How Do You Treat Mutational Falsetto?

How Do You Treat Mutational Falsetto?

Mutational falsetto (also referred to as puberphonia, adolescent falsetto, or pubescent falsetto) is a type of functional voice disorder that causes individuals to habitually use a high-pitched voice following puberty. Some individuals with this disorder may speak with a breathy, rough, or weak-sounding voice. Mutational falsetto typically emerges during adolescence, in most cases between 11 and 15 years of age, alongside the physical and hormonal changes that come with puberty.  

This form of vocal disorder occurs more frequently in young men, as it causes individuals to speak with a voice that is much higher than is typical for someone of that age and sex. Mutational falsetto is usually not the result of physical differences or abnormalities but instead is considered to be psychogenic. This means that the voice disorder is caused by emotional or psychological factors, often stemming from inappropriate usage of the vocal mechanism. 

Mutational falsetto can have significant impact on an individual’s ability to communicate with confidence and their sense of self. In most cases, puberphonia requires treatment with a speech and language pathologist and will not go away on its own. Speech therapy for mutational falsetto often involves a variety of voice therapy approaches and techniques. If you or a loved one might benefit from voice therapy for mutational falsetto, we’d love to hear from you. Connect with us by scheduling your free introductory call now!

What are the Symptoms of Mutational Falsetto?

As we enter puberty, normal changes in the larynx cause our vocal pitch to decrease. These changes occur in both males and females; however, on average, the pitch decreases by an entire octave for males, while for women, their pitch only decreases by a few semi-tones. 

In males, the larynx grows significantly and descends, causing a visible lump in the throat known as an Adam’s apple. The vocal folds also become thicker and longer, as do the nasal cavities. These anatomical changes cause the voice to become deeper and more characteristic of adult males. 

Mutational falsetto occurs when this transition to a lower-pitched voice fails following puberty. The symptoms of puberphonia are an abnormally high-pitched voice, as well as a voice that is hoarse, breathy, shallow, or weak sounding. 

What Causes Puberphonia?

There are several known causes of puberphonia, both biological and psychological in nature. In instances of the disorder in males, however, biological causes are relatively rare. 

Psychological Causes

  • Emotional Stress
  • Delayed Puberty or Sexual Development
  • Resistance to the Onset of Puberty or Related Changes
  • Self-Consciousness Caused by Emerging Adulthood or Voice-Breaking

Biological Causes

  • Laryngeal Muscle Tension
  • Asymmetrical Vocal Folds
  • Congenital Abnormalities of the Larynx
  • Poor Muscle Coordination
  • Vocal Cord Paralysis

Symptoms Of Mutational Falsetto

  • High pitched voice
  • Weak or thin-sounding voice
  • Hoarse sounding voice
  • Mono pitched voice

If you are experiencing any of the above symptoms and want to consult with an experienced speech and language pathologist, schedule your free introductory call today. 

How is Mutational Falsetto Treated?

Voice therapy with a qualified speech and language pathologist is the most effective method of treatment for mutational falsetto. Voice therapy for puberphonia typically involves several approaches, including direct voice therapy, indirect voice therapy, and audiovisual feedback. 

Direct Voice Therapy 

Direct Voice Therapy focuses on adjusting the way the voice is used with the goal of improving its quality, strength, and endurance. Some of the most commonly used direct vocal therapy techniques include: 

Basic Vocal Exercises: Vocal exercises work to strengthen and increase the flexibility of the vocal cords, improve breathing patterns, and reduce muscle tension. 

Coughing: The speech therapist asks the individual to cough while pressing their fingers to their Adam’s apple. This exercise effectively shortens the vocal folds, which in turn helps to reduce the pitch of the voice. The individual can then practice speaking at a lower pitch and train the voice to be deeper. 

Speech Range Masking: This technique incorporates the theory that when individuals speak in loud environments, they speak more clearly and loudly in order to get their message across. During speech therapy, the individual will practice speaking while “background noise” is playing. This allows them an opportunity to develop a “loud and clear” voice, which can then be practiced without the background noise. 

Glottal Attacks: A glottal attack refers to when fully closed vocal folds are pushed open by the airflow used to make a sound or exhale strongly. This approach involves the individual breathing in and then producing a vowel sound as they exhale. 

Effortful Closure: These techniques use pressure from pushing or pulling to close the glottis. The glottis is the opening between the larynx and the vocal folds, which is considered the major valve connecting the lungs and the mouth. During these exercises, the individual will produce certain sounds or words while engaging in a push, pull, or isometric activity. The effort used in the push or pull (such as pushing against a wall or pulling a heavy object towards them) while producing the targeted sounds causes the larynx to lower, effectively lowering vocal pitch at the same time. 

Muscle Relaxation Techniques: The muscles surrounding the larynx and vocal folds benefit from relaxation techniques to reduce pressure on them. This is achieved through repeated yawning, sighing, or speaking or singing the “m” sound. 

Humming a Scale: The speech therapist will ask the individual to begin humming at the highest pitch they can manage and gradually humming lower notes. This technique allows the individual to practice vocalizing at a lower pitch while also relaxing the muscles controlling the larynx and vocal folds. 

Indirect Voice Therapy

Indirect voice therapy for mutational falsetto focuses on addressing any contributing psychological factors and creating an environment in which direct voice therapy can be most effective. This often involves emotional counseling, performed either by a qualified SLP, psychologist, or counselor, with the goal of identifying and addressing psychological elements that may be contributing to the voice disorder. This can also include education about vocal hygiene and how behavior affects the voice in the long term. 

Audiovisual Feedback

When treating puberphonia in speech therapy, audiovisual feedback provides concrete information about the individual’s pitch and vocal health. This creates opportunities to identify the ideal pitch and vocal range for the individual as reflected in average ranges for their age and gender. Once this ideal range has been identified, the individual can work with the speech and language pathologist to speak within that range with the goal of achieving a natural and automatic vocal range. Incorporating audiovisual feedback into speech therapy for mutational falsetto treatment approaches has been shown to be a successful aspect of intervention. 

If you would like to learn more about how speech therapy for puberphonia works, or are ready to get started, simply schedule your free introductory call today!