{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:45:17Z","timestamp":1787755517987,"version":"build-2784847793"},"reference-count":62,"publisher":"American Academy of Audiology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2021,5,1]]},"abstract":"<jats:p><jats:bold>Abstract<\/jats:bold>  <jats:bold>Background<\/jats:bold>\u2003Digits-in-noise (DIN) tests have become popular for hearing screening over the past 15 years. Several recent studies have highlighted the potential utility of DIN as a school-aged hearing test. However, age may influence test performance in\n children due to maturation. In addition, a new antiphasic stimulus paradigm has been introduced, allowing binaural intelligibility level difference (BILD) to be measured by using a combination of conventional diotic and antiphasic DIN. <jats:bold>Purpose<\/jats:bold>\u2003This study determined age-specific\n normative data for diotic and antiphasic DIN, and a derived measure, BILD, in children. A secondary aim evaluated the validity of DIN as a smartphone self-test in a subgroup of young children. <jats:bold>Research Design<\/jats:bold>\u2003A cross-sectional, quantitative design was used. Participants with\n confirmed normal audiometric hearing were tested with a diotic and antiphasic DIN. During the test, arrangements of three spoken digits were presented in noise via headphones at varying signal-to-noise ratio (SNR). Researchers entered each three-digit spoken sequence repeated by the participant\n on a smartphone keypad. <jats:bold>Study Sample<\/jats:bold>\u2003Overall, 621 (428 male and 193 female) normal hearing children (bilateral pure tone threshold of\u2009\u2264\u200920\u2009dB hearing level at 1, 2, and 4\u2009kHz) ranging between the ages of 6 and 13 years were recruited. A subgroup\n of 7-year-olds (<jats:italic>n<\/jats:italic>\u2009=\u200930), complying with the same selection criteria, was selected to determine the validity of self-testing. <jats:bold>Data Collection and Analysis<\/jats:bold>\u2003DIN testing was completed via headphones coupled to a smartphone. Diotic and antiphasic DIN speech\n recognition thresholds (SRTs) were analyzed and compared for each age group. BILD was calculated through subtraction of antiphasic from diotic SRTs. Multiple linear regressions were run to determine the effect of age on SRT and BILD. In addition, piecewise linear regressions were fit across\n different age groups. Wilcoxon signed-rank tests were used to determine differences between self- and facilitated tests. <jats:bold>Results<\/jats:bold>\u2003Age was a significant predictor, of both diotic and antiphasic DIN SRTs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). SRTs improved by 0.15\u2009dB and 0.35\u2009dB\n SNR per year for diotic and antiphasic SRTs, respectively. However, age effects were only significant up to 10 and 12 years for antiphasic and diotic SRTs, respectively. Age significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) predicted BILD, which increased by 0.18\u2009dB per year. A small\n SRT advantage for facilitated over self-testing was seen but was not significant (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). <jats:bold>Conclusions<\/jats:bold>\u2003Increasing age was significantly associated with improved SRT and BILD using diotic and antiphasic DINs. DIN could be used as a smartphone self-test\n in young children from 7 years of age with appropriate quality control measures to avoid potential false positives.<\/jats:p>","DOI":"10.1055\/s-0041-1727274","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T22:40:56Z","timestamp":1628635256000},"page":"315-323","source":"Crossref","is-referenced-by-count":15,"title":["Speech Recognition in Noise Using Binaural Diotic and Antiphasic Digits-in-Noise in Children: Maturation and Self-Test Validity"],"prefix":"10.3766","volume":"32","author":[{"given":"Jenique","family":"Wolmarans","sequence":"first","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina C.","family":"De Sousa","sequence":"additional","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Frisby","sequence":"additional","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faheema","family":"Mahomed-Asmail","sequence":"additional","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cas","family":"Smits","sequence":"additional","affiliation":[{"name":"Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Moore","sequence":"additional","affiliation":[{"name":"Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De Wet","family":"Swanepoel","sequence":"additional","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2087","reference":[{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/00003446-199810000-00001","article-title":"Children with minimal sensorineural hearing loss: prevalence, educational performance, and functional status","volume":"19","author":"F H Bess","year":"1998","journal-title":"Ear 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