Error Rate (WER) by half while adapting 0.03% of all weights. Alleviating the need for cohort-specific models, we next propose the novel use of a meta-learned hypernetwork to generate highly individualized, utterance-level adaptations on-the-fly for a diverse set of atypical speech characteristics. Evaluating adaptation at the global, cohort and individual-level, we show that hypernetworks generalize better to out-of-distribution speakers, while maintaining an overall relative WER reduction of 75.2% using 0.1% of the full parameter budget.

The performance of Automatic Speech Recognition (ASR) systems has constantly increased in state-of-the-art development. However, performance tends to decrease considerably in more challenging conditions (e.g., background noise, multiple speaker social conversations) and with more atypical speakers (e.g., children, non-native speakers or people with speech disorders), which signifies that general improvements do not necessarily transfer to applications that rely on ASR, e.g., educational software for younger students or language learners. In this study, we focus on the gap in performance between recognition results for native and non-native, read and spontaneous, Swedish utterances transcribed by different ASR services. We compare the recognition results using Word Error Rate and analyze the linguistic factors that may generate the observed transcription errors.

Background:Speech patterns have emerged as potential diagnostic markers for conditions with varying etiologies. Machine learning (ML) presents an opportunity to harness these patterns for accurate disease diagnosis. Objective: This review synthesized findings from studies exploring ML's capability in leveraging speech for the diagnosis of neurological, laryngeal and mental disorders. Methods: A systematic examination of 564 articles was conducted with 91 articles included in the study, which encompassed a wide spectrum of conditions, ranging from voice pathologies to mental and neurological disorders. Methods for speech classifications were assessed based on the relevant studies and scored between 0-10 based on the reported diagnostic accuracy of their ML models. Results: High diagnostic accuracies were consistently observed for laryngeal disorders, dysarthria, and changes related to speech in Parkinsons disease. These findings indicate the robust potential of speech as a diagnostic tool. Disorders like depression, schizophrenia, mild cognitive impairment and Alzheimers dementia also demonstrated high accuracies, albeit with some variability across studies. Meanwhile, disorders like OCD and autism highlighted the need for more extensive research to ascertain the relationship between speech patterns and the respective conditions. Conclusion: ML models utilizing speech patterns demonstrate promising potential in diagnosing a range of mental, laryngeal, and neurological disorders. However, the efficacy varies across conditions, and further research is needed. The integration of these models into clinical practice could potentially revolutionize the evaluation and diagnosis of a number of different medical conditions.

It is widely accepted that information derived from analyzing speech (the acoustic signal) and language production (words and sentences) serves as a useful window into the health of an individual's cognitive ability. In fact, most neuropsychological testing batteries have a component related to speech and language where clinicians elicit speech from patients for subjective evaluation across a broad set of dimensions. With advances in speech signal processing and natural language processing, there has been recent interest in developing tools to detect more subtle changes in cognitive-linguistic function. This work relies on extracting a set of features from recorded and transcribed speech for objective assessments of speech and language, early diagnosis of neurological disease, and tracking of disease after diagnosis. With an emphasis on cognitive and thought disorders, in this paper we provide a review of existing speech and language features used in this domain, discuss their clinical application, and highlight their advantages and disadvantages. Broadly speaking, the review is split into two categories: language features based on natural language processing and speech features based on speech signal processing. Within each category, we consider features that aim to measure complementary dimensions of cognitive-linguistics, including language diversity, syntactic complexity, semantic coherence, and timing. We conclude the review with a proposal of new research directions to further advance the field.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Several studies have shown that speech and language features, automatically extracted from clinical interviews or spontaneous discourse, have diagnostic value for mental disorders such as schizophrenia and bipolar disorder. They typically make use of a large feature set to train a classifier for distinguishing between two groups of interest, i.e. a clinical and control group. However, a purely data-driven approach runs the risk of overfitting to a particular data set, especially when sample sizes are limited. Here, we first down-select the set of language features to a small subset that is related to a well-validated test of functional ability, the Social Skills Performance Assessment (SSPA). This helps establish the concurrent validity of the selected features. We use only these features to train a simple classifier to distinguish between groups of interest. Linear regression reveals that a subset of language features can effectively model the SSPA, with a correlation coefficient of 0.75. Furthermore, the same feature set can be used to build a strong binary classifier to distinguish between healthy controls and a clinical group (AUC = 0.96) and also between patients within the clinical group with schizophrenia and bipolar I disorder (AUC = 0.83).

