A Guide to Dealing with Accents and Difficult Authors

GENERAL TRANSCRIPTION TIPS............................................................................2

OVERCOMING THE ACCENTED DICTATOR..............................................................4

BEHIND THE SCENES OF ACCENTS - SPEECH PATTERNS.......................................5

THE ACCENTED DICTATOR NUANCES....................................................................8

SPANISH DICTATOR PRONUNCIATION TIPS..........................................................11

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 GENERAL TRANSCRIPTION TIPS

1. Question--When you hear an accented dictator, what's the first thing you
should do? Take a deep breath and put yourself into a fresh mindset, even
if it means walking away from your computer for a minute or two.
2. Critical thinking is of utmost importance. What is critical thinking? First
and foremost, it is always remembering that you are transcribing a full
report and not typing just a word at a time. Let's look at this critical
thinking more closely…

When unsure of a word or phrase:

A. Take a good look/listen at and to the content and context of what is being
said. What has the dictator been talking about up until this point? Is he or she
talking about someone/something/ something specific? Who? What? Is he or she
discussing a specific part of the body? If a dictator is discussing the upper, middle,
and lower ‘lohbeds’ of the lungs, you'll probably be wrong if you are hearing the term
‘loads’ rather than ‘lobes.’ If a dictator is talking about the foot, it's a good bet that
he/she's not saying ‘aorta.’ What part of speech are you looking for-is it a noun, a
verb? You can use your experience as an MT to figure out what is most likely being
said, and then listen again, i.e., ‘Lungs are clear to as-blah-blah-blah and
percussion.’ True, we ask that you not guess, but this is beyond guessing, it's what is
called empiricism or MT common sense which comes from experience

B. Has he/she talked about this earlier in the report? Can you look back to that
specific someone or something to see if this current word or phrase has been used
before? Could it be in the diagnosis section? If you are thinking of this report as a
whole, chances are that you will recognize a term that you've entered as a blank
before if you happen to hear it again.

3. General Tips
a. When referencing, remember your similar vowels/consonants -
For words beginning with an unknown vowel, reference ALL vowels, A-E-I-O-U-
Y.
For words that begin with an ‘F’ sound, reference ‘PH.’
For hard C-sounding words, reference both ‘C’ and ‘K;’ for soft C words,
reference both ‘S’ and ‘C’ words.
For B-sounding words, reference ‘D,’ ‘P,’ ‘T,’ and ‘V.’
For Z-sounding words, reference ‘X,’ i.e., Xylocaine.
b. Write out the sounds of the word you hear phonetically, syllable by
syllable. Try changing stressed syllables, similar-sounding letters, etc.
Say the word out loud with the accent on the different syllables.
c. Now write the term, as above, WITHOUT LOOKING. At times, looking at
the word as ‘foreign’ will help to see it more clearly.
d. The first time you have a dictator who you feel is difficult, make a macro
of the completed job or completed section, whether or not you have
blanks. You may hear something in a future job that you're not hearing
today, or, you may not hear in a future job what you do hear today!
Eventually you'll have a full sample.
e. Keep a list of accented pronunciations of words. Write the word
phonetically the way it sounded to you, write it correctly spelled, and note
the nationality of the dictator. This will increase your awareness of
pronunciation variants and improve your ability at understanding various
accents. You can also keep a list of specific dictators and do the same for
them.

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 f. When you receive feedback or suddenly recognize a term, make a macro
of it, with both the correct spelling and the phonetic spelling.
g. Depending on the accent, use the phonetics handout you received
(Diphthong Nuances)** Keep that as a cheat sheet near your pc.
h. Follow the railroad crossing signs-STOP - LOOK - LISTEN, and then relisten.
Leave a blank, which may be filled in later.
i. And last but not least--Make a game of transcribing ESL dictators. Does
the dictator sound like Roseanne, Ricky Ricardo, Crocodile Dundee, or
Arnold Schwarzenegger (how DO you spell his name?) to you?
Sometimes, relating an accent to a familiar character from TV or movies
can help get your ears ‘into the rhythm’ of the accent you are hearing.

4. And now, background noises. They are a hindrance, not only on the
dictator's end, but on your end as well. This is more important than most people
realize.
Is the baby crying?
Are there children playing or arguing?
Is the TV/radio/CD playing?
All these things make it more difficult to hear what is already a difficult report.
5. The last tip, but by far not the least, is the same thing I used to tell workers
involved in direct patient care-- ‘When you start feeling frustrated, WALK AWAY!’

