Dysarthria Assessment

Detecting intra-operative speech impairment during awake craniotomy is essential for preserving language function. However, automated detection remains challenging because operating-room recordings contain substantial acoustic interference, clinically relevant speech events are rare, and available cohorts are small and heterogeneous across speakers. This study presents a systematic component-wise evaluation of a pipeline for distinguishing dysarthric from no-trouble speech in the DATABRASE corpus of awake-craniotomy recordings. The pipeline incorporates speaker diarization to isolate patient speech, a multi-view representation combining handcrafted acoustic descriptors with multilayer wav2vec 2.0 embeddings, speaker-conditional normalization and transferability-based feature selection to improve cross-speaker robustness, and a cascaded classifier comprising a gradient-boosted first stage and a neural second stage. Evaluation was conducted under strict speaker-independent conditions using leave-one-speaker-out cross-validation. The results show that cross-speaker performance is influenced more strongly by the speech representation than by classifier choice. The AUCs of three classifiers differed by no more than 4.7%, whereas replacing conventional acoustic descriptors with the multilayer self-supervised representation produced AUC improvements of 18.2%-26.1%. Diarization-conditioned feature extraction and the proposed classifier cascade provided additional consistent gains. These findings indicate that reliable patient-specific speech isolation and strong pretrained representations are more important than increased classifier complexity in low-resource intra-operative settings. They also quantify the potential performance gains that may be achieved through patient-specific preoperative calibration.

Most multilingual dysarthria-severity systems either train on a single aetiology-language pair or pool heterogeneous aetiologies into one label space. We test that pooling assumption with four matched HuBERT-base contrastive embedding models under a shared backbone, training recipe, corpus registry and held-out evaluation: one mixed-aetiology baseline and three aetiology-specific models for cerebral palsy (CP), Parkinson's disease (PD) and amyotrophic lateral sclerosis (ALS). Training combines clinically labelled speech with ordinal pseudo-labels from a training-free phonological profiling method [1], [2]. On speaker-disjoint, leakage-filtered held-out subsets, the per-aetiology models outperform the mixed baseline across all three target aetiologies: CP (macro F1 0.829 vs 0.676, +22.6 % relative), PD (0.715 vs 0.511, +40.0 %) and ALS (0.788 vs 0.596, +32.3 %). On CP, adding 144 SAP and 44 CDSD pseudo-labelled speakers lifts macro F1 from 0.786 to 0.829 over a clinical-only CP model (+4.3 percentage points). Training data span three to seven languages per aetiology. We position this as a controlled comparison of label-space design choices and discuss pseudo-label calibration, split hygiene, and confidence-thresholded deployment as important limitations for future work.

Amyotrophic lateral sclerosis (ALS) progressively impairs speech motor control, making acoustic analysis a promising biomarker for severity and progression estimation. We propose a subject-level graph framework that aggregates multiple phonation recordings into a unique k-nearest-neighbor graph built from pretrained SSL embeddings of 2s segments. We compare four SSL front-ends (wav2vec 2.0, HuBERT, data2vec-audio, and UniSpeech-SAT) and five graph neural networks (GCN, residual GCN, GAT, GraphSAGE, and GIN) on the SAND dataset tasks (339 participants: 205 ALS, 134 control): 5-class dysarthria severity and 4-class ALSFRS-R progression prediction. On the official validation set, the best configuration (HuBERT+GIN) achieves macro-F$_1$ of 0.73 for Task 1 and 0.69 for Task 2, outperforming SAND validation baselines (0.61 and 0.58). These results highlight the potential of combining GNNs with pretrained cross-lingual speech representations for low-resource ALS detection and progression monitoring.

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.

Dysarthria severity assessment is essential for therapy planning and longitudinal monitoring, yet manual perceptual rating is time-consuming and variable across clinicians. Although deep learning models achieve strong performance, their black-box nature limits clinical adoption. Existing speech explainability methods typically provide acoustic feature importance scores that are difficult for end-users to interpret. We propose an influence-based, instance-level explainability framework that explains each decision through supportive and competing training samples. Using gradient-based influence approximations, we compute per-utterance influence scores to identify supportive and competing training samples for each prediction. Controlled deletion experiments from 5 to 20 percent validate the explanations, showing that removing highly influential samples systematically shifts predictions. This approach provides auditable explanations by linking decisions to perceptible reference cases.

Dysarthria is a speech disorder marked by reduced intelligibility and communicative effectiveness. Automatic utterance-level assessment of dysarthric speech can support scalable speech monitoring and therapy-related analysis. Yet training such systems is bottlenecked by the scarcity of clinically annotated dysarthric speech. This work proposes to augment dysarthric speech assessment using data from speech synthesis evaluations, specifically human-annotated utterances with Mean Opinion Score (MOS) labels from the QualiSpeech corpus. Experiments show that fine-tuning on speech synthesis assessment data consistently improves performance on both intelligibility and naturalness prediction, while joint training yields gains primarily on naturalness. These results suggest that synthesis artifacts and dysarthric speech share perceptual commonalities, and speech synthesis evaluation corpora offer a practical augmentation source that reduces reliance on scarce clinical annotations.

