Puberphonia: From classic to modern approach

Voice is a significant component of communication that allows us to express information and emotions, so it is the foundation of verbal communication. Maturation of the body involves dilation of the larynx and lower positioning of the larynx in the neck, resulting in multiple changes in voice quality. The rapid changes in the human larynx during puberty are more evident in males. Such changes can result in voice mutation - puberphonia. Puberphonia, also called mutational dysphonia or mutational falsetto, is the failure of a natural decrease in fundamental frequency or pitch. We can also defined puberphonia as persistent adolescent voice even after puberty in the absence of organic cause. This functional voice disorder can have multiple consequences on the personality and quality of life of an individual that often encounters problems that include psychological, emotional, social, and professional difficulties. This article aims to review the relevant and accessible literature on puberphonia in a comprehensive concise manner, highlighting the etiology, prevalence, clinical manifestation, consequences on quality of life, as well as evolution of the approach and attitude to its treatment.

Transgender and Nonbinary Adolescents: The Role of Voice and Communication Therapy

Purpose Current literature to describe the role of voice and communication therapy in gender-affirming interdisciplinary care for transgender and nonbinary adolescents is very limited. As a result, professionals providing voice and communication therapy are not always integrated into gender clinics and treatment plans for patients seeking gender-affirming care. Using case studies to demonstrate the complexity and nuance of gender-affirming care, this clinical focus article provides education about gender identity, gender expression, and gender roles as well as rationale and outcomes for voice and communication therapy with transgender and nonbinary adolescents. Conclusion An interdisciplinary and gender-affirming approach is critical for adolescent voice and speech therapy success. Given the state of transgender health care and need for evidence-based interventions, this clinical focus article addresses gaps in training and research by recommending an interdisciplinary and culturally responsive approach to voice and communication therapy with transgender and nonbinary adolescents.

Voice Change in Pop Culture

The chapter discusses the way popular understanding and misunderstanding of voice change is largely perpetuated by mainstream media. Portrayals of voice change distributed via music, television, and movies have contributed to a simulacrum of adolescent voice change, a situated reality not based in fact but accepted in pop culture. The generally embraced perception of voice change is that it is a time of humiliation, anxiety, turmoil, and dread. Voice change is not always pleasant, but students and music educators perceive and approach the experience with such angst and trepidation well before it begins that is rarely given the opportunity to be something positive or exciting. The chapter examines and distills episodes of The Brady Bunch, The Wonder Years, and The Goldbergs, popular television series that spanned a period of more than 40 years, each with an episode focused on the adolescent changing voice.

Anatomy and Physiology

The chapter describes how an understanding of the way the voice operates can empower both female and male adolescent singers as well as the teachers assisting them through the voice change process. It unpacks basic vocal anatomy and physiology, and then overlays physiological transformations that occur in the larynx during female and male voice change. A special section addresses the impact of hormones on the adolescent voice (especially for females) and promotes awareness of premenstrual vocal syndrome. The chapter encourages music educators to frequently discuss and reference vocal anatomy and physiology with adolescent singers in order to demystify vocal challenges and dispel myths and misunderstandings about how the voice and body function.

Emerging Considerations

The chapter discusses emerging considerations of adolescent voice change beyond classification systems and provides new food for thought about working with the adolescent changing voice. A section of the chapter specifically addresses female singers, for while it is common to have more females than males in choral programs, enrollment numbers do not ensure that choral programs are meeting females’ musical, developmental, and personal needs. In addition, discussion of the documentary Riot Acts provides insight into voice change from the perspective of professional musicians who identify as transgender. The chapter ends with ideas for working with changing voices, especially with regard to approaching choral repertoire.

Introduction

The book describes voice change as a whole-body experience for adolescents, both female and male, which, while not always easy, should not scare music teachers away from working with adolescent singers. Many aspects of adolescent voice change are addressed throughout this book, but there may be exceptions to what is discussed. Everyone has an endocrine system that contains glands to produce hormones, but this system is sometimes influenced or disrupted by biological makeup, environmental conditions, or malnourishment; in addition, some people are diagnosed with atypical chromosomal structures. As a result, it is acknowledged that not every person on the planet does, in fact, experience a voice change. The focus of Thinking Outside the Voice Box remains on adolescent females and males who are engaged in the singing process and experiencing symptoms and expectations of a “typical” adolescent voice change.

Thinking Outside the Voice Box

Thinking Outside the Voice Box: Adolescent Voice Change in Music Education is different from other books on voice change in that it encourages new and holistic ways of thinking about the female and male adolescent changing voice. It gives choral music educators (or anyone interested in the changing voice) the opportunity to step away from typical considerations of voice change and explore the experience within the bigger picture of adolescence. Female and male adolescent voice change are addressed at length, but special efforts have been made to bring new attention to female voice change to boost considerations of females in choral music education. Holistic considerations encompass the importance of understanding physical development during adolescence, including the body, brain, and auditory system; vocal anatomy and physiology in general, as well as during male and female voice change; the impact of hormones on the adolescent voice, especially for female singers; ideas of resolve and perseverance that are essential to adolescent navigation of voice change; and exploration of portrayals of voice change that have contributed to a situated reality not based in fact, but accepted in pop culture. Choral educators are also given a larger scope of voice classification systems and other foundational ideas in choral music education through examination of some of the most eminent works in the profession. Emerging considerations of adolescent voice change beyond classification systems provide new food for thought about working with the adolescent changing voice.