Puberphonia is the inappropriate persistence of higher-pitched prepubertal voice long after puberty and normal voice change. Also called mutational falsetto. Such individuals maintain something like their high-pitched, childhood voice by speaking in falsetto register.

The cause of puberphonia is never known with precision. Some think the condition arises more often in men whose voices mutate to the normal and mature male quality suddenly and precipitously, dropping abruptly into the bass or bass-baritone range. It is as though the person isn’t given time to adapt to the new sound of the voice. Some individuals with puberphonia can produce normal voice on request, but consider it “ugly,” or even their “monster voice.” Others need considerable coaching to find the normal voice. Once convinced by voice experts that the “monster” voice actually sounds great and is the “normal” one, most individuals can adopt the new voice fairly rapidly. The process of normalization typically involves only two or three sessions of speech/voice therapy, provided the therapist is highly experienced and voice therapy-qualified.