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Do LLMs Reliably Identify Correct Information Units in Aphasic Discourse?

Correct Information Units (CIUs) are central to discourse assessment in aphasia because they quantify communicative informativeness rather than linguistic form alone. However, CIU scoring is time intensive and requires trained raters. This study examined whether instruction-tuned large language models (LLMs) can reliably perform token-level CIU classification from aphasic discourse transcripts. Sixteen picture-description transcripts elicited with the Cat Rescue stimulus were annotated for CIU status according to Nicholas and Brookshire (1993). The sample spanned four severity strata: control, mild, moderate, and severe aphasia. Four publicly available instruction-tuned LLMs were benchmarked under zero-shot and two few-shot prompting conditions across five stratified random seeds. Performance was evaluated against consensus human labels using accuracy, precision, recall, F1, and Cohen's kappa. Zero-shot prompting was insufficient across models. In contrast, few-shot prompting yielded substantial gains and produced competitive performance for three viable models. Mean few-shot F1 scores ranged from 0.776 to 0.817 across Llama-3.1-8B, Qwen2.5-7B, and Mistral-7B, with no significant differences between fixed global and per-chunk local example selection. Phi-3-mini was unstable and did not yield reliable performance. Viable models showed high recall but lower precision, suggesting systematic over-classification of tokens as CIUs. Performance also varied by discourse severity, with the weakest results in more severe aphasia. Few-shot LLM prompting can support automated CIU identification without gradient-based task training, but agreement with human annotation remains insufficient for fully autonomous use. These findings support LLM-based CIU scoring as a promising human-in-the-loop component of discourse assessment systems.

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