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Pediatric Therapy Corner: Puberphonia – A Male with a Female Voice

All material Copyright © 09 Gal Levy
By: Gal Levy, MS CCC-SLP
Gal Levy M.Sc. CCC-SLP, has more than 20 years of experience in clinical treatments of voice, fluency, articulation and tongue mobility.
puberphonia
Gal is a founder of a Linkedin voice or voiceless online group as well as founder of an online stuttering group in Facebook. He is currently Director of Community Development, Voice Health & Science at the Modern Vocalist.com, the largest website for professional voice users on the internet. Gal also practices in numerous settings including his private practice, school models and home health.
Gal’s monthly radio show in collaboration with KEOM 88.5FM advised local listeners about voice and fluency disorders and treatments. Gal is a member in good standing of ASHA (CCC-SLP), TSHA, ISHLA and The Voice Foundation. You may reach him via [email protected]  or VM: 206-203-0591.
What is a normal voice change?
When a young man is reaching the age of 16 (with some teens it starts at the age of 13 or younger) his voice must have changed to become a more “manly” voice…dropping down the pitch to the male voice range of Tenor, Baritone or Bass.
Adam’s apple will become evident as the system lowers anatomically, making his vocal cords longer and the tone they produce lower (coming down from the child’s voice of around 400Hz to a man’s voice around 100 Hz).
This is a normal outcome of the hormonal changes in the body during adulthood.
What is Puberphonia?
Some men do not go through this change and stay with their high-pitched voice, creating a “womanly” voice output ( around 200 Hz) for them, making social encounters very uneasy for them, as their voice is high pitched woman-like while their appearance and behavior is of a young male.
How can we diagnose Puberphonia?
Usually patients will seek help, because they are very uneasy with that situation and its social implications.

  1. First step will be with their family doctor who will perform a hormonal blood test – if there is a hormonal malfunction then the answer will be for the doctor to give them an adequate hormonal treatment to produce the needed adulthood changes.
  2. If hormonal results are OK, then we proceed to step two, a referral to an ENT surgeon, which will scope the vocal cords and analyze their location to see if anything could be done surgically, and that they do not suffer from any other diseases or anatomical malfunctions. If this situation cannot be treated medically, then we proceed to:
  3. Voice therapy. The speech pathologist will evaluate the voice, breath support techniques and vocal output habits. Then a special pitch changing designated vocal technique will be implemented with the patient. teaching him to change his habitual pitch and lower it to an accepted range of a more “manly” sound.

How do we treat Puberphonia?
Using specially designed pitch changing techniques like:

  • Cooper Technique features midsection breath-support only after pitch control mastery for speech. This technique is especially effective for Puberphonia cases (young men with high pitch).
  • MBS Technique features midsection breath-support with powerful projection of voice mastery for speech. This technique is especially effective for anyone who cannot be heard or wants to increase the volume of his speech.
  • WMD (Sonorant) Technique features midsection breath-support with powerful pitch mastery for speech. This technique is especially effective for pitch disorders as well as for anyone who wants to perform using speech or singing.

Treatment for Puberphonia disorder is not easy in some cases – Although teaching pitch changing techniques and changing breath support techniques is not hard, sometimes the problem is persistent and step four will have to take place: referring the patient to a psychologist and co-treating him with counseling as well as voice therapy.
This Month’s Featured Clinician: Gal Levy, CCC-SLP
For more information about this organization please call VM: 206-203-0591

PediaStaff hires pediatric and school-based professionals nationwide for contract assignments of 2 to 12 months. We also help clinics, hospitals, schools, and home health agencies to find and hire these professionals directly. We work with Speech-Language Pathologists, Occupational and Physical Therapists, School Psychologists, and others in pediatric therapy and education.

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