Automatic speech recognition (ASR) for pathological speech remains underexplored, especially for Huntington's disease (HD), where irregular timing, unstable phonation, and articulatory distortion challenge current models. We present a systematic HD-ASR study using a high-fidelity clinical speech corpus not previously used for end-to-end ASR training. We compare multiple ASR families under a unified evaluation, analyzing WER as well as substitution, deletion, and insertion patterns. HD speech induces architecture-specific error regimes, with Parakeet-TDT outperforming encoder-decoder and CTC baselines. HD-specific adaptation reduces WER from 6.99% to 4.95% and we also propose a method for using biomarker-based auxiliary supervision and analyze how error behavior is reshaped in severity-dependent ways rather than uniformly improving WER. We open-source all code and models.

The rapid advancements in speech technologies over the past two decades have led to human-level performance in tasks like automatic speech recognition (ASR) for fluent speech. However, the efficacy of these models diminishes when applied to atypical speech, such as stuttering. This paper introduces AS-70, the first publicly available Mandarin stuttered speech dataset, which stands out as the largest dataset in its category. Encompassing conversational and voice command reading speech, AS-70 includes verbatim manual transcription, rendering it suitable for various speech-related tasks. Furthermore, baseline systems are established, and experimental results are presented for ASR and stuttering event detection (SED) tasks. By incorporating this dataset into the model fine-tuning, significant improvements in the state-of-the-art ASR models, e.g., Whisper and Hubert, are observed, enhancing their inclusivity in addressing stuttered speech.

Autism spectrum disorder (ASD) is a prevalent psychiatric condition characterized by atypical cognitive, emotional, and social patterns. Timely and accurate diagnosis is crucial for effective interventions and improved outcomes in individuals with ASD. In this study, we propose a novel Multi-Atlas Enhanced Transformer framework, METAFormer, ASD classification. Our framework utilizes resting-state functional magnetic resonance imaging data from the ABIDE I dataset, comprising 406 ASD and 476 typical control (TC) subjects. METAFormer employs a multi-atlas approach, where flattened connectivity matrices from the AAL, CC200, and DOS160 atlases serve as input to the transformer encoder. Notably, we demonstrate that self-supervised pretraining, involving the reconstruction of masked values from the input, significantly enhances classification performance without the need for additional or separate training data. Through stratified cross-validation, we evaluate the proposed framework and show that it surpasses state-of-the-art performance on the ABIDE I dataset, with an average accuracy of 83.7% and an AUC-score of 0.832. The code for our framework is available at https://github.com/Lugges991/METAFormer

