# A Proactive Multi-Agent Dialogue Framework for Assessing Social Language Disorder Traits in Autism

arXiv: https://arxiv.org/abs/2605.22993 · HTML: https://mlsanity.com/paper/2605.22993/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 9 of its 35 references that are in the map.
- First posted on arXiv 21 May 2026.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 9 of 9)

- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [AutoGen: Enabling Next-Gen LLM Applications via Multi-Agent Conversation](https://mlsanity.com/paper/2308.08155/) (2023)
- [Self-Evolving Multi-Agent Simulations for Realistic Clinical Interactions](https://mlsanity.com/paper/2503.22678/) (2025)
- [Uncertainty of Thoughts: Uncertainty-Aware Planning Enhances Information Seeking in Large Language Models](https://mlsanity.com/paper/2402.03271/) (2024)
- [BED-LLM: Intelligent Information Gathering with LLMs and Bayesian Experimental Design](https://mlsanity.com/paper/2508.21184/) (2025)
- [Tree of Uncertain Thoughts Reasoning for Large Language Models](https://mlsanity.com/paper/2309.07694/) (2023)
- [Simulated patient systems powered by large language model-based AI agents offer potential for transforming medical education](https://mlsanity.com/paper/2409.18924/) (2024)
- [Video-based Contrastive Learning on Decision Trees: from Action Recognition to Autism Diagnosis](https://mlsanity.com/paper/2304.10073/) (2023)
- [Video-based Analysis Reveals Atypical Social Gaze in People with Autism Spectrum Disorder](https://mlsanity.com/paper/2409.00664/) (2024)

## Abstract (arXiv)

Characteristic linguistic behaviors associated with Social Language Disorder (SLD) in autism spectrum disorder, including echoic repetition, pronoun displacement, and stereotyped media quoting, are largely absent from spontaneous conversation and only emerge under specific conversational conditions. In structured clinical assessments, this latency means that questioning strategy selection is a critical yet underappreciated determinant of how much diagnostic information a conversation yields. Whether large language models (LLMs) can be guided to proactively select questioning strategies that systematically surface these latent traits remains largely unexplored. Here we present TPA (Think, Plan, Ask), a proactive multi-agent dialogue framework applied to the language assessment component of the Autism Diagnostic Observation Schedule Module 4 (ADOS-2), in which a doctor agent explicitly reasons about which traits remain unobserved before selecting a clinically grounded strategy and generating a targeted question. A patient agent grounded in real ADOS-2 clinical data enables reproducible evaluation without real patient participation, validated across three independent experiments confirming adequate fidelity to real patient language. Evaluated on 484 episodes from 35 patients, TPA outperforms six competitive dialogue planning baselines across all primary metrics, achieving 82.1% SLD trait coverage, 16.6% higher than automated replay of real clinical dialogues conducted by trained clinicians (65.5%), with substantially greater per-turn diagnostic efficiency (AUCC: 0.628 vs. 0.458, absolute gain +0.170). These results demonstrate that proactive questioning strategy selection substantially improves the efficiency of automated SLD trait assessment, with direct implications for scalable AI-assisted clinical screening.