We previously introduced a training-free method for dysarthria severity assessment based on d-prime separability of phonological feature subspaces in frozen self-supervised speech representations, validated on 890 speakers across 5 languages with HuBERT-base. Here, we scale the analysis to 3,374 speakers from 25 datasets spanning 12 languages and 5 aetiologies (Parkinson's disease, cerebral palsy, ALS, Down syndrome, and stroke), plus healthy controls, using 6 SSL backbones. We report three findings. First, aetiology-specific degradation profiles are distinguishable at the group level: 10 of 13 features yield large effect sizes (epsilon-squared > 0.14, Holm-corrected p < 0.001), with Parkinson's disease separable from the articulatory execution group at Cohen's d = 0.83; individual-level classification remains limited (22.6% macro F1). Second, profiles show cross-lingual profile-shape stability: cosine similarity of 5-dimensional consonant d-prime profiles exceeds 0.95 across the languages available for each aetiology. Absolute d-prime magnitudes are not cross-lingually calibrated, so the method supports language-independent phenotyping of degradation patterns but requires within-corpus calibration for absolute severity interpretation. Third, the method is architecture-independent: all 6 backbones produce monotonic severity gradients with inter-model agreement exceeding rho = 0.77. Fixed-token d-prime estimation preserves the severity correlation (rho = -0.733 at 200 tokens per class), confirming that the signal is not a token-count artefact. These results support phonological subspace analysis as a robust, training-free framework for aetiology-aware dysarthria characterisation, with evidence of cross-lingual profile-shape stability and cross-backbone robustness in the represented sample.

Wav2vec 2.0 (W2V2) has shown strong performance in pathological speech analysis by effectively capturing the characteristics of atypical speech. Despite its success, it remains unclear which components of its learned representations are most informative for specific downstream tasks. In this study, we address this question by investigating the regression of dysarthric speech descriptors using annotations from the Speech Accessibility Project dataset. We focus on five descriptors, each addressing a different aspect of speech or voice production: intelligibility, imprecise consonants, inappropriate silences, harsh voice and monoloudness. Speech representations are derived from a W2V2-based feature extractor, and we systematically compare layer-wise and time-wise aggregation strategies using attentive statistics pooling. Our results show that intelligibility is best captured through layer-wise representations, whereas imprecise consonants, harsh voice and monoloudness benefit from time-wise modeling. For inappropriate silences, no clear advantage could be observed for either approach.

Dysarthric speech severity assessment typically requires trained clinicians or supervised models built from labelled pathological speech, limiting scalability across languages and clinical settings. We present a training-free method that quantifies dysarthria severity by measuring degradation in phonological feature subspaces within frozen HuBERT representations. No supervised severity model is trained; feature directions are estimated from healthy control speech using a pretrained forced aligner. For each speaker, we extract phone-level embeddings via Montreal Forced Aligner, compute d-prime scores along phonological contrast directions (nasality, voicing, stridency, sonorance, manner, and four vowel features) derived exclusively from healthy controls, and construct a 12-dimensional phonological profile.Evaluating 890 speakers across 10 corpora, 5 languages (English, Spanish, Dutch, Mandarin, French), and 3 primary aetiologies (Parkinson's disease, cerebral palsy, ALS), we find that all five consonant d-prime features correlate significantly with clinical severity (random-effects meta-analysis rho = -0.50 to -0.56, p < 2e-4; pooled Spearman rho = -0.47 to -0.55 with bootstrap 95% CIs not crossing zero). The effect replicates within individual corpora, survives FDR correction, and remains robust to leave-one-corpus-out removal and alignment quality controls. Nasality d-prime decreases monotonically from control to severe in 6 of 7 severity-graded corpora. Mann-Whitney U tests confirm that all 12 features distinguish controls from severely dysarthric speakers (p < 0.001).The method requires no dysarthric training data and applies to any language with an existing MFA acoustic model (currently 29 languages). We release the full pipeline and phone feature configurations for six languages.

The limited availability of dysarthric speech data makes cross-lingual detection an important but challenging problem. A key difficulty is that speech representations often encode language-dependent structure that can confound dysarthria detection. We propose a representation-level language shift (LS) that aligns source-language self-supervised speech representations with the target-language distribution using centroid-based vector adaptation estimated from healthy-control speech. We evaluate the approach on oral DDK recordings from Parkinson's disease speech datasets in Czech, German, and Spanish under both cross-lingual and multilingual settings. LS substantially improves sensitivity and F1 in cross-lingual settings, while yielding smaller but consistent gains in multilingual settings. Representation analysis further shows that LS reduces language identity in the embedding space, supporting the interpretation that LS removes language-dependent structure.

Dysarthric speech quality assessment (DSQA) is critical for clinical diagnostics and inclusive speech technologies. However, subjective evaluation is costly and difficult to scale, and the scarcity of labeled data limits robust objective modeling. To address this, we propose a three-stage framework that leverages unlabeled dysarthric speech and large-scale typical speech datasets to scale training. A teacher model first generates pseudo-labels for unlabeled samples, followed by weakly supervised pretraining using a label-aware contrastive learning strategy that exposes the model to diverse speakers and acoustic conditions. The pretrained model is then fine-tuned for the downstream DSQA task. Experiments on five unseen datasets spanning multiple etiologies and languages demonstrate the robustness of our approach. Our Whisper-based baseline significantly outperforms SOTA DSQA predictors such as SpICE, and the full framework achieves an average SRCC of 0.761 across unseen test datasets.