Monday, 21 December 2020

Puberphonia ENT Research • Education Program

 

SIVA ENT Hospital (P) Ltd

Puberphonia ENT Research  • Education Program

Welcome to Puberphonia ENT Research. It is created to Support Scientific Activities related to Puberphonia. We are doing a series of weekly online lectures given by top speakers in the field of Puberphonia..

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kumaresan@doctor.com

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The goal of Puberphonia ENT Research Education and Traing program is to provide information on puberphonia specialty, educational links and resources, as well as dates of important upcoming Webinars and events.

 It is divided in to three parts.

1. Puberphonia camp. Identification by trained volunteers at village level for census. Uplifting Society by Providing Innovative Solutions: A study of puberphonia, a Social Entrepreneurship.

2.Puberphonia cure centre. The scope of add on practice for physio therapist, speech therapist, any AYUSH degree therapist after UMAR learning and training. They can diagnose and treat puberphonia and allied speech problems according to their system. 

3.Puberphonia workshop.Traing ENT Otolaryngology residents, Fellows, interested Junior Consultants and students to train in UMAR principle

We are very interested in hearing from you. If there are any topics you think would be helpful to include, please let us know by clicking the “contact” link below..

1.            Puberphonia camp, Identification by trained volunteers at village level for census. Uplifting Society by Providing Innovative Solutions: A study of puberphonia, a Social Entrepreneurship in India.

      Education is going through a big transition due to the ongoing changes in the way we use technology and the way we communicate. Online availability of the content has brought about revolutionary changes in the learning process of the students. Because the content is anyway available, so the level of learning has shifted to the next grade. All these practices may bring some innovation in the delivery of the courses and may enhance the quality of the outcome. The real change will come with the change in the mindset of the leadership behind the institutions. The vision and mission of the educational institutions need to change from product delivery to societal change. We don’t want lengthy manuscripts written for various journals for the purpose of publications but we need real action along with the novel thoughts to bring about the change in the lives of people. Actual interventions involving latest breakthroughs should be of much more importance than having research grants for incremental changes in existing research.

 

        Focus is on lifelong learning skills so that the students can adapt themselves to the new careers in the 21st century. It is being taken care that students are passionate about the society around them and hey come up with some solutions to change their life in a meaningful manner. -Social entrepreneurship has become the buzz word in India and around the world. People have found this concept of hilanthropy a bit intriguing in nature. It has the best mixture of social service and entrepreneurship; this ombination makes it most attractive and so unique in nature. Usually entrepreneurship is related to economic activities and being ruthlessly profit making and ignoring social benefits or societal well being. In the present era of heavy industrialization and economic growth, societal gains have taken back seat or even out of the sight all around the world, including India, with the concept of social entrepreneurship rising in India and around the world has helped in serving the society in more meaningful manner than ever before along with living the spirit of entrepreneurship with its fullest.

ENTHUSIASM  FACED BY PUBERPHONIA WORK IN SOCIAL ENTREPRENEURSHIP

     1.   Finance- One of the challenges for entrepreneurship in India remains lack of financial sources. Puberphonia identification training and treatment offering a unique product and set of services make it even easier to get financial support from claints.

      2.   Talented/dedicated workforce- This is a very unique challenge faced by social entrepreneurship exclusively. Generally people get into jobs to get a handsome salary and perks, but with social entrepreneurship this becomes a bit hard. Since the prime objective of puberphonia treatment is to get social gains/benefits it makes revenue by itself.

         3.  The problem of creativity- The next safety which is faced by puberphonia social entrepreneurship is gaining of creativity regarding thinking great ideas for betterment of society and earning profits as well. This fusion is very easy to think and implemented particularly in health care.

       4.  Global Recognition is a leading provider of recognition awards - the role of international opportunity recognition became an emergent research stream in puberphonia.

Our first impression is puberphonia is much more, larger than it is cited. In our small single ENT doctor clinic we are able to get more than 600 cases in a matter of 2 years.

Data Collection and Treatment Method

After  getting  the  ethical  consideration  of  verbal  and written  permission  from  each  sample,  the  structured questionnaire  was  used  to  assess  the  impact  of puberphonia on society by interview method. Even though the investigator has  found  his  own  simple  method  of  puberphonia  relief  in 1990  [4], vigorous  propaganda  is  done  since  11  November 2016. In  a short period in our center we got 476 cases which indicates  that  prevalence  of  puberphonia  is  high.  The investigator  have  done  the  treatment  of”  Pharyngeal  resonance  manipulation”  followed  by  breath  of  fire  and breath  yoga  therapy  of  three  to  five  days  by  the  trained personal, and the  effectiveness of treatment  is daily assessed and  guided  them  when  needed.  At  the  end  of  the  data collection in puberphonia  center we were  able to collect  476 cases by the investigators.

          Puberphonia is a voice disorder which is distinguished by the habitual and continuous use of prepubertal high-pitched voice of a child even after puberty. It is not a rare disorder, in which the patient manifests higher register voice than others of their same age group. Previous report says that the prevalence is 1 in 900,000 population. The impact of voice disorder varies greatly from person to person, environment, occupation, family members and overall personality. These are all the variables that can affect the way voice disorder affect a particular person. In general, people with puberphonia tend to encounter problems that include emotional, psychological, social and professional difficulty.

