Vision Language Models (VLMs) have achieved remarkable progress in multimodal tasks, yet they often struggle with visual arithmetic, seemingly simple capabilities like object counting or length comparison, which are essential for relevant complex tasks like chart understanding and geometric reasoning. In this work, we first investigate the root causes of this deficiency through a suite of probing tasks focusing on basic visual arithmetic. Our analysis reveals that while pre-trained vision encoders typically capture sufficient information, the text decoder often fails to decode it correctly for arithmetic reasoning. To address this, we propose CogAlign, a novel post-training strategy inspired by Piaget’s theory of cognitive development. CogAlign trains VLMs to recognize invariant properties under visual transformations. We demonstrate that this approach significantly improves the performance of three diverse VLMs on our proposed probing tasks. Furthermore, CogAlign enhances performance by an average of 4.6% on CHOCOLATE and 2.9% on MATH-VISION, outperforming or matching supervised fine-tuning methods while requiring only 60% less training data. These results highlight the effectiveness and generalizability of CogAlign in improving fundamental visual arithmetic capabilities and their transfer to downstream tasks.

Large Vision-Language Models (LVLMs) have shown significant potential in assisting medical diagnosis by leveraging extensive biomedical datasets. However, the advancement of medical image understanding and reasoning critically depends on building high-quality visual instruction data, which is costly and labor-intensive to obtain, particularly in the medical domain. To mitigate this data-starving issue, we introduce Self-Training Large Language and Vision Assistant for Medical (STLLaVA-Med). The proposed method is designed to train a policy model (an LVLM) capable of auto-generating medical visual instruction data to improve data efficiency, guided through Direct Preference Optimization (DPO). Specifically, a more powerful and larger LVLM (e.g., GPT-4o) is involved as a biomedical expert to oversee the DPO fine-tuning process on the auto-generated data, encouraging the policy model to align efficiently with human preferences. We validate the efficacy and data efficiency of STLLaVA-Med across three major medical Visual Question Answering (VQA) benchmarks, demonstrating competitive zero-shot performance with the utilization of only 9% of the medical data.