Previous work has demonstrated the utility of speech-based digital biomarkers for remotely tracking longitudinal progression in people with Amyotrophic Lateral Sclerosis (pALS). Here, we investigate the responsiveness of these biomarkers across languages for consistency. We collected audiovisual data using a cloud-based multimodal dialogue platform, where pALS interacted with a virtual guide to perform several speaking exercises. We automatically extracted speech, linguistic and orofacial metrics from 143 English-speaking pALS (36 bulbar onset, 107 non-bulbar onset) and 26 Dutch-speaking pALS (10 bulbar, 16 non-bulbar onset). We used growth curve models to estimate the trajectory of these metrics over time. We observe that for most of these metrics, English-speaking pALS and Dutch-speaking pALS follow similar trajectories, i.e. the slopes are not statistically different from each other, demonstrating the potential of such speech-based biomarkers for remote monitoring across languages.

= 94). We further evaluated the sensitivity of speech metrics in tracking disease progression in pALS while their ALSFRS-R speech score remained unchanged at 3 out of a total possible score of 4. We observed that timing-related speech metrics showed significant longitudinal changes even after accounting for learning effects. The findings of this study have the potential to inform disease prognosis and functional outcomes of clinical trials.

Multiple speech biomarkers have been shown to carry useful information regarding Amyotrophic Lateral Sclerosis (ALS) pathology. We propose a two-step framework to compute optimal linear combinations (indexes) of these biomarkers that are more discriminative and noise-robust than the individual markers, which is important for clinical care and pharmaceutical trial applications. First, we use a hierarchical clustering based method to select representative speech metrics from a dataset comprising 143 people with ALS and 135 age- and sex-matched healthy controls. Second, we analyze three methods of index computation that optimize linear discriminability, Youden Index, and sparsity of logistic regression model weights, respectively, and evaluate their performance with 5-fold cross validation. We find that the proposed indexes are generally more discriminative of bulbar vs non-bulbar onset in ALS than their individual component metrics as well as an equally-weighted baseline.

We investigate the feasibility, task compliance and audiovisual data quality of a multimodal dialog-based solution for remote assessment of Amyotrophic Lateral Sclerosis (ALS). 53 people with ALS and 52 healthy controls interacted with Tina, a cloud-based conversational agent, in performing speech tasks designed to probe various aspects of motor speech function while their audio and video was recorded. We rated a total of 250 recordings for audio/video quality and participant task compliance, along with the relative frequency of different issues observed. We observed excellent compliance (98%) and audio (95.2%) and visual quality rates (84.8%), resulting in an overall yield of 80.8% recordings that were both compliant and of high quality. Furthermore, recording quality and compliance were not affected by level of speech severity and did not differ significantly across end devices. These findings support the utility of dialog systems for remote monitoring of speech in ALS.

Abstract We explore the utility of an on-demand multimodal conversational platform in extracting speech and facial metrics in children with Autism Spectrum Disorder (ASD). We investigate the extent to which these metrics correlate with objective clinical measures, particularly as they pertain to the interplay be-tween the affective, phonatory and motoric subsystems. 22 participants diagnosed with ASD engaged with a virtual agent in conversational affect production tasks designed to elicit facial and vocal affect. We found significant correlations between vocal pitch and loudness extracted by our platform during these tasks and accuracy in recognition of facial and vocal affect, as-sessed via the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA-2) neuropsychological task. We also found significant correlations between jaw kinematic metrics extracted using our platform and motor speed of the dominant hand assessed via a standardised neuropsychological finger tapping task. These findings offer preliminary evidence for the usefulness of these audiovisual analytic metrics and could help us better model the interplay between different physiological subsystems in individuals with ASD.

We propose a cloud-based multimodal dialog platform for the remote assessment and monitoring of Amyotrophic Lateral Sclerosis (ALS) at scale. This paper presents our vision, technology setup, and an initial investigation of the efficacy of the various acoustic and visual speech metrics automatically extracted by the platform. 82 healthy controls and 54 people with ALS (pALS) were instructed to interact with the platform and completed a battery of speaking tasks designed to probe the acoustic, articulatory, phonatory, and respiratory aspects of their speech. We find that multiple acoustic (rate, duration, voicing) and visual (higher order statistics of the jaw and lip) speech metrics show statistically significant differences between controls, bulbar symptomatic and bulbar pre-symptomatic patients. We report on the sensitivity and specificity of these metrics using five-fold cross-validation. We further conducted a LASSO-LARS regression analysis to uncover the relative contributions of various acoustic and visual features in predicting the severity of patients' ALS (as measured by their self-reported ALSFRS-R scores). Our results provide encouraging evidence of the utility of automatically extracted audiovisual analytics for scalable remote patient assessment and monitoring in ALS.