Difference Versus Disorder

Accents are a natural part of spoken languages. No accent is intrinsically "better" than another, and many accents do not interfere with communicative ability. Accented speech, as stated above, is a variation in the speech produced by a group of individuals—this variation is influenced by their geographic area or the effect of their L1 on the sound system of their L2. Accents reflect a communication difference and not a communication disorder. Speech-language pathologists (SLPs) may facilitate accent modification as an elective service, but they do not approach this service as remediation of a disorder. The terminology used to describe an accent and the services related to accent modification reflects this distinction.

Why Services Are Sought

Accents often serve as a source of pride for individuals and frequently reflect the social, cultural, ethnic, and geographic background of a person. However, at times, an accent may impede effective and efficient communication. Some issues that may arise and that may warrant individuals to seek elective SLP services are

• difficulty being understood;
• frequent need to repeat oneself;
• attention being directed more toward the accent than the message; and/or
• listeners' negative attitudes toward speakers with the accent.

These communication challenges may negatively affect professional and educational advancement, self-esteem, social interactions, and everyday life activities (Brady, Duewer, & King, 2016; Carlson & McHenry, 2006). Therefore, an individual may choose to seek elective accent modification services from an SLP or other service provider. Individuals typically seek accent modification services to improve intelligibility. Others seek such services to reduce their regional or non-native accent and align their speech with a Standard American English accent. Yet other individuals seek accent modification services to learn a new accent (e.g., actors in plays and film productions).

Evaluating Programs and Service Providers

Accent modification services can be provided by a number of different professions (e.g., a speech-language pathologist or an ESL instructor). Because accent modification is still evolving as an area of expertise, careful consideration should be taken when selecting a service provider. The following is the requisite knowledge base needed to work in the area of accent modification:

• Phonetics, including narrow transcription (Morley, 1996)
• Phonology (Morley, 1996)
• Changes in speech production during connected speech (Morley, 1996)
• Current instructional approaches and appropriate goal setting (Morley, 1996)
• Impact of L2 acquisition as well as linguistic and dialectal variation
• Ability to provide models of target sounds

When providing accent modification services, clinicians should be sensitive to cultural diversity and should be able to differentially diagnose a communication disorder and a communication difference (Sikorski, 2005). It is essential to work with a clinician who has this knowledge base and the demonstrated ability to apply it to individuals without speech disorders.

Roles and Responsibilities

General SLP Roles and Responsibilities

SLPs play a central role in the assessment and pronunciation training of persons seeking accent modification services. The professional roles and activities in speech-language pathology include clinical/educational services (assessment, planning, and pronunciation training), advocacy, education, administration, and research. See ASHA's Scope of Practice in Speech-Language Pathology (2016).

Appropriate roles for SLPs include, but are not limited to,

• educating individuals who seek accent modification services;
• educating other professionals about the needs of persons receiving accent modification services and the role of SLPs in service provision;
• educating other professionals about effective listening strategies when communicating with individuals who have accents;
• conducting a comprehensive, culturally and linguistically appropriate assessment of communication skills;
• identifying any communication disorders that may also be evident;
• determining functional impact on communication and need for accent modification services;
• developing modification plans, providing pronunciation training, documenting progress, and determining appropriate dismissal criteria;
• counseling persons seeking accent modification services regarding communication-related issues;
• remaining informed of research in the area of accent modification and helping advance the knowledge base related to the nature and provision of accent modification services.

As indicated in the Code of Ethics, Principle II, Rule A (ASHA, 2016), SLPs "shall engage in only those aspects of the professions that are within the scope of their professional practice and competence, considering their certification status, education, training, and experience" (Principle II, Rule A). SLPs who serve this population should be appropriately trained to do so.

Assessment

Assessment for individuals seeking accent modification services is different, in some ways, from a typical assessment of someone with a communication disorder. The goal here is to understand the impact of an individual's speech pattern on their intelligibility and functionality rather than to determine a differential diagnosis of a disorder. SLPs use assessments to evaluate accentedness, comprehensibility, and intelligibility and to establish goals and objectives that meet the needs of the individual client (Behrman & Akhund, 2013; Celce-Murcia et al., 1996; Schmidt, 1997; Sikorski, 2005). These dimensions of an accent can be assessed in various ways, including

• subjective rating scales (e.g., client's perception of communicative effectiveness in various settings);
• phonetic transcription tasks;
• analysis of suprasegmentals (stress, intonation, pitch, rhythm, timing) in words and sentences;
• phonetic/phonological analysis and error analysis (e.g., sound substitutions, omissions, etc.);
• percent exact word match between the utterance and the listener's transcription; and
• acoustic analysis of the speech signal.

