Safety boundary maintenance in consumer AI systems responding to pediatric health queries: a cross-platform benchmark evaluation under naturalistic and adversarially pressured conditions

How can we evaluate whether frontier AI systems recognize child-safety risks before they escalate into explicit harm? Existing child safety evaluations focus on child sexual abuse material, yet many child-safety failures begin earlier: in model assistance that helps adults manipulate, impersonate, profile, or isolate minors, and in model responses that deepen children's emotional dependence on AI systems rather than redirecting them toward human support. We introduce CAREBench (Child AI Risk Evaluation), a benchmark to assess such upstream child-safety risks in language models. CAREBench contains 500 prompts spanning twelve risk categories, including grooming and relationship engineering, deception and impersonation, surveillance and privacy, sextortion and sexual abuse, AI anthropomorphization, emotional dependency, and mental illness sensitivity. Developed with response annotations from parents and clinicians, the benchmark excludes explicit abuse material and imagery; instead, it evaluates whether models recognize, refuse, de-escalate, or redirect risky interactions before harm becomes overt. Evaluating seven frontier models on our benchmark, we find failure rates ranging from 2% to 58%, with failure patterns that vary across risk categories. CAREBench provides a responsibly scoped evaluation for LLM developers to identify and close gaps in child safety policies.

Health AI is evolving from answering questions to agentic systems that converse with patients, reason about health records, and act on their behalf. Primary care guards against diagnostic errors and unsafe care; agents assisting in this domain warrant evaluation against the same risks. Current benchmarks focus on medical knowledge, assessed through isolated question-answering or clinician-facing tasks. PatientAgentBench benchmarks patient-facing agentic healthcare; it evaluates a foundation model, wrapped in an agent with a sandbox of healthcare tools, conversing with a simulated patient. Each conversation is scored by an LLM-as-a-Jury across six dimensions via over a hundred conversation-agnostic, clinician-grounded criteria. To validate alignment, licensed clinicians annotated shared conversations, yielding 79-93% adjacent agreement between jury and expert raters, on par with or exceeding clinician inter-rater agreement. We benchmarked 10 models across four families on the same 1,200 scenarios and found clinical gaps. Triage quality is the most discriminating dimension: pass rates rise from 32% for the weakest models to 88% for the strongest, with agents often acting on administrative requests without clinical screening. Clinical safety and workflow accuracy follow the same pattern: the weakest models fail often, fabricating unexecuted actions, while frontier models fail on only 1-3% of cases, from unverified tool outputs and omitted crisis resources in an emergency. More capable models narrow these gaps but do not close them; the strongest scores only 4.25 of 5 overall. These failures surface only in sustained, tool-using conversations against realistic patient records, confirming that static benchmarks are insufficient as healthcare agentic systems gain autonomy. We release the framework as a reproducible, clinician-validated evaluation standard to help the field close this gap.

Children increasingly have access to Large Language Models (LLMs), which may expose them to responses that are developmentally inappropriate or require age-sensitive safety, guidance, and boundaries. Existing LLM safety evaluations largely focus on general harmful-content avoidance and do not explicitly target child-facing safety. We introduce KIDBench, a benchmark for evaluating child-facing LLM safety for ages 7-11 using a LLM-as-a-Judge rubric grounded in developmental-psychology. KIDBench contains realistic child queries across ten categories, with single-turn prompts and multi-turn child-actor simulations. We compare no-cues prompts with no child context, implicit-cues prompts that suggest a child speaker, and explicit age instructions. Implicit-cues improve scores by 8.6-46.8% over no-cue, while explicit age provides an additional 9.9-30.4% improvement over implicit-cues. Cross-lingual and cultural evaluations show uneven safety behavior across languages and country contexts. Multi-turn simulations show peak quality drops of up to 0.959 points on the 1-5 scale. We also introduce KIDGuardLlama, a child-safety evaluator, and KIDLlama, a child-safe response model. Code, data, and evaluation resources are available at https://github.com/MichiganNLP/kidbench.