PathBench: Speech Intelligibility Benchmark for Automatic Pathological Speech Assessment

Large Audio-Language Models (LALMs) have been widely used as judge models for the automatic evaluation of generated speech. However, prior approaches predominantly focus on holistic naturalness, leaving fine-grained paralinguistic distinctions underexplored. We introduce ParaPairAudioBench, a pairwise benchmark of 5,175 audio pairs across five paralinguistic dimensions: Style, Rate, Emphasis, Age, and Gender. Our experiments show that current LALM judges still lag behind human judgments by 32%p on average and exhibit severe calibration failures, particularly in Tie cases where the correct decision is to abstain. To further analyze lexical versus acoustic reliance, the benchmark includes both same-transcript and cross-transcript conditions. ParaPairAudioBench enables multi-dimensional, calibration-aware assessment of the reliability of LALM-as-a-Judge for paralinguistic speech evaluation.

Speech offers a uniquely informative window into health by simultaneously engaging neurological, motor, respiratory, and vocal systems. Current clinical speech AI methods have largely progressed through isolated condition-specific studies, making results difficult to compare and generalization difficult to assess. We introduce SpeechDx, a large-scale benchmark for clinical speech AI spanning 12 datasets and 27 tasks across diverse health conditions. To enable evaluation across shared clinical mechanisms, SpeechDx structures tasks by the stage of speech production they disrupt: conceptualization, formulation, and articulation. The benchmark tests generalization by including tasks with limited labeled data and evaluating the same health condition across multiple datasets, distinguishing clinically meaningful patterns from dataset artefacts. We systematically evaluate 12 state-of-the-art audio encoders across all tasks and under zero-shot cross-condition transfer. Results show that large-scale speech models represent the strongest overall baselines, domain-specific models improve performance only on closely matched tasks, and no current representation generalizes reliably across the clinical speech landscape. SpeechDx establishes a shared evaluation framework for tracking progress toward general-purpose clinical speech representations

Current voice AI benchmarks typically evaluate isolated capabilities such as speech intelligibility, word error rate, or text-based dialogue quality, but they rarely test whether systems harness the acoustic information that distinguishes spoken language from its textual representation. To this end, we introduce the Real World Voice EQ Bench, a multidimensional benchmark for evaluating voice AI across text-to-speech (TTS), speech-to-speech (STS), speech understanding (SU), and automatic speech recognition (ASR). Our evaluations indicate that performance is highly dimension-specific. For TTS, naturalness, expressiveness, identity stability, and reliability are largely independent evaluation dimensions. For STS, access to audio does not guarantee use of vocal affect, and some agents remain largely transcript-driven. For SU, models perform unevenly across paralinguistic tasks. For ASR, real world accent, emotion, noise, and conversational conditions expose failures that are not captured by established clean-speech benchmarks. Together, these results show that voice AI should be evaluated as a profile of acoustic, expressive, interactional, and robustness capabilities rather than by a single aggregate score.