Automatic anonymization techniques are essential for ethical sharing of pathological speech data, yet their perceptual consequences remain understudied. We present a comprehensive human-centered analysis of anonymized pathological speech, using a structured protocol involving ten native and non-native German listeners with diverse linguistic, clinical, and technical backgrounds. Listeners evaluated anonymized-original utterance pairs from 180 speakers spanning Cleft Lip and Palate, Dysarthria, Dysglossia, Dysphonia, and healthy controls. Speech was anonymized using state-of-the-art automatic methods (equal error rates in the range of 30-40%). Listeners completed Turing-style discrimination and quality rating tasks under zero-shot (single-exposure) and few-shot (repeated-exposure) conditions. Discrimination accuracy was high overall (91% zero-shot; 93% few-shot), but varied by disorder (repeated-measures ANOVA: p=0.007), ranging from 96% (Dysarthria) to 86% (Dysphonia). Anonymization consistently reduced perceived quality across groups (from 83% to 59%, p<0.001), with pathology-specific degradation patterns (one-way ANOVA: p=0.005). Native listeners showed a non-significant trend toward higher original speech ratings (Delta=4%, p=0.199), but this difference was minimal after anonymization (Delta=1%, p=0.724). No significant gender-based bias was observed. Perceptual outcomes did not correlate with automatic metrics; intelligibility was linked to perceived quality in original speech but not after anonymization. These findings underscore the need for listener-informed, disorder-specific anonymization strategies that preserve both privacy and perceptual integrity.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that often emerges in early childhood. ASD assessment typically involves an observation protocol including note-taking and ratings of child's social behavior conducted by a trained clinician. A robust machine learning (ML) model that is capable of labeling adult and child audio has the potential to save significant time and labor in manual coding children's behaviors. This may assist clinicians capture events of interest, better communicate events with parents, and educate new clinicians. In this study, we leverage the self-supervised learning model, Wav2Vec 2.0 (W2V2), pretrained on 4300h of home recordings of children under 5 years old, to build a unified system that performs both speaker diarization (SD) and vocalization classification (VC) tasks. We apply this system to two-channel audio recordings of brief 3-5 minute clinician-child interactions using the Rapid-ABC corpus. We propose a novel technique by introducing auxiliary features extracted from W2V2-based automatic speech recognition (ASR) system for children under 4 years old to improve children's VC task. We test our proposed method of improving children's VC task on two corpora (Rapid-ABC and BabbleCor) and observe consistent improvements. Furthermore, we reach, or perhaps outperform, the state-of-the-art performance of BabbleCor.

This study explores voice cloning to generate synthetic speech replicating the unique patterns of individuals with dysarthria. Using the TORGO dataset, we address data scarcity and privacy challenges in speech-language pathology. Our contributions include demonstrating that voice cloning preserves dysarthric speech characteristics, analyzing differences between real and synthetic data, and discussing implications for diagnostics, rehabilitation, and communication. We cloned voices from dysarthric and control speakers using a commercial platform, ensuring gender-matched synthetic voices. A licensed speech-language pathologist (SLP) evaluated a subset for dysarthria, speaker gender, and synthetic indicators. The SLP correctly identified dysarthria in all cases and speaker gender in 95% but misclassified 30% of synthetic samples as real, indicating high realism. Our results suggest synthetic speech effectively captures disordered characteristics and that voice cloning has advanced to produce high-quality data resembling real speech, even to trained professionals. This has critical implications for healthcare, where synthetic data can mitigate data scarcity, protect privacy, and enhance AI-driven diagnostics. By enabling the creation of diverse, high-quality speech datasets, voice cloning can improve generalizable models, personalize therapy, and advance assistive technologies for dysarthria. We publicly release our synthetic dataset to foster further research and collaboration, aiming to develop robust models that improve patient outcomes in speech-language pathology.

In this paper, we introduce a zero-shot Voice Transfer (VT) module that can be seamlessly integrated into a multi-lingual Text-to-speech (TTS) system to transfer an individual's voice across languages. Our proposed VT module comprises a speaker-encoder that processes reference speech, a bottleneck layer, and residual adapters, connected to preexisting TTS layers. We compare the performance of various configurations of these components and report Mean Opinion Score (MOS) and Speaker Similarity across languages. Using a single English reference speech per speaker, we achieve an average voice transfer similarity score of 73% across nine target languages. Vocal characteristics contribute significantly to the construction and perception of individual identity. The loss of one's voice, due to physical or neurological conditions, can lead to a profound sense of loss, impacting one's core identity. As a case study, we demonstrate that our approach can not only transfer typical speech but also restore the voices of individuals with dysarthria, even when only atypical speech samples are available - a valuable utility for those who have never had typical speech or banked their voice. Cross-lingual typical audio samples, plus videos demonstrating voice restoration for dysarthric speakers are available here (google.github.io/tacotron/publications/zero_shot_voice_transfer).