How we identify puberphonia

                Simply identify puberphonia boys with ears-on hearing their tone by voice. Many may even refuse to conjunction with an atypically high pitch, common symptoms include a weak, breathy, or hoarse voice,

as well as a low vocal intensity, pitch breaks, and shallow breathing. Emotional stress, self-consciousness resulting from an early breaking of the voice, Self-consciousness resulting from emerging adulthood, excessive admiration of another male or sibling, excessive maternal protection, social consequences of speaking in the falsetto register, because a high-pitched voice pathologized as women, women are less likely to be referred to clinicians to treat falsetto speech, some older adult women, however, may seek a referral for this disorder due to increasing weakness of their voice and vocal fatigue at the end of the day (these cases are often referred to as "juvenile voice" or "little girl's voice" rather than puberphonia.

One can assess the personality and identify the possibility of puberphonia in males  1. Physical/ mental health problem with unknown origin. 2. Destroys their self esteem, 3. Leads to low confidence, self doubt, anxiety and depression, 4. Anxious avoidance behavior,5. Obsessive thoughts about self image, 6. Eating disorder like anorexia and binge eating, 7. Delayed or no marriage, 8. Live lonely or leave the home 9. Live with friends, 10.Suicide tendency in some after rejection by a female partner.  Male having married, their wife incest them to change their voice because of social stigma and  multivarious reasons. Even some boys may leave the house and disappear. Boys may refuse to attend classes, mostly due to bulling. Evan senior officer looses the power of control.

People would make comments a big business man/ politician in the society by not recognizing ther puberphonia. For istance we like to suggest few comments:  ‘You should do voiceovers for kids movies’ or ‘How old are you?’ and sounding less, like a child, more womanly. Even British prime minister Margaret Thatcher had elocution lessons to make her voice powerful, to recognize her as a “ Iron Lady”.

 

The first part of the questionnaire inquired about functional communication and social participation and second part focused on emotional responses. All participants filled out the puberphonia health questionnaire and also took part in individual interviews to gather in depth information. Conversing over the telephone was a problem for 100%, while 100% experienced difficulties when talking to same age girls. 100% reported difficulties in work place or place of education. Among the participants, 10% communicated by writing on paper and 87% used text messages to communicate. 70% of the participants showed psychological distress with puberphonia. Different coping strategies are used to overcome these difficulties. Adolescents are more affected than young adults. Apart from impact on voice of the puberphonia, this disorder also has impact on social and psychological level. The case history generally concerns about the level of psychological impact of the patient, but research has not yet addresses the change in the psycho-social behavior of the patient. There is lack of awareness about the disorder and also the treatment. It has also been noted that the patient with puberphonia, has a tendency to be left out alone. There has been very little research in puberphonia patient’s psychological and social behaviors. Supportive study revealed that participants filled out the General Health Questionnaire and also took part in individual interviews to gather in depth information.

         Now a day, suicide has become a major public health problem which can have a lasting effect on the family and the entire community. According to WHO, around 8,00,000 people die due to suicide every year. National Institute of Mental Health states that suicide is the second leading cause of death among individuals ranging from 15 to 30 years. People with suicidal tendency tend to have certain problems like mental disorders, depression or alcohol abuse may be due to financial crisis, life stress or even chronic pain and illness. One of the cause may be puberphonia and rejection by opposite sex or by bullying. Such people do not openly talk about their problems and end up attempting/committing suicide. One of the major reasons for this problem is lack of awareness on treatment and could be done from this intervention to reduce suicide rates to create more awareness about it. As medical professions should identify puberphonia early and treat quickly and confidently with non invasive process. Once we correct the voice in puberphonia, communication and quality of life improves. We find that patients socialize more and participate in more activities.

                 The third party recognized the voice of his father. Genetics also play a role in how our voices mature. Although how a child's voice develops owes something to mimicry of their parents, people from the same family will often sound alike because laryngeal anatomy is dictated by ancestral DNA just like every other physical trait. 

      The most common symptoms include pitch breaks, hoarseness, breathiness, difficulty in vocal projection, and visible laryngeal muscle tension. GRBAS scale, was used to assess the voice, perceptually.  This scale evaluates voice on five scales - Grade (G), Roughness (R), Breathiness (B), Asthenia (A), and Strain (S).  Each parameter is rated on a 4-point rating scale ranging from 0 (normal), 1 (slight), 2 (moderate), and 3 (extreme).   Praat software was used for acoustic assessment of voice.  Prat is a software tool used to analyze, synthesize, and manipulate speech and has an built-in voice report tool.

The psychosocial impact of puberphonia was assessed with the Voice Handicap Index .  It is a 30 item, 5 point (0 to 4) scale, where 0 denotes “never” and 4 denotes “always”.  From the scores, the impact of the voice disorder may be classified as mild, moderate or severe.  Low scores (greater than 30) indicate that there is a minimal amount of handicap associated with the voice disorder.  A score of 31 to 60 denotes a moderate amount of handicap and a VHI score from 60 to 120 represents a significant amount of handicap due to a voice problem.  VHI is a useful instrument to monitor the treatment efficacy for voice disorders.

Pre and post therapy testing was performed using VHI administration and perceptual and acoustic analyses.

Voice Therapy:   All patients underwent a voice therapy schedule with the following techniques:

Counseling regarding the basics of patient anatomy, physiology and human growth to understand what is happening. It aims to alleviate anxiety, depression and other psychosocial impacts of puberphonia.  The patient is counseled about the effects of  childish voice communication and the likely positive changes resulting from the use of a new voice.

