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Introduction

Puberphonia is a functional voice disorder that is characterized by the habitual use of a high pitched voice after puberty.

The voice may also be heard as breathy, rough and lacking in power. Puberphonia usually occurs in between the ages of 11 and 15 years.

Puberphonia do not present with underlying anatomical abnormalities. The habitual use of a high pitch while speaking is associated with tense muscles surrounding the vocal folds.

Causes

There are a number of proposed causes for the development of puberphonia. The aetiology of puberphonia can be both organic or psychogenic in nature.
Psychogenic cause of puberphonia includes:

Organic cause of puberphonia

Treatment

This condition is most often treated using voice therapy (vocal exercises by speech therapist Dr. Mahipal Singh & Saroj Rathore. The duration of treatment 40 to 50 hours speech therapy.

Techniques used

Cough – The patient is asked to apply pressure on the Adam's apple and cough. This results in the shortening of the vocal folds which is the physiological mechanism that reduces pitch.

Speech Range Masking

When speaking in noisy backgrounds, people speak louder and more clearly in order to be heard

The patient practices speaking while a masking noise is playing. Then, the patient listens to a recording of his voice during the masking session and tries to match it without the masking. By doing this, the patient practices their loud and clear voice.

Glottal Attack before a vowel:

A glottal attach is when the vocal folds are fully closed and then pushed open by the air pressure from breathing out. The patient breathes in and then makes vowel breathes out.

Lowering of Larynx to Appropriate position:

The larynx is lowered by the patient by putting pressure on the Adam Apple. By lowering the larynx, the vocal folds relax & thus pitch is lowered.

Humming while sliding down the scale:

The patient starts humming at the highest pitch that they can reach and then keeps lowering the pitch while humming.
This allows the patient to practice using a lower pitch and also to relax the laryngeal muscles.

The patients says boom just after swallowing:

This is repeated with the patient turning his head to either side and also while lowering the chin.