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Living with foreign accent syndrome: Insider perspectives

Background: Foreign accent syndrome (FAS) represents an acquired neurological speech disorder where an individual suddenly appears to be involuntarily speaking with an accent they have never used before. Numerous studies have sought to uncover the underlying neurological, psycholinguistic, and acoustic correlates of this. No studies have examined FAS from the perspective of the speaker. Aims: We aimed to investigate and characterise the experience of living with FAS. Methods & Procedures: We conducted in-depth semi-structured interviews with 13 people with neurogenic FAS in their own homes. Interviews were transcribed verbatim. We employed Framework Analysis (Ritchie & Lewis 2003) and iterative feedback to participants to identify and confirm common emerging themes. Results & Outcomes: Four main themes emerged linked to (i) factors associated with the underlying neurological condition that could have a bearing on experiences and reactions independent of the FAS; (ii) altered accent: sense of self; (iii) altered accent: reactions of others. A fourth theme, coping strategies and adaptation, contained elements spanning the three others. Accounts highlighted negative aspects of FAS that individuals had to struggle to overcome. Positive outcomes were also identified. All participants stressed that the experience of FAS entailed a journey into unknown territory. Even if the journey's end was a return of the former accent, a new sense of self persisted as a result of the FAS experience. Conclusions: People with FAS are exposed to issues and adjustments shared with people with neurological conditions in general and speech disorders in particular. They experience the personal and interactional issues associated with being a stranger within a community with a different accent. An understanding of FAS requires attention to all these planes. We argue that the true essence of the experience of FAS lies in the unique intersection of these dimensions, and this determines the personal journeys of people with FAS.