Therapy techniques included:

             Vegetative sounds – patient is asked to produce a cough or throat clear to initiate voicing.

             Hard glottal attack – patient is asked to produce vowels and words in a sudden plosive manner.

             Glottal fry – patient is asked to produce the lowest possible pitch on vowels and words then on short phrases and short sentences.

             Confidential voice therapy – patient is asked to use a breathy, soft, gentle speech.

             Humming while sliding down the scale

             Yawning technique

             Inspiratory phonation

             Incomplete swallowing sonorous ( full and loud and deep

             Use of nasal sounds

             UMAR training – our new research methotd- uvula manipulation – in one day high pitch voice turn to normal low pitch voice

 Our voice training  will continue  with fire of breathing along with other manipulation for 3 complete days as outpatient procedure with no medicine.  The patients were made aware of their newly acquired low-pitched voice and were counseled to accept it as their own voice.  When the patient was able to produce the low-pitched vowel, the same was used to produce nonsense syllables, words, phrases and sentences in a hierarchical manner. Our UMAR treatment is 95% successful and less time taking-maximum 3 days and habituate by home training for 21 days as home training.

The camp .Our over-arching goal for the program is to help campers to:

• Explore what PUBERPHONIA is, and what it is not

• Become aware of their own unique way of Speaking.

• Engage in group settings with others who puberphonia and learn to talk openly about their speech

• Make decisions about what changes they would like to make in either speaking.

• Provide opportunities for speaking in a variety of communication situations.

An innovative puberphonia care programme to deliver awareness, screening, diagnosis, and treatment for the underserved.

 


 600 puberphonia identified and treated globally

 


  

Age wise treated cases

 

Aim

 

1. Identify the one problem- puberphonia you can solve.

One of the main misconceptions around coaching and consulting is that you need to be an expert in the entirety of a field. That couldn’t be further from the truth.

The reality is, in order to have a successful business; you have to be a specialist, not a generalist. People choose a coach or consultant because they believe them to be uniquely qualified to solve their particular problem. Your business must solve one specific problem, for one specific group of people. Those who have that problem will seek you, before anyone else, to solve it.

By specializing, you also gain a deep understanding of your market, thus allowing you to speak to their specific pain points and increasing confidence that you can actually help solve them.

2. Figure out the steps to success.

Once you’ve figured out the one problem you solve and who you solve it for, the next step is to map out the specific steps clients will need to take to get the desired result. Once you know what they'll need to do, arrange those steps into chronological actions. Then, record yourself walking through each of those steps.

3. Speaks to the end result.

The final piece of the puzzle is to compile all the work you’ve done so far so you can start attracting clients. You'll want to create four lead-generation pages. The first page should have a strong headline that speaks to the end result you get for your client.

4. Confirmation page.

• Explore what PUBERPHONIA is, and what it is not

• Become aware of their own unique way of Speaking.

• Engage in group settings with others who puberphonia and learn to talk openly about their speech

• Make decisions about what changes they would like to make in either speaking.

• Provide opportunities for speaking in a variety of communication situations.

An innovative puberphoniar care programme to deliver awareness, screening, diagnosis, and treatment for the underserved.

Early screening and diagnosis.

These can be easily detected through a simple hearing of the tone of the voice by a social worker using an android cell phone-down down loaded voice pitch analyzer. . With early screening and diagnosis, puberphonia is curable. UMAR with a philosophy to create sustainable program of low-cost puberphonia care including awareness, screening, diagnosis, and treatment to the underserved, particularly in densely populated, low-income urban settlements and rural areas by leveraging medical technology, telecommunication, and frugal innovation. It is a hallmark example of health system innovation, serving dual objects of social impact and business viability simultaneously.

 

 

  

 

Direct recording the voice and finding out the pitch/  Puberphonia camp at school with oculus                          Camp at village

With an ENT surgeon as the central point of care, the programs are operationalized through trained community health workers (CHW) equipped with an “android cell phone.” Patients with a positive provisional diagnosis are routed to the point of care for receiving low-cost treatment, including advanced diagnosis anr UMAR noninvasive ,out patient therapy .

 




False and myth about puberphonia

 

There are a number of proposed causes for the development of  Puberphonia, that the etiology of  Puberphonia can be both organic (biological) and psychogenic (psychological) in nature.

 

1.            Hormonal, similarly at puberty, guys' bodies begin producing excess of hormone called testosterone which causes changes in several parts of the body, including the voice. For starters, a guy's, also known as the voice box, grows bigger. Examination of these patients should include a complete physical examination including a genital examination also. Secondary sexual characters should be assessed; hypogonadism should be ruled out. Genetic origin, Family history of Puberphonia is proposed. We tested testosterone level 100 case of Puberphonia as a sample study. Their level from 310 to 675ng/dl.

2.                            It is not due to psychological. As they are left out of society they are considered as indifferent.

3 It is not due to habitual use. They may try all the ways to break the voice. It is concluded that it is not curable.

4.            Puberphonia boys are not smart and intelligent. They will have a normal life if they are not disturbed by the society.

5.            It is not due to anatomical reason in the vocal tract. They are having normal vice on coughing and yarning.

6.            It is not due to neurological. After puberphonia treatment they lead a normal life.

7.            Bad parenting is not the cause for developing pubertphonia. Puberphonia is not a disease, it is a life experience.

