# Automatic estimation of verbal fluency index in people with Motor Neuron Disease using ASR alignment and pause modelling

arXiv: https://arxiv.org/abs/2609.38203 · HTML: https://mlsanity.com/paper/2609.38203/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 6 of its 26 references that are in the map.
- First posted on arXiv 22 Sep 2026.

## Builds on (most cited first, 6 of 6)

- [Robust Speech Recognition via Large-Scale Weak Supervision](https://mlsanity.com/paper/2212.04356/) (2022)
- [wav2vec 2.0: A Framework for Self-Supervised Learning of Speech Representations](https://mlsanity.com/paper/2006.11477/) (2020)
- [HuBERT: Self-Supervised Speech Representation Learning by Masked Prediction of Hidden Units](https://mlsanity.com/paper/2106.07447/) (2021)
- [WhisperX: Time-Accurate Speech Transcription of Long-Form Audio](https://mlsanity.com/paper/2303.00747/) (2023)
- [Speech Intelligibility Assessment of Dysarthric Speech by using Goodness of Pronunciation with Uncertainty Quantification](https://mlsanity.com/paper/2305.18392/) (2023)
- [Automatic Prediction of Amyotrophic Lateral Sclerosis Progression using Longitudinal Speech Transformer](https://mlsanity.com/paper/2406.18625/) (2024)

## Abstract (arXiv)

Monitoring cognitive impairment (CI) in motor neuron disease (MND) is essential for timely treatment and care, yet challenging due to co-occurring speech difficulties. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) provides a robust metric for CI assessment, with the Verbal Fluency Index (VFI) a central element. Building on recent advances in automated speech analysis, this study proposes a system for estimating VFI. It leverages a unique MND dataset and combines ASR (WhisperX) and VAD (Silero) with refined timestamping to predict the VFI and extract several clinically interpretable measures. Our approach outperformed systems based on traditional acoustic features and self-supervised embeddings, evaluated using multiple regression algorithms. Clinically inspired features consistently outperformed the other sets, with the best models achieving strong results (P-words: R2 0.9, NRMSE 0.05; S-words: R2 0.8, NRMSE 0.08), demonstrating the feasibility of automated VFI estimation.