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Improving Communication Skills in Healthcare

esl rulesLynda Katz Wilner and Marjorie Feinstein-Whittaker, co-founders of ESL RULES  (www.eslrules.com), recently wrote an article published by The American Speech-Language-Hearing Association in the December 2013 issue of Perspectives on Communication Disorders in Culturally and Linguistically Diverse Populations. The following is an overview with excerpts from the article. Click the link at the end to read the article in its entirely.

Abstract

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s healthcare environment, interactions are challenged by diversity-Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.

Key Points

  • Hospitals and medical centers in the United States are rich with diverse providers, ancillary staff, and patient populations. Each culture has its own value system, communication style, and beliefs about health and illness.
  • These diverse providers and patient populations provide a growing niche for speech-language pathologists (SLPs) and other communication consultants to provide communication training in the workplace. 
  • A comprehensive accent modification program should address skills for efficiency, adaptability, clarity, credibility, active listening, and empathy.
  • Assessment of the health care provider’s ability to pronounce medically related vocabulary and scenarios should be included. RULES  and materials for improving communication in healthcare are discussed.
  • Health care providers need to understand and know how to appropriately respond to the unique social, cultural, and economic influences affecting their patients (Gray, 2013).

Summary

Improved health care and cultural communication impacts the overall experience for both the English speaking  and LEP patient, IMGs or United States Medical Graduate physicians, and the diverse nursing and support staff. Consequently, patient satisfaction, delivery of positive outcomes, the facility’s reputation, and decreased risk exposure of the hospital are the end product of effective language and cultural communication. In the new health care model, this will ultimately improve the sustainability of medical systems in the United States. As SLPs, (speech-language pathologists) we can have a substantial and positive impact facilitating clear, understandable, and compassionate communication amongst all of the parties involved.

Perspectives article ASHA 2013

Contact us about any curriculum or materials needs. We also conduct workshops to medical professionals.

wgsuccessfullyspeaking

Is it "ate" or "it"?

Our clients who speak English as a Second Language (ESL) and are enrolled in accent modification training are often are perplexed by pronunciation RULES. How do we pronounce “-ate” when it appears at the end of a word?  We've covered this in our RULES student workbook, but let’s look at more examples. The World Dictionary defines the “-ate” suffix in the following manner: For adjectives, it is used to denote the appearance or characteristics of the noun, e.g., fortunate. For nouns, it denotes an office, rank, or group with certain functions, e.g., senate, electorate. These words can also become verbs, e.g., separate, graduate, liberate.

The pronunciation changes according to the part of speech. The same word that can be used as a noun/adjective or a verb, but is stressed or pronounced differently and has a different  meaning, is called a heteronym. Check our video on two and three syllable heteronyms.

For all of the three and four syllable words ending in “-ate,” place the primary stress on the first syllable, regardless of the part of speech. However, for nouns or adjectives, the last syllable is not stressed and it is pronounced as “it.” For verbs, the last syllable has secondary stress and  is pronounced as “ate.”

Some of the words below are heteronyms and will be indicated with an asterisk.*

VERBS – pronounce the last syllable as “ate”

liberate                               equivocate                        corroborate                        integrate

indicate                              interrogate                        appreciate                          hesitate

segregate                           alleviate                              ameliorate                         hibernate

meditate                             terminate                          germinate                         elongate

aggravate                           participate                         concentrate                       communicate

translate                            anticipate                           hyphenate                         relegate

depreciate                         discriminate                       proliferate                        disseminate

dominate*                         conjugate*                         laminate*                          coordinate*

subordinate*                    graduate*                           estimate*                           syndicate*

separate*                           moderate*                         delegate*                            elaborate*

duplicate*

ADJECTIVES OR NOUNS- pronounce the last syllable as “it”

intimate                             fortunate                            inordinate                         electorate

consulate                           passionate                          separate*                           moderate*

indiscriminate                  elaborate*                          coordinate*                       graduate*

estimate*                           syndicate*                          delegate*                           duplicate*

Let us know of some more examples that you found. Check out more RULES in RULES Student Workbook.rules

Contact us to learn how to master the RULES.

