Si-Ioi Ng

Si-Ioi Ng, Pranav S. Ambadi, Kimberly D. Mueller et al.

Current methods for automated assessment of cognitive-linguistic impairment via picture description often neglect the visual narrative path - the sequence and locations of elements a speaker described in the picture. Analyses of spatio-semantic features capture this path using content information units (CIUs), but manual tagging or dictionary-based mapping is labor-intensive. This study proposes a BERT-based pipeline, fine tuned with binary cross-entropy and pairwise ranking loss, for automated CIU extraction and ordering from the Cookie Theft picture description. Evaluated by 5-fold cross-validation, it achieves 93% median precision, 96% median recall in CIU detection, and 24% sequence error rates. The proposed method extracts features that exhibit strong Pearson correlations with ground truth, surpassing the dictionary-based baseline in external validation. These features also perform comparably to those derived from manual annotations in evaluating group differences via ANCOVA. The pipeline is shown to effectively characterize visual narrative paths for cognitive impairment assessment, with the implementation and models open-sourced to public.

Si-Ioi Ng, Pranav S. Ambadi, Kimberly D. Mueller et al.

Existing methods for analyzing linguistic content from picture descriptions for assessment of cognitive-linguistic impairment often overlook the participant's visual narrative path, which typically requires eye tracking to assess. Spatio-semantic graphs are a useful tool for analyzing this narrative path from transcripts alone, however they are limited by the need for manual tagging of content information units (CIUs). In this paper, we propose an automated approach for estimation of spatio-semantic graphs (via automated extraction of CIUs) from the Cookie Theft picture commonly used in cognitive-linguistic analyses. The method enables the automatic characterization of the visual semantic path during picture description. Experiments demonstrate that the automatic spatio-semantic graphs effectively differentiate between cognitively impaired and unimpaired speakers. Statistical analyses reveal that the features derived by the automated method produce comparable results to the manual method, with even greater group differences between clinical groups of interest. These results highlight the potential of the automated approach for extracting spatio-semantic features in developing clinical speech models for cognitive impairment assessment.

Si-Ioi Ng, Lingfeng Xu, Ingo Siegert et al.

There has been a surge of interest in leveraging speech as a marker of health for a wide spectrum of conditions. The underlying premise is that any neurological, mental, or physical deficits that impact speech production can be objectively assessed via automated analysis of speech. Recent advances in speech-based Artificial Intelligence (AI) models for diagnosing and tracking mental health, cognitive, and motor disorders often use supervised learning, similar to mainstream speech technologies like recognition and verification. However, clinical speech AI has distinct challenges, including the need for specific elicitation tasks, small available datasets, diverse speech representations, and uncertain diagnostic labels. As a result, application of the standard supervised learning paradigm may lead to models that perform well in controlled settings but fail to generalize in real-world clinical deployments. With translation into real-world clinical scenarios in mind, this tutorial paper provides an overview of the key components required for robust development of clinical speech AI. Specifically, this paper will cover the design of speech elicitation tasks and protocols most appropriate for different clinical conditions, collection of data and verification of hardware, development and validation of speech representations designed to measure clinical constructs of interest, development of reliable and robust clinical prediction models, and ethical and participant considerations for clinical speech AI. The goal is to provide comprehensive guidance on building models whose inputs and outputs link to the more interpretable and clinically meaningful aspects of speech, that can be interrogated and clinically validated on clinical datasets, and that adhere to ethical, privacy, and security considerations by design.