8.            It is easily curable by uvula resonance manipulation.

 

 

2.3. Data Collection and Treatment Method

After  getting  the  ethical  consideration  of  verbal  and written  permission  from  each  sample,  the  structured questionnaire  was  used  to  assess  the  impact  of puberphonia on society by interview method. Even though the investigator has  found  his  own  simple  method  of  puberphonia  relief  in 1990  [4], vigorous  propaganda  is  done  since  11  November 2016. In  a short period in our center we got 476 cases which indicates  that  prevalence  of  puberphonia  is  high.  The investigator  have  done  the  treatment  of”  Pharyngeal resonance  manipulation”  followed  by  breath  of  fire  and breath  yoga  therapy  of  three  to  five  days  by  the  trained personal, and the  effectiveness of treatment  is daily assessed and  guided  them  when  needed.  At  the  end  of  the  data collection in puberphonia  center we were  able to collect  476 cases by the investigators.

3. Results

The assessment of impact of puberphonia on society among puberphonia in males from the age group of 15 to 70 years is depicted  in  figure  1  and  figure  2  depicts  the  marital  status report  among  puberphonia  males.  The  results  also  revealed that there is  a  significant association between salaried  versus dependent which is depicted in figure 3 and figure 4 shows the geographical location data of puberphonia male.

4. Discussion

The  first  part  of  the  questionnaire  inquired  about functional  communication  and  social  participation  and second part focused on emotional responses.  All participants filled out  the puberphonia health questionnaire and also took part  in  individual  interviews  to  gather  in  depth  information.

Conversing  over  the  telephone  was  a  problem  for  100%, while  100%  experienced  difficulties  when  talking  to  same age girls. 100% reported difficulties in work place or place of education.

Among the participants, 10% communicated by writing on paper and 87% used  text  messages to communicate. 70% of the  participants  showed  psychological  distress  with puberphonia.  Different  coping  strategies  are  used  to overcome  these  difficulties.  Adolescents  are  more  affected than young adults. Apart  from  impact  on  voice  of  the  puberphonia,  this disorder  also has  impact  on social  and  psychological  level.

The  case  history  generally  concerns  about  the  level  of psychological impact of the  patient, but research has  not  yet address  the  change  in  the  psycho-social  behavior  of  the patient.  There  is  lack  of  awareness  about  the  disorder  and also the treatment. It has also been noted that the patient with puberphonia,  has  a  tendency  to  be left  out alone.  There has been  very  little  research  in  puberphonia  patient’s psychological  and  social  behaviors.  Supportive  study revealed  that  participants  filled  out  the  General  Health Questionnaire  and  also  took  part  in individual  interviews to gather  in  depth information.  Conversing  over the  telephone was  a  problem for  87%  while 73%  experienced  difficulties when  talking  to  same  age  girls.  60%  reported  difficulties  in work  place  or  place  of  education.  77%  had  difficulties  in social  situations.  Only  20%  experienced  difficulties  when interacting with family members [10].

Now  a  day,  suicide  has  become  a  major  public  health problem which can have a lasting effect on the family and the entire  community.  According  to  WHO,  around  8,00,000 people die due to suicide every year [7]. National Institute  of Mental Health states  that suicide is the second  leading cause of death among  individuals ranging from 15  to 30 years  [5].

People  with suicidal tendency  tend  to have certain problems like  mental  disorders,  depression  or  alcohol  abuse  may  be due  to  financial  crisis,  life  stress  or  even  chronic  pain  and illness. One of the cause maybe puberphonia and rejection by opposite  sex or by bullying.  Such  people  do  not openly talk about  their  problems  and  end  up  attempting/committing suicide. One of the major reasons for this  problem is lack  of awareness  on  treatment  and  could  be  done  from  this intervention to  reduce suicide rates to create more awareness about it. As medical professions should identify puberphonia early  and  treat  quickly  and  confidently  with  non  invasive process.

Once we correct the voice in puberphonia, communication and  quality  of  life  improves.  We  find  that  patients  socialize more and participate in more activities.

Highlights  of  puberphonia  males-  functional  communication and social participation

1. Critical  aspects  of  communication  skills  have  been impacted by puberphonia.

2. Adolescents who are puberphonia are teased and bullied more than their fluent peers.

3. Adolescents  may  not  find  puberphonia  voice  a stigmatizing  condition  however  they  prefer  not  to discuss it with other people.

4. Families  have  experienced  high  levels  of  emotional strain in conducting the  marriage for puberphonia boys and recognize the impact of puberphonia among boys.

Puberphonia can cause  wide ranging psychosocial impact.

This  is  particularly  the  case  for  adolescents  who  may  face additional  physical,  emotional  and  personality  changes  as they  become  adults.  This  study  reports  the  findings  of  an investigation  into  the social  and  communication  impacts  of puberphonia.

The following Message should be recognized by the public and medical professionals

1. Puberphonia is a very common problem.

2. It needs treatment and treatment available.

3. It is not a hormonal disease and physiological disease.

4. Puberphonia boys are smart and intelligent.

5. Bad parenting is not the etiology for puberphonia and.

2.3. Data Collection and Treatment Method

After  getting  the  ethical  consideration  of  verbal  and written  permission  from  each  sample,  the  structured questionnaire  was  used  to  assess  the  impact  of puberphonia on society by interview method. Even though the investigator has  found  his  own  simple  method  of  puberphonia  relief  in 1990  [4], vigorous  propaganda  is  done  since  11  November 2016. In  a short period in our center we got 476 cases which indicates  that  prevalence  of  puberphonia  is  high.  The investigator  have  done  the  treatment  of”  Pharyngeal resonance  manipulation”  followed  by  breath  of  fire  and breath  yoga  therapy  of  three  to  five  days  by  the  trained personal, and the  effectiveness of treatment  is daily assessed and  guided  them  when  needed.  At  the  end  of  the  data collection in puberphonia  center we were  able to collect  476 cases by the investigators.

