SpeechDx: A Multi-Task Benchmark for Clinical Speech AI
Authors: Sejal Bhalla, Larry Kieu, Aina Merchant, Eyal de Lara, Alex Mariakakis
Organizations: University of Toronto, Canada
Abstract
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
Automatic speech intelligibility assessment is crucial for monitoring speech disorders and therapy efficacy. However, existing methods are difficult to compare: research is fragmented across private datasets with inconsistent protocols. We introduce PathBench, a unified benchmark for pathological speech assessment using public datasets. We compare reference-free, reference-text, and reference-audio methods across three protocols (Matched Content, Extended, and Full) representing how a linguist (controlled stimuli) versus machine learning specialist (maximum data) would approach the same data. We establish benchmark baselines across six datasets, enabling systematic evaluation of future methodological advances, and introduce Dual-ASR Articulatory Precision (DArtP), achieving the highest average correlation among reference-free methods.
Bence Mark Halpern, Thomas Tienkamp, Defne Abur +1
Automatic speech recognition (ASR) has advanced remarkably for standard speech, yet speech affected by neurological conditions remains a challenge. We present S-DiverSe (Spanish Diverse Speech), a corpus of 3.2 hours of in-the-wild Spanish speech from 22 speakers with amyotrophic lateral sclerosis, Parkinson's disease, and stroke. The dataset contains 444 manually transcribed audio segments with metadata on speaker sex, disease type, and intelligibility. S-DiverSe is designed to support ASR evaluation and development for neurologically affected Spanish speech. We describe the dataset, analyze its composition, and report baseline ASR results alongside initial adaptation experiments. Our findings reveal that heuristic text post-processing is more robust than fine-tuning for out-of-domain neurological Spanish speech. This underscores the need for dedicated in-the-wild Spanish benchmarks.
As large audio language models (LALMs) advance, robust evaluation frameworks have become essential. In this context, Spanish speech understanding under realistic acoustic conditions has received particularly little attention. We introduce ESCUCHA, the first Spanish speech understanding benchmark designed to evaluate LALMs across heterogeneous acoustic conditions and reasoning abilities. ESCUCHA comprises 1,000 human-curated questions paired with audio, totaling 162.9 hours sourced directly ``from the wild'' rather than drawn from existing datasets, with durations ranging from a few seconds to over 80 minutes. The benchmark emphasizes reasoning, spanning 9 perceptual and 10 reasoning categories, and it captures linguistic diversity through multiple Spanish accents and non-normative speech. ESCUCHA further includes multi-audio questions, spoken questions, and audio instructions, and it flags which questions support open-ended evaluation. Benchmarking several state-of-the-art multimodal and speech models reveals substantial performance gaps relative to trained humans.