Reliable clinical deployment of machine learning requires models that know when they are likely to fail, particularly for subgroups underrepresented in training data. A common case is pediatric care, where models trained on adult cohorts can silently under-perform on children with no indication that something has gone wrong. As retraining with labeled pediatric data is often infeasible, detecting such failures at inference time is a critical clinical need. Building on the VIDS (Variational Inference under Distribution Shifts) framework, we introduce VIDS-Seg, which applies amortized variational inference over a lightweight prediction head to make this adaptive, OOD-aware prior tractable for dense image segmentation. We evaluate VIDS-Seg on left ventricular segmentation in echocardiography, a setting where pediatric anatomy differs systematically from the adult population most segmentation models are trained on, training on an adult cohort (EchoNet-Dynamic) and evaluating zero-shot on a pediatric cohort (EchoNet-Pediatric). Across all age strata, VIDS-Seg matches competitive baselines in segmentation accuracy while producing substantially higher spatial correspondence between predicted uncertainty and segmentation error, an advantage that persists even after applying temperature scaling to all baselines. Downstream, it yields more accurate and stable ejection fraction estimates and more reliable detection of cardiac malfunction in the infant subgroup. Our results indicate that OOD-aware uncertainty quantification can serve as a practical safety layer for deployed segmentation models, enabling detection of silent failures in underrepresented subgroups without retraining or additional labeled data.
We introduce a new problem domain for human action recognition: the fine-grained analysis of children's gait behaviors from standard RGB video. We specifically target the ambulatory patterns of children aged 3-17 years. Such behaviors arise naturally in the diagnosis and treatment of several critical developmental and neuromuscular disorders, such as cerebral palsy and hemiplegia. Despite their clinical value, current 3D sensor-based gait analysis systems are expensive, intrusive, and often impractical for young subjects. To address this, we introduce a new dataset comprising over 1,100 high-frame-rate (60 FPS) video sequences from 110 subjects, accompanied by synchronized, anonymized pose sequences. In each session, the child performs a 5-second "walk-around" task, capturing the gait cycle from multiple viewpoints. Crucially, we demonstrate that current state-of-the-art approaches, including gait foundation models and Multimodal Large Language Models (MLLMs), fail to effectively resolve these clinical nuances. We identify the key technical challenges in analyzing these erratic and subtle motor patterns and describe a unified end-to-end framework for decoding fundamental components of pediatric gait. Through comprehensive experimental results, we demonstrate the potential of this dataset to drive novel research questions and establish a rigorous baseline for automated child gait assessment.
Children with rare genetic diseases often exhibit distinctive facial phenotypes, yet developing computer vision systems for early diagnosis remains challenging due to extreme data scarcity, privacy constraints, and limited data sharing in pediatric settings. These challenges not only hinder automated diagnosis but also restrict the availability of visual resources for clinical genetic counseling. While prior work has shown that synthetic data can augment real datasets and preserve phenotype-level semantics, it remains unclear whether synthetic data alone is sufficient for learning in ultra-low-resource pediatric settings. In this work, we study the synthetic-only regime for pediatric rare disease recognition. Under a controlled experimental setup, models are trained exclusively on phenotype-aware synthetic facial images at increasing scales. We find that synthetic-only training achieves performance comparable to real-data-only baselines at sufficient scale across multiple backbones, suggesting that high-fidelity synthetic data can approximate clinically meaningful distributions. These findings together further enable the use of synthetic pediatric facial images as privacy-preserving resources for genetic education and counseling, supporting clinician training and patient communication. Our results highlight the potential of computer vision to improve data efficiency and expand accessible visual tools in children's healthcare.