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Medical consultations are intrinsically speech-centric. However, most prior works focus on long-text-based interactions, which are cumbersome and patient-unfriendly. Recent advances in speech language models (SpeechLMs) have enabled more natural speech-based interaction, yet the scarcity of medical speech data and the inefficiency of directly fine-tuning on speech data jointly hinder the adoption of SpeechLMs in medical consultation. In this paper, we propose SpeechMedAssist, a SpeechLM natively capable of conducting speech-based multi-turn interactions with patients. By exploiting the architectural properties of SpeechLMs, we decouple the conventional one-stage training into a two-stage paradigm consisting of **(1) Knowledge &amp; Capability Injection via Text** and **(2) Modality Re-alignment with Limited Speech Data**, thereby reducing the requirement for medical speech data to only **10k** synthesized samples. To evaluate SpeechLMs for medical consultation scenarios, we design a benchmark comprising both single-turn question answering and multi-turn simulated interactions. Experimental results show that our model outperforms all baselines in both effectiveness and robustness in most evaluation settings.

ACL 2026

SpeechMedAssist: Efficiently and Effectively Adapting Speech Language Models for Medical Consultation

### Welcome to 2025 Annual Conference of the Nations of the Americas Chapter of the Association for Computational Linguistics

Welcome to the 2025 meeting of the Nations of the Americas Chapter of the Association for Computational Linguistics! I am proud to help organize the first NAACL conference to carry the new name of our organization, one that emphasizes inclusion for all of the Americas. I am also pleased to welcome you to Albuquerque, New Mexico, a state whose unique blend of cultural influences will make for an excellent backdrop for NAACL 2025, especially with this year’s special theme on NLP in a Multicultural World. 
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*- Colin Cherry, Google, NAACL 2025 General Chair* 

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NAACL 2025

Welcome to 2025 Annual Conference of the Nations of the Americas Chapter of the Association for Computational Linguistics

Medical consultations are intrinsically speech-centric. However, most prior works focus on long-text-based interactions, which are cumbersome and patient-unfriendly. Recent advances in speech language models (SpeechLMs) have enabled more natural speech-based interaction, yet the scarcity of medical speech data and the inefficiency of directly fine-tuning on speech data jointly hinder the adoption of SpeechLMs in medical consultation. In this paper, we propose SpeechMedAssist, a SpeechLM natively capable of conducting speech-based multi-turn interactions with patients. By exploiting the architectural properties of SpeechLMs, we decouple the conventional one-stage training into a two-stage paradigm consisting of **(1) Knowledge & Capability Injection via Text** and **(2) Modality Re-alignment with Limited Speech Data**, thereby reducing the requirement for medical speech data to only **10k** synthesized samples. To evaluate SpeechLMs for medical consultation scenarios, we design a benchmark comprising both single-turn question answering and multi-turn simulated interactions. Experimental results show that our model outperforms all baselines in both effectiveness and robustness in most evaluation settings.

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It is my great pleasure and honor to welcome you to the 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026), held in San Diego, California, USA, July 2–7, 2026. ACL 2026 continues our fields tradition of excellence in scholarship, innovation, and inclusivity, and I am deeply grateful to the many volunteers who have worked tirelessly to bring this event to life.

It is exciting to see the many developments in the field reflected at our conference, such as the advancement of large language models (born out of our community) into many application directions. This is not without challenges, partly due to unsolved problems, and partly due to misuse of the technology. All this is reflected well at ACL 2026. The conference also reflects that the field is not only about advancing technology, but also the science of fundamentally understanding language and how it is use by many different speaker communities. 
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The 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026) will take place in San Diego, California, from July 2 - 7, 2026.

The Key-Value (KV) cache introduces substantial memory overhead during large language model (LLM) inference. Although existing vector quantization (VQ) methods reduce KV cache usage and provide flexible representational capacity across bit-widths, they suffer severe performance degradation at ultra-low bit-widths due to key cache outliers that hinder effective codebook utilization. To address this challenge, we propose VecInfer, a novel VQ method for aggressive KV cache compression while enabling efficient inference. By applying smooth and Hadamard transformations, VecInfer suppresses outliers in the key cache, enabling the codebook to comprehensively cover the original data distribution and thereby reducing quantization difficulty. To facilitate efficient deployment, we design an optimized CUDA kernel that fuses computation with dequantization to minimize memory access overhead. Extensive evaluations demonstrate that VecInfer consistently outperforms existing quantization baselines across both long-context understanding and mathematical reasoning tasks. With only 2-bit quantization, VecInfer achieves performance comparable to full precision, while delivering up to $\mathbf{2.7\times}$ speedup in large-batch self-attention computation and $\mathbf{8.3\times}$ reduction in single-batch end-to-end latency on Llama-3.1-8B with a 196k sequence length.