Stuttering is a speech disorder where the natural flow of speech is interrupted by blocks, repetitions or prolongations of syllables, words and phrases. The majority of existing automatic speech recognition (ASR) interfaces perform poorly on utterances with stutter, mainly due to lack of matched training data. Synthesis of speech with stutter thus presents an opportunity to improve ASR for this type of speech. We describe Stutter-TTS, an end-to-end neural text-to-speech model capable of synthesizing diverse types of stuttering utterances. We develop a simple, yet effective prosody-control strategy whereby additional tokens are introduced into source text during training to represent specific stuttering characteristics. By choosing the position of the stutter tokens, Stutter-TTS allows word-level control of where stuttering occurs in the synthesized utterance. We are able to synthesize stutter events with high accuracy (F1-scores between 0.63 and 0.84, depending on stutter type). By fine-tuning an ASR model on synthetic stuttered speech we are able to reduce word error by 5.7% relative on stuttered utterances, with only minor (<0.2% relative) degradation for fluent utterances.

This paper presents a new approach for classification of dysfluent and fluent speech using Mel-Frequency Cepstral Coefficient (MFCC). The speech is fluent when person's speech flows easily and smoothly. Sounds combine into syllable, syllables mix together into words and words link into sentences with little effort. When someone's speech is dysfluent, it is irregular and does not flow effortlessly. Therefore, a dysfluency is a break in the smooth, meaningful flow of speech. Stuttering is one such disorder in which the fluent flow of speech is disrupted by occurrences of dysfluencies such as repetitions, prolongations, interjections and so on. In this work we have considered three types of dysfluencies such as repetition, prolongation and interjection to characterize dysfluent speech. After obtaining dysfluent and fluent speech, the speech signals are analyzed in order to extract MFCC features. The k-Nearest Neighbor (k-NN) and Support Vector Machine (SVM) classifiers are used to classify the speech as dysfluent and fluent speech. The 80% of the data is used for training and 20% for testing. The average accuracy of 86.67% and 93.34% is obtained for dysfluent and fluent speech respectively.

Voice disorders are pathologies significantly affecting patient quality of life. However, non-invasive automated diagnosis of these pathologies is still under-explored, due to both a shortage of pathological voice data, and diversity of the recording types used for the diagnosis. This paper proposes a novel solution that adopts transformers directly working on raw voice signals and addresses data shortage through synthetic data generation and data augmentation. Further, we consider many recording types at the same time, such as sentence reading and sustained vowel emission, by employing a Mixture of Expert ensemble to align the predictions on different data types. The experimental results, obtained on both public and private datasets, show the effectiveness of our solution in the disorder detection and classification tasks and largely improve over existing approaches.

The Norwegian Parliamentary Speech Corpus (NPSC) is a speech dataset with recordings of meetings from Stortinget, the Norwegian parliament. It is the first, publicly available dataset containing unscripted, Norwegian speech designed for training of automatic speech recognition (ASR) systems. The recordings are manually transcribed and annotated with language codes and speakers, and there are detailed metadata about the speakers. The transcriptions exist in both normalized and non-normalized form, and non-standardized words are explicitly marked and annotated with standardized equivalents. To test the usefulness of this dataset, we have compared an ASR system trained on the NPSC with a baseline system trained on only manuscript-read speech. These systems were tested on an independent dataset containing spontaneous, dialectal speech. The NPSC-trained system performed significantly better, with a 22.9% relative improvement in word error rate (WER). Moreover, training on the NPSC is shown to have a "democratizing" effect in terms of dialects, as improvements are generally larger for dialects with higher WER from the baseline system.

