It deals with the myriad hardships of immigration, painting a vivid picture of the struggle to assimilate, the sense of displacement, and the confusion of identity suffered by the García family, as they are uprooted from familiarity and forced to begin a new life in New York City.

For example, she mentions that it was Mr. Victor, of the US embassy and a member of the Central Intelligence Agency (CIA), who persuaded Carlos García to join the resistance against Trujillo, and later helped him in leaving the country, and obtaining a job with an international cardiovascular team.

A major turning point in the novel comes with Laura's discovery of a bag of Sofía's marijuana, and her subsequent punishment of being removed from her boarding school and forced to spend a year in the Dominican Republic with family.

The second part of the novel finishes with the chapter "Floor Show", in which the García family goes to a Spanish restaurant and Sandra witnesses the host's wife amorously attempting to kiss her father on the way to the bathroom.

"An American Surprise" tells of their early ideas of New York City, "where it was winter and the snow fell from heaven to earth like the Bible's little pieces of manna bread.

Her nicknames, which reflect and represent the different aspects of her personality, consist of "Joe", "Yosita", "Yoyo" and simply "Yo", which is also the title of the sequel to How the García Girls Lost Their Accents.

Alvarez defies the Aristotelian notion of a well-knit plot, as the story is told in reverse chronological order through a series of fifteen chapters, with no linear, unifying storyline.

[7] In Julia Alvarez: A critical companion, Scholar Silvio Sirias argues that "a well-constructed plot has an underlying structure that promises the reader that the author is in control, and that any event she is telling will eventually make sense".

[33] Scholar Julie Barak argues that the reverse chronological order Alvarez employs is actually a unique stylistic technique which adds "to the reader's uncertainty and instability, [allowing for the recreation] of the Garcia girls' own ambiguities".

[34] Scholar William Luis observes a strong resemblance between the structure of Julia Alvarez's How the García Girls Lost Their Accents and Alejo Carpentier's Viaje a la Semilla as both employ the tactic of backwards narration and consequently lay claim to two beginnings and two endings.

[6] Alvarez has also been said to follow the stylistic traditions established by novels such as Pedro Juan Labarthe's The Son of Two Nations: The Private Life of a Columbia Student (1931), Marcio Veloz Maggiolo's El prófugo (1962), Humberto Cintrón's Frankie Cristo (1972), and Richard Ruiz's The Hungry American (1978).

[35] Julie Barak emphasizes the significance of "one other stylistic idiosyncrasy of the work that adds to the sophistication of [Alvarez's] artistry" as there is a marked transition from third to first person narration for each girl in the last section of the novel.

[16] Luis describes this shift as a pivotal moment after which the events assume a chronological order and time accelerates, illuminating life in such a manner that it suddenly makes sense.

[34] Jacqueline Stefanko rationalizes Alvarez's decision to alternate amongst the varying voices of all four García girls, wither her assertion that "the amnesia produced by the diasporic cultures of Latinas gets negotiated within the text through polyphony".

[38] Through her creation of How the García Girls Lost Their Accents Alvarez has intentionally fictionalized her own life story in a polyphonous manner which extends beyond the boundaries of traditional style and genre, thus setting herself apart from the average author both stylistically and structurally.

[44] Latin American literature scholar, Jacqueline Stefanko, along with several of her peers, has made pointed mention of the significant implications Yolanda's multiple nicknames hold for her fragile and fragmented sense of self.

The quest undertaken by the García sisters for the clarification of their confused identities, however, is an attempt to achieve a solution to the problem posed by the fragmented self, and thus warrants separate categorization.

[50] Yolanda achieves this clarity through the act of writing and even as a young girl she revels in the completion of her speech for the Teacher's Day address because "she finally sound[s] like herself in English!

[54] Julie Barak confirms Gonzalez Echevarria's assertions regarding Latin American immigration and continues on to demonstrate how the privileged, wealthy existence led by the García girls in the Dominican Republic serves to further complicate their process of assimilation.

[55] The García girls are quite conflicted upon their arrival in the United States as they find that distinct cultural groups are lumped together under one broad "immigrant" category and newcomers are encouraged to assimilate silently to the American norm.

[6] Yolanda's conflict with her father regarding the potentially controversial speech she has prepared for the Teacher's Day Address provides a classic example of the manner in which the García girls are pressured to conform to the norm.

[56] Yolanda feels as though she has sacrificed her principles and sold out to the hyper-sensitive authorities when her father forces her to discard her empowering, rebellious achievement of artistic self-expression for "two brief pages of stale compliments and the polite commonplaces on teachers.

[58] Even after the García family has spent several years in the United States, safe from the threat of Trujillo's retribution, a relentless paranoia continues to plague Carlos, their father, "who still lives in fear of the SIM and who is afraid to speak of 'revolt' out loud".

[60] In a very brief chapter entitled "Snow", Alvarez reveals the impact of this widespread cultural paranoia through the character of Yolanda, who mistakes her first experience of snowfall for "the beginning of a much anticipated nuclear attack",[61] causing a panicked outbreak of general hysteria in her classroom.

[62] As they continue to grow and mature, the girls have many disappointing encounters which leave them fearful of the loneliness that must await them in this foreign country where they struggle hopelessly to fit in and be understood.

This is evident in the very first chapter, "Antojos", as Alvarez reveals the panic evoked in the adult Yolanda at the sudden realization that she is stranded in a guava field in the Dominican Republic, where women do not go about unchaperoned at night.

[41] The youngest child, Sofía carries with her only a single memory of her brief childhood on the island, in which the García's Haitian maid, Chucha, says a voodoo goodbye to the girls before they leave for the United States.

[67] The Women's Review of Books also lauds the author, stating that "With this first novel, Julia Alvarez joins the rank of other Latina writers such as Nicholasa Mohr and Helena María Viramontes".

"[68] The Publishers Weekly article notes that "the novel provided a keen look at the island social structure they [the García family] wistfully remember and the political turmoil they escaped".

Julia Alvarez was awarded the status of Doctor Honoris Causa, Humanidades, by Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic on January 24, 2006 for How the García Girls Lost Their Accents.