Foreign language accent syndrome is a language disorder that has been little studied worldwide. To date, only 60 cases have been documented from England, America, Germany, and Australia. The tone of voice changes abruptly and seemingly without reason. Those affected lose their natural speech pattern and adopt the accent of a foreign language. As a cause, physicians suspect neurological disorders, with which the patients adopt a foreign-sounding speech melody, which goes back to a voice formation disorder.
What is foreign speech accent syndrome?
Because foreign language accent syndrome is an extremely rare speech disorder that has been diagnosed only 60 times worldwide, research is still in its infancy. The causes are largely unclear; medical experts attribute this speech disorder, with which patients adopt the accent of a foreign language, to a stroke or craniocerebral trauma, for example as a result of an accident. Consequently, this voice formation disorder does not arise spontaneously and in isolation, but always in conjunction with the previously mentioned factors.
Causes
Most of the cases of foreign language accent syndrome documented to date are due to brain injury following an accident or stroke. Based on the research to date, scientists believe that injuries to the left hemisphere of the brain are responsible for this speech disorder. However, a conclusive delimitation of this brain hemisphere has not been possible so far. Since the strange speech melody occurs immediately after regaining the ability to speak, linguists suspect that disturbances in the motor center and the speech center, respectively, are responsible for the altered speech pattern.
Symptoms, complaints, and signs
In some cases, medical professionals documented the temporary occurrence of speech loss after a neurological disorder. Symptoms of foreign language accent syndrome occur immediately after traumatic brain injury, stroke, or, in rare cases, a migraine attack. Some of the affected persons show this speech disorder even without a phase of temporary speech loss. Characteristic of this clinical picture is a permanent change in the usual speech melody. For outsiders, the changed speech behavior is often unpleasant; the pitch is perceived as unnaturally high with a squeaky undertone. The patient’s new pronunciation is far removed from the original colloquial speech, which is why it is interpreted as a foreign language, foreign accent, or dialect.
Diagnosis and course
A patient from England suddenly speaks with a Chinese accent after a severe migraine attack, although she has never traveled to China and has not learned the Chinese language. Originally, this speech disorder was not attributed to the extremely severe migraine attack that preceded this symptom, but to a stroke resulting from dilated blood vessels. One of the first known cases was documented in 1941. A Norwegian woman suddenly spoke with a German accent after a severe head injury caused by a shell fragment. She got into trouble with her compatriots, who thought she was a German spy. A woman from Thuringia suddenly spoke German with a Swiss accent after a third stroke. Other case studies include an American woman who speaks with an Australian accent after dental surgery and an Australian woman who adds a French speech melody to her native language after an accident. The final diagnosis is not easy, as this speech disorder is poorly researched. Only the characteristic symptom of an altered speech melody, with which the patients speak with a foreign accent, gives a hint in the right direction. Even if this voice formation disorder is not life-threatening, it still causes great disadvantages for those affected, which can even lead to a loss of identity. Due to his native language, his social environment and his personality, every person has a unique speech melody that makes him unmistakable. If the speech pattern suddenly changes for no apparent reason, this can lead to severe psychological stress, as the patient is perceived very differently by his or her environment.Some patients exhibit only a slightly altered pronunciation, while others forcibly distance themselves from their identity known to the social environment with a completely altered speech pattern. Often, little understanding is shown to those affected, as the behavior is perceived as affected, unnatural, and premeditated. In some cases, patients may be happy if their altered speech pattern is merely perceived as funny. Drastic reactions are possible, especially in everyday professional life, since in this case there is often no possibility to explain the altered speech behavior. Exclusion and isolation, leading to further psychological problems, can be the result.
Complications
Foreign language accent syndrome is not itself a medical complication. In most cases, the person’s health is not affected by this syndrome. The syndrome causes the patient to speak in a different accent after a stroke. However, this does not affect the rest of the person’s health. The foreign accent syndrome can have a negative impact on the environment and social relationships, but this is rare. In difficult cases, a short-term loss of speech ability is possible. This loss is not permanent, although some limitations in speech may occur after the loss. Foreign language accent syndrome can also occur after a severe migraine and is not permanent. In this case, no other symptoms occur. Most people are uncomfortable with foreign language accent syndrome, which leads to decreased self-esteem and often shame. It is no longer possible to lead an ordinary life. It is not uncommon for the affected person to be perceived bizarrely by those around them and especially by people they do not know. This can lead to severe depression and psychological difficulties. In this case, treatment by a psychologist is possible. Foreign language accent syndrome cannot be treated directly. However, it is possible to adjust the accent with the help of speech exercises. Here, likewise, no further complaints occur.
When should one go to the doctor?
In the case of foreign language accent syndrome, it is usually not necessary to see a doctor. There is no impairment in coping with everyday life or in speech. The affected person’s vocalization is altered, but he or she is still easily understood by other people. It is not a speech defect that needs to be fundamentally investigated or treated. Rather, the accent is altered and cannot be controlled. Since no other physical or mental changes or abnormalities occur with foreign language accent syndrome, a visit to the doctor is necessary in most cases only in the case of secondary disorders. If headaches or migraines occur, a doctor should be consulted. In case of sleep disturbances, inner restlessness or reduced performance, a visit to the doctor should be made. Help is also needed as soon as emotional or mental problems occur. A reduced sense of well-being, depressive moods or a lack of self-confidence are signs and reasons for which a doctor or therapist should be consulted. If there is conspicuous social behavior, shame or loss of quality of life, there is mental suffering that should be evaluated by a doctor or therapist. If other speech problems such as stuttering occur as a result of foreign language accent syndrome, a physician should be consulted. If the foreign language is needed for professional reasons, supportive speech therapy can be sought for individual language training.
Treatment and therapy
Because it is an extremely rare speech disorder worldwide, research findings have been insufficient and the causes have not been conclusively documented. Therefore, there is no classic therapy tailored to foreign language accent syndrome. Most of the patients known so far have undergone speech therapy. However, it is not yet clear whether this is suitable for restoring the patient’s natural speech behavior. If the speech disorder is due to a stroke or a brain injury following an accident, the classic therapy methods available for these disorders are the most suitable. In addition to surgical interventions and the administration of medication, speech and physiotherapies are also available in this case.
Outlook and prognosis
A definite outlook on the prognosis in foreign language accent syndrome cannot yet be made with regard to a possible cure. Thus, the speech therapies that are used here in a few individual cases are more experimental than indicated. Accordingly, the observation of the few known affected persons remains to be seen in order to finally make statements about healing and relapse chances. Furthermore, the foreign language accent syndrome bears many risks for psychological stress. Starting from the fact that the affected persons lose a part of their identity due to their changed speech melody, their social environment will also change. Work colleagues, relatives and friends will sometimes react with confusion or incomprehension. This not infrequently leads to psychological discomfort, which can extend to depression. As a result, complete isolation on the part of the affected person can occur. Because the prospects for recovery from foreign language accent syndrome are so uncertain, there is also a long-lasting feeling of uncertainty or helplessness for those affected. However, there are isolated cases where people claim to have had a temporary accent after a coma, stroke, or similar traumatic stress. However, this has passed. So it may well be that foreign language accent syndrome also regresses spontaneously.
Prevention
Because it is a voice-formation disorder that develops in association with brain injury, stroke, or migraine attacks, prevention in the clinical sense is not possible. The reason why foreign language accent syndrome occurs in some patients with stroke or brain injury and not in others has not yet been adequately explored.
Follow-up
Follow-up for foreign language accent syndrome, which is extremely rare, is rather modest, given the just 60 cases that have been reported to date. In keeping with the rarity of the syndrome, treatment approaches are lacking. Apparently, there is a neurological disorder in the speech center. If it were known how this occurs, treatment including aftercare would sometimes be possible. So far, follow-up care has been limited to treatment of the underlying disorder, following a stroke, cerebral hemorrhage, or traumatic brain injury. The concept, type, and length of follow-up care for foreign language accent syndrome depend on the underlying condition. Surgical, orthopedic, physical therapy, or neurological remedial measures may be necessary to improve the symptoms of the underlying disorder at hand. This may also improve the symptoms of foreign language accent syndrome affecting the left hemisphere of the brain. In rare cases, foreign language accent syndrome manifests after a severe migraine attack. Often, however, this is not the actual cause at all, but the stroke symptoms. Accordingly, aftercare in terms of migraine does not bring any improvement. What is important, however, is that those affected can lose their sense of identity. In addition, occupational problems can arise. Psychotherapeutic help and language training may therefore be useful.
What you can do yourself
Since foreign language accent syndrome has been little researched and diagnosed in only 60 cases, there is little experience in treatment. Rather, this is based on the triggering condition (traumatic brain injury, stroke). In the case of a speech disorder, speech therapy with an expert speech therapist is recommended in any case. This can also influence voice pitch and speech behavior through targeted training. In this way, the squeaky voice of those affected by the foreign language accent syndrome can be improved. Tension in the back, neck and head area can also have an effect on speech behavior. Visiting a physiotherapist or osteopath helps to relieve blockages and tension. In addition, those affected should reduce the risk of another stroke – if this is the cause of the disease. This can be achieved through a healthy diet rich in vital substances and regular exercise in fresh air. Furthermore, everything that is good for the soul and reduces stress helps. This can include mindfulness exercises such as yoga and chi gong, as well as relaxation methods such as progressive muscle relaxation according to Jacobsen or autogenic training. The social environment often reacts alienated to the changes in pronunciation. However, maintaining social contacts is fundamentally important for the recovery process.Friends and relatives should therefore inform themselves about the disease. Attending a self-help group can also offer support to sufferers and their relatives.