Speech pathology has impacts on communication abilities and quality of life. While deep learning-based models have shown potential in diagnosing these disorders, the use of sensitive data raises critical privacy concerns. Although differential privacy (DP) has been explored in the medical imaging domain, its application in pathological speech analysis remains largely unexplored despite the equally critical privacy concerns. To the best of our knowledge, this study is the first to investigate DP's impact on pathological speech data, focusing on the trade-offs between privacy, diagnostic accuracy, and fairness. Using a large, real-world dataset of 200 hours of recordings from 2,839 German-speaking participants, we observed a maximum accuracy reduction of 3.85% when training with DP with high privacy levels. To highlight real-world privacy risks, we demonstrated the vulnerability of non-private models to gradient inversion attacks, reconstructing identifiable speech samples and showcasing DP's effectiveness in mitigating these risks. To explore the potential generalizability across languages and disorders, we validated our approach on a dataset of Spanish-speaking Parkinson's disease patients, leveraging pretrained models from healthy English-speaking datasets, and demonstrated that careful pretraining on large-scale task-specific datasets can maintain favorable accuracy under DP constraints. A comprehensive fairness analysis revealed minimal gender bias at reasonable privacy levels but underscored the need for addressing age-related disparities. Our results establish that DP can balance privacy and utility in speech disorder detection, while highlighting unique challenges in privacy-fairness trade-offs for speech data. This provides a foundation for refining DP methodologies and improving fairness across diverse patient groups in real-world deployments.

Dysarthric speech quality assessment (DSQA) is critical for clinical diagnostics and inclusive speech technologies. However, subjective evaluation is costly and difficult to scale, and the scarcity of labeled data limits robust objective modeling. To address this, we propose a three-stage framework that leverages unlabeled dysarthric speech and large-scale typical speech datasets to scale training. A teacher model first generates pseudo-labels for unlabeled samples, followed by weakly supervised pretraining using a label-aware contrastive learning strategy that exposes the model to diverse speakers and acoustic conditions. The pretrained model is then fine-tuned for the downstream DSQA task. Experiments on five unseen datasets spanning multiple etiologies and languages demonstrate the robustness of our approach. Our Whisper-based baseline significantly outperforms SOTA DSQA predictors such as SpICE, and the full framework achieves an average SRCC of 0.761 across unseen test datasets.

Voice disorders significantly impact patient quality of life, yet non-invasive automated diagnosis remains under-explored due to both the scarcity of pathological voice data, and the variability in recording sources. This work introduces MVP (Multi-source Voice Pathology detection), a novel approach that leverages transformers operating directly on raw voice signals. We explore three fusion strategies to combine sentence reading and sustained vowel recordings: waveform concatenation, intermediate feature fusion, and decision-level combination. Empirical validation across the German, Portuguese, and Italian languages shows that intermediate feature fusion using transformers best captures the complementary characteristics of both recording types. Our approach achieves up to +13% AUC improvement over single-source methods.

The automatic identification and analysis of pronunciation errors, known as Mispronunciation Detection and Diagnosis (MDD) plays a crucial role in Computer Aided Pronunciation Learning (CAPL) tools such as Second-Language (L2) learning or speech therapy applications. Existing MDD methods relying on analysing phonemes can only detect categorical errors of phonemes that have an adequate amount of training data to be modelled. With the unpredictable nature of the pronunciation errors of non-native or disordered speakers and the scarcity of training datasets, it is unfeasible to model all types of mispronunciations. Moreover, phoneme-level MDD approaches have a limited ability to provide detailed diagnostic information about the error made. In this paper, we propose a low-level MDD approach based on the detection of speech attribute features. Speech attribute features break down phoneme production into elementary components that are directly related to the articulatory system leading to more formative feedback to the learner. We further propose a multi-label variant of the Connectionist Temporal Classification (CTC) approach to jointly model the non-mutually exclusive speech attributes using a single model. The pre-trained wav2vec2 model was employed as a core model for the speech attribute detector. The proposed method was applied to L2 speech corpora collected from English learners from different native languages. The proposed speech attribute MDD method was further compared to the traditional phoneme-level MDD and achieved a significantly lower False Acceptance Rate (FAR), False Rejection Rate (FRR), and Diagnostic Error Rate (DER) over all speech attributes compared to the phoneme-level equivalent.