VecInfer: Efficient LLM Inference with Low-Bit KV Cache via Outlier-Suppressed Vector Quantization

Applying language models (LMs) to tables is challenging due to the mismatch between the two-dimensional structure of tables and the one-dimensional inputs expected by LMs. This mismatch forces linearization, making LMs particularly sensitive to irrelevant cells. Subtable selection mitigates this challenge by isolating question-relevant content prior to answer generation. However, existing approaches either rely on independent row or column selection, failing to capture cross-row and cross-column dependencies, or attempt global reasoning and face challenges similar to holistic table QA under noisy contexts. We propose *PieTa* (Piece of Table), a divide-and-conquer subtable selection framework that progressively aggregates locally selected evidence without requiring explicit global reasoning. *PieTa* uses an iterative, window-based multi-resolution process to construct compact subtables that capture global dependencies while limiting LM exposure to irrelevant content. Extensive experiments demonstrate that *PieTa* consistently outperforms prior subtable-based and holistic table QA approaches.

Piece of Table: A Divide-and-Conquer Approach for Selecting Subtables in Table Question Answering

Decision-making is a cognitively intensive task that requires synthesizing relevant information from multiple unstructured sources, weighing competing factors, and incorporating subjective user preferences. Existing methods, including large language models and traditional decision-support systems, fall short: they often overwhelm users with information or fail to capture nuanced preferences accurately. We present Decisive, an interactive decision-making framework that combines document-grounded reasoning with Bayesian preference inference. Our approach grounds decisions in an objective option-scoring matrix extracted from source documents, while actively learning a user's latent preference vector through targeted elicitation. Users answer pairwise tradeoff questions adaptively selected to maximize information gain over the final decision. This process converges efficiently, minimizing user effort while ensuring recommendations remain transparent and personalized. Through extensive experiments, we demonstrate that our approach significantly outperforms both general-purpose LLMs and existing decision-making frameworks achieving up to 20% improvement in decision accuracy over strong baselines across domains.

 Decisive: Guiding User Decisions with Optimal Preference Elicitation from Unstructured Documents

Despite recent progress, the reasoning capabilities of large multimodal language models (MLLMs) remain fundamentally constrained by static supervision, where fixed prompts, rules, or reward models provide non-adaptive guidance throughout training. Such static signals are often sufficient to enforce output formats, but fail to shape the underlying reasoning process, leading to brittle generalization and performance saturation in complex decision-making tasks. We propose \textbf{Evo-PI}, a principle-centric learning framework that treats reasoning principles as explicit, language-based supervision signals that can be generated, evaluated, and iteratively evolved. Instead of relying on fixed rewards, Evo-PI enables a co-evolutionary loop in which principles guide model reasoning, while model behaviors in turn refine the principles that supervise them. This dynamic alignment mechanism allows supervision to progressively adapt to the model’s reasoning deficiencies. We instantiate Evo-PI in medical visual question answering as a high-stakes testbed requiring structured visual–textual reasoning. Across eight benchmarks and multiple model backbones, Evo-PI consistently improves reasoning accuracy, achieving gains of up to 24.6%. Our results suggest that evolving principle-guided supervision offers a scalable and general paradigm for training expert-aligned reasoning in multimodal language models.

Evo-PI: Aligning Medical Reasoning via Evolving Principle-Guided Supervision

Large language model (LLM) web agents are increasingly used for web navigation but remain far from human reliability on realistic, long-horizon tasks. Existing evaluations focus primarily on end-to-end success, offering limited insight into where failures arise. We propose a hierarchical planning framework that analyzes web agents across three layers (i.e., high-level planning, low-level execution, and re-planning), enabling process-based evaluation of reasoning, grounding, and recovery. Our experiments show that structured Planning Domain Definition Language (PDDL) plans produce more concise and goal-directed strategies than natural language (NL) plans, but low-level execution remains the dominant bottleneck. These results indicate that improving perceptual grounding and adaptive control, not only high-level reasoning, is critical for achieving human-level reliability. This hierarchical perspective provides a principled foundation for diagnosing and advancing LLM web agents.

