"Just my take on this.
US ATC is generally brilliant, but I notice two things which can be a problem at some airports which are very busy. One, they sometimes think that a HEAVY can do exactly the same approach as a tightly flown 737. Two, there is a tendency to drop formal instructions into a quickly spoken vernacular, which is fine if you are local, but confuses foreign visitors."
1. I agree on the comment about vernacular. IMO U.S. ATC needs to 'tighten up' their communication to non English native speakers.
2. Why can't a heavy do the same approach a 737 can? The only really challenging one's are the DCA River Visual 19 and w/b's don't fly there. The LGA Expressway Visual is a blast if flown correctly, especially in a w/b.