Mental distress like depression and anxiety contribute to the largest proportion of the global burden of diseases. Automated diagnosis systems of such disorders, empowered by recent innovations in Artificial Intelligence, can pave the way to reduce the sufferings of the affected individuals. Development of such systems requires information-rich and balanced corpora. In this work, we introduce a novel mental distress analysis audio dataset DEPAC, labeled based on established thresholds on depression and anxiety standard screening tools. This large dataset comprises multiple speech tasks per individual, as well as relevant demographic information. Alongside, we present a feature set consisting of hand-curated acoustic and linguistic features, which were found effective in identifying signs of mental illnesses in human speech. Finally, we justify the quality and effectiveness of our proposed audio corpus and feature set in predicting depression severity by comparing the performance of baseline machine learning models built on this dataset with baseline models trained on other well-known depression corpora.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

In this work, we present a novel perspective on cognitive impairment classification from speech by integrating speech foundation models that explicitly recognize speech dialects. Our motivation is based on the observation that individuals with Alzheimer's Disease (AD) or mild cognitive impairment (MCI) often produce measurable speech characteristics, such as slower articulation rate and lengthened sounds, in a manner similar to dialectal phonetic variations seen in speech. Building on this idea, we introduce VoxCog, an end-to-end framework that uses pre-trained dialect models to detect AD or MCI without relying on additional modalities such as text or images. Through experiments on multiple multilingual datasets for AD and MCI detection, we demonstrate that model initialization with a dialect classifier on top of speech foundation models consistently improves the predictive performance of AD or MCI. Our trained models yield similar or often better performance compared to previous approaches that ensembled several computational methods using different signal modalities. Particularly, our end-to-end speech-based model achieves 87.5% and 85.9% accuracy on the ADReSS 2020 challenge and ADReSSo 2021 challenge test sets, outperforming existing solutions that use multimodal ensemble-based computation or LLMs.

The disparity in phonology between learner's native (L1) and target (L2) language poses a significant challenge for mispronunciation detection and diagnosis (MDD) systems. This challenge is further intensified by lack of annotated L2 data. This paper proposes a novel MDD architecture that exploits multiple `views' of the same input data assisted by auxiliary tasks to learn more distinctive phonetic representation in a low-resource setting. Using the mono- and multilingual encoders, the model learn multiple views of the input, and capture the sound properties across diverse languages and accents. These encoded representations are further enriched by learning articulatory features in a multi-task setup. Our reported results using the L2-ARCTIC data outperformed the SOTA models, with a phoneme error rate reduction of 11.13% and 8.60% and absolute F1 score increase of 5.89%, and 2.49% compared to the single-view mono- and multilingual systems, with a limited L2 dataset.

Laughing, sighing, stuttering, and other forms of paralanguage do not contribute any direct lexical meaning to speech, but they provide crucial propositional context that aids semantic and pragmatic processes such as irony. It is thus important for artificial social agents to both understand and be able to generate speech with semantically-important paralanguage. Most speech datasets do not include transcribed non-lexical speech sounds and disfluencies, while those that do are typically multi-speaker datasets where each speaker provides relatively little audio. This makes it challenging to train conversational Text-to-Speech (TTS) synthesis models that include such paralinguistic components. We thus present DisfluencySpeech, a studio-quality labeled English speech dataset with paralanguage. A single speaker recreates nearly 10 hours of expressive utterances from the Switchboard-1 Telephone Speech Corpus (Switchboard), simulating realistic informal conversations. To aid the development of a TTS model that is able to predictively synthesise paralanguage from text without such components, we provide three different transcripts at different levels of information removal (removal of non-speech events, removal of non-sentence elements, and removal of false starts), as well as benchmark TTS models trained on each of these levels.

