Synthetic Speech, Real Signal: Paralinguistic Preservation and Cross-Lingual Augmentation via Voice Cloning

Synthetic data augmentation in speech is common practice for linguistic tasks like ASR, but has seen far less work for paralinguistic ones, especially clinical tasks where labelled data is expensive and some patient groups are underrepresented. Voice cloning is one such augmentation approach, but is typically evaluated on speech intelligibility (WER) or speaker similarity (SS) rather than on downstream performance, and it remains unclear whether these preserve the paralinguistic signal such tasks depend on. We benchmark eight voice cloning models on five paralinguistic tasks across public and clinical datasets, showing most preserve signal with modest degradation. We then clone English clinical speech into Japanese and find that training on cloned data outperforms raw cross-lingual transfer for depression and anxiety detection on real Japanese speech, suggesting voice cloning is a promising direction for augmenting clinical speech data in low-resource languages.

SpeechDx: A Multi-Task Benchmark for Clinical Speech AI

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

Predicting Upcoming Stuttering Events from Three-Second Audio: Stratified Evaluation Reveals Severity-Selective Precursors, and the Model Deploys Fully On-Device

Audio-based stuttering systems to date have been trained for detection -- what disfluency is present now -- leaving prediction, the capability needed for closed-loop intervention, unstudied at deployable scale. We train a 616K-parameter CNN on SEP-28k (Apple, 20,131 three-second clips) to predict whether the next contiguous clip contains any disfluency. (1) Severity-selective precursor signal: on the episode-grouped test set, aggregate preblock AUC is modest (0.581 [0.542, 0.619]), but stratifying by upcoming event type reveals concentration on clinically severe events -- blocks 0.601 [0.554, 0.651] and sound repetitions 0.617 [0.567, 0.667] both exclude chance, while fillers (0.45) and word repetitions (0.49) are at chance. The aggregate objective converges to a severity-selective predictor because severe events carry prosodic precursors; fillers do not. (2) Cross-population transfer: without fine-tuning, the same checkpoint applied to 1,024 pediatric Children-Who-Stutter utterances (FluencyBank Teaching) attains AUC 0.674 detection and 0.655 prediction; DisfluencySpeech and LibriStutter reach 0.58-0.60 AUC. (3) Deployable on-device: lossless export to CoreML (1.19 MB), ONNX (40 KB), TFLite. Neural-Engine latency per 3 s window: 0.25 ms (iPhone 17 Pro Max, A19 Pro) to 0.55 ms (iPhone SE 3rd-gen and M1 Max). A 4 Hz streaming simulation uses 0.54% of the real-time budget. Platt-calibrated outputs (test ECE 0.010, from 0.177 raw). Five negative ablations -- output-level Future-Guided Learning, multi-clip GRU, time-axis concatenation, asymmetric focal loss, direct block-targeted training -- none improved over the vanilla baseline.