Foreign accent syndrome
|Foreign accent syndrome|
|Classification and external resources|
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.
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.
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."
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-occurring 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.
- Kurowski, K.M.; Blumstein, S.E.; Alexander, M. (1996). "The foreign accent syndrome: a reconsideration" (PDF). Brain and Language (54(1)): 1–25.
- "Severe migraines give Devon woman a bizarre Chinese accent at". Asylum.co.uk. Retrieved 16 June 2011.
- Mariën, P.; Verhoeven, J.; Wackenier, P.; Engelborghs, S.; De Deyn, P. P. (2009). "Foreign accent syndrome as a developmental motor speech disorder". Cortex. 45 (7): 870–878. doi:10.1016/j.cortex.2008.10.010. PMID 19121521.
- Marie P. (1907). Presentation de malades atteints d’anarthrie par lesion de l’hemisphere gauche du cerveau. Bulletins et Memoires Societe Medicale des Hopitaux de Paris, 1: 158–160.
- "Croatian teenager wakes from coma speaking fluent German". The Daily Telegraph. London: Telegraph Media Group. 12 April 2010. Retrieved 17 April 2010.
- Pick, A. 1919. Über Änderungen des Sprachcharakters als Begleiterscheinung aphasicher Störungen. Zeitschrift für gesamte Neurologie und Psychiatrie, 45, 230–241.
- Monrad-Krohn G. H. (1947). "Dysprosody or Altered 'Melody of Language'". Brain. 70: 405–15.
- "Foreign Accent Syndrome Support". Retrieved 24 October 2013.
- Miller, Nick; Jill Taylor; Chloe Howe; Jennifer Read (September 2011). "Living with foreign accent syndrome: Insider perspectives". Aphasiology. 25 (9): 1053–1068. doi:10.1080/02687038.2011.573857. Retrieved 9 December 2012.
- Mariën P., Verhoeven J., Engelborghs, S., Rooker, S., Pickut, B. A., De Deyn, P.P. (2006). A role for the cerebellum in motor speech planning: evidence from foreign accent syndrome. Clinical Neurology and Neurosurgery, 108, 518-522.
- Mariën P., Verhoeven J. (2007). Cerebellar involvement in motor speech planning: some further evidence from foreign accent syndrome. Folia Phoniatrica et Logopaedica, 59:4, 210-217.
- "Unusual illnesses: Curiouser and curiouser". The Independent. 21 September 2010. Retrieved 2 June 2015.
- "George Michael: I woke up from coma with a West Country accent". The Daily Telegraph. London. 18 July 2012. Retrieved 17 December 2012.
- Lukas, Rimas (March 2014). "Foreign Accent Syndrome". EBSCO Publishing. Retrieved 15 July 2014.
- Verhoeven, Jo; Mariën, Peter. "Suprasegmental aspects of Foreign Accent Syndrome". Speech Prosody in Atypical Populations. Assessment and Remediation, eds V. Stojanovik and J. Setter (Guilford: J and R Press): 103–128.
- Verhoeven, Jo; Mariën, Peter (2010). "Neurogenic foreign accent syndrome: Articulatory setting, segments and prosody in a Dutch speaker". Journal of Neurolinguistics. 23 (6): 599–614. doi:10.1016/j.jneuroling.2010.05.004.
- Keulen, Stefanie; Mariën, Peter; Wackenier, Peggy; Jonkers, Roel; Bastiaanse, Roelien; Verhoeven, Jo (10 March 2016). "Developmental Foreign Accent Syndrome: Report of a New Case". Frontiers in Human Neuroscience. 10 (65). doi:10.3389/fnhum.2016.00065.
- Keulen, Stefanie; Verhoeven, Jo; De Witte, Elke; De Page, Louis; Bastiaanse, Roelien; Mariën, Peter (27 April 2016). "Foreign Accent Syndrome As a Psychogenic Disorder: A Review". Frontiers in Human Neuroscience. 10 (168). doi:10.3389/fnhum.2016.00168.
- Keulen, Stefanie; Verhoeven, Jo; Bastiaanse, Roelien; Mariën, Peter; Mavroudakis, Nicolas; Paquier, Philippe (2 March 2016). "Perceptual Accent Rating and Attribution in Psychogenic FAS: Some Further Evidence Challenging Whitaker's Operational Definition". Frontiers in Human Neuroscience. 10 (62). doi:10.3389/fnhum.2016.00062.
- Keulen, Stefanie; Verhoeven, Jo; De Page, Louis; Jonkers, Roel; Bastiaanse, Roelien; Mariën, Peter (19 april 2016). "Psychogenic Foreign Accent Syndrome: A New Case". Frontiers in Human Neuroscience. 10 (143). doi:10.3389/fnhum.2016.00143. Check date values in:
- Ryalls, Jack; Whiteside, Janet. "An atypical case of foreign accent syndrome". Clinical Linguistics and Phonetics. 20 (2–3): 157–162. doi:10.1080/02699200400026900.
- Naidoo, Raveeni (1 July 2008). "A Case of Foreign Accent Syndrome Resulting in Regional Dialect". the Canadian Journal of Neurological Science. Retrieved 3 July 2008.
- "Ontario woman gains East Coast accent following stroke". CBC News. 3 July 2008. Retrieved 3 July 2008.
