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Preclinical Dialogue Simulation: Evaluating Response Accessibility in Conversational Artificial Intelligence for Aphasia Therapy.

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Related Experiment Video

Updated: Jun 15, 2025

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ABCD: A Simulation Method for Accelerating Conversational Agents With Applications in Aphasia Therapy.

Gerald C Imaezue1, Harikrishna Marampelly2

  • 1Department of Communication Sciences and Disorders, University of South Florida, Tampa.

Journal of Speech, Language, and Hearing Research : JSLHR
|June 13, 2025
PubMed
Summary
This summary is machine-generated.

Agent-Based Conversational Dialogue (ABCD) simulates AI-driven speech therapy, overcoming barriers in aphasia treatment development. This novel approach uses AI agents to mimic aphasic errors, enabling cost-effective research and innovation in conversational AI for therapy.

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Area of Science:

  • Computational linguistics
  • Artificial intelligence in healthcare
  • Speech-language pathology

Background:

  • Aphasia therapy development faces limitations due to clinician shortages, patient recruitment challenges, and funding constraints.
  • Current methods for developing AI-driven speech therapy tools are resource-intensive, requiring extensive fine-tuning with diverse errorful speech samples.

Purpose of the Study:

  • To introduce Agent-Based Conversational Dialogue (ABCD), a novel method for simulating goal-driven spoken dialogues between two conversational AI agents.
  • To address barriers in aphasia therapy development by creating a cost-effective and rapid agent development and piloting system.

Main Methods:

  • Developed AI clinician (Re-Agent) and AI patient (AI-Aphasic) agents using OpenAI's GPT-4o, integrated with speech-to-text and text-to-speech APIs.
  • Utilized prompt engineering, chain-of-thought (CoT), and zero-shot techniques for agent development, avoiding resource-intensive fine-tuning.
  • Simulated response elaboration training with varying semantic constraints (pictures vs. topics) and evaluated Re-Agent's performance using discourse metrics (global coherence, local coherence, grammaticality).

Main Results:

  • Re-Agent demonstrated accurate performance across all discourse metrics, semantic parameters, prompting techniques, and aphasic error levels.
  • Zero-shot prompts yielded more direct and logically related responses, robust to aphasic speech inputs.
  • Chain-of-thought (CoT) prompts, while effective, occasionally led to minor reductions in local coherence due to complex reasoning.

Conclusions:

  • Agent-Based Conversational Dialogue (ABCD) offers a foundational computational approach to accelerate innovation and preclinical testing of conversational AI for speech-language therapy.
  • ABCD circumvents the need for extensive, diverse errorful speech samples for clinical AI fine-tuning.
  • The scalability of ABCD with advancing AI systems, including large language models and speech technologies, enhances its potential for clinical integration.