What makes acquired foreign accent syndrome foreign?

EX, strongly right handed, presented with acquired neurogenic foreign accent syndrome (FAS) after a right anterior communicating artery aneurysm haemorrhage. We describe perceived and spectrographically viewed changes to her speech and attempt to ascertain why EJC was perceived as foreign, stepping beyond the general path of assuming observed changes automatically explain the perceived foreignness. EJC's speech is compared with local English and foreign accent speakers; correlational and regression statistics are employed to explore which changes in EJC's speech most strongly associate with perceived foreignness. Vowel, consonant cluster and stress pattern changes emerge as significantly salient. It is argued that listener perception plays as important a role in FAS as the underlying speech disturbance. In EJC's case we conclude that she presents with a right hemisphere-based apraxic-ataxic speech disorder. (c) 2006 Elsevier Ltd. All rights reserved.