Case History

It is important that the clinician conduct a thorough case history to determine the individual's language history. Relevant questions might revolve around where the client has lived and how long they lived in a particular area. A language history will include questions about

• the languages spoken by the client;
• the age of acquisition;
• the context in which the target language was learned (academic or community);
• length and age of exposure to each language spoken; and
• which languages are used in the home, at work, and in social settings.

Learner variables should be considered early on as they may also serve to guide the assessment protocol. Variables include "age, proficiency level, linguistic and cultural background, prior exposure to the target language, amount and type of prior pronunciation instruction, language aptitude, learning style, and previous exposure to a second language" (Celce-Murcia et al., 1996, p. 320). Another important factor to consider is the client's motivation for accent modification services (Moyer, 1999).

Along with a thorough case history, three main areas need to be considered when evaluating a client who is seeking accent modification services: segmentals, suprasegmentals, and language (e.g., syntax and morphology).

Segmentals

Segmentals are the individual sounds of a language, including consonants and vowels. Every language has a unique set of vowels and consonants and unique ways in which these sounds can be combined or used in words. An articulation assessment will survey the production of consonants, vowels, diphthongs, and consonant clusters in single words, in sentences, and in spontaneous speech.

Awareness of a language's speech-sound system—and, in particular, allophonic variations—is important when assessing segmental features of a language. If a sound in the target language is not part of the phonemic inventory of the individual's L1, then the individual may replace it with an allophone—a variation of a phoneme (e.g., the flap in "butter" being replaced with an aspirated /t/; Behrman, 2014). Auditory discrimination tests are often included in an assessment protocol to determine whether the client is able to perceive the difference among minimal pairs (i.e., pin and pen).

Clinicians should educate themselves on the phonetic inventory and phonological rules of the client's native language, if possible. Comparing and contrasting the L1 and English sound systems will help the clinician better understand why some consonants, vowels, and syllable shapes may be difficult for the client to produce. Clients often feel validated when they are made aware of the differences between their L1 and English.

Suprasegmentals

Suprasegmentals are the prosodic features of speech that include stress, intonation, pitch, timing, and loudness (Behrman, 2014; Celce-Murcia et al., 1996; Sikorski, 2005). Modifications in the suprasegmental features of a language may make a significant impact on speaker intelligibility (Celce-Murcia et al., 1996; Hahn, 2004; Sikorski, 2005; Trofimovich & Baker, 2006). The following list offers a summary of the various suprasegmental features that are assessed and a brief description of each (Bernthal & Bankson, 1993):

• Stress —the prominence or emphasis on a particular part of an utterance or syllable. For example:
  • TEL-e-phone
  • com-PU-ter
  • make him STOP!
  • PLEASE come with us
• Intonation —the vocal pitch contour or pattern that changes within and across words and that impacts meaning. For example:
  • This is my car? [rising, question]
  • This is my car. [falling, statement]
• Pitch —how high or how low someone's voice is perceived to be
• Timing/rhythm—the duration of sounds and pauses within an utterance
• Loudness— the vocal intensity used by a speaker

Language

For speakers learning English as their L2, the majority of the time that they spend learning L2 is typically devoted to learning syntax, morphology, and vocabulary. An assessment of these aspects of language may assist with determining the individual's proficiency in L2. Language sampling can be gathered from a variety of settings, including the workplace, and may include structured sentences as well as spontaneous conversation (Sikorski, 2005). Language interacts with phonology. For example, an individual may present with a lack of bound morphemes, such as a plural marker. This may be perceived as final consonant deletion or one who has difficulty with consonant clusters. Careful consideration of L1 and its impact on L2 is critical.

Cultural Considerations

Individuals seeking accent modification services will reflect a variety of unique cultural and linguistic backgrounds and experiences. Accent modification services should be provided in a manner that considers each client's unique needs and values. For additional information on providing culturally competent services, see Cultural Competence.

Pronunciation Training/Accent Modification

The goal of any accent modification program is improved communication skills. The field of accent modification is relatively young, yet it has evolved over time with a focus on different methods and approaches. When developing a training program, the clinician should consider all of the assessment areas outlined above in order to provide the most comprehensive approach.