Psychotherapy or counseling is typically conducted through spoken conversation between a therapist and a client. Analyzing the speech characteristics of psychotherapeutic interactions can help understand the factors associated with effective psychotherapy. This paper introduces CUEMPATHY, a large-scale speech dataset collected from actual counseling sessions. The dataset consists of 156 counseling sessions involving 39 therapist-client dyads. The process of speech data collection, subjective ratings (one observer and two client ratings), and transcription are described. An automatic speech and text processing system is developed to locate the time stamps of speaker turns in each session. Examining the relationships among the three subjective ratings suggests that observer and client ratings have no significant correlation, while the client-rated measures are significantly correlated. The intensity similarity between the therapist and the client, measured by the averaged absolute difference of speaker-turn-level intensities, is associated with the psychotherapy outcomes. Recent studies on the acoustic and linguistic characteristics of the CUEMPATHY are introduced.

Large language models (LLMs) chatbots like ChatGPT are increasingly used for mental health support. They offer accessible, therapeutic support but also raise concerns about misinformation, over-reliance, and risks in high-stakes contexts of mental health. We crowdsource large-scale users' posts from six major social media platforms to examine how people discuss their interactions with LLM chatbots across different mental health conditions. Through an LLM-assisted pipeline grounded in Value-Sensitive Design (VSD), we mapped the relationships across user-reported sentiments, mental health conditions, perspectives, and values. Our results reveal that the use of LLM chatbots is condition-specific. Users with neurodivergent conditions (e.g., ADHD, ASD) report strong positive sentiments and instrumental or appraisal support, whereas higher-risk disorders (e.g., schizophrenia, bipolar disorder) show more negative sentiments. We further uncover how user perspectives co-occur with underlying values, such as identity, autonomy, and privacy. Finally, we discuss shifting from "one-size-fits-all" chatbot design toward condition-specific, value-sensitive LLM design.

Depression, a prevalent mental health disorder impacting millions globally, demands reliable assessment systems. Unlike previous studies that focus solely on either detecting depression or predicting its severity, our work identifies individual symptoms of depression while also predicting its severity using speech input. We leverage self-supervised learning (SSL)-based speech models to better utilize the small-sized datasets that are frequently encountered in this task. Our study demonstrates notable performance improvements by utilizing SSL embeddings compared to conventional speech features. We compare various types of SSL pretrained models to elucidate the type of speech information (semantic, speaker, or prosodic) that contributes the most in identifying different symptoms. Additionally, we evaluate the impact of combining multiple SSL embeddings on performance. Furthermore, we show the significance of multi-task learning for identifying depressive symptoms effectively.

Dysfluent speech detection is the bottleneck for disordered speech analysis and spoken language learning. Current state-of-the-art models are governed by rule-based systems which lack efficiency and robustness, and are sensitive to template design. In this paper, we propose YOLO-Stutter: a first end-to-end method that detects dysfluencies in a time-accurate manner. YOLO-Stutter takes imperfect speech-text alignment as input, followed by a spatial feature aggregator, and a temporal dependency extractor to perform region-wise boundary and class predictions. We also introduce two dysfluency corpus, VCTK-Stutter and VCTK-TTS, that simulate natural spoken dysfluencies including repetition, block, missing, replacement, and prolongation. Our end-to-end method achieves state-of-the-art performance with a minimum number of trainable parameters for on both simulated data and real aphasia speech. Code and datasets are open-sourced at https://github.com/rorizzz/YOLO-Stutter

