2027 Standards and Implementation Procedures for the Certificate of Clinical Competence in Audiology (CCC-A)

Effective Date: August 1, 2027

Introduction

The Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC) is a semi-autonomous credentialing body of the American Speech-Language-Hearing Association (ASHA). The charges to the CFCC are to define the standards for clinical certification; to apply those standards in granting certification to individuals; to have final authority to withdraw certification in cases where certification has been granted on the basis of inaccurate information; and to administer the certification maintenance program.
 
An Audiology Practice and Curriculum Analysis was conducted in 2023–2024 under the auspices of the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) and the CFCC. The CFCC reviewed the survey analysis and developed the following standards to meet current entry-level practice requirements. 
 
A 2020 to 2027 audiology standards crosswalk [PDF] is available to document changes and updates to the standards. Contact certification@asha.org with general questions about certification standards or maintenance.

• Standard I – Academic Qualifications
• Standard II – Knowledge and Skills Outcomes
• Standard III – Supervised Clinical Practicum Experience
• Standard IV – Examination
• Standard V – Maintenance of Certification
• Citation

Standard I: Academic Qualifications

Applicants for certification must hold a doctoral degree in audiology from a program that is accredited by the CAA, a program that is in CAA candidacy status, or the equivalent.

Implementation: Each applicant’s program director or official designee must complete and submit a Program Director Verification Form. The official graduate transcript and/or letter from the registrar must be received by the ASHA National Office no later than one (1) year from the date that the application was received.

Applicants from a program holding CAA accreditation or candidacy status in audiology throughout the period of enrollment must submit (a) an official graduate transcript showing that the degree has been awarded or (b) a letter from the university registrar verifying completion of requirements for the degree.

Applicants who hold a doctoral degree (e.g., AuD, PhD, MD, etc.) from a non–CAA-accredited program must submit a transcript/s from their graduate program/s to confirm that their graduate coursework covers the same content as a CAA-accredited clinical audiology doctoral degree program. See the AuD coursework outline for further details.

Applicants who were educated outside the United States or its territories must meet all ASHA certification standards. Coursework must have been completed in an institution of higher education that is regionally accredited or recognized by the appropriate regulatory authority for that country.

Standard II: Knowledge and Skills Outcomes

Applicants for certification must have acquired knowledge of and developed skills in the areas of practice identified in Standard II and as acquired and verified in accordance with Standard III.

Implementation: The competent practice of audiology requires audiologists to integrate knowledge and skills across all areas of practice and across the lifespan. The knowledge and skills are organized to reflect the practice expectations for entry-level audiologists and are categorized into different areas, but the knowledge and skills are not independent of one another.

The CFCC defines "knowledge" as the understanding of a task and "skills" as the ability to perform tasks effectively through practice and application. The term individuals served refers to patients, clients, students, caregivers and care partners, family/guardians, audiology colleagues, and/or other professionals.

The following professional knowledge of and skills are crucial to providing competent entry-level clinical care that applies to all areas of practice:

• Applying evidence-based practice for
  • assessment, treatment, and management of hearing and balance function and
  • prevention, identification, evaluation, and intervention.
• Performing critical analysis of literature as related to evidence-based practice.
• Delivering competent professional services regardless of an individual’s age; citizenship; disability; ethnicity; gender; gender expression; gender identity; genetic information; national origin, including culture, language, dialect, and accent; race; religion; sexual orientation; or veteran status.
• Practicing in a manner that is sensitive and respectful of the values of individuals served.
• Recognizing the impact of cultural and linguistic factors on service delivery.
• Communicating in a way that is appropriate for the individuals served.
• Participating in professional development and continuing education activities for continued competency and compliance with licensure and credentialing requirements.
• Adhering to professional ethics and standards.

Standard II-A: Fundamentals of Clinical Practice

Applicant has demonstrated knowledge of and skills in the following areas:

A1. Anatomy, physiology, embryology, genetics, neuroanatomy, and neurophysiology of the auditory, balance, speech, language, and voice mechanisms, and related body systems across the lifespan
A2. Pathologies, syndromes, medications, and medical treatments that impact hearing and balance for purpose of assessment and intervention
A3. Limitations of audiologic and vestibular assessments and interventions
A4. Impact of hearing loss on an individual’s education, vocation, psychosocial well-being, cognition, language, and speech across the life span
A5. Principles of early hearing detection and intervention programs for newborns, school-age children, and other at-risk individuals
A6. Factors that impact performance of individuals served during assessments and interventions
A7. Psychometrics (e.g., test development principles, reliability, and validity)
A8. Principles and current technologies of signal processing and connectivity
A9. Communication modalities and/or systems including manual language options