What About Spell Check?

spell check
spell check

English spelling is a challenge, even for computers! Here is a reprint of a recently re-circulated poem on LinkedIn that highlights the "dangers" of putting too much trust into your computer's spell-check feature. This can lead us down the wrong path of communication. For those speaking English as a Second Language, who have less familiarity with English, the results can be somewhat amusing, if not embarrassing. Look at the passage below and see if you can make the necessary corrections. We'd love to hear from you to see if you know of any other similar passages:  

Eye halve a spelling chequer

It came with my pea sea

It plainly marques four my revue

Miss steaks eye kin knot sea.

Eye strike a key and type a word

And weight four it two say

Weather eye am wrong oar write

It shows me strait a weigh.

As soon as a mist ache is maid

It nose bee fore two long

And eye can put the error rite

Its rare lea ever wrong.

Eye have run this poem threw it

I am shore your pleased two no

Its letter perfect awl the weigh

My chequer tolled me sew.

Check out our communication products for non-native English speakers. Effective communication entails proper language, pronunciation, and writing skills. www.eslrules.com.

Is Silence Golden?

They say that silence is golden. Whether or not that maxim rings true, silent letters can be perplexing to second language learners and can be challenging for their pronunciation. Our clients who attend accent modification/accent reduction classes realize that effective communication involves mastering these idiosyncratic rules. Of course there are many exceptions, but the following are examples of some common words containing letters that should not be pronounced. /b/ is often silent when following /m/ at the end of a word

comb                   tomb                    climb                    thumb                 dumb

/b/ is often silent preceding /t/ in a word

debt                      doubt

/l/ is often silent when followed by /m/

palm                     salmon                 psalm                   calm                     balm

/l/ is often silent when followed by /k/

talk                       walk                     chalk                    yolk                        folk   

/gh/ is often silent

daughter              through                although              dough                   taught

/g/ is often silent when followed by /m/ or /n/

align                     foreign                 resign                   malign                   ensign                 

/w/ is often silent before /r/

written                 wreath                 wrap                     wrought                wrong

/t/ is often silent at the ends of words

ballet                    cabaret                gourmet                  bouquet                buffet   

/k/ is often silent before /n/

knight                  knit                       knife                     kneel                      knot

/p/ is often silent

receipt                 pneumonia          raspberry             psychologist

/st/ can be silent

listen                    whistle                 thistle                   glisten

 /ch/  can be silent

yacht

/h/ is silent in the beginning of some words:

honor                   herbal                   honest                  heirs                      honorable

There are many more examples of silent letters in the English language, and exceptions to the “RULES” mentioned above.

Let us know which words you can  find.rulesrulesbythesound

To learn more about pronunciation variations for English consonants and vowels and practice their pronunciation variations,  please see RULES By the Sound.   the RULES by the Sound Pronunciation Platform, and RULES: Rules for Using Linguistic Elements of Speech.

Malapropisms and Verbal Missteps

  We have all done it! Regardless of whether or not English is our first language, sometimes what comes out of our mouths isn't what we intended.

malapropisms  - noun  /ˈmæl ə prɒpˌɪz əm/

Definition: an amusing error that occurs when a person mistakenly uses a word that sounds like another word but that has a very different meaning.

We are collecting examples of this entertaining verbal missteps. Please add any ones that you encounter.

"Obama Steaks" (Omaha Steaks)

"I heard her over-talking about..."  (I overheard her talking.)

"It was straight from the mouth of the horse." (It was straight from the horse's mouth.)

Gloria, in Modern Family, is a master of mispronunciation and malapropisms. This clip captures both the humor and the frustrations of non-native English communication.

Here are some more malapropisms:

"For all intensive purposes" (for all intents and purposes)

"I will take a look at your website and get back to you when a need rises." (a need arises)

"I’ll meet you at the Christian Silence Reading Room (Christian Science Reading Room)

idioms
idioms

Often, idioms are misused. The substitution of a single word may change the meaning entirely. For example, if you told someone to "break an arm," it would not convey the expression for good luck, which is "break a leg." For more idioms, check our Medically Speaking Idioms in our webstore at http://www.eslrules.com/product/medically-speaking-idioms-audio-cd/

We'd love to hear from you.

Tips for Teaching When You Have an Accent

One of our clients recently earned her PhD  after many long, hard years of study.  Since she knew she wanted to pursue a career in academia, she took accent modification and presentation skills training to prepare her for her oral dissertation and job interviews. As busy as she was, she devoted as much time as possible to her independent self-study between sessions. She made tremendous progress and was able to secure a faculty position at a university of her choice.

