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Puberphonia Meghan Moynahan Voice Disorders April 17, 2003.

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

1 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

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

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 McFarlanes 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

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 patients 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, 17-18. 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: http://www.unc.edu/~chooper/classes/voice/webtherapy/falsetto.htm


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