Speech-language pathologists' support for multilingual speakers' English intelligibility and participation informed...

To use the ICF to classify characteristics and aspirations of multilingual university students and faculty who seek speech-language pathologists' support for intelligibility in English and to identify activities, facilitators, and barriers that impact participation in society.

A retrospective record review was conducted on files of 175 clients attending a university clinic for intelligibility enhancement (accent modification). Participants came from 35 countries and spoke 28 different home languages.

Assessment and intervention for intelligibility enhancement involved consideration of ICF components of Body Functions and Structures (e.g., articulating phonemes, rate, prosody), Environmental Factors (e.g., support), and Personal Factors (e.g., motivation). Consonant substitutions and deletions were common, although participants were often unaware of these. For example, only 25.6% of participants reported English dental fricatives (/θ/ and /ð/) were difficult to pronounce; however, 94.9% substituted them with other phonemes such as [t] and [d]. The combination of substitutions/deletions, fast speech rate, low speaking volume, and differences in word stress exacerbated poor intelligibility. More time conversing in English was associated with greater confidence and less difficulty communicating in English, although more time knowing English was not. Difficult communication situations were reported to be conversing over the phone, talking to strangers, and communicating in English on professional fieldwork placements. Participants were motivated to seek intelligibility enhancement for academic, employment, and social reasons.

To ensure multilingual speakers are able to participate fully in society, intelligibility enhancement requires a multi-pronged approach where speech and environmental characteristics interweave.