- Bunyan, Nigel (4 July 2006). "Geordie wakes after stroke with new accent". The Daily Telegraph. London: Telegraph Media Group Limited. Retrieved 20 December 2007.
- Lewis, Angie; Guin, Karen. "Communicative Disorders Clinic Diagnoses Rare Foreign Accent Syndrome in Sarasota Woman". University of Central Florida-College of Health and Public Affairs. Retrieved 29 December 2007.
- "Experience: I woke up with a Russian accent". The Guardian. London.
- "Foreign Accent Syndrome (FAS) Support". Utdallas.edu. Retrieved 24 October 2013.
- Schocker, Laura (5 June 2011). "Woman Gets Oral Surgery, Wakes Up With Irish Accent". The Huffington Post. Retrieved 16 June 2011.
- "Woman Gets New Accent After Dentist Visit". Wmtw.com. 6 May 2011. Retrieved 16 June 2011.
- Spencer, Ellen (June 5, 2015). "What Accent?". Snap Judgment. NPR. Retrieved June 23, 2016.
- "Health Sentinel: Connecting symptoms finally leads to disorder diagnosis". The News-Sentinel. 6 December 2010.
- "Migraine left woman with Chinese accent". The Sunday Times. 20 April 2010. Retrieved 20 April 2010.
- "Severe Migraine Leaves English Woman with Chinese Accent". Fox News. 19 April 2010. Retrieved 20 April 2010.
- "Plymouth woman 'woke up sounding Chinese'". BBC News. 3 September 2013. Retrieved 3 September 2013.
- Morris, Steven (14 September 2010). "Woman's migraine gave her French accent". The Guardian. London.
- "Migraine gives woman French accent". The Independent. London. 14 September 2010.
- "Coping with Foreign Accent Syndrome". BBC News. 13 September 2010. Retrieved 3 September 2013.
- "Woman's Accent Foreign Even to Her". The Seattle Times. 27 October 2008. Retrieved 27 October 2008.
- "BBC One – The Woman Who Woke Up Chinese". bbc.co.uk. 3 September 2013. Retrieved 24 October 2013.
- "Sarah Colwill, British Woman, 'Woke Up Chinese' After Suffering Severe Migraine In Hospital [VIDEO]". Medicaldaily.com. 7 March 2010. Retrieved 24 October 2013.
- Thomas, Emily (4 September 2013). "Sarah Colwill Speaks Out About Foreign Accent Syndrome In BBC Documentary 'The Woman Who Woke Up Chinese'". The Huffington Post. Retrieved 24 October 2013.
- "Texas mom has jaw surgery, ends up with British accent". .ajc.com. 23 June 2016. Retrieved 27 June 2016.
- Doug Criss (23 June 2016). "Texas woman sports British accent after surgery". CNN. Retrieved 25 June 2016.
- "Godsend - Snap #614 | Snap Judgment". snapjudgment.org. Retrieved 2016-12-06.
- Dankovičová J, Gurd JM, Marshall JC, MacMahon MKC, Stuart-Smith J, Coleman JS, Slater A. Aspects of non-native pronunciation in a case of altered accent following stroke (foreign accent syndrome). Clinical Linguistics and Phonetics 2001;15:195-218.
- Gurd, J. M.; Bessell, N. J.; Bladon, R. A.; Bamford, J. M. (1988). "A case of foreign accent syndrome, with follow-up clinical, neuropsychological and phonetic descriptions". Neuropsychologia. 26 (2): 237–251. doi:10.1016/0028-3932(88)90077-2. PMID 3399041.
- Gurd, J. M.; Coleman, J. S.; Costello, A.; Marshall, J. C. (2001). "Organic or functional? A new case of foreign accent syndrome". Cortex; a journal devoted to the study of the nervous system and behavior. 37 (5): 715–718. doi:10.1016/s0010-9452(08)70622-1. PMID 11804223.
- Ryalls, Jack; Miller, Nick (2015). Foreign accent syndromes. London: Psychology Press. ISBN 978-1-84872-153-1.
- Article from New Zealand 13 July 2010
- "Stroke gives man Italian accent" at BBC Radio 4 Home Truths, 4 November 2005
- "I woke up with a foreign accent" at ABC News
- Journal of Neurolinguistics, Volume 19, Issue 5. Special issue on foreign accent syndrome.
- "Foreign Accent Syndrome Support" – site created by researchers at University of Texas at Dallas
- "Health Sentinel: Connecting symptoms finally leads to disorder diagnosis" – article from Fort Wayne, IN describing a woman's struggles with rare conditions, including Foreign Accent Syndrome. 6 December 2010
- "Woman Goes to Bed with Migraine, Wakes Up with European Accent" – article from Wabash, IN The Paper 24 July 2013.
- "FAS Sisters" Ellen and Fran meet for the first time weeks after Ellen's onset of Foreign Accent Syndrome and years after Fran's. Video, May 2009
- "Re:FAS Sisters" – A YouTube video of Foreign Accent Syndrome speech at six months post onset. November 2009. Six months after onset of Foreign Accent Syndrome.
- "FAS birthday 2" Video of Ellen explaining differences in Foreign Accent Syndrome manifestations learned over four years.
- "Foreign Accent Syndrome – Ellen5e Learning and teaching Ellens- FAS_Birthday_4"- video of Ellen speaking four years post onset of Foreign Accent Syndrome. Shows adaptation technique for singing and speech. May 11, 2013.