3. Results

The assessment of impact of puberphonia on society among puberphonia in males from the age group of 15 to 70 years is depicted  in  figure  1  and  figure  2  depicts  the  marital  status report  among  puberphonia  males.  The  results  also  revealed that there is  a  significant association between salaried  versus dependent which is depicted in figure 3 and figure 4 shows the geographical location data of puberphonia male.

4. Discussion

The  first  part  of  the  questionnaire  inquired  about functional  communication  and  social  participation  and second part focused on emotional responses.  All participants filled out  the puberphonia health questionnaire and also took part  in  individual  interviews  to  gather  in  depth  information.

Conversing  over  the  telephone  was  a  problem  for  100%, while  100%  experienced  difficulties  when  talking  to  same age girls. 100% reported difficulties in work place or place of education.

Among the participants, 10% communicated by writing on paper and 87% used  text  messages to communicate. 70% of the  participants  showed  psychological  distress  with puberphonia.  Different  coping  strategies  are  used  to overcome  these  difficulties.  Adolescents  are  more  affected than young adults. Apart  from  impact  on  voice  of  the  puberphonia,  this disorder  also has  impact  on social  and  psychological  level.

The  case  history  generally  concerns  about  the  level  of psychological impact of the  patient, but research has  not  yet address  the  change  in  the  psycho-social  behavior  of  the patient.  There  is  lack  of  awareness  about  the  disorder  and also the treatment. It has also been noted that the patient with puberphonia,  has  a  tendency  to  be left  out alone.  There has been  very  little  research  in  puberphonia  patient’s psychological  and  social  behaviors.  Supportive  study revealed  that  participants  filled  out  the  General  Health Questionnaire  and  also  took  part  in individual  interviews to gather  in  depth information.  Conversing  over the  telephone was  a  problem for  87%  while 73%  experienced  difficulties when  talking  to  same  age  girls.  60%  reported  difficulties  in work  place  or  place  of  education.  77%  had  difficulties  in social  situations.  Only  20%  experienced  difficulties  when interacting with family members [10].

Now  a  day,  suicide  has  become  a  major  public  health problem which can have a lasting effect on the family and the entire  community.  According  to  WHO,  around  8,00,000 people die due to suicide every year [7]. National Institute  of Mental Health states  that suicide is the second  leading cause of death among  individuals ranging from 15  to 30 years  [5].

People  with suicidal tendency  tend  to have certain problems like  mental  disorders,  depression  or  alcohol  abuse  may  be due  to  financial  crisis,  life  stress  or  even  chronic  pain  and illness. One of the cause maybe puberphonia and rejection by opposite  sex or by bullying.  Such  people  do  not openly talk about  their  problems  and  end  up  attempting/committing suicide. One of the major reasons for this  problem is lack  of awareness  on  treatment  and  could  be  done  from  this intervention to  reduce suicide rates to create more awareness about it. As medical professions should identify puberphonia

early  and  treat  quickly  and  confidently  with  non  invasive process.

Once we correct the voice in puberphonia, communication and  quality  of  life  improves.  We  find  that  patients  socialize more and participate in more activities.

Highlights  of  puberphonia  males-  functional communication and social participation

1. Critical aspects  of  communication  skills  have  been impacted by puberphonia.

2. Adolescents who are puberphonia are teased and bullied more than their fluent peers.

3. Adolescents  may  not  find  puberphonia  voice  a stigmatizing  condition  however  they  prefer  not  to discuss it with other people.

4. Families have experienced  high  levels  of  emotional  strain in conducting the  marriage for puberphonia boys and recognize the impact of puberphonia among boys.

Puberphonia can cause wide ranging psychosocial impact.

This  is  particularly  the  case  for  adolescents  who  may  face additional  physical,  emotional  and  personality  changes  as they  become  adults.  This  study  reports  the  findings  of  an investigation  into  the social  and  communication  impacts  of puberphonia.

The following Message should be recognized by the public and medical professionals

1. Puberphonia is a very common problem.

2. It needs treatment and treatment available.

3. It is not a hormonal disease and physiological disease.

4. Puberphonia boys are smart and intelligent.

5. Bad parenting is not the etiology for puberphonia and.

Data Collection and Treatment Method

After  getting  the  ethical  consideration  of  verbal  and written  permission  from  each  sample,  the  structured questionnaire  was  used  to  assess  the  impact  of puberphonia on society by interview method. Even though the investigator has  found  his  own  simple  method  of  puberphonia  relief  in 1990  [4], vigorous  propaganda  is  done  since  11  November 2016. In  a short period in our center we got 476 cases which indicates  that  prevalence  of  puberphonia  is  high.  The investigator  have  done  the  treatment  of”  Pharyngeal resonance  manipulation”  followed  by  breath  of  fire  and breath  yoga  therapy  of  three  to  five  days  by  the  trained personal, and the  effectiveness of treatment  is daily assessed and  guided  them  when  needed.  At  the  end  of  the  data collection in puberphonia  center we were  able to collect  476 cases by the investigators.

