Presentation is loading. Please wait.

Presentation is loading. Please wait.

Meghan Moynahan Voice Disorders April 17, 2003

Similar presentations

Presentation on theme: "Meghan Moynahan Voice Disorders April 17, 2003"— Presentation transcript:

1 Meghan Moynahan Voice Disorders April 17, 2003
Puberphonia Meghan Moynahan Voice Disorders April 17, 2003

2 What is Puberphonia? Unusual high pitch that persists beyond puberty
Other symptomshoarseness, breathiness, pitch breaks, inadequate resonance, shallow breathing, muscle tension, lack of variability Common complaints are inability to shout or compete with background noise and vocal fatigue A.K.A- falsetto, mutational falsetto, pubescent falsetto, incomplete mutation, persistent falsetto, adolescent transitional dysphonia Males are said to have mutational falsetto; females are said to have childlike or juvenile voice

3 Who experiences Puberphonia?
Postpubescent males due to inability of pitch to lower Individuals with hearing impairment due to poor auditory feedback Adult men and women

4 Reasons Puberphonia Occurs…
Embarrassment of the “new” voice Failure of a male to accept their adult role Over identification of a male with his mother Social Immaturity Desire to maintain soprano singing voice Muscle incoordination/dysfunction with no known etiology Puberphonia is a psychogenic voice disorder; Researchers find that there may be a number of reasons this disorder occurs Embarrassment of the new voice makes them hold on to their old one especially if it occurs before the rest of their peers

5 Reasons Puberphonia Occurs…continued
Current researchers feel that the more likely cause is an attempt to control unstable pitch and quality characteristics High pitched voice characterized by puberphonia is caused by increased tension and contraction of the muscles in the larynx causing it to elevate

6 Goals for Puberphonia Teach the patient to phonate at a low pitch by showing him how to use his phonatory and respiratory musculature to its full capacity Demonstrate that the new low-pitch is to be used and avoid the old high-pitch The SLP should see that the patient is comfortable with his “new” voice through encouragement and help him use it in different situations

7 Voice Therapy for Puberphonia
Cough Speech-range masking Glottal Attack before a vowel Relaxation techniques to reduce tension of the larynx Visi-Pitch Digital manipulation of the thyroid cartilage while producing a vowel Boone McFarlane find that therapy begins with the cough…coughing produces the male’s adult voice Boone McFarlane speech range masking next technique oral reading on tenth word masking is introduced Hooper patient breathes in, build air pressure w/o letting air put posture the vowel, vowel is released Visi-Pitch visually represents pitch levels

8 Voice Therapy…continued
Lowering the larynx to an appropriate position Humming while sliding down the scale

9 Half-Swallow Boom Technique
Ask client to swallow, and as this action is still in progress, say “boom” Let the client produce “boom” in a low pitched voice Ask the client to say “boom” louder and with less breathiness Have the client discriminate between the normal production from the “boom” production with help of tape recorded samples

10 Half-Swallow Boom…continued
Teach the client to turn the head first to one side and to the other and say “boom” each time Lower the chin while saying boom Ask the client to add sounds and words to “boom” ( boom /i/, boom one) Teach the client to add phrases and sentences Fade out the boom and swallow Ask the client to lift the chin up and bring the head back to the midline as he or she produces normal speech

11 Why Half-Swallow Boom is believed to work…
The swallow procedure maximizes closure of the larynx “Boom” is a single word composed of voiced sounds that is able to be produced as air is released from the constricted larynx and the oral opening is minimized Produces posterior pressure on the larynx Boone and McFarlane believe this technique is a slow progression to get the pt. to lower their pitch

12 Questionable Technique…Half-Swallow Boom
Pannbacker(2001) finds Boone and McFarlane’s half-swallow boom is not effective Can be physiologically impossible to swallow and say “boom” at the same time Can induce vocal hyperfunction and damage to vocal folds which can increase the risk of worsening a voice problem This can cause an iatrogenic voice problemone that is caused or worsened by actions of the clinician Half swallow boom is recommended for unilateral v.f. paralysis, bowing of the v.f. or falsetto States that all effort closure techniques should be used sparingly and cautiously Boone and McFarlane state that effective in a case with unilateral vocal fold paralysis but in the clinical trials there was no sign of benefit and an increase in hoarseness was noted Pannbacker states that there is a need for more data to determine whether or not it is effective Boone and McFarlane do not suggest to use the half swallow boom for falsetto in the 2000 edition of their book

13 Questionable Technique…continued
No empirical evidence that this technique is effective Pannbacker trying to say that all effort closure techniques should be used in moderation because of the damage they can cause

14 Voice Therapy as a Whole
Overall voice therapy is very promising Typical puberphonic patient produces a functional lower pitch during the first session Highly motivated to use their new voice Very rare that they need follow up therapy or psychological counseling It is recommended to continue therapy until the patient’s “new” voice is stabilized

15 References Boone, D.R. & McFarlane, S.C. (2000). The Voice and Voice Therapy. Englewood Cliffs, New Jersey: Prentice Hall Pannbacker, M. (2001) Half-Swallow Boom: Does it Really Happen? American Journal Of Speech-Language Pathology, 10, Stemple, J.C.,Glaze L.E. & Klaben, B.G. (2000) Clinical Voice Pathology: Theory and Management. San Diego, California: Singular Publishing Group Wilson, D.K. (1987). Voice Problems of Children, Third Edition. Baltimore, Maryland: Waverly Press Inc. Falsetto. Retrieved on March 25, 2003, from University of North Carolina Voice Disorders Website:

Download ppt "Meghan Moynahan Voice Disorders April 17, 2003"

Similar presentations

Ads by Google