Although she was a “listener-friendly” speaker by this point, she wanted some pointers to maximize her "understandability"  in the classroom setting.

The following are some useful tips if you or your students are in a similar situation:

  1. Acknowledge your accent and give your students “permission” to request a repetition or clarification if they don’t understand something you said.
  2. Make sure you are FACING THE CLASS while speaking. DO NOT talk while writing on the board or looking at the screen!
  3. Speak at a slightly slower rate than normal. This may be difficult if you are nervous, so be sure to PAUSE after important points, and use deep slow breaths to calm you down.
  4. Practice your lecture ALOUD ahead of time. Make a note of any particularly challenging words, and make sure you are using the correct stress pattern.
  5. If you have to use unfamiliar words that are difficult to pronounce, either write them down or provide additional information or context, e.g., “The test will not be cumulative; in other words, the exam will only cover content from the midterm to the final.”

By following these tips, you will enhance the quality of your presentation skills. Let us know if you have any other suggestions.

Accent Modification "Milestones"

Business group portrait

A lot of adults considering accent modification training subscribe to the adage, “You can’t teach an old dog new tricks.” Although it is more difficult to change speech habits after the teen years, with awareness and practice, a successful outcome (sometimes described as listener-friendly speech) is a reasonable, attainable goal. What factors influence individual performance in changing speech behavior?

The following factors must be considered:

• The perceived strength of the accent (vowel and consonant production, intonation patterns, etc.) • Overall English language proficiency • The presence of any cognitive, speech-language or hearing disorders such as dyslexia, ADHD, etc. • Motivation and time devoted to independent practice • Responsiveness to constructive feedback • Current employment situation/responsibilities • Career aspirations • Support network • Insight into communication differences

Clients enrolled in a weekly 12-16 week program typically begin to notice concrete changes at approximately the mid-point of training. At that time, clients may begin to report that they can identify and self-correct speech differences in their own speech. They are also more aware of the speech patterns of others, and report that they are better listeners because they are more tuned in to the subtleties of communication.

At the end of training, clients typically are more consistent with their mainstream sound production, and use intonation patterns that are more in line with native speakers. They often speak more slowly, project their voice more appropriately, and have a greater sense of confidence when speaking to both native and non-native English speakers. They often realize that they no longer have to repeat themselves.

It is important to note that everyone progresses at a different rate, and the end results vary. However, despite the challenging and demanding nature of this type of training, with positive and constructive input, time, and patience, accent training can be a powerful and empowering pursuit.

Conducting Interviews

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In most corporations, Human Resource managers and senior level staff conduct many of the interviews after an initial screening process. However, in smaller companies, individuals who do not regularly participate in these sessions, may be called upon to be part of a group interview, or asked to speak with students seeking internships, or other low- profile or entry level positions.If you find yourself in this potentially uncomfortable position, here are some tips for handling this important task:

Before the interview, brainstorm about the qualities that you and your team are seeking in the candidate. These characteristics go beyond the obvious required technical or professional expertise or experience. Your list may include qualities such as:

  • Passion about what he/she will be doing
  • Outgoing personality
  • Thoughtful and considerate disposition/attitude
  • Mentoring/nurturing communication style
  • Sense of humor
  • Well-rounded person with diverse interests
  • Desire to push boundaries and inspire team members
  • Good time manager

Once you have created your “ideal” candidate in your mind, you can formulate questions that will help guide you in your selection process. Here are some examples:

  • How do you typically handle multiple projects and deadlines? (ability to prioritize, delegate, manage time)
  • Who or what inspires you? (passion)
  • How would you describe your work ethic? (reliability, punctuality, etc.)
  • What projects have you spear-headed? (initiation, leadership, etc.)
  • How do you prefer to give and provide feedback? (communication style)
  • What kind of work environment do you thrive in? (collaborative vs. independent, fast-paced or laid-back, flexible or structured, etc.)

What if you aren't getting the answers you seek? As the interviewer, you maintain control of the conversation, and can probe or push back as needed. Some helpful comments might include:

  • Can you give me a little more background on that particular problem and how you handled it?
  • I’d like to hear more details or specifics about....
  • I’m afraid I’m not following what you meant by...
  • What exactly did you mean when you said....
  • I’m really interested in hearing more about...
  • Can you tell how that issue finally got resolved?