         The study concludes that our treatment for puberphonia by an out patient  treatment by uvula manipulation and breath of fire therapy not only improves the voice, it is also improved the personality of puberphonia client and we provides thorough further knowledge about puberphonia among the society and health professionals.

2. The scope of add on practice for physio therapist, speech therapist, any AYUSH degree therapist after UMAR learning and training. They can diagnose and treat puberphonia and allied speech problems according to their system. 

     Puberphonia cure centre.

             The scope of add on practice for physio therapist, speech therapist, any AYUSH degree therapist after UMAR learning and training. They can diagnose and treat puberphonia and allied speech problems.  Our preliminary study suggests that physical therapy techniques may have a role in the treatment of a subset of puberphonia patients. Larger, comparative studies are needed to better characterize the role of physical therapy in this population. Puberphonia  is characterized by increased musculoskeletal tension with excessive muscular recruitment in the larynx, pharynx and mouth with concomitant disruption of efficient vibratory parameters. Puberphonia voice disorder is further classified as primary or secondary. Primary occurs in the absence of identifiable fixed laryngeal pathology (e.g. vocal fold/tract lesions, paralysis), while secondary refers to unknown etiology that occurs concomitantly with such pathologies. Clinically, both types present with variable symptomology including hoarseness, vocal fatigue, effortful voice production, change in habitual pitch, reduced vocal range, pain with voice use, muscular cramping and neck stiffness which can be a subject added treated modality for therapist, speech therapist, any AYUSH degree therapist.

            About 1% of the population, are born with a predisposition to speak in a different manner, among that one problem is puberphonia.  Speech Language Pathologist Speech-language pathologists provide services to children (from neonates through to school age), adolescents, adults and geriatrics with special needs in the areas of communication and swallowing. The clinical services include, but are not limited to clinical and/or instrumental screening, assessment, identification, diagnosis, treatment, and management of • Speech sound production delays and disorders including articulation disorder, phonological disorder, apraxia of speech, and dysarthria • Language delays and disorders including comprehension and expression in verbal and/or non-verbal modalities • Fluency disorders including puberphonia, normal non fluency, stuttering and cluttering • Voice disorders including disorders of phonation quality, pitch, loudness and respiration • Resonance disorders including hyper nasality, hypo nasality and cul-de-sac resonance and mixed resonance • Swallowing and feeding disorders • Cognitive-communicative disorders including disorders of social communication skills, attention, memory, reasoning, sequencing, problem solving, and executive functions • Pre-literacy and literacy skills including phonological awareness, decoding, reading, comprehension, and writing • Communication and swallowing disorders in the context of other diagnoses or impairments including but not limited to hearing impairments, traumatic brain injury, dementia, developmental, intellectual or genetic disorders, and neurological impairments • Development, assessment and selection of augmentative and alternative communication systems including unaided and aided strategies for individuals who have limited in their ability to communicate verbally, and provision of education and training in their use. • Selecting, fitting, and establishing effective use of prosthetic/adaptive devices for communication and swallowing such as trachea esophageal prostheses, speaking valves, electro larynx, etc. • Modifications or improvement of speech and language proficiency and communication effectiveness such as, care and improvement of professional voice.

A call for puberphonia eradication program

ELIGIBILITY – Physio Therapist, Speech Therapist, Any AY(N)USH degree or students.

      We on behalf of SIVA ENT Hospital, Puberphonia Cure Centre really very happy to have a heart to heart communication. I specially thank you from the bottom of my heart for your awareness to overcome puberphonia and the interest shown towards this Centre. Read this book to have positive good ideas and to get correct, factual and practical information about puberphonia and its cure.

   This is not a professional rather it is a heart-to-heart life-saving communication with us by several puberphonia boys, who also has been humiliated, teased, ignored, uncared for and under-estimated just like few because of puberphonic voice for years. With the motto of “SERVICE TO PUBERPHONIA PERSONS ABOVE SELF”, since over 30 years we have been dedicated wholeheartedly to serve around puberphonia persons of India and around the Globe, who are still suffering from lack of confidence, low self esteem, frustration, depression, several hurdles and difficulties and have lost all hope in life due to their puberphonic voice. Many people in India are suffering from puberphonia but most of them are brilliant, creative, talented, imaginative and intelligent. Can you imagine the massive wastage of resources for the nation and the whole World?

 Depressed, Tensed, Humiliated, Frustrated And Have Lost All Hope In Life Due To Puberphonia?

Don't worry! Puberphonia is not a disease, neither is it by birth nor is it any physical defect. It is purely a dour, life style and bad habitual problem which is easily curable in just 3 days. Unbelievable but true. Over the past more than 600 people have cured their puberphonia under our guidance.  Why not you join with us to treat it?

  



                                          The Big Shift: Moving from "Doer" to "Leader"

No matter how severe or how old the puberphonia problem, we can treat it.AT IS PUBERPHONIA

What is Pubberphonia ?: Puberphonia voice is childish or girl’s voice.

The good news is that puberphonia is not a disease. There is nothing wrong with the tongue, throat or any other speech organs. When they speak alone the voice is high pitch. SES STAMMERING

Puberphonia develops at the time of boys attain adulthood change, as a result of non breaking of voice.

