Retrieval-Augmented Generation of Pediatric Speech-Language Pathology vignettes: A Proof-of-Concept Study

Abstract: Clinical vignettes are essential educational tools in speech-language pathology (SLP), but manual creation is time-intensive. While general-purpose LLMs can generate text, they lack domain-specific knowledge, leading to hallucinations and requiring extensive expert revision. This study presents a proof-of-concept system integrating retrieval-augmented generation (RAG) with curated knowledge bases to generate pediatric SLP case materials. A multi-model RAG-based system was prototyped integrating curated domain knowledge with engineered prompt templates, supporting five commercial (GPT-4o, Claude 3.5 Sonnet, Gemini 2.5 Pro) and open-source (Llama 3.2, Qwen 2.5-7B) LLMs. Seven test scenarios spanning diverse disorder types and grade levels were systematically designed. Generated cases underwent automated quality assessment using a multi-dimensional rubric evaluating structural completeness, internal consistency, clinical appropriateness, and IEP goal/session note quality. This proof-of-concept demonstrates technical feasibility for RAG-augmented generation of pediatric SLP vignettes. Commercial models showed marginal quality advantages, but open-source alternatives achieved acceptable performance, suggesting potential for privacy-preserving institutional deployment. Integration of curated knowledge bases enabled content generation aligned with professional guidelines. Extensive validation through expert review, student pilot testing, and psychometric evaluation is required before educational or research implementation. Future applications may extend to clinical decision support, automated IEP goal generation, and clinical reflection training.