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Researchers identify rare ‘Foreign Accent’ syndrome

A University of Central Florida speech expert has diagnosed an extremely rare disorder in a Sarasota woman that caused her to speak with a British accent after she suffered a stroke. The case of Foreign Accent Syndrome — a disorder linked to stroke-related or other internal brain injuries that leaves affected people with a foreign-sounding accent — is one of fewer than 20 reported worldwide since 1919, according to Jack Ryalls, professor of communicative disorders at UCF. From University of Central Florida:

UCF clinic diagnoses rare Foreign Accent Syndrome

University of Central Florida speech expert diagnoses disorder that caused woman to speak with British accent after a stroke

ORLANDO — A University of Central Florida speech expert has diagnosed an extremely rare disorder in a Sarasota woman that caused her to speak with a British accent after she suffered a stroke.

The case of Foreign Accent Syndrome — a disorder linked to stroke-related or other internal brain injuries that leaves affected people with a foreign-sounding accent — is one of fewer than 20 reported worldwide since 1919, according to Jack Ryalls, professor of communicative disorders at UCF.

In November 1999, 57-year-old Tiffany Noell of Sarasota suffered a stroke that left the right side of her body paralyzed. She was also unable to speak. After months of physical therapy, she was no longer paralyzed and was able to speak with some difficulty. Her speech gradually improved during the next year until she was speaking with the same fluency as she had before the stroke. However, instead of the familiar New York accent she once had, she spoke with a British accent.

Noell had never traveled to Britain. She didn’t recognize her own voice. Her friends and family didn’t understand it, and strangers constantly asked her where she was from. One doctor told her she was not working hard enough to get her old voice back.

“At times I thought I was losing my mind,” Noell said. “Without the support of my internist and therapist, I wouldn’t have been able to cope.”

This year, four years after her stroke, she received an e-mail from a friend who found a New York Times article about research on language problems conducted by Jennifer Gurd, a professor at Oxford University in England. “When I read the article I realized there was a chance I had a legitimate medical problem,” Noell recalled, “and that it had a name — Foreign Accent Syndrome.”

Noell contacted Gurd, who referred her to UCF’s Ryalls, an expert on neurologically based speech and language disorders who had previously studied the syndrome.

Ryalls invited Noell to UCF and conducted several language tests designed especially for her. He checked her ability to change word stress patterns and accentuation by having her pronounce sentences like, “I wanted to record the record onto a cassette tape.” He also had her repeat words stressing the wrong syllable in sentences like, “Put the emPHAsis on the wrong sylLABle.”

The tests enabled Ryalls to analyze Noell’s speech prosody, or the ability to use the appropriate syllable emphasis, and accentuation, which differs in British and American English. He wanted to determine if she was applying the wrong syllable stress as part of her accent.

After Ryalls’ initial exams, Janet Whiteside, an adult neurological disorder specialist at UCF, conducted other standardized tests for language and cognitive functions in the university’s Communicative Disorders Clinic.

Based on the test results, Ryalls diagnosed Noell’s mysterious acquisition of a British accent as Foreign Accent Syndrome. He has submitted a report of her case for publication in a professional journal.

The first widely known case of Foreign Accent Syndrome reported in English was in 1941, when a Norwegian woman suffered a brain injury after shrapnel hit her head during World War II. She experienced severe language problems but eventually recovered, speaking with a perceived German accent. Her community later ostracized her.

Ryalls said his research on this and other cases, including Noell’s, suggests the syndrome is associated with damage to the left hemisphere of the brain, where language processing occurs.

Ryalls said Noell developed unique ways to cope with her new voice. “She began to respond to people’s constant questions about where in England she was from by asking, ‘Where do you think I’m from?'” Regardless of the city named, Noell would say the person was right.

“In some ways, her response showed she was beginning to accept the accent,” Ryalls said. “It was an ingenious coping mechanism, but it also reveals that she had begun to resign herself to the change in her speech.”

Although she started to cope with her accent, she avoided most social contact and eventually developed agoraphobia, a fear of open spaces. “She suffered greatly from some particularly unsympathetic people who did not understand her changed voice,” Ryalls said.

Noell said she wants people to know about this strange syndrome that can result from a stroke and hopes she can spare others the same alienation and misunderstanding she suffered.

“If I can bring notice to this condition, especially within the medical community, doctors may be able to help others who find themselves in my situation,” Noell said.




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11 thoughts on “Researchers identify rare ‘Foreign Accent’ syndrome”

  1. Thank you and Please maintain updating your Web site. I is going to be stopping by each and every time you do . br

  2. hello tiffany a lomg time has passed but i so hope you are now able to deal with and understand your condition.Ihave a daughter who suffers with seizures as a result of brain damage of late she has started to talk with an accent posh when calm and italian like when angry she thinks that she is acting grown up she says. she is 32 but does not function at that age i have dealt with a lot with her but this is baffling me and i am unclear what is going on i do not want people to think she is loosing her mind but not sure how to help her as she has also become overly assertive. anything that you say i am sure will be a comfort to me can you get back to me be well and thankyou sue

  3. Thank you Michael,

    I just now found time to go through some of the internet listings which have been posted about me and/or my condition. It is still fairly new to me being diagnosed – even though I have suffered through this for four years – but I would very much like to chat with you about your feelings as to FAS! It makes sense to me for sure. Anything I can find out to further help in the research is why I agreed to go public when the University asked me to do so. You may reach me through this web site as I just joined so I could pen you and post you a note. I thank you so very much for having taken your time to pen your note and for your interest in this rare situation I am in. Happy New Year Michael. Tiffany (~.~)

  4. This is an interesting issue. It’s my guess that the person with a new accent is holding her (or his) mouth and tongue differently after the stroke.

    Try it yourself: speak through lips pursed into an ‘ooo’ and keep your tongue mostly behind your front lower teeth and you get an approximation of a French accent. Pull your lips into a wide smile/grimace and you get the mid west or John Wayne.

    The doctors should speak to an accomplished voice impersonator. Together they could make huge breakthroughs.

  5. I’m a student of language and linguistics with a BA and MA in linguistics, and I find this whole topic fascinating. I am not a speech pathologist, but this still raises questions, so I have to ask.

    “Accents” occur due to dialectal differences. A person perceives an accent when one hears a speech pattern that differs from ones own. So, accents are relative. But what most Americans would call an English accent is actually a generalization. There are countless different “English” accents, each indicative of a particular region or even neighborhood. This isn’t just the case with the English of England, but is true of any language that has been spoken by a language community for at least a few generations.

    So, here’s my question(s): has anyone yet attempted to do a more in-depth dialectical study of persons with this syndrome? For instance, does Theresa have a Northern or Southern Irish accent? Does the woman in the article, Tiffany Noell, speak with a “BBC English” dialect (sometimes known as Received Pronunciation)? Liverpool? South London?

    It seems to me that a dialectical analysis of the speech patterns that are found with patients who have this syndrome would be illuminating in perhaps a number of ways. If there is evidence of a specific dialect, then it would require further in-depth research. If it reveals under closer scrutiny that the “English accent” is a composite of various dialects, then this may be an indicator of artificiality. Now, by “artificiality” I don’t mean to suggest that the people with the syndrome are faking it. Rather, the artificiality may instead be an indicator of the development toward “re-coordination” that the brain had to re-navigate and that, rather than following the old suite of articulations — which may have been rendered unusable due to damage — a new and closely related set of articulations is found that, as a matter of chance, ends up taking on certain accentual features. Or so it seems to me.

    Best,

    Michael

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