Whatever may be the reason for developing puberphonia, they have uncontrolled excitement, tension, fear, nervousness, hesitation, anticipation of child/ladies voice, faulty way of breathing, very fast speaking habit, lack of confidence and courage to speak.

HOW DOES PUBERPHONIA DEVELOP?

Neither does it start by birth nor is there any physical defect. Adult male continue to talk in their childhood high pitch tone..

All these things which recognized in the adulthood continue to be a lifelong problem.

Does Puberphonia Get Cured On Its Own? .No.

Most of the parents in India surprisingly comment that 'Ignore the problem, it will be cured by itself when you grow up – it is a passing phase'. It is not that puberphonia once voiced is not curable at all naturally, and then so many golden years of one's life become a nightmare. This time will never come back and there is no way to compensate for it. The formative period of anybody's life – school life, adolescence, college life and so on are the stages in which to build up one's personality, skill and other essential qualities for a bright life and a successful career. But during those vital periods, if one is forced to stay in the shell, avoiding people and engage in all other self-defeatist behavior, naturally it affects one's success and achievement in life. So without waiting for the fortunate day when it may or may not get cured on its own, take immediate action to solve the most complicated problem of a person's life – voice.

Is Puberphonia Curable, Controllable Or Incurable? Yes curable, the most neglected and ignored problems in the world.

DIFFICULTIES FACED BY PUBERPHONIC VOICE PERSONS

Puberphonia is something seldom understood and rarely have people shown their concern for people suffering from it. Since it does not kill a person or affect the major internal body organs, it is not taken seriously. To others, puberphonia is a joke they can tease and laugh about but only a puberphonia person knows what they are going through because of their high pitch voice.

             Even after knowing better than most of the people, they cannot express their knowledge; people consider them to be dull & incompetent.

             Puberphonia leads to depression, tension, frustration, pessimism and they develops inferiority complex and ultimately lose all hope & ambition in life and often think of committing suicide.

             Due to poor communication with examiner, marks obtained in oral exams are less even if they are prepared very well.

             Puberphonia boys always have to take the help of others to go anywhere or meet anybody, so they do not become self-sufficient or independent.

             Due to this problem, puberphonia boys get easily irritated and annoyed, thus losing your cool calm and composure.

             During social functions & marriage gatherings, puberphonia boys try to avoid people & they treat them as unsocial because of your inability to interact.

             They are not able to ask questions or clarify doubts in class & hence have to remain ignorant in some topics.

             They often do not get due credit & appreciation for the hard sincere & honest work that they have done.

             To take up any challenging task is very difficult for them because of constant fear & lack of confidence.

             To participate in a interview, marriage proposal, delayed conceiving, quiz contest, elocution or perform in the stage is very difficult.

             In most of the cases they admit their inability & have to settle for a petty job that is much less dignified compared to their qualification.

             They have definitely missed or are missing the beautiful school/college life which other students happily & cheerfully enjoy by participating in all extracurricular activities.

             To meet top people for important work, a lot of tension mounts making it problematic to discuss freely.

             In spite of having everything in life because of their indifferent pitch in speech, their dreams always remain unfulfilled.

The essential life line is : Their deep knowledge, very good intellectual ability, creative ideas, good aptitude skill & excellent academic & other records are wasted unless they are capable enough to communicate very well, display pleasing and attractive personality to command leadership. Today these things are absolutely necessary to excel in life. We request you to learn to treat puberphonia.

STATUS OF PUBERPHONIA PERSONS

It is very unfortunate that the status of puberphonia persons is extremely pathetic and painful. They are being subjected to teasing, humiliation, underestimation, neglect and ill-treatment everywhere. Sometimes they are ignored, made fun of and even tortured. In the society, people misunderstand them; do not respect them and puberphonia persons are exploited in various ways. They are often victims of cheating, bullying and injustice because they cannot protest. People stereotype puberphonia persons as dull, foolish, unsmart, incompetent, timid and other similar negative things.

In short, the puberphonia persons are very much deprived of leading a normal and respectable life. They are leading a life full of frustration, depression and hopelessness, wandering through life aim-less and goal-less. In reality, puberphonia persons are more intelligent, creative, imaginative and have fast thought process. It is frustrating to see them underachieving and being under-rewarded compared to their skills and talents.

Moreover they face such discouragement that they feel unaccepted in their own families and friend circles. Their relatives and friends may often try to hide the fact from the society that are related to them or even know them. Since that love, support and encouragement in life is lost, they are left with just loneliness, unhappiness, hopelessness, helplessness, frustration and feelings of worthlessness, which can all lead to suicide attempts. Puberphonia persons are not just discriminated against by their family, friends or society, but also by themselves. They view themselves as "diseased", "handicapped", incapable, worthless and undeserving of good things in life because of their puberphonia problem and their repeated failures to utilize opportunities and shine.

FAMOUS PEOPLE WITH PUBERPHONIA

Many. We believe that puberphonia also have the full right and all the necessary qualities and the potential to transform yourself into a fluent confident and an excellent speaker within a short period. We have already proved it several times. The only thing you need is the link with me to cure puberphonia.

TREATMENT TECHNIQUES

Enriched 600 puberphonia patients life with ancestral voice by an innovative ,noninvasive successful uvula, the accessory speech organ, resonance manipulation treatment. A live demonstration  with  palatal-uvula obturators, short-term prosthetics oculus ,Virtual Reality and APP used to create low pitch speech production.  “Treat puberphonia in one day” workshop provides opportunity for “hands-on” or skill-based practice or learning.

