Historical changes in the average age of puberty have had profound effects on the composing of music for children's voices. Due to the significant drop in pitch to the vocal range, people may unintentionally speak in head voice or even strain their voices using pitches which were previously chest voice, the lowest part of the modal voice register. Occasionally, voice change is accompanied by unsteadiness of vocalization in the early stages of untrained voices. Cavities in the sinuses, the nose, and the back of the throat grow bigger, thus creating more space within the head to allow the voice to resonate. Along with the larynx, the vocal folds (vocal cords) grow significantly longer and thicker. This growth is far more prominent in males than in females and is more easily perceived. Under the influence of sex hormones, the voice box, or larynx, grows in both sexes. It usually happens months or years before the development of significant facial hair. Adult pitch is reached 2–3 years later but the voice does not stabilize until the early years of adulthood. Most of the voice change begins around puberty.
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