Native talkers are able to enhance acoustic characteristics of their speech in a speaking style known as “clear speech,” which is better understood by listeners than “plain speech.” However, despite substantial research in the area of clear speech, it is less clear whether non-native talkers of various proficiency levels are able to adopt a clear speaking style and if so, whether this style has perceptual benefits for native listeners. In the present study, native English listeners evaluated plain and clear speech produced by three groups: native English talkers, non-native talkers with lower proficiency, and non-native talkers with higher proficiency. Listeners completed a transcription task (i.e., an objective measure of the speech intelligibility). We investigated intelligibility as a function of language background and proficiency and also investigated the acoustic modifications that are associated with these perceptual benefits. The results of the study suggest that both native and non-native talkers modulate their speech when asked to adopt a clear speaking style, but that the size of the acoustic modifications, as well as consequences of this speaking style for perception differ as a function of language background and language proficiency.
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This content will become publicly available on November 5, 2026
Patient-Provider Communication and Health Disparities: An Experiment Exploring Language Proficiency and Communication Accommodation
Abstract Effective communication is critical for equitable healthcare delivery. In situations where there is language discordance between patients and providers, with one person speaking a shared language more proficiently, communication challenges may exacerbate disparities, particularly for racially or ethnically minoritized patients. Even when patients and providers are both fluent enough in English to not need interpretation, communication challenges intensify when patients are required to use their second language (L2) to interact with a native English (L1) speaking healthcare provider. Communication accommodation encompasses speech adjustments used to mitigate these barriers. Because communication accommodation strategies are not explicitly taught in healthcare training, it is unknown how healthcare providers adjust and the role a patient’s English proficiency plays in guiding provider language choices. This experimental study tested how L1 physician assistant students modify their communication during intake interviews with Latine L2 avatar patients of varying English proficiency, using the mixed-reality simulation platform Mursion. Data from 41 physician assistant students in 2023–2024 were analyzed for acoustic (i.e., speech rate, pitch modulation) and lexical adjustments (i.e., word frequency, contextual diversity). Results revealed significant accommodations: students reduced their speech rate, narrowed their pitch range, and used higher-frequency vocabulary when interacting with lower-proficiency L2 avatars. The results demonstrate that communication accommodation occurs and could be a potential mechanism for the widening or narrowing of healthcare disparities in patient outcomes. Future work should consider identifying which accommodations improve patients’ comprehension of medical advice and their relationships with healthcare providers.
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- Award ID(s):
- 2141281
- PAR ID:
- 10646271
- Editor(s):
- Laurencin, Cato
- Publisher / Repository:
- Journal of Racial and Ethnic Health Disparities
- Date Published:
- Journal Name:
- Journal of Racial and Ethnic Health Disparities
- ISSN:
- 2197-3792
- Subject(s) / Keyword(s):
- Communication barriers Healthcare disparities Language Cultural competency Simulation training
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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