This topic is important to the prospective Physio Therapist, Speech Therapist and  AYUSH  Therapist because it is specific, relevant common condition of an unknown etiology. It is based on an extensive research literature, though didactic presentations are kept to a minimum. Active learning is encouraged through case-based discussions, group exercises, video case review, and communication skills practice. It's a great way to teach hands-on skills in puberphonia because it offers participants a chance to try out our/your new noninvasive, outpatient treatment methods in an easily recognized, common, unattended voice problem. The interactive portions of the workshop should be stressed and should include both small- and large-group discussions and activities wherever possible. One will experience the most 28 years experienced best quality methods with 6 articles published and 29 workshop conducted.

 

 

In a seminar on ‘Voice care for students and teachers,’ conducted by Tamil Nadu Science and Technology Centre in coordination with Medical Advance Research Foundation, close to 150 teachers got a respite from talking,

3. Puberphonia workshop.Traing ENT Otolaryngology residents, Fellows, interested Junior Consultants and students to train in UMAR principle

Workshop content

1. Use of voice pitch analyzer in puberphonia, cough, yarning and snoring.

2. Bernoulli Effect. The Bernoulli Effect provides an explanation of how the vocal folds actually vibrate and produce sound.

3. Tholkappier article, 2500 years back written Tamil poem. The voice originates from abdomen. 

4. Venturi   effect.  Venturi effect is a system for speeding the flow of the air at uvular level, by constricting it in a cone shape tube.

5. Ripple Phenomenon. The ripples are cause either by wind currents blowing in the mouth.

 6. Resonance by shell (“sanku-in Tamil language”), comparable to nasal resonance. The principle of resonance affects how we perceive sound waves. All objects possess a natural or resonant frequency at which they tend to vibrate

7. Meditation / Yoga “breath of fire” breathing training. Deeply inhaling and exhaling fully through the nose or mouth. During the inhale, the diaphragm is pushed out and pulled during the exhale.

8.  Pavlov Conditioning theory of habituation. Pavlovian theory is a learning procedure that involves pairing a stimulus with a conditioned response.

9. Uvula as a speech organ; Uvula trill and uvula consonants; both uvula and speech serve to differentiate human beings from animals. Our conclusion is that the uvula is an accessory organ of speech, and may be another marker of human evolution that differentiates man from other mammals

10.Puberphonia  App. Focus on what the puberphonia can do instead of overemphasizing what he can't do.

11. Virtual reality training with “Oculus”. Use of non-immersive virtual environments to provide assessment and intervention.

12. Gaining the ancestral voice in the place of puberphonia voice, because no surgery is involved. Participants will benefit from learning a range of shared rituals they can use to manifest various objectives sought. They will leave the programme with the self-confidence to extend their knowledge in creating their own rituals and customising them for increased spiritual development, growth and achievement.

Practical references by the workshop instructor published articles

1,     “Tholkappiyam Leads Bernoullies Phenomenon in Voice Production and Maintenance, Kumaresan, M. World Classical Tamil Conference, 5-day Summit | June 2010, Coimbatore.

2.        Assess the Impact of Puberphonia in the Society - Science ...article. MuthiahKumaresan,Science publishing group.com › … May, 2019.

3.       An immediate and permanent cure for Puberphonia   www.researchgate.net › amp.uthiahKumaresan  Journal of eISSN: 2379-6359, Otolaryngology-ENT Research, Published: July 31, 2018.

4.       A study of parallels in the works of Tholkappiyar and Bernoulli, Dr.M.Kumaresan, The 10th World Tamil Conference, Chicago July... Published:  4th July 2019.

5.       Fast Track Treatment for Puberphonia, Kumaresan M* and NavinBharath, Published: February 05, 2020.Scholarly Journal of Otolaryngology (SJO)

6.       New concept for uvula manipulation to treat Puberphonia, Journal of Otolaryngology-ENT Research, Muthiah Kumaresan; K.NavinBharath, Volume 12 Issue 3 – 2020.

7. Research Article, Puberphonia Treatment by Uvula Manipulation, Muthiah Kumaresan1* and Navin Bharath2 Received: September 28, 2020, Published: November 18, 2020

© All rights are reserved by Muthiah Kumaresan and Navin Bharath. Acta Scientific Otolaryngology

Volume 2 Issue 12 December 2020.

Herewith I am enclosing video of one of a puberphonia treated patients. https://youtu.be/AHaktHeOEk0.

MEET OUR FANTASTIC TEAM     

1. Prof.Dr.R.Ponnudurai MD, DPM,MNAMS,PhD   BC ROY Award, Clinical psychiatrist

2. Prof (Dr).K.Pearlson PT,MBT(Aus),COMT(Aus)Manual therapist ,                                                                           Founder President, Federation of Indian Manual Therapists FIMT                                                                                                            

3. Dr.M.Kumaresan   MS(ENT), DLO. FICS,FIMSA,FCCP, Science Popularization Award Govt of Tamil Nadu, Gold Medal Acoustic Society of America, SIVA ENT Hospital                                                                          

4. Dr.K.Navin Bharath MS(ENT), ENT Deprtment, Saveetha Medical College                                                                                                                                                                                                                                                                                                                                                                    

 

 5. Mr. Elangovan  Darling Parameswaran BASAP (Audiology and speech therapy)

 

Website – https://www.SivaENT.com

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