Spontaneous speech has many affective and pragmatic functions that are interesting and challenging to model in TTS. However, the presence of reduced articulation, fillers, repetitions, and other disfluencies in spontaneous speech make the text and acoustics less aligned than in read speech, which is problematic for attention-based TTS. We propose a TTS architecture that can rapidly learn to speak from small and irregular datasets, while also reproducing the diversity of expressive phenomena present in spontaneous speech. Specifically, we add utterance-level prosody control to an existing neural HMM-based TTS system which is capable of stable, monotonic alignments for spontaneous speech. We objectively evaluate control accuracy and perform perceptual tests that demonstrate that prosody control does not degrade synthesis quality. To exemplify the power of combining prosody control and ecologically valid data for reproducing intricate spontaneous speech phenomena, we evaluate the system's capability of synthesizing two types of creaky voice. Audio samples are available at https://www.speech.kth.se/tts-demos/prosodic-hmm/

The delayed access to specialized psychiatric assessments and care for patients at risk of suicidal tendencies in emergency departments creates a notable gap in timely intervention, hindering the provision of adequate mental health support during critical situations. To address this, we present a non-invasive, speech-based approach for automatic suicide risk assessment. For our study, we have collected a novel dataset of speech recordings from 20 patients from which we extract three sets of features, including wav2vec, interpretable speech and acoustic features, and deep learning-based spectral representations. We proceed by conducting a binary classification to assess suicide risk in a leave-one-subject-out fashion. Our most effective speech model achieves a balanced accuracy of 66.2,%. Moreover, we show that integrating our speech model with a series of patients' metadata, such as the history of suicide attempts or access to firearms, improves the overall result. The metadata integration yields a balanced accuracy of 94.4,%, marking an absolute improvement of 28.2,%, demonstrating the efficacy of our proposed approaches for automatic suicide risk assessment in emergency medicine.

Rare diseases, including Inborn Errors of Metabolism (IEM), pose significant diagnostic challenges. Case reports serve as key but computationally underutilized resources to inform diagnosis. Clinical dense information extraction refers to organizing medical information into structured predefined categories. Large Language Models (LLMs) may enable scalable information extraction from case reports but are rarely evaluated for this task. We introduce CaseReportBench, an expert-annotated dataset for dense information extraction of case reports, focusing on IEMs. Using this dataset, we assess various models and prompting strategies, introducing novel approaches such as category-specific prompting and subheading-filtered data integration. Zero-shot chain-of-thought prompting offers little advantage over standard zero-shot prompting. Category-specific prompting improves alignment with the benchmark. The open-source model Qwen2.5-7B outperforms GPT-4o for this task. Our clinician evaluations show that LLMs can extract clinically relevant details from case reports, supporting rare disease diagnosis and management. We also highlight areas for improvement, such as LLMs' limitations in recognizing negative findings important for differential diagnosis. This work advances LLM-driven clinical natural language processing and paves the way for scalable medical AI applications.

Rare diseases affect hundreds of millions worldwide, yet diagnosis often spans years. Convectional pipelines decouple noisy evidence extraction from downstream inferential diagnosis, and general/medical large language models (LLMs) face scarce real world electronic health records (EHRs), stale domain knowledge, and hallucinations. We assemble a large, domain specialized clinical corpus and a clinician validated reasoning set, and develop RareSeek R1 via staged instruction tuning, chain of thought learning, and graph grounded retrieval. Across multicenter EHR narratives and public benchmarks, RareSeek R1 attains state of the art accuracy, robust generalization, and stability under noisy or overlapping phenotypes. Augmented retrieval yields the largest gains when narratives pair with prioritized variants by resolving ambiguity and aligning candidates to mechanisms. Human studies show performance on par with experienced physicians and consistent gains in assistive use. Notably, transparent reasoning highlights decisive non phenotypic evidence (median 23.1%, such as imaging, interventions, functional tests) underpinning many correct diagnoses. This work advances a narrative first, knowledge integrated reasoning paradigm that shortens the diagnostic odyssey and enables auditable, clinically translatable decision support.