Organizations: MBZUAI, UAE · SpeechCare, Portugal & UAE · School of Health Sciences & IEETA, University of Aveiro, Portugal · SLAI & CUHK (SZ), China · University of Edinburgh, UK
Abstract
Atypical speech is receiving greater attention in speech technology research, but much of this work unfolds with limited interdisciplinary dialogue. For stuttered speech in particular, it is widely recognised that current speech recognition systems fall short in practice, and current evaluation methods and research priorities are not systematically grounded in end-user experiences and needs. In this work, we analyse these gaps through 1) a scoping review of papers that deal with stuttered speech and 2) a survey of 70 stakeholders, including adults who stutter and speech-language pathologists. By analysing these two perspectives, we propose a taxonomy of stuttered-speech research, identify where current research directions diverge from the needs articulated by stakeholders, and conclude by outlining concrete guidelines and directions towards addressing the real needs of the stuttering community.
Speech translation (ST) is increasingly adopted in user applications, yet its evaluation largely focuses on decontextualized testbeds and holistic quality, rather than end users' communication needs. We introduce Ouvia, an evaluation framework for measuring user-perceived usability of speech translation outputs in real-world settings. Ouvia focuses on one-to-one communication: an English speaker needs to convey a request to a Portuguese speaker, and the message is automatically translated. Through a custom web app and multi-phase study design, we collect more than 1,750 such interactions in healthcare and everyday situations, mediated by four ST systems, involving speakers from three English dialects and two genders. We find that modern ST serves people only to a limited extent -- only around half of interactions are rated as usable -- with significant gaps in reported usability across demographic groups. Moreover, among quality metrics, we find that QA-based evaluation is a substantially stronger predictor of real-world usability than standard approaches. Together, these findings stress the importance of situated, user-centered evaluation frameworks that go beyond holistic quality scores and attend to who the technology serves -- and how well.
Giuseppe Attanasio, Beatrice Savoldi, Daniel Chechelnitsky +4
This paper develops Virtual Speech Therapist (VST), an intelligent agent-based platform that streamlines stuttering assessment and delivers customized therapy planning through automated and adaptive AI-driven workflows. VST integrates state-of-the-art deep learning-based stuttering classification, and multi-agent large language model (LLM) reasoning to support evidence-based clinical decision-making. The VST begins with the acquisition and feature extraction of patient speech samples, followed by robust classification of stuttering types. Building on these outputs, VST initiates an agentic reasoning process in which specialized LLM agents autonomously generate, critique, and iteratively refine individualized therapy plans. A dedicated critic agent evaluates all generated therapy plans to ensure clinical safety, methodological soundness, and alignment with peer-reviewed evidence and established professional guidelines. The resulting output is a comprehensive, patient-specific therapy draft intended for clinician review. Incorporating clinician feedback, the system then produces a finalized therapy plan suitable for patient delivery, thereby maintaining a clinician-in-the-loop paradigm. Experimental evaluation by expert speech therapists confirms that VST consistently generates high-quality, evidence-based therapy recommendations. These findings demonstrate the system's potential to augment clinical workflows, reduce clinician burden, and improve therapeutic outcomes for individuals with speech impairments. An interactive user interface for the proposed system is available online at: https://vocametrix.com/ai/stuttering-therapy-planning-agent , facilitating real-time stuttering assessment and personalized therapy planning.
Shakeel Sheikh, Patrick Marmaroli, MD Sahidullah +4
Speech technologies are deployed in high-stakes settings, yet fairness concerns remain fragmented across tasks and disciplines. Existing surveys either adopt a general machine-learning perspective that overlooks speech-specific properties or focus on a single task, missing failure patterns shared across the speech domain. Synthesizing over 400 studies spanning generation and perception tasks and emerging speech-language models, this survey presents a unified framework that links formal fairness definitions to evaluation, diagnosis, and mitigation. We formalize seven fairness definitions adapted to the speech modality and organize the field's conceptual evolution through three paradigms: Robustness, Representation, and Governance. We then ground evaluation metrics in the mathematical cores of these definitions and offer a decision tree for metric selection. We diagnose bias sources along the speech processing pipeline, surfacing speech-specific mechanisms such as channel bias as a demographic proxy and annotation subjectivity in emotion labels. We systematize mitigation strategies across four intervention stages, mapping each to the diagnosed sources. Finally, we identify open challenges and propose directions for future research.