Why Do LLM-based Web Agents Fail? A Hierarchical Planning Perspective

Surprisal theory links human processing effort to the predictability of an upcoming linguistic unit, but empirical work often leaves the notion of a unit underspecified. In practice, experimental stimuli are segmented into linguistically motivated units (e.g., words), while pretrained language models assign probability mass to a fixed token alphabet that typically does not align with those units. As a result, surprisal-based predictors depend implicitly on ad hoc procedures that conflate two distinct modeling choices: the definition of the unit of analysis and the choice of regions of interest over which predictions are evaluated. In this paper, we disentangle these choices and give a unified framework for reasoning about surprisal over arbitrary unit inventories. We argue that surprisal-based analyses should make these choices explicit and treat tokenization as an implementation detail rather than a scientific primitive.

On the Proper Treatment of Units in Surprisal Theory

Emergent communication (EmCom) with deep neural network-based agents promises to yield insights into the nature of human language, but remains focused primarily on a few subfield-specific goals and metrics that prioritize communication schemes which represent attributes with unique characters one-to-one and compose them syntactically. We thus reinterpret a common EmCom setting, the attribute-value reconstruction game, by imposing a small-vocabulary constraint to simulate double articulation, and formulating a novel setting analogous to naturalistic inflectional morphology (enabling meaningful comparison to natural language communication schemes). We develop new metrics and explore variations of this game motivated by real properties of inflectional morphology: concatenativity and fusion. Through our experiments, we discover that simulated phonological constraints encourage concatenative morphology, and emergent languages replicate the tendency of natural languages to fuse grammatical attributes.

Discovering Properties of Inflectional Morphology in Neural Emergent Communication

Social reasoning---inferring unobservable beliefs and intentions from partial observations of other agents---remains a challenging task for large language models (LLMs). We evaluate the limits of current reasoning language models in the social deduction game Avalon and find that while the largest models demonstrate strong performance, they require extensive test-time inference and degrade sharply when distilled to smaller, real-time-capable variants. To address this, we introduce a hybrid reasoning framework that externalizes belief inference to a structured probabilistic model, while using an LLM for language understanding and interaction. Our approach achieves competitive performance with much larger models in Agent-Agent play and, notably, is the first language agent to defeat human players in a controlled study---achieving a 67% win rate and receiving higher qualitative ratings than both reasoning baselines and human teammates. We release code, models, and a dataset to support future work on social reasoning in LLM agents.

Bayesian Social Deduction with Graph-Informed Language Models

Why do some languages like Czech permit free word order, while others like English do not? We address this question by pretraining transformer language models on a spectrum of synthetic word-order variants of natural languages. We observe that greater word-order irregularity consistently raises model surprisal, indicating reduced learnability. Sentence reversal, however, affects learnability only weakly. A coarse distinction of free- (e.g., Czech and Finnish) and fixed-word-order languages (e.g., English and French) does not explain cross-lingual variation. Instead, the structure of the word and subword vocabulary strongly predicts the model surprisal. Overall, vocabulary structure emerges as a key driver of computational word-order learnability across languages.

Vocabulary Shapes Cross-Lingual Variation of Word-Order Learnability in Language Models

When an AI assistant remembers that Sarah is a single mother working two jobs, does it interpret her stress differently than if she were a wealthy executive? As personalized AI systems increasingly incorporate long-term user memory, understanding how this memory shapes emotional reasoning is critical. We investigate how user memory affects emotional intelligence in large language models (LLMs) by evaluating 15 models on human validated emotional intelligence tests. We find that identical scenarios paired with different user profiles produce systematically divergent emotional interpretations. Across validated user-independent emotional scenarios and diverse user profiles, systematic biases emerged in several high-performing LLMs where advantaged profiles received more accurate emotional interpretations. Moreover, LLMs demonstrate significant disparities across demographic factors in emotion understanding and supportive recommendations tasks, indicating that personalization mechanisms can embed social hierarchies into models’ emotional reasoning. These results highlight a key challenge for memory-enhanced AI: systems designed for personalization may inadvertently reinforce social inequalities.

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