A different style of interviewing using the behavioral-based interview questions. Give the interviewee a situation and ask how he responded. This will give you insight into how he would respond in the new position. For example, “Tell me a time when you had to work on a team and the leader was not accomplishing the goals. What did you do?”

Finally, make sure that the candidates take advantage of the opportunity to ask YOU questions (by Joseph). If they don’t inquire, it may mean that they haven’t done their homework about the position, or the company.

Remember, specific skill training can happen on the job, but you need to make sure you hire someone who will fit in with the culture of your company, and the other employees who may be part of the team.


Reading Aloud to Improve Your Accent

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We understand that it is very difficult to squeeze independent accent modification homework into an already hectic day. One of the best and easiest ways to reinforce what you have learned during the week is just to read out loud as many times per day as possible.

Think of all of the reading materials you come in contact with on a daily basis. Take a few moments to read the first few sentences aloud, making sure to accurately produce a target sound, use appropriate word or sentence level stress, practice voice projection, or reinforce any of your new speech and communication goals.

Here are at least 36 reminders (yes, 36) of what you are exposed to daily to heighten your awareness:

At work:
1. E-mails
2. Business cards
3. Technical manuals
4. Faxes
5. Reports
6. Memos
7. Documents
8. LinkedIn postings
9. Websites

At school:
1. Bulletin boards/announcements
2. Whiteboards/blackboards
3. Dictionaries
4. Blogs
5. Textbooks
6. Assignments
7. E-mails

On the road:
1. Highway signs
2. Street signs
3. Construction/traffic warnings
4. Bus/train schedules
5. Storefront signs
6. Billboards
7. Menus

At home:
1. Novels
2. Newspapers
3. Magazines
4. Advertisements
5. Recipes/cookbooks
6. Carry-out menus
7. Catalogues
8. Children’s books (read-alouds)
9. Cards and letters
10. E-mails
11. Facebook updates
12. Coupons/circulars
13. Calendars

Make a point to read as much as you can out loud every day! You will make a significant dent in your practice time!

Contact us at info@eslrules.com for more independent practice ideas.


Is it "S" or "Z"?

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A common conundrum for many non-native English speakers is how to pronounce “s” in a word. Is it pronounced “s” as it appears or “z”? How do we know? Can one differentiate “diseased” from “deceased”? If not, the message can certainly be misinterpreted, e.g., “The patient is diseased/deceased.” So, in an attempt to clarify some of the English patterns and make some sense to the idiosyncrasies of American English, we organized some patterns or RULES for the pronunciation of “s”.Of course, there are exceptions, and we welcome your feedback and any patterns that you have observed that may be helpful to English language learners.

When “S” is in the beginning or the end of the word, we usually pronounce it as “S.” Beginning of words: see                sip                      same                   said sat                suit                     soot                     soak soft              sock                    soy                       sour sun              sir                        sign                     sale/sail

It is more challenging to determine the correct pronunciation when “s” appears in the middle or endings of words.

Ending of words:

“S” Pronounced as “S” mess           mass                    class                    bass hiss             lease                    dose                    moose/mousse boss            increase              decrease             close (adjective) case            endorse               worse                  purse loose          gas                        horse                  crease nurse         license                 hearse                 terse abuse (noun)                           recluse                refuse (noun) Exceptions: hose, fuse, use, lose, close (verb), surprise, please, his, was, does, is, appease, phase, amuse, cruise, abuse (verb), refuse Middle of Words: “S” Pronounced as “Z” raisin          season                 reason                 disease miserly       easel                    diesel                   weasel rising          closing                laser                     basil/basal doesn't       wasn't                  isn't                     commiserate hesitate      design                 present               causal phrasal       preside

Exceptions: dosing, casing, endorsing, increasing, decreasing, bison, worsen, person, fuselage “S” Pronounced as /ʒ/or “zh” measure     pleasure             fusion                 vision visual          casual                 lesion                 version leisure        incision              provision           exclusion

“SS” Pronounced as “S” lesson          classical             fossil                    guessing depressed   assign                 missile                message possessive  assess

"SS" Pronounced as "Z" scissors       possess “SS” Pronounced as“/ʃ/ or “SH tissue           mission              fissure                 issue possession “S” pronounced as“S” courtesy      curtsy                  crisis                   aside

It certainly appears that in the middle of words, “S” is usually pronounced as something other than “S.” So, unfortunately, we must rely on memorizing the patterns that you see above.