In most cases, the goal of accent modification services is to improve an individual's intelligibility so that others are able to comprehend their speech and/or communicate without their accent being a distraction. In accent modification, clinicians frequently use rating scales to measure accentedness, intelligibility, and comprehensibility, all of which are somewhat independent from one another (Derwing & Munro, 1997; Munro & Derwing, 1995). There is a general correlation between a higher degree of accentedness and lower intelligibility/comprehensibility. However, some speakers with strong accents may be as intelligible and/or comprehensible as someone with a lesser degree of accentedness (Munro & Derwing, 1995). Other variables that affect intelligibility include characteristics of the speaker, characteristics of the listener, particular language pairings, language familiarity, use of particular phonemes, and the speech task (Bent & Bradlow, 2003; Bradlow & Bent, 2008; Levy & Law, 2010; Mahendra, Bayles, & Tomoeda, 1999).

Accent Modification Goals

Goal setting is typically a collaborative process between the clinician and the client. It is not realistic to expect that individuals will eliminate their accent and sound like a native English speaker (Celce-Murcia et al., 1996). A more achievable goal may be to improve intelligibility and communicative effectiveness by the SLP teaching the individual a combination of pronunciation, syntactic, and intonation skills.

Accent Modification Training or Strategies

A number of different accent modification training or strategies are used in the field. The following specific strategies have been suggested for pronunciation training:

• Listen and imitate—the client repeats a clinician-provided model (Celce-Murcia et al., 1996)
• Phonetic training—explicit teaching of phonemes via descriptions and articulatory position diagrams of the phonetic alphabet (Celce-Murcia et al., 1996)
• Minimal pair drill—contrasting between similar sounds via listening discrimination and verbal production (Celce-Murcia et al., 1996)
• Contextualized minimal pairs—contrasting between similar sounds in a meaningful context (Celce-Murcia et al., 1996)
• Visual aids—cues to assist in the production of sound (i.e., pictures, mirrors, the vowel quadrilateral, and sound–color charts; Celce-Murcia et al., 1996)
• Tongue twisters—phrases or sentences that are difficult to produce because of the use of successive consonantal sounds (e.g., Peter Piper picked a peck of pickled peppers; Celce-Murcia et al., 1996)
• Developmental approximation drills—following a developmental sequence in learning sounds of the L2 (Celce-Murcia et al., 1996)
• Practice of vowel production and altering stress patterns (Celce-Murcia et al., 1996)
• Reading aloud (Celce-Murcia et al., 1996)
• Recording of client's production for auditory feedback and review (Celce-Murcia et al., 1996)
• Auditory discrimination training (Bradlow, Akahane-Yamada, Pisoni, & Tohkura, 1999)

Billing

Accent modification is an elective service. Because an accent is not a communication disorder, these services cannot be billed to insurance.

There are instances when a client who seeks accent modification services also has a speech or language disorder. If an SLP is providing services, they must be certain to note the distinction and separate what types of services are being provided (i.e., elective services for accent modification vs. treatment for a communication disorder). The only services that can be billed to insurance are those provided to evaluate or treat a communication disorder—not those provided to treat a communication difference, such as accented speech.

Service Delivery

Provider

Provider refers to the person offering the treatment. Accent modification services can be provided by SLPs, ESL instructors, voice and speech coaches, and other professionals.

Format

Format refers to the structure of the training (e.g., group and/or individual). Accent modification is an area of practice that can be delivered individually or in a small group.

Setting

Setting refers to the location of services (e.g., home, community based, work). Services can be carried out in an SLP's office, in the client's home, or within the community to promote generalization.

Dosage

Dosage refers to the frequency, intensity, and duration of service. Many accent modification programs may be intensive in nature. Dosage is determined on the basis of each client's specific needs.

Ethical Considerations

ASHA Principle of Ethics I, Rule J of ASHA's Code of Ethics states, "Individuals shall accurately represent the intended purpose of a service, product, or research endeavor and shall abide by established guidelines for clinical practice and the responsible conduct of research" (ASHA, 2016). Principle I, Rule K states, "Individuals who hold the Certificate of Clinical Competence shall evaluate the effectiveness of services provided, technology employed, and products dispensed, and they shall provide services or dispense products only when benefit can reasonably be expected" (ASHA, 2016). SLPs delivering accent modification services will want to carefully evaluate the effectiveness and appropriateness of services and accurately represent the goals and expectations of services.

ASHA Code of Ethics (2016), Principle III, Rule B states, "Individuals shall avoid engaging in conflicts of interest whereby personal, financial, or other considerations have the potential to influence or compromise professional judgment and objectivity." SLPs will want to appropriately represent their skills and services when advertising and will want to provide services to only those individuals who may benefit from accent modification services. For more information on appropriate representation when marketing services to the public, see Issues in Ethics: Public Announcements and Public Statements (ASHA, 2015).

Title VII of the 1964 Civil Rights Act protects individuals from employment discrimination on the basis of sex, color, national origin, and religion. Accent discrimination falls under the purview of discrimination based on national origin. According to Title VII of the Civil Rights Act, "An employer may not base a decision on an employee's foreign accent unless the accent materially interferes with job performance" (U.S. Equal Employment Opportunity Commission, 2008, p. 1. Employers are not required to hire individuals whose communication materially interferes with satisfactory job performance. However, employers must show impartiality concerning different types of accents. For example, employers are not permitted to show a preference for French or German accents over Japanese or Spanish accents (Franklin, 2012).

It is not within the scope of the SLP to identify cases of accent discrimination. However, providers of accent modification services should be aware of this aspect of the Civil Rights Act and be willing to inform their clients of this provision, when appropriate.

ASHA Resources

• Code of Ethics
• Issues in Ethics: Public Announcements and Public Statements
• Scope of Practice in Speech-Language Pathology

Other Resources

This list of resources is not exhaustive and the inclusion of any specific resource does not imply endorsement from ASHA.

• The Speech Accent Archive
• U.S. Equal Employment Opportunity Commission: Facts About National Origin Discrimination

Pronunciation Training Articles

The following articles offer a focus on various pronunciation training models:

Behrman, A. (2014). Segmental and prosodic approaches to accent management. American Journal of Speech-Language Pathology, 23, 546–561.

Bradlow, A. R., Akahane-Yamada, R., Pisoni, D. B., & Tohkura, Y. (1999). Training Japanese listeners to identify English /r/and /l/: Long-term retention of learning in perception and production. Perception & Psychophysics, 61, 977–985.

Bradlow, A. R. (2008). Training non-native language sound patterns: Lessons from training Japanese adults on the English /ɹ/-/l/ contrast. In J. G. Hansen Edwards & M. L. Zampini (Eds.), Phonology and second language acquisition (pp. 287–308). Amsterdam, the Netherlands: John Benjamins.

Brady, K. W., Duewer, N., & King, A. M. (2016). The effectiveness of a multimodal vowel-targeted intervention in accent modification.Contemporary Issues in Communication Science and Disorders, 43, 23–34.

Carlson, H. K., & McHenry, M. A. (2006). Effect of accent and dialect on employability. Journal of Employment Counseling, 43 (2), 70–83.

Derwing, T. M., & Munro, M. J. (2009). Second language accent and pronunciation teaching: A research-based approach. TESOL Quarterly, 39, 379–397.

Hahn, L. (2004). Primary stress and intelligibility: Research to motivate the teaching of suprasegmentals. TESOL Quarterly, 38, 201–223.

Hashemian, M., & Fadaei, B. (2011). A comparative study of intuitive-imitative and analytic-linguistic approaches towards teaching English vowels to L2 learners. Journal of Language Teaching and Research, 2, 969–976.

McLeod, S. (Ed.). (2007). The international guide to speech acquisition. Clifton Park, NY: Thomson Delmar Learning.

Morley, J. (1996). Second language speech/pronunciation: Acquisition, instructions, standards, variation, and accent. In J. E. Alatis, C. A. Straelhle, M. Ronkin, & B. Gallenberger (Eds.), Current trends and future prospects (pp. 140-160). Washington, DC: Georgetown University Press.

Schmidt, A. M. (1997). Working with adult foreign accent: Strategies for intervention. Contemporary Issues in Communication Science and Disorders, 24, 53–62.

American Speech-Language-Hearing Association. (2015). Issues in ethics: Public announcements and public statements. Available from www.asha.org/Practice/ethics/Public-Announcements-and-Public-Statements/

American Speech-Language-Hearing Association. (2016).Code of ethics [Ethics]. Available from www.asha.org/policy/

American Speech-Language-Hearing Association. (2016). Scope of practice in speech-language pathology [Scope of Practice]. Available from www.asha.org/policy/.

Behrman, A. (2014). Segmental and prosodic approaches to accent management.American Journal of Speech-Language Pathology, 23, 546–561.

Behrman, A., & Akhund, A. (2013). The influence of semantic context on the perception of Spanish-accented American English.Journal of Speech, Language, and Hearing Research, 56, 1567–1578.

Bent, T., & Bradlow, A. R. (2003). The interlanguage speech intelligibility benefit. The Journal of the Acoustical Society of America, 114, 1600–1610.

Bernthal, J. E., & Bankson, N. W. (1993). Articulation and phonological disorders (3rd ed.). Englewood Cliffs, NJ: Prentice Hall.