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 OVERCOMING THE ACCENTED DICTATOR

Question to think about-

Why would you want to learn to transcribe ESL/accented dictators? (For those of you
unfamiliar with the term ESL, it is the acronym for ‘ English as a second language’)
1. Self-satisfaction or sense of accomplishment when you've finished a difficult
job.
2. Educational. Each time you are able to understand a word you've not been
able to understand in the past, you've learned something.
3. Employment opportunities.
A. Difficult dictators are a good part of the reason that a higher level
account is considered such. Think about the pay scale difference between the
different account levels.
B. What might the chances be of becoming an editor with accented-
dictator experience?

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 BEHIND THE SCENES OF ACCENTS - SPEECH PATTERNS

The ability to predict the next word or phrase is instinctively done when listening to
an individual whose native language is the same as yours. Accents, whether they be
regional or foreign, affect this predictability, and this in turn affects our
understanding of that familiar, expected ‘next word or phrase.’

We begin ‘getting used to’ our specific speech pattern in utero. In fact, our speech
‘template’ is pretty much empty at birth, and only with the repetitive sounds of our
parents/caretakers/family, do we learn how to form words, sentences, and questions,
and how to use pausing techniques specific to our language-our speech pattern.

Speech patterns
We're going to discuss 3 parts of these patterns:
1. Intonation
2. Stress
3. Rhythm

1. Intonation - Loosely defined, our tone or flow-Can you speak in a

monotone pattern?

Thepatientinroom304keepstryingtogetoutofbed

What is the difference between monotoned speech and normal speech?

Intonation is the change in pitch when we speak-the rising and falling, the ups and
downs of our speech. When one North American speaks to another North American,
how does the one being spoken to know when the sentence is finished? How does he
or she know if a question was asked or a statement made-we can't see a question
mark or period-it's the intonation-the flow, the higher ending of a question sentence
versus the lower ending of a statement sentence, because For the most part, North
Americans drop their voice level when ending a sentence and raise it when ending a
question.

The Chinese language does not use the same English language statement pitch
pattern, or question pitch pattern, and I would guess that E. Indian or Swahili doesn't
either!! In fact, the intonation used by speakers from the northern United States is
different from that used by speakers in the southern United States.

2. Stress - and I don't mean the stresses of transcribing an accented

dictator! In a normal speech pattern, parts of words are stressed (think accent
marks) and parts of sentences are stressed. The intonation changes in stressed
words/sentence parts; there is a difference in pitch (higher) and volume (louder/with
more force).
What we consider ‘Improper’ stressing of syllables is a major reason for difficulty
transcribing accented dictators. Let's try putting stresses on the different syllables of
some familiar words, starting with esophagus.

e soph' a gus, e' soph a gus, e soph a' gus, e soph a gus' (in this term, the sound of
the ‘e’ and ‘a’ sounds can also differ-ee, eh, ih)

in ci' sion, in' ci sion, in ci sion' --and guess what else can happen to words? Watch
the syllables: in the French pronunciation there are 4 syllables--in ci si on-vs only 3 in
the North American pronunciation.

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By the same token, a difference in the pitch of the same word can change its
meaning. In English, for example, think about what happens to stressed syllables in
the word
Con tent' and the word con' tent. (If I'm not mistaken, this is called a homograph-
word spelled the same but having diff meaning-homonym = word like another in
sound, w/different meaning - there/their) .

The Spanish stress rule is that if a word ends in a vowel or ‘n’ or ‘s,’ the accent is on
the next-to-the-last syllable. For all other endings, the accent is on the last syllable,
unless the accent mark is written in.
esophagus = esoph A' gus
incision = stays the same
arrhythmia = arrhyth MI' a
acid = ac ID'

Anyone dealing with Spanish/South American accents?

The following are some examples of common differences in syllable stressing:

residual = resi DOO' al
obesity = obi SI' ty
verapamil = vera PAM' il
capillaries = cap PI lar ees
peritoneum =per i TON' eum

Stress Differences in Sentence Parts

Stress indicates the important word in a phrase or sentence; therefore, changes in

stress in sentences might also cause changes in meaning or context.

Let's put stresses on different parts of sentences. For example, if someone asks,

Where did the patient go? The answer would be ‘The patient went to surgery,’
surgery being the most important part of the sentence; however, by changing the
question, we also change the stress word in the sentence: ‘Who went to surgery?’
‘The patient went to surgery,’ with ‘patient’ being the most important word.

3. NOW LET'S TALK ABOUT Rhythm

The regularly recurring patterns of stressed syllables.

Want to try that sentence again?

‘Thepatientinroom304keepstryingtogetoutofbed.’

A. Monotone - It's not easy to do, right? It sounds funny, right? It's difficult to
change a speech pattern.

B. Pauses -

Different languages have different pausing rules.