 

If you find more rules or more exceptions, please let us know!

 


May I Have Your Attention?

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The fine art of listening-We are all used to multi-tasking and pride ourselves on being able to accomplish numerous things at once. However, to be a good listener, particularly in the workplace, we have to truly focus on our conversational partner(s).

Here are some things to keep in mind to ensure that we are listening as carefully as possible:

1. Timing is everything: Don’t start a conversation when you have to dash out the door to a meeting in 3 minutes. Allow yourself 15-20 minutes when you can devote the necessary time and attention to the conversation.

2. Select a private and quiet place: Close the door to your office, or go for a walk around the perimeter of the building. That way you won’t have to worry about co-workers eavesdropping at inopportune moments.

3. Be open-minded: You may have strong opinions, but make a conscious effort to hear alternative viewpoints and ideas.

4. Observe non-verbal cues: Look at the speaker, which will help you "read" any non-verbal communication (impatience, distractibility, annoyance).

5. Minimize distractions: Turn off phones and beepers (or put on vibrate), and have portable devices and computers out of reach, and out of immediate view. It is just too tempting to quickly check messages and e-mails.

5. Write it down: Keep a pen and pad handy to keep notes, if appropriate.

6. Keep the conversation going: Maintain good eye contact, nod your head, smile and lean slightly toward the other person to convey interest.

7. Provide verbal/vocal feedback: Demonstrate that you are following the conversation. Use phrases such as, "I see," "I understand," "So what you are saying... ," or "um-hmm."

8. Be honest: If you don’t understand what is being said, or the message behind it, don’t nod as if you are following. Be direct and honest. Use phrases such as, "I’m not following, you," "I don’t understand," "Can you explain what you mean?", etc.

9. Probe: Ask Wh- questions to encourage the speaker to share more information. For example, “What part of the proposal needs editing?,”vs. “Do you like the proposal?”

10. Time’s up: End the conversation clearly vs. just drifting off. Have some closure, including a summary of what was discussed. For example, “I am happy that we had a chance to review the preliminary outline. I will get back to you before the end of the day with my revisions.”

For more information about communication skills in the workplace, contact info@eslrules.com.


What is the Pronunciation RULE for "X"?

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Several of our clients have asked us the pronunciation rule for "X." Some make the mistake of pronouncing it as "S." Many do not realize that "X" is a combination or cluster of two sounds; "K" and "S," as in "six" (pronounced as "sicks"). When it is at the end of the word, we pronounce it like "ks," as in "fax", "mix," or even "next." However, in some circumstances, it is pronounced as "GZ" as in "exam" (pronounced as "egg-zam"). So, what is the rule? When is it pronounced as "KS" and when as "GZ"? Let's look at "X" when it is in the middle of words.


When the "X" is followed by a consonant, it is usually pronounced as "KS."
Here are some examples:
extra exception excellent expect
extract excited experiment experience
exterminate exception exceed excel
excess exchange exclamation exclude
excavate excursion excuse exhale
expectorant expense expel expert
extreme expire explain explode
explore express expunge extrovert

When the "X" is followed by a vowel, it is usually pronounced as "GZ."
Here are some examples:
exist example executive exacerbate
exact exaggerate exude exalt
exam examination examine exit
exasperated exempt exonerate exorbitant
exotic exuberant exude

Exceptions: exercise execution

When there is a silent "H," we treat the word as if it were followed by a vowel: exhausted, exhibit, exhume, and exhort , but not "exhale."

Remember; "X" is a consonant cluster which means you must pronounce two consonants. It will be either "KS" or "GZ."

For more RULES to help you pronounce American English, visit us at www.eslrules.com.



What Does Your Body Language Say?

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A lot of what we “say” has nothing to do with speech at all. Dr. Albert Mehrabian conducted a study in 1982 about the likability of strangers. Communication was divided into vocal (how we sound), visual (how we look), and verbal (what we say). The visual aspect of communication was 55% of the impact! (Vocal was 38% and Verbal was 7%). These results have often been misinterpreted and were used to determine only one word utterances. Regardless of the actual results, the importance of nonverbal communication cannot be overlooked. Visual/non-verbal communication including posture, gestures, facial expression, and eye contact, are critical to accurately and effectively communicate our thoughts and ideas. We often make our first impression with non-verbal communication. What is your first and lasting impression?

