Background FAS has been described in adults following acute injury to the brain. Children commonly develop an accent closer to that of their peers than their parents’ native accent. Children with ASD often have a speech and language disorder. There have been no recorded cases of children speaking with a foreign accent that they have not been exposed to.

We present 3 British children with Asperger’s syndrome who speak with an American sounding accent with no prior exposure to it. We will show DVD clips of their speech.

Case 1: White English girl, 8, with unilateral hearing loss following congenital CMV infection. Attending main stream school with a statement of special educational needs (SEN), but with significant social and communication difficulties; diagnosed as Asperger’s syndrome. Fluent speech with a strong American accent.

Case 2: White English boy, 9, with CHARGE syndrome, attending main stream school with a statement of SEN; good speech, but with poor social interaction skills and significant obsessional behaviour; was diagnosed as Asperger’s syndrome. Speaks with a clear American accent.

Case 3: Black British boy, 6 with behavioural difficulties, in main stream school with significant social and communication difficulties; diagnosed with Asperger’s syndrome. Has clear speech with an American accent.

Discussion There are over 90 cases reported from many parts of the world in adults who have suddenly developed a foreign accent following trauma to the brain such as stroke, waking up after anaesthesia, migraine, brain tumour. It is thought to be due to involvement of speech area of brain.

There has been no report of a child with FAS.

None of our children have had any documented acute brain trauma but 2 of them have some co- morbidities. Their unexplained foreign accents have baffled both parents and professionals alike.

Conclusions We hypothesise some children with ASD could have had a brain injury of an obscure nature leading to both the behavioural difficulties and pronunciation disorder that sounds like a foreign accent. We suggest that the combination of ASD and FAS is a new syndrome.