"In 1998, the International Civil Aviation Organization (ICAO) took a heightened interest in the role of language in airline accidents. Member states agreed to take steps to ensure air traffic control personnel and flight crews involved in flight operations where the use of the English language is required were proficient in conducting and comprehending radiotelephony communications in English. Since then, ICAO developed its English language requirements and urged its members to document their English Language Proficiency (ELP) test implementation plans by March 8, 2008. This report is a compilation of written responses and comments by a group of 48 U.S. pilots of their difficulties in international operations. There were 12 international U.S. pilots from American, Continental, Delta, and United Airlines. In this report, the pilots' responses to questions 54-59 and their comments from discussions of those questions with 2 interviewers are presented as a compiled narrative. We derived 5 recommendations from these interviews. (1) Research is needed to determine the optimal speech rate for ATC messages. (2) ATC messages must be delivered using standard ICAO terms and phraseology. (3) Graphic and text representations of taxi clearances, route clearances, and route modifications should be made available to pilots on the flight deck as stand-alone messages. (4) Research is needed to identify how controllers communicate nonstandard situations (e.g., maneuvering around thunderstorms, traffic conflicts, delays). (5) Research is needed to determine the extent to which the absence of party-line information has on situational awareness and safety prior to takeoff and landing as pilots attempt to discern the intentions (and potential threat) of other pilots (especially those less proficient in English)."--Report documentation page.