Bradlow, A. R., Akahane-Yamada, R., Pisoni, D. B., & Tohkura, Y. (1999). Training Japanese listeners to identify English /r/and /l/: Long-term retention of learning in perception and production. Perception & Psychophysics, 61, 977–985.

Bradlow, A. R., & Bent, T. (2008). Perceptual adaptation to non-native speech. Cognition, 106, 707–729.

Brady, K. W., Duewer, N., & King, A. M. (2016). The effectiveness of a multimodal vowel-targeted intervention in accent modification.Contemporary Issues in Communication Science and Disorders, 43, 23–34.

Carlson, H. K., & McHenry, M. A. (2006). Effect of accent and dialect on employability. Journal of Employment Counseling, 43 (2), 70–83.

Celce-Murcia, M., Brinton, D. M., & Goodwin, J. M. (1996). Teaching pronunciation: A reference for teachers of English to speakers of other languages . Cambridge, United Kingdom: Cambridge University Press.

Civil Rights Act of 1964 § 6, 42 U.S.C. § 2000d.

Derwing, T. M., & Munro, M. J. (1997). Accent, intelligibility, and comprehensibility: Evidence from four L1s. Studies in Second Language Acquisition, 19, 1–16.

Derwing, T. M., & Munro, M. J. (2009). Putting accent in its place: Rethinking obstacles to communication. Language Teaching, 42, 276–490.

Franklin, A. D. (2012). Acquisition of a phonological system in adulthood. In B. V. Peter & A. MacLeod (Eds.), Comprehensive perspectives on child speech development and disorders (pp. 225–246). Hauppauge, NY: Nova Science Publishers.

Hahn, L. (2004). Primary stress and intelligibility: Research to motivate the teaching of suprasegmentals. TESOL Quarterly, 38, 201–223.

Levy, E. S., & Law, F. F. (2010). Production of French vowels by American-English learners of French: Language experience, consonantal context, and the perception-production relationship. The Journal of the Acoustical Society of America, 128, 1290–1305.

Mahendra, N., Bayles, K., & Tomoeda, C. (1999). Effect of an unfamiliar accent on the repetition ability of normal elders and individuals with Alzheimer's disease. Journal of Medical Speech-Language Pathology, 7, 223–230.

Morley, J. (1996). Second language speech/pronunciation: Acquisition, instructions, standards, variation, and accent. In J. E. Alatis, C. A. Straelhle, M. Ronkin, & B. Gallenberger (Eds.), Current trends and future prospects (pp. 140–160). Washington, DC: Georgetown University Press.

Moyer, A. (1999). Ultimate attainment in L2 phonology. Studies in Second Language Acquisition, 21, 81–108.

Munro, M. J., & Derwing, T. M. (1995). Foreign accent, comprehensibility, and intelligibility in the speech of second language learners. Language Learning, 45, 73–97.

Schmidt, A. M. (1997). Working with adult foreign accent: Strategies for intervention.Contemporary Issues in Communication Science and Disorders , 24, 53–62.

Sikorski, L. D. (2005). Regional accents: A rationale for intervening and competencies required. Seminars in Speech and Language, 26(2), 118–125.

Trofimovich, P., & Baker, W. (2006). Learning second language suprasegmentals: Effect of L2 experience on prosody and fluency characteristics of L2 speech. Studies in Second Language Acquisition, 28, 1–30.

U.S. Equal Employment Opportunity Commission. (2008). Facts about national origin discrimination. Retrieved from https://www.eeoc.gov/facts/fs-nator.html

Valles, B., Jr. (2015). The impact of accented English on speech comprehension (Doctoral dissertation). Retrieved from ProQuest Dissertations & Theses—Gradworks (Publication No. 3708574). Available from http://gradworks.proquest.com/37/08/3708574.html

Acknowledgements

Content for ASHA's Practice Portal is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the page:

• Alison Behrman, PhD, CCC-SLP
• Kathryn Brady, PhD, CCC-SLP
• Barb Cicholski, MA, CCC-SLP
• Kate DeVore, MA, CCC-SLP
• Amber Franklin, PhD, CCC-SLP
• Jenna Luque, MA, CCC-SLP
• Erika Levy, PhD, CCC-SLP
• Anna Schmidt, PhD, CCC-SLP
• Benigno Valles, PhD, CCC-SLP

Citing Practice Portal Pages

The recommended citation for this Practice Portal page is:

American Speech-Language-Hearing Association (n.d.). Accent Modification (Practice Portal). Retrieved month, day, year, from www.asha.org/Practice-Portal/Professional-Issues/Accent-Modification/.