Foreign Accent Syndrome and Strokes
Foreign Accent Syndrome is an extremely rare speech disorder. Documentation exists for only 60 cases of diagnosed Foreign Accent Syndrome between 1941 and 2009. As more people receive a Foreign Accent Syndrome diagnosis, doctors learn more about what causes the syndrome, possible outcomes of the syndrome and which treatment approaches are effective with this rare speech disorder. The majority of the Foreign Accent Syndrome cases diagnosed, to date, are the result of a stroke.
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Features
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Individuals who have suffered a stroke resulting in Foreign Accent Syndrome suddenly develop an accent completely different from their own. They may have never even visited, let alone lived in the area the accent represents. For example, a Chicagoan may suffer a stroke and suddenly develop a strong Italian accent. The most well-known case of this rare speech disorder occurred in 1941. A Norwegian woman sustained serious head injuries from shrapnel. When she began speaking again, she had a German accent.
Cause
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Foreign Accent Syndrome is the result of a serious head injury or stroke damage in one or more areas of the brain responsible for speech. The rare speech disorder is most often due to stroke damage in the left hemisphere of the brain where language processing occurs. Only two cases of Foreign Accent Syndrome were the result of stroke damage to the right hemisphere of the brain in an area known to affect speech prosody.
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Identification
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Diane Garst and William Katz of The University of Texas at Dallas maintain that individuals suffering from Foreign Accent Syndrome present with prosodic and segmental changes in speech. Prosody refers to the stress the individual puts on syllables as they speak. The stress can be equal across all syllables or the stress may be stronger on one syllable than on another. Segmenting refers to consonants and vowel use. The consonants and vowels in words spoken can be altered in some way, elongated, substituted with another sound or dropped from the word altogether. Stroke damage can affect either one, or both, of these aspects of speech, making it sound as though the patient is speaking with an accent.
Diagnosis and Treatment
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According to the American Speech-Language-Hearing Association, the diagnosis and treatment of Foreign Accent Syndrome is the most effective with a multi-disciplinary approach. The appropriate diagnostic and treatment team will include a neurologist, radiologist and speech-language pathologist for the medical diagnosis and treatment planning. A clinical psychologist and neuropsychologist will be involved to ensure the disorder is not a conversion disorder and is due to stroke damage. After the diagnosis of this rare speech disorder, treatment will include medical monitoring of stroke damaged areas, speech therapy, accent training (as actors receive) and psychological counseling.
Considerations
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The individual diagnosed with Foreign Accent Syndrome should receive psychological counseling. The individual may feel as if part of their identity is missing and will need assistance adjusting to her new voice and the other effects of stroke damage. She may require support and assistance in dealing with the reactions she receives from family, friends and acquaintances. There have been cases where this rare speech disorder cleared up over a couple months, but it can go on for many years. She will need support until she is able to accept and adjust to the change in her life.
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