Foreign accent syndrome as a developmental motor speech disorder

Mariën, Peter; Verhoeven, Jo; Wackenier, Peggy; Engelborghs, Sebastiaan; De Deyn, Peter P.

doi:10.1016/j.cortex.2008.10.010

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Volume 45, Issue 7 , Pages 870-878, July 2009

Foreign accent syndrome as a developmental motor speech disorder

Peter Mariën
- Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital and Laboratory of Neurochemistry and Behaviour, Born-Bunge Foundation, University of Antwerp, Antwerp, Belgium
- Department of Linguistics, Vrije Universiteit Brussel, Brussels, Belgium and Faculty of Medicine, University of Gent, Gent, Belgium
- Both authors contributed equally to the manuscript.
- Corresponding author. Department of Neurology, ZNA Middelheim Hospital, Lindendreef 1, B-2020 Antwerp, Belgium.
Jo Verhoeven
- Department of Language and Communication Science, City University, London, UK
- Both authors contributed equally to the manuscript.
Peggy Wackenier
- Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital and Laboratory of Neurochemistry and Behaviour, Born-Bunge Foundation, University of Antwerp, Antwerp, Belgium
Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital and Laboratory of Neurochemistry and Behaviour, Born-Bunge Foundation, University of Antwerp, Antwerp, Belgium
Peter P. De Deyn
- Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital and Laboratory of Neurochemistry and Behaviour, Born-Bunge Foundation, University of Antwerp, Antwerp, Belgium

Received 9 April 2008; received in revised form 14 July 2008 and 14 August 2008; accepted 31 October 2008. published online 05 January 2009.

Action editor Mike Anderson

Abstract

Introduction

Foreign Accent Syndrome (FAS) is a relatively rare motor speech disorder in which the pronunciation of a patient is perceived by listeners of the same language community as distinctly foreign. FAS has been well documented in adult patients with etiologically heterogeneous, though mostly vascular brain lesions affecting the motor speech network of the language dominant hemisphere. In addition, reports exist of adult patients in whom FAS was due to a psychiatric illness. Although FAS has been reported in children, such accounts are rare and have remained largely anecdotal in that there have been no formally documented cases of FAS as a developmental motor speech disorder.

Methods and results

For the first time, we describe the clinical, cognitive and neurolinguistic findings in two patients who in the absence of a history of psychiatric illness or acquired brain damage already presented with FAS at an early stage of speech and language development. In the first patient “developmental FAS” was associated with a dysharmonic distribution of neurocognitive test results indicating slight underdevelopment of visuo-spatial skills and visual memory. The second patient presented with “developmental FAS” associated with specific language impairment (SLI). Independent support for a diagnosis of FAS in both patients was obtained in an accent attribution experiment in which groups of native speakers of (Belgian) Dutch assessed the type of foreign accent of a sample of the patients’ conversational speech. Both patients were judged as non-native speakers of Dutch by the majority of participants who predominantly identified the accent as French.

Conclusion

This paper for the first time documents two patients who presented with FAS on a developmental basis. The finding that FAS does not only occur in the context of acquired brain damage or psychogenic illness but also exists as developmental motor speech impairment requires a re-definition of FAS as a clinical syndrome.

Keywords: Foreign Accent Syndrome, Specific language impairment, Apraxia of speech, Language, Motor speech, Cognition