Remember what was said earlier about improper stressing? What we call ‘improper’
pausing is another one of the major reasons for difficulty transcribing accented
dictators.’ Think about your fast dictators-how often do they pause?

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Sometimes several words may sound like one because the dictator does not pause
between them. Conversely, one word may sound like several words.

Pauses may also occur so that syllables from one word appear to be part of the
following word, or syllables from the second word appear as part of the first; this
happens often with plurals.

So, intonation, stress, and rhythm are the 3 parts of speech patterning, and the
differences in these is what gives us difficult-dictator problems.

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 THE ACCENTED DICTATOR NUANCES

General ‘Anomalies’
A. Punctuation
- The comma may be pronounced ‘coma.’
- For European speakers, the term ‘stop’ may mean a comma.
- A period may be referred to as ‘point,’ or ‘dot,’ or ‘stop,’ or ‘full stop.’
- A colon may be called ‘two points.’
B. Beginnings, Middles, and Endings
In an attempt to be clear, a speaker may pronounce final consonants so that it
sounds like an added syllable at the end of a word, i.e., ‘chestah’ for chest,
‘explain-ed’ for explained.

A schwa (eh sound) may be added in the middle of a word, creating an extra syllable,
i.e., ‘ad-eh-van-tage,’ ‘ad-eh-venture,’ ‘ad- eh-vance.’

The schwa is also often used as a thinking filler, much as ‘uh’ is used by
Americans; therefore, you may hear ‘eh’ in between words where you might
otherwise hear a pause.

Confusion with our plurals, yielding different English endings-’abdomens’ for

abdomen, ‘childs’ for children.

The final sounds of words may be dropped-’spaz’ for spasm, ‘neoplaz’ for neoplasm.

Spanish

Vowels
A = ah
E = eh
I = ee
O = oh
U = oo
Y = ee

Silent ‘e’ (see under ‘‘s’)

‘ge’ pronounced like ‘hay’

‘gi’ pronounced like ‘hee’

‘h’ is silent, but is often used to break up a diphthong.

‘j’ is pronounced like an English ‘h’ (‘hingle bells’)

‘ll’ is pronounced as ‘y’ or ‘j’ sound.

‘n’ in certain consonant combinations can be pronounced as ‘ng’ i.e.,

‘sandwich’ can come out as ‘sangwich’

‘nb’ can be pronounced as ‘mb’ i.e., ‘invitation’ can come out as ‘imbitation’

‘nf’ can be pronounced as ‘mf’ i.e., ‘information’ can come out as ‘imformation’

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‘qu’ followed by ‘e’ or ‘i’ is pronounced like English ‘k,’ i.e., quit can come out as ‘kit’

‘s’ Some Spanish speakers (from central Spain) have an acquired lisp, pronouncing ‘s’
as ‘th,’ as in ‘grath-ias’ rather than ‘grac-ias.’

‘sh’ This consonant combination does not occur in Spanish, and many ESL have
trouble with it, pronouncing it ‘ch.’ i.e., ‘shampoo’ would come out as ‘champu’

‘sp’ Many dialects add a schwa (‘eh’ sound) before words beginning with an ‘s,’ so
that in pronouncing English words starting with ‘s,’ a Spanish speaker will often add
an ‘eh’ before it, so that ‘spoon’ may come out as ‘eh-spoon,’ skin to ‘eh-skin,’ stone
to ‘eh-stone,’ etc.

Silent ‘e’ Spanish speakers have difficulty with the silent ‘e,’ especially at the end of a
word, therefore pronouncing, ‘trouble’ as ‘trobley’

‘v’ Spanish makes little or no distinction in pronunciation between ‘b’ and ‘v’;
therefore, ‘v’ is pronounced as a ‘b,’ so that ‘vascular’ becomes ‘bascular.’

Spanish speakers have a tendency to begin a vowel (usually ‘eh’) in front of

consonants; therefore, ‘speaker’ may become ‘ehspeaker.’

Since in Spanish all consonants are pronounced the same way all the time, Spanish-
speaking people may have problems with ‘through’ vs ‘slough,’ ‘ulnar’ vs ‘Lincoln,’
‘swore’ vs ‘sword,’ or ‘‘column’ vs ‘colonel,’ and may use the wrong pronunciation
with these letter combinations.

East Indian

East Indian speakers often say ‘perrid’ (with a rolled ‘r’) for period.

Phrases to be expected when listening to East Indian dictators: ‘pay attention on’;
‘discuss about’; ‘convey him my greetings’

Questions/Statements to be expected when listening to East Indian dictators:

‘You're going, isn't it?’ ‘He's here, no?’ ‘Who you have come for?’ ‘They're late
always.’ ‘My all friends are waiting.’
Q: ‘You didn't come on the bus?’ A: ‘Yes, I didn't’

AND… just a couple of differences:

Male cousin = ‘cousin-brother’ (I guess that would make a female cousin a ‘cousin-
sister.’

