CLAP-Based Automatic Word Naming Recognition in Post-Stroke Aphasia

Aphasia following stroke commonly produces systematic naming errors with characteristic profiles, but whether general-purpose language models not designed for clinical simulation can reproduce these patterns remains untested. We investigated (1) whether lesions or controlled perturbations to a multimodal language model can reproduce different types of errors in picture naming, and (2) whether the framework can reproduce the complete error profile of individual persons with aphasia (PWAs). Using LLaVA 1.6, we evaluated perturbation configurations that varied the layer, proportion, and amount of noise applied to model units. We examined 278 PWAs on the Philadelphia Naming Test, classifying responses into seven categories using a validated neural classifier. Six of seven response categories (correct, semantic, mixed, unrelated, neologism, no response errors) emerged at clinically-comparable proportions across distinct parameter space regions, with formal paraphasia being the exception. Searching the perturbation space revealed configurations that reproduced the individual error profile in at least six of seven categories for 97.8% of PWAs and in all seven categories for 79.5% of PWAs. Monte Carlo baselines confirmed that this matching reflects joint inter-category structure rather than marginal overlap. These results establish a quantitative framework for reproducing individual aphasic error patterns in picture naming. They suggest the potential for language models to serve as digital twins of individuals with post-stroke aphasia.

While language therapy is the primary treatment for post-stroke aphasia, limited clinical resources often restrict patient access to proper care. Addressing this gap requires reliable training simulations for medical professionals. However, current AI efforts focus almost exclusively on speech processing, leaving speech generation largely unexplored. This study introduces AphaVoice, a novel text-to-speech (TTS) framework explicitly engineered to synthesize highly realistic aphasic speech. Evaluated against state-of-the-art TTS systems, AphaVoice demonstrates a superior ability to capture the clinical feature of dysfluency, outperforming existing models in temporal metrics while consistently maintaining speaker identity. By leveraging latent space shifting, the model also supports multi-speaker generation without sacrificing phonetic realism. Ultimately, AphaVoice provides a scalable, high-fidelity tool for medical training and clinical simulation related to aphasia.

Automatic dysarthria severity assessment is limited by the scarcity of labeled pathological speech data. To address this, we propose Cross-lingual Retrieval-Augmented Classification (CRAC), which leverages speech from a different language via an align-retrieve-fuse pipeline. Supervised contrastive learning first shapes a severity-focused embedding space, then a vector database is built from the opposite-language corpus. During both training and inference, the classifier retrieves top-k references from the aligned space and fuses them with the input via cross-attention. Evaluated on Korean post-stroke and Italian ALS dysarthria datasets under a speaker-independent three-class protocol, CRAC achieves balanced accuracies of 87.3% on Korean and 86.7% on Italian, improving over monolingual baselines by 8.4 and 20.0 percentage points, respectively.