What is Foreign Accent Syndrome? Understanding this Rare Speech Disorder

What Is Foreign Accent Syndrome?

Foreign Accent Syndrome (also known as FAS) is a rare neurological speech disorder in which a person's speech changes suddenly, making it sound like a foreign accent. The individual’s fluency, vocabulary, and grammar typically remain the same. What changes are the way that words are pronounced and the rhythm or prosody of speech. This often results in speech that can be perceived by others as foreign.

How Common is Foreign Accent Syndrome? 

FAS is incredibly rare. Since French neurologist Pierre Marie first described the condition in 1907, there have only been 100-200 confirmed cases recorded. Because it is uncommon, foreign accent syndrome is sometimes met with skepticism and is often misdiagnosed. 

Types of Foreign Accent Syndrome

There are two main types of foreign accent syndrome:

• Structural - Structural FAS (also known as neurogenic FAS)  stems from damage to the area of the brain that controls the muscles used to speak. 
• Functional - Functional FAS (also known as psychogenic FAS) develops without a findable notable cause. In some cases, it may occur after seizures or migraines. In others, it is linked to mental health conditions that involve hyperactivity or disorganized activity in certain areas of the brain.  

In addition to the main types, there are also two subtypes of foreign accent syndrome:

• Mixed - Mixed FAS is classified by similarities of both structural and functional FAS. 
• Developmental - Developmental FAS is thought to occur due to brain development and activity differences. 

What Causes Foreign Accent Syndrome? 

Structural FAS stems from damage to the brain, often in the Broca area of the frontal lobe. Some common causes of this damage include:

• Stroke (accent change after a stroke is the most common)
• Traumatic Brain Injury (TBI)
• Brain Aneurysm
• Brain Cancer
• Multiple Sclerosis (MS)
• Frontotemporal Dementia

The exact cause of functional FAS is unknown. The rarity of this condition makes it difficult to pinpoint the exact cause. In some cases, it is linked to brain activity that is not organized normally and is hyperactive. There are also cases where it worsens during migraines or after seizures. Certain mental health conditions like schizophrenia, bipolar disorder, and dissociative disorders have also been linked to functional FAS. 

Symptoms of Foreign Accent Syndrome

Foreign accent syndrome is not about acquiring a new language or accent. The accent is often a result of disruptions to the typical speech planning and patterns. 

Some of the main signs and symptoms include:

• Altered Rhythm and Tone: A change in the speed, pitch, and length of sounds. This leads to a distorted speaking rhythm.
• Variation in Pronunciation of Vowels and Consonants: Vowel sounds may be prolonged or substituted, and consonants might be dropped, distorted, or substituted. 
• Prosody Changes: Abnormal pitch patterns and altered syllable stress, with equal or excessive stress on some syllables.
• Difficulty Coordinating Words: Individuals may experience problems with word articulation and coordinating the different parts of speech.
• Emotional Distress and Confusion: Individuals may feel confused and upset, wondering why they are suddenly speaking this way. This can also lead to isolation.  

Diagnosing Foreign Accent Syndrome

Because FAS is so rare, it is often initially misdiagnosed. An accurate diagnosis requires a detailed patient history as well as a collaborative medical approach, typically including:

• Neurological examination to identify any brain damage or abnormalities.
• Neuroimaging (MRI or CT scans) to locate areas of damage in the brain.
• Psychiatric assessment in cases where psychogenic FAS is suspected.
• Speech and Language Evaluation to assess speech patterns.  

Speech Therapy For Foreign Accent Syndrome

Once FAS has been diagnosed, a structured and individualized speech therapy program can significantly improve communication skills and reduce the impact of the condition.

Key therapy goals may include:

• Improving Speech Intelligibility -  focusing on clarity and consistency of speech. 
• Modifying Rhythm and Intonation - Re-training natural speech patterns through rhythm exercises, prosody training, and pitch control. 
• Fixing Articulation Errors - Working on mispronounced vowels and consonants. 

Living with FAS can be socially and emotionally challenging. Many individuals report feeling like a different person, facing skepticism from friends and family due to their altered speech. 

Support from family and friends, as well as access to professional speech therapy, can greatly improve quality of life. At Great Speech, we offer speech therapy virtually in the comfort of your own home. Whether your FAS is resulting from an unknown cause or brain damage due to a stroke or TBI, we would love to help you. Let’s see if we are a good fit! Schedule your free introductory call today.