Neurodiversity-Aware Multimodal Affective Computing for Neurodevelopmental Assessment: From Norm-Referenced Classification to Context-Sensitive Decision Support

Multimodal affective computing underpins key tasks such as sentiment analysis and emotion recognition. Standard evaluations, however, often assume that textual, acoustic, and visual modalities are equally available. In real applications, some modalities are systematically more fragile or expensive, creating imbalanced missing rates and training biases that task-level metrics alone do not reveal. We introduce MissBench, a benchmark and framework for multimodal affective tasks that standardizes both shared and imbalanced missing-rate protocols on four widely used sentiment and emotion datasets. MissBench also defines two diagnostic metrics. The Modality Equity Index (MEI) measures how fairly different modalities contribute across missing-modality configurations. The Modality Learning Index (MLI) quantifies optimization imbalance by comparing modality-specific gradient norms during training, aggregated across modality-related modules. Experiments on representative method families show that models that appear robust under shared missing rates can still exhibit marked modality inequity and optimization imbalance under imbalanced conditions. These findings position MissBench, together with MEI and MLI, as practical tools for stress-testing and analyzing multimodal affective models in realistic incomplete-modality settings.For reproducibility, we release our code at: https://anonymous.4open.science/r/MissBench-4098/

Voice-based screening offers a scalable and non-invasive way to assess neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD), but their staging remains challenging due to the difficulty of integrating heterogeneous data. This paper presents NeurMLLM, an efficient multimodal generative framework for neurodegenerative disease staging. NeurMLLM first encodes the spectrograms and Mel-frequency cepstral coefficients of audio data with vision transformers and projects their representations into the embedding space of a large language model (LLM), where they are concatenated with transcript and demographic instruction tokens as a single unified sequence. The LLM is then instruction-tuned via Low-Rank Adaptation using task prompts to autoregressively predict a constrained label token, enabling a generative classification. By evaluating on the Bridge2AI-Voice dataset for fine-grained staging of AD and PD, we observe that NeurMLLM achieves strong performance, consistently outperforming classical machine learning methods and existing LLM-based approaches. The results show the high potential of multimodal LLMs in neurodegenerative disease staging, improving staging accuracy and supporting accessible deployment.

Dementia affects millions of older adults worldwide, yet early detection remains difficult outside clinical settings. Traditional models primarily rely on text or voice-based responses, capturing only a limited view of human cognition despite the inherently multimodal nature of human expression. This work proposes a contactless, multimodal screening framework that leverages video, audio, and text signals collected during structured voice-based interactions with Amazon Alexa. By incorporating these modalities, our approach captures a more holistic representation of human behavior encompassing speech patterns, vocal characteristics, facial expressions, and linguistic structure, which may enable more accurate detection of cognitive decline. Different participants completed three conversational tasks designed to probe spontaneous speech, comprehension, and recall. We pursued three objectives: (1) evaluate which of the three Alexa tasks provides the most informative cognitive signals, (2) compare the effectiveness of unimodal models, and (3) assess the benefits of multimodal fusion models. Task-level analysis shows that the video model achieves its best performance on Command-Reading, with an accuracy of 0.65 (AUC 0.69), while the audio model performs best on Question-Answering, reaching an accuracy of 0.67 (AUC 0.73). In contrast, the multimodal model demonstrates consistently stable performance across tasks, achieving an accuracy of 0.76 (AUC 0.75) on Command-Reading and 0.76 (AUC 0.73) on Question-Answering. These findings demonstrate that multimodal behavioral cues captured through naturalistic interactions can reliably distinguish MCI from healthy aging, highlighting the limitations of traditional diagnostic paradigms and supporting the shift toward multimodal, real-world cognitive assessment frameworks.