100 percent = ‘cent percent’

Arabic

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There is no ‘p’ sound in Arabic and therefore ‘p’ may be converted to ‘b.’ An MT who
worked in Saudi Arabia reported questioning the term ‘boberglib,’ only to find out the
physician was dictating the word ‘paper clip.’

Chinese

‘L’ - Although Chinese has an ‘L’ sound, it is made differently and dictators may have
great difficulty with this, particularly in combination with other consonants.

‘R’ - Chinese has this sound, but it does not have this sound as a consonant;
therefore, any consonant combination that contains ‘R’ is difficult.

‘TH’ - Chinese does not have this sound. A Chinese dictator may substitute ‘t’ or ‘d’
for ‘th.’

‘THR’ - A very difficult consonant combination for those of Chinese descent.

‘V’ - Some Chinese speakers may add a ‘y’ sound to the front of words which begin
with the

‘ee’ sound such as ‘yeat’ instead of ‘eat.’

Chinese does not make nouns plural. A Chinese dictator may make words plural
inappropriately or not make words plural that should be.

Chinese does not have pronouns that are gender specific (‘he,’ ‘she,’ etc.) so you
should watch for sex inconsistencies.

Chinese does not have verb tenses. They convey time with time adverbs such as
‘yesterday,’ ‘today,’ etc., and Chinese dictators may have problems with verb tenses
(is vs was), either keeping them consistent, or using the appropriate tense.

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 SPANISH DICTATOR PRONUNCIATION TIPS

Basic Rules of Accentuation

1) Words ending in a vowel, or n or s, the next to last syllable is stressed.
2) For words ending in a consonant other than n or s stress falls on the last syllable.
3) If the word has an accent mark, then that syllable is stressed, ignoring the rules
above.

Syllable division involving two vowels

1) The vowels a, e, and o are "strong" vowels, and i and u are "weak". Where two
vowels fall together, the following rules affect syllable division and accentuation:
1.1) A weak + strong combination belongs to one syllable with the stress falling
on the strong vowel. aceite, cierra, causa.
1.2) A weak + weak combination belongs to one syllable with the stress falling on
the second vowel. viuda, fuimos, diluir.
1.3) A strong + strong combination is divided into two syllables. bom-be- ar, po-
le-a, em-ple- o
1.4) If the word has an accent mark, then that syllable is stressed. flido, da,
encas

Vowels
a -- like the a in father
e -- for a syllable ending in a vowel, like the e in they; for a syllable ending in a
consonant, like the e in get
i -- like the i in machine
o -- for a syllable ending in a vowel, like the o in vote; for a syllable ending in a
consonant, like the o in pot
u -- like the u in rule; silent after q and in the groups gue and gui
y -- When used as a vowel, such as in the words y and voy, it is pronounced like the
Spanish i.

Diphthongs
ai, ay -- like the i in side
au -- like the ou in found
ei, ey -- like the ey in they
eu -- like the vowel sounds in may-you
oi, oy -- like the oy in boy

Semiconsonants
i, y -- like the y in yes. Examples: bien, hielo
u -- like with w in well. Examples: huevo, fuente, agua

Consonants
b, v -- When found at the beginning of a word or following a consonant, these are
pronounced like a b. Otherwise, they have a sound which falls somewhere in between
the English b and v sounds.
c -- before a consonant or a, o, or u, like the c in cat; before e or i like an s
ch -- like the ch in church. Historically, the Spanish ch has been treated as a separate
letter although this has recently been changed. Therefore, many dictionaries list
words beginning with ch after the c's and before the d's.
d -- like the English d except between vowels and following l or n where pronounced
like the th in this
f -- like the f in for
g -- before e or i, like the Spanish j; otherwise like the g in get
h -- silent

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j -- like an h but stronger; silent when at the end of a word
k -- like a k
l -- like an l
ll -- like the y in you
m -- like an m
n -- like an n; except where it appears before a v, like an m-- like the n in onion
p -- like a p
q -- like a k; always followed by a silent u
r -- pronounced with a strong trill at the beginning of a word and following an l, n, or
s; very little trill when at the end of a word; and medium trill in other positions
rr -- strongly trilled
s -- before consonants b, d, g, l, m, n, like a z; otherwise like an s
t -- like a t
v -- see b, v
w -- usually like a v
x -- when between vowels, like the x in box; before a consonant, like an s
y -- like the y in yes
z -- like an s

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