Here are some tips for “putting your best foot forward.” Body Language · Stand with your feet about 6” apart · Keep your weight on the balls of your feet · Bend your knees slightly · Square your hips with shoulders for a powerful stance · Avoid shifting your weight or leaning on furniture or walls · Keep your chin parallel to the ground · Maintain appropriate personal space distance (be aware of cultural differences) Gestures · Keep your hands relaxed, at your sides · Do not cover your mouth with your hands when talking · Avoid arm crossing, hand-wringing, pointing, and fidgeting · Keep your hands out of your pockets · Gesture naturally and appropriately (be culturally sensitive!) · Take up space with your gestures (your elbows should not be attached to your torso)

Facial Expressions · Smile naturally and appropriately · Open your eyes widely · Move your eyebrows expressively Eye Contact · Look at your conversational partner for the duration of a thought · Don’t dart eyes from side to side · Do not look over your listener's shoulder · Remember to blink-don’t stare · If uncomfortable, look at the bridge of the nose of the listener

Your visual message should be consistent with what you say (verbal) and how you say it (vocal). Your body language SPEAKS volumes!

For more advice on effective non-verbal communication, contact info@eslrules.com


Ten Tips for Effective Communication

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Many non-native speakers seeking accent modification/accent reduction training look for strategies to improve their pronunciation. One-on-one or small group training with a communication skills professional is ideal. There are also many self-help training programs available. Unfortunately, this does not provide the essential feedback to see if you are pronouncing the words correctly. Many software programs are wonderful tools, but don't have the ability to identify subtle stress and intonation patterns which is an essential feature to address in accent modification. Here are some tips to either get started, supplement the training you might currently be taking, or brush up on your skills:


1. Identify a speech role model
Find someone whose speech is pleasant to your ear. This can be a radio or TV personality, a family member, friend or colleague. Do you like the tone, rate of speech, resonant quality, phrasing? Try to emulate those desirable features in your own communication.

2. Get a professional’s opinion
It is difficult to change aspects of your speech if you don’t know what may be detracting from the effectiveness of your communication. Find a specialist who can help you identify areas that may need improvement. Make sure to check references!

3. Video or audio-record yourself
This can be as low or high-tech as you please, but it is very helpful to hear and see how you may present yourself to others. Consider how you look (fidgeting with your hair, wringing your hands, pacing), how you sound (monotone, rapid-fire, nasal, whiny), and how you speak (using professional language or too much slang, rambling or concise)?

4. Solicit feedback from those you trust
If you feel as though your communication may be holding you back at work, ask your manager, co-workers, and others for honest feedback. Seek people who interact with you in a variety of settings such as on the phone, in meetings, during formal presentations, etc.

5. Project your voice
Take deep abdominal breaths and speak as you exhale; do not waste any air. Keep your mouth open and relaxed. Look in the direction you want your voice to go and imagine your breath stream floating along a string to your target (the person or object farthest away from you). Take replenishing breaths as needed so the end of your sentence sounds as loud and strong as the beginning. Stand up when speaking.

6. Pronounce your sounds clearly
Make sure that your speech sounds are accurate and clear, especially at the ends of words. Finish the words so that you say “thinking” vs. “thinkin',” and “biggest,” vs. “bigges-.”

7. Speak at a slightly slower rate
Slightly reduce your speaking rate by stretching out the vowels, and pausing where a comma or period would occur. Chunk information into manageable groupings, and then take a breath before continuing. Try to speak at the same rate as the person with whom you are speaking (assuming they are not racing themselves!)

8. Use appropriate intonation
Try to speak with a natural, varied inflection pattern. Stress the last important word in a thought group.
Stress the word by slightly raising your pitch, , speaking slightly louder, and lengthening your vowels.
If you just use a louder voice, you may sound angry. Smile to infuse a little more energy and/or personality in your voice.

9. Practice whenever, wherever, and with whomever you can
Use every speaking situation as an opportunity to practice your best speech techniques. Listen and observe the reactions/responses to your speech from your mail carrier, doorman, barista, newspaper vendor, secretary, etc.