Applicant has demonstrated knowledge of and skills in the following areas:

A10. Gathering, reviewing, and evaluating information from referral sources to facilitate assessment planning and identification of potential etiologic factors
A11. Utilizing certified interpretation services to effectively communicate in the preferred language of the individuals served
A12. Obtaining a case history to facilitate evaluation, intervention, and treatment
A13. Selecting, administering, and interpreting questionnaires and other patient-report instruments related to hearing, tinnitus, and balance function
A14. Applying the principles and techniques of service delivery modifications related to the needs, abilities, and goals of the individuals served
A15. Communicating audiologic findings and recommendations in a manner that is understandable and appropriate for the individuals served
A16. Documenting audiologic services provided in a manner that is understandable and appropriate
A17. Documenting all aspects of audiologic care consistent with payor requirements and with local, state, and federal regulations (e.g., licensing boards, Health Insurance Portability and Accountability Act [HIPAA])
A18. Collaborating with internal and external service providers and support personnel
A19. Applying the principles, methods, and applications of acoustics to clinical practice (e.g., basic parameters of sound, simple and complex stimuli, sound measurement, room acoustics)
A20. Utilizing a sound-level meter or other instrumentation to determine intensity and other characteristics of sounds dependent on environmental context
A21. Applying psychoacoustic principles, methods, and applications to hearing function (e.g., loudness, pitch, duration, masking, binaural hearing, and threshold estimation)
A22. Applying the principles and practices of research while adhering to policies regarding research ethics and the protection of human subjects

Standard II-B: Assessment of Auditory Function Across the Lifespan

Applicant has demonstrated knowledge of and skills in the following areas:

B1. Performing otoscopy, integrating otoscopic findings with other results, and making appropriate referrals and recommendations
B2. Selecting, administering, interpreting, and making appropriate recommendations based on the results of

• pure-tone air and bone conduction testing with effective masking;
• speech audiometry and word recognition measures in quiet and in noise with effective masking;
• tests for non-physiologic hearing loss;
• behavioral measures appropriate to the characteristics of individuals served;
• screening tools for auditory processing; and
• assessment of tinnitus and decreased sound tolerance.

B3. Selecting, administering, interpreting, and making recommendations based on the results of

• acoustic immittance measures;
• otoacoustic emissions (OAE) testing; and
• electrophysiologic measures.

Applicant has demonstrated knowledge in the following areas:

B4. Selecting, administering, and interpreting results of comprehensive central auditory processing test battery
B5. Selecting, administering, and interpreting additional evoked potentials (e.g., auditory middle latency response, auditory late response, cognitive potentials, electroneuronography (EnoG)

Standard II-C: Audiologic Intervention and Device Management Across the Lifespan

Applicant has demonstrated knowledge of and skills in the following areas:

C1. Determining candidacy for and identifying type and features of

• hearing protection and/or a hearing conservation program;
• non-surgical or implantable hearing devices (e.g., hearing aids, cochlear implants, bone conduction devices);
• hearing assistive technology (e.g., frequency modulation [FM] systems, infrared over-the-counter [OTC] hearing devices, alerting devices); and
• audiologic rehabilitation (e.g., auditory training, speech reading).

C2. Identifying additional tests beyond the initial assessment to confirm candidacy for intervention
C3. Evaluating perceived hearing difficulties and the individual’s expectations related to self-assessment tools and hearing devices
C4. Obtaining ear impressions safely and effectively
C5. Determining the need for and/or providing cerumen management, and demonstrating knowledge of regulatory, patient, and medical limiting factors
C6. Selecting, fitting, and verifying hearing protection devices (HPDs)
C7. Conducting in situ and simulated verification measures (e.g., electroacoustic measures, real-ear–to–coupler difference [RECD], and speech mapping)
C8. Programming hearing aids using prescriptive targets
C9. Verifying and validating function of hearing aids and making modifications
C10. Programming cochlear implants
C11. Verifying and validating function of cochlear implants and making modifications
C12. Programming bone conduction devices
C13. Verifying and validating function of bone conduction devices and making modifications
C14. Fitting and managing hearing assistive technology
C15. Troubleshooting and addressing hearing device concerns and managing connectivity
C16. Providing device and non-device interventions for tinnitus, hyperacusis, and other sound tolerance disