Foreign accent syndrome is a rare medical condition in which patients develop speech patterns that are perceived as a foreign accent that is different from their native accent, without having acquired it in the perceived accent's place of origin.
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Foreign accent syndrome usually results from a stroke, but can also develop from head trauma, migraines or developmental problems. The condition was first reported in 1907, and between 1941 and 2009 there were sixty-two recorded cases.
Its symptoms result from distorted articulatory planning and coordination processes and although popular news articles commonly attempt to identify the closest regional accent, speakers suffering from foreign accent syndrome acquire neither a specific foreign accent nor any additional fluency in a foreign language. Despite an unconfirmed news report in 2010 that a Croatian speaker had gained the ability to speak fluent German after emergence from a coma, there has been no verified case where a patient's foreign language skills have improved after a brain injury. There have been a few reported cases of children and siblings picking up the new accent from someone with foreign accent syndrome.
History
The condition was first described in 1907 by the French neurologist Pierre Marie, and another early case was reported in a Czech study in 1919. Other well-known cases of the syndrome have included one that occurred in Norway in 1941 after a young woman, Astrid L., suffered a head injury from shrapnel during an air-raid. After apparently recovering from the injury, she was left with what sounded like a strong German accent and was shunned by her fellow Norwegians.
Signs and symptoms
To the untrained ear, those with the syndrome sound as though they speak their native languages with a foreign accent; for example, an American native speaker of English might sound as though he spoke with a south-eastern English accent, or a native English speaker from Britain might speak with a New York American accent. However, researchers at Oxford University have found that certain specific parts of the brain were injured in some foreign accent syndrome cases, indicating that particular parts of the brain control various linguistic functions, and damage could result in altered pitch and/or mispronounced syllables, causing speech patterns to be distorted in a non-specific manner. Contrary to popular beliefs that individuals with FAS exhibit their accent without any effort, these individuals feel as if they are suffering from a speech disorder. More recently, there is mounting evidence that the cerebellum, which controls motor function, may be crucially involved in some cases of foreign accent syndrome, reinforcing the notion that speech pattern alteration is mechanical, and thus non-specific.
The perception of a foreign accent is likely to be a case of pareidolia on the part of the listener. Nick Miller, Professor of Motor Speech Disorders at Newcastle University has explained: "The notion that sufferers speak in a foreign language is something that is in the ear of the listener, rather than the mouth of the speaker. It is simply that the rhythm and pronunciation of speech has changed."
The late British singer George Michael claimed in 2012 that, after waking from a three-week long coma, he had a temporary West Country accent.
Diagnosis
Since this syndrome is very rare, it takes a multidisciplinary team to evaluate the syndrome and diagnose it, including speech-language pathologists, Neurolinguists, neurologists, neuropsychologists, and psychologists. In 2010, Verhoeven and Mariën identified several subtypes of Foreign Accent Syndrome. They described a neurogenic, developmental, psychogenic and mixed variant. Neurogenic FAS is the term used when FAS occurs after central nervous system damage. Developmental FAS is used when the accent is perceptible as of an early age, e.g. children who have always spoken with an accent. Psychogenic FAS is used when FAS is psychologically induced, associated with psychiatric disorder or clear psychiatric traits. The term mixed FAS is used when patients develop the disorder after neurological damage, but the accent change has such a profound impact on the self-perception and identity that they will modify or enhance the accent to make it fit with the new persona. Hence, there is a psychological component. Diagnosis, up until today, is generally purely perceptually based. However, in order to find out what subtype the patient is suffering from, complementary investigations are necessary. This differentiation is necessary for the clinician to allow for correct therapeutic guidance. Psychological evaluations may be performed in order to rule out any psychiatric condition that may be causing the change in speech, as well as tests to assess reading, writing, and language comprehension in order to identify comorbid disorders often co-occuring with the disorder. One of the symptoms of this syndrome is that the patient moves their tongue or jaw differently while speaking, which creates a different sound, so a recording is done of the speech pattern in order to analyze it. Often images of the brain are taken with either MRI, CT, SPECT or PET scans. This is done in order to see if there is structural and or functional damage in the areas of the brain that control speech and/or rhythm and melody of speech. EEG is sometimes performed to investigate whether there are disturbances at the electrophysiological level.
Society and culture
Cases of foreign accent syndrome often receive significant media coverage, and cases have been reported in the popular media as resulting from various causes including stroke, allergic reaction, physical injury, and migraine. A woman with foreign accent syndrome was featured on both Inside Edition and Discovery Health Channel's Mystery ER in October 2008, and in September 2013 the BBC published an hour-long documentary about Sarah Colwill, a woman from Devon, whose "Chinese" foreign accent syndrome resulted from a severe migraine. In 2016, a Texas woman, Lisa Alamia, was diagnosed with Foreign Accent Syndrome when, following a jaw surgery, she developed what sounded like a British accent. Ellen Spencer, a woman from Indiana who has foreign accent syndrome, was interviewed on the American public radio show, Snap Judgment.
In season 2 episode 12 of the American television series Hart of Dixie, one storyline revolves around character Annabeth Nass and a man she's attracted to named Oliver who has foreign accent syndrome.
Also in the TV show Scream Queens, a female patient has the syndrome which then becomes very contagious to one of the three major characters in the show.