10. Practice idiosyncratic stress rules when reading
Everywhere you look, you will see proper nouns (business cards); compound nouns (grocery store circulars); numbers (appointment books), and other written references to pronunciation rules. Use every opportunity to read aloud practicing your newly learned techniques for proper stress and intonation.

Contact us at info@eslrules.com if you have any questions.




To Text or Not to Text?

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Like it or not, we live in a technologically changing world, which has impacted all areas of our lives, especially the workplace. For the most part, these advances are useful and contribute to our efficiency and success.

E-mails and virtual meetings have revolutionized the way we conduct business. People are learning the rules of "netiquette," and can now email without offending the readers with all CAPS or annoying them with the overuse of emoticons!

But where does texting fit into the equation? Yes, it is instant, and efficient, but the biggest pitfall that we see is the lack of a paper trail.

Admittedly, many of us are trying to be green, and do more in less time, but is texting a good workplace practice?

Lately, we have been receiving more and more text messages related to work. We have heard recruiters and management complain that employees are texting in to report absences or appointment changes. Texts are harder to read, difficult to save, and add an extra layer when we need to print them out or forward them. Sometimes you just need a paper trail!

Although texts are great for letting someone know you are running late for a meeting, or communicating with friends or family members, we believe that lengthy, confidential, or contractually-oriented messages just don't work on a Smartphone.

"Textiquette"
1. Turn off alerting pings of incoming messages when you are in meetings
2. Turn off sound to prevent tapping as you text outgoing messages
3. Know your audience and their preferred mode of communication, e.g., text, e-mail, voicemail, instant message
4. Use abbreviations your audience will understand
5. If using voice-to-text feature (i.e., Siri), check it for accuracy before sending
6. Be aware of information that should not be distributed to others
7. Look to see if anyone else is in the message group
8. Learn your company's policy regarding texting in the workplace.

Please let us know if you agree or not! And please respond don't text your response; respond below in the comments section!
:-)


What's Up With Uptalk?

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We have all heard the sing-song Valley Girl intonation pattern...”Hi, my name is Tiffany?”...

Whenever we hear it, we really do want to cringe, especially when it is during a formal presentation made by an otherwise intelligent, sophisticated woman. It is about as effective as shooting oneself in the foot!

However, for many of our clients, ending a sentence with a rising intonation pattern denotes friendliness in their culture (e.g., Turkey, Romania, etc.). There also is a trend among well-educated consultants to use up-talk to reflect a collaborative relationship with their clients.

So what are we as trainers to do?

First, explore why your client is using that type of speech pattern. Is it unconscious or is it intentional? Explore intercultural and work-culture influences.

If you and your client decide that habitual use of “up-talk” is detracting from the delivery of the message, here are a few techniques to work on it.

1. Use audio or video recordings. As with most speech habits, just hearing your own voice can bring the necessary awareness to a speaking style or habit.

2. Talk about how up-talk can be perceived. To many, a rising inflection pattern at the end of a message can incorrectly convey lack of experience or confidence. If that is not the intent, exploring ways to habituate a downward inflection would be
worthwhile.

3. Practice saying the same sentence using 3 different inflection patterns, and talk about how the messages come across. For example, a rising inflection typically indicates surprise, uncertainty; a falling pattern indicates authority or certainty, and a partial rise indicates that more information will follow. Try the following examples out and see what we mean.

- First, say it like a statement of fact (falling pattern)
- Then, say it like you are totally surprised to hear that because you thought otherwise. (rising pattern)
- Finally, say it like it wasn't actually true and you may add more information (partial rise)

a. Yukiko doesn’t like her job.

b. Our grades were posted.

c. We have a conference call at seven a.m.

d. Kayla invited 400 people to her wedding.

e. Kit speaks five languages fluently.

If you need help coming across as a capable and effective speaker, contact us at info@eslrules.com.


Chinese vs. USA Classrooms

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Everyone who works with nonnative English speaking college students understands the cultural differences that comes with living and studying abroad. There are so many adjustments that must be made. Everything is unfamiliar from getting around and using public transportation, buying and ordering food and beverages, dealing with housing considerations, money, social customs, etc.

But another challenge that rarely gets attention is the philosophical and practical differences in the educational system. These cultural differences may ultimately influence behavior in the workplace.

One of our clients shed some light on what he has observed between his education in China and his experiences at Northeastern University in Boston.


CHINA
- Classes are primarily straight lectures.

