Which procedure would be effective in remediating a falsetto voice for an adult male with severe bilateral hearing loss?

• A. Development of phonation from coughing
• B. Pushing exercises
• C. Manual depression of the larynx
• D. Manual elevation of the larynx

Answer: (C)

The main idea here is using a physical cue to shift phonation from a high, falsetto pattern to a more modal, chest-like voice by changing the position of the larynx. Lowering the larynx directly affects vocal fold interaction and pitch: when the larynx is depressed, the voice can drop into a lower, more robust register with better vocal fold closure. For an adult male with severe hearing loss, this tactile, kinesthetic cue is especially helpful because auditory feedback is limited, so the therapist’s manual guidance provides a concrete way to feel and reproduce the target position and feel a more natural voice.

Why this works better than the other approaches: letting phonation develop from coughing creates an abrupt, uncontrolled voice that’s not suitable for sustained, controlled speech. Pushing exercises don’t target the laryngeal height in a way that reliably shifts the register. Elevating the larynx would push the voice toward an even higher pitch, reinforcing falsetto rather than remediating it.