Definition

Foreign accent syndrome (FAS) is a rare speech disorder. If you have FAS, you adopt what sounds like a foreign accent, even though you may never have traveled to that particular country.

Causes

FAS is caused by damage to the part of the brain that controls the rhythm and melody of speech. The damage may be due to:

• Stroke, which is the main cause
• Trauma to the brain, such as a sharp blow to the skull
• Brain hemorrhage
• Multiple sclerosis
• Brain tumor

FAS is also linked it to other symptoms, such as:

• Aphasia —a communication disorder that can affect the ability to understand and express language
• Speech apraxia —a speech disorder that affects the ability to make sounds, syllables, and words

Risk Factors

Factors that increase your chance of developing FAS include:

• Being at high risk for stroke
• Having aphasia or apraxia

Symptoms

Those with foreign accent syndrome speak in a distorted rhythm and tone, such as:

• Making vowel sounds longer and lower such as changing English “yeah” to German “jah”
• Changing sound quality by moving the tongue or jaw differently while speaking
• Substituting words or using inappropriate words to describe something
• Stringing sentences together the wrong way

If you have FAS, you may be able to speak easily and without anxiety. Other people are able to understand you. The accent that you have adopted could be within the same language, such as American-English to British-English.

Symptoms can last for months, years, or may be permanent.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done paying particular attention to the muscles used in speech. A psychological evaluation may also be done to rule out psychiatric conditions.

Your language skills will be assessed. This can be done with:

• Tests to assess reading, writing, and language comprehension
• Use of recordings to analyze speech patterns

Images will be taken of your brain. This can be done with:

• MRI scan
• CT scan
• Single-photon emission computed tomography (SPECT) scan
• PET scan

Your brain activity may be measured. This can be done with an electroencephalogram (EEG).

Since this condition is rare, you will most likely be evaluated by a team of specialists, including:

• Speech-language pathologist
• Neurologist
• Neuropsychologist
• Psychologist

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

• Speech therapy—You may be taught how to better move your lips and jaw during speech.
• Counseling —Since FAS is a rare disorder, you may feel isolated and embarrassed. Counseling can help you and your family better cope with the condition.

Prevention

Since FAS is closely linked to stroke, follow these guidelines to prevent stroke:

• Exercise regularly.
• Eat a healthful diet.
• If you smoke, talk to your doctor about ways to quit. Also talk to your doctor about how to limit how much alcohol you drink.
• Maintain a healthy weight.
• Check your blood pressure often.
• Take a low dose of aspirin if your doctor says it is safe.
• Keep chronic conditions under control.
• Call for emergency medical services if you have symptoms of a stroke, even if symptoms stop.
• Do not use drugs.

National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov

Speech-Language and Audiology Canada http://sac-oac.ca

Garst D, Katz W. Foreign accent syndrome. ASHA Leader. 2006;11:10-11,31.

Miller N. Foreign accent syndrome. Not such a funny turn. Inter J Ther & Rehab. 2007;14:388.

Foreign accent syndrome. American Speech-Language-Hearing Association website. Available at:
http://www.asha.org/Publications/leader/2006/060815/f060815c/
Published August 15, 2006. Accessed November 23, 2014.

Reeves, R, Burke R, Parker, J. Characteristics of psychotic patients with foreign accent syndrome. J Neuropsychiatry Clin Neurosci. 2007;19:70-76.