- There is no concept of “office hours”


- Students do not ask questions or comment


- Students sit quietly, take copious notes and memorize the material

- Tests focus on what students memorized


- Classes are typically 50-minutes

- Students must seek permission



- Serious atmosphere; no banter or jokes


- Unacceptable to challenge the teacher


UNITED STATES
- Classes are more discussion oriented.

- Students have regular access to professors for questions, conversations

- Students are encouraged to ask questions and make comments

Students are expected to contribute to the lesson and interpret the material

- Tests focus on making sure students have learned the material and have comprehended and processed what
was taught. Test formats vary and include take-home, open book, and essay formats

- Classes are typically 60-90 minutes

- Students have freedom to leave the room without permission to get water, make a phone call, use the bathroom

- More relaxed atmosphere, jokes and saracasm is acceptable

- Independent thoughts are encouraged
For this client, and many others like him, students need help “fitting in” to the American classroom. It is often useful to address pronunciation, conversational skills, vocabulary and general topics related to culture so that students can actively participate in their education, and enjoy and appreciate their American educational experience. This will also help them as they enter the workforce in the USA.

Giggle, Giggle..... :-)

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Many of our clients reveal their nervousness, particularly in public speaking situations, by giggling. There may also be a cultural component to this reaction. However, in the USA work environment, giggling detracts from a speaker’s credibility, power, and effectiveness. What can be done to curb this behavior?

One of the best techniques to bring this behavior to your clients' or employees' attention is to videotape them during their sessions or more formal presentations. Once they are aware of the behavior, we have found it helpful to track the frequency of occurrences, so they can note a decrease over time as they learn to some practical strategies.

These behaviors can be tracked as follows:

1. During every session, keep a running log and mark off a blank sheet of paper with check marks or hash marks every time the behavior occurs. You can track occurrences during spontaneous conversations or structured tasks.

2. Keep track of the number of times the client can successfully inhibit the behavior with gentle reminders, such as modeling a slow, deep breath.

3. Track the instances when the client self-monitors and self-regulates using trained strategies.

Strategies:
- Taking a few gentle “candle breaths” (easy exhalations as if gently making a candle flicker)
- Taking a sip of water or tea
- Changing visual focus (look away momentarily)
- Distract yourself; look around the room and silently name what you see, e.g., "white walls," "green carpet," "wooden desk"
- Ignoring and re-directing thoughts with a transitional comment such as,“Getting back to what I was
saying.”
- Silently counting to five.

If you need additional help controlling your nervousness, contact us at info@eslrules.com.


Peaches, Nectarines, and...

5425379We recently talked about idioms in our September ESL RULES  newsletter. It is clear that this language area is a significant challenge for many nonnative English speakers who want to understand their American colleagues, sound natural, and speak in a colorful manner to express their ideas.Some comments that we heard from clients this week highlight these challenges.

One client said, "I understand that comparing apples and  oranges means to try to talk about two very different things as though they were the same, but can I talk about other fruits in the same way? In other words, can I say 'it is like comparing peaches and nectarines?' "

I also heard a Para-Olympian interviewed on television recently. He was  talking about how inspired he was by one of his fellow athletes. He stated that he had “tears in his eyes and had chicken bumps.” Again, substituting one poultry breed for another (chicken for goose) is not going to make sense to most listeners.

One of the problems with idioms is that the expressions have to be used exactly as they were intended. Using a “substitution” often renders the entire expression meaningless. So, conceptually it may make sense to compare bananas and mangoes,  but no one will understand what you are talking about. Similarly, although chicken and geese are related creatures (poultry), the expression just doesn’t work.

Another client explained to me that he thought “all thumbs” meant very coordinated. When I asked him to explain his reasoning, he told me how people can type so fast with their thumbs on their Blackberry. This was fascinating and I understood his reasoning completely. Imagine his surprise when he learned that “all thumbs” meant to be clumsy and uncoordinated!  Another client told me that she thought “all thumbs” meant to do a great job, considering the common “thumbs-up” gesture that we give one another for encouragement.

Sometimes, in our changing world, the old expressions don’t suit the current technological or social environment. Will these expressions change over time?

Please weigh in with your thoughts and any examples of idiom confusion!

For additional resources on teaching idioms, check out Medically Speaking Idioms and our resource page on our website at www.eslrules.com.