UCF clinic diagnoses rare Foreign Accent Syndrome

November 18, 2003

CLARIFICATION: In a news release sent Tuesday, Nov. 18, the patient diagnosed with Foreign Accent Syndrome was identified as Tiffany Noell. The University of Central Florida learned late Tuesday night that the patient, whose legal name is Judi Roberts, has used the pseudonym Noell for a few years to protect her family from being embarrassed. She has been treated under this name and is in the process of making it her legal name but has not yet submitted the paperwork.

ORLANDO, Nov. 19, 2003 - 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 Judi Roberts 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.

Roberts 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," Roberts 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," Roberts recalled, "and that it had a name - Foreign Accent Syndrome."

Roberts 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 Roberts 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 Roberts'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 Roberts'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 Roberts's, suggests the syndrome is associated with damage to the left hemisphere of the brain, where language processing occurs.

Ryalls said Roberts 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, Roberts 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. Roberts even started using a pseudonym, Tiffany Noell, because she was concerned about embarrassing her family. "She suffered greatly from some particularly unsympathetic people who did not understand her changed voice," Ryalls said.

Roberts 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," Roberts said.
About the Clinic
The UCF Communicative Disorders Clinic offers a variety of low-cost rehabilitation and testing services to adult clients with impaired speech or language abilities due to a stroke, traumatic brain injury or degenerative diseases like Alzheimer's and Lou Gehrig's. It also helps children with special needs in communication, language and literacy. The clinic serves more than 400 people a year. For further information about the clinic, call 407-249-4770.

Karen Guin, College of Health and Public Affairs, 407-823-1270, kguin@mail.ucf.edu
Tom Evelyn, UCF News and Information, 407-823-5988, tevelyn@mail.ucf.edu

University of Central Florida

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