Normally, we hear people say "he speaks with an American accent".
Does "he speaks using an American accent" make sense?
If it does, what is the role of "using an American accent" in that sentence? is it an object or an adverb?
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"He speaks using an accent" can be correct in contexts where one might also say "he puts on an accent." I think that your phrasing, particularly in the present tense, would be very uncommon, but not incorrect. "Put on" would be more common.
In that sentence, "using an American accent" is an adverbial dependent clause.
More on "put on" vs. "use"...
As Tᴚoɯɐuo mentioned, one context of "use" could be an actor. In my mind, uses of "put on" would be mostly in comedic situations, like someone telling a joke (or doing a comedy routine) in an accent, while "use" would appear in more uncommon, more serious contexts. Maybe a double agent who "uses" a Russian accent as part of his cover?
The more common way is indeed:
You are less likely to see either: