Age-Related Maturation of Antiphasic Arabic Digits-in-Noise Thresholds in Children

Pediatric data in Arabic are largely absent from the digits-in-noise (DIN) literature, representing a critical gap in knowledge. This study aimed to describe the developmental patterns of Arabic antiphasic DIN thresholds in children aged 5-17 years, determine the age at which DIN thresholds converge with adult levels, and characterize age-related changes in task performance metrics, including response time, response time variability, psychometric function slopes, and digit-position effects.

Audiometrically normal Arabic-speaking children (n = 65) and adults (n = 33) completed antiphasic DIN testing. Age-related trends were analyzed to identify the onset of adultlike performance, with thresholds beyond this point compared to adults using equivalence testing. Exploratory analyses estimated developmental inflection points via segmented regression and reported effect sizes with confidence intervals. Further supplementary analyses examined age-related trends in response times, response time variability, psychometric slopes, and effects of digit position (1/2/3) on response accuracy.

Most 5-year-olds were unable to complete the DIN task, but thresholds approached adultlike levels from the age of 10 years, with evidence of equivalence from the age of 13 years within predefined bounds. Exploratory segmented regression suggested inflection points near the ages of 6 and 10 years, although confidence intervals were wide for the latter. Increasing age was linked to faster and more consistent responses with less consistent evidence for changes in psychometric slope. Response accuracy in the youngest children varied by digit position.

Findings indicate rapid maturation of antiphasic Arabic DIN performance, with task acquisition emerging in early school age and near-adult thresholds observed in early adolescence. The observed developmental pattern likely reflects a combination of auditory and task-related cognitive and linguistic factors; however, these processes were not directly assessed in the present study and should be interpreted cautiously. These results provide provisional developmental reference points and require validation and test optimization in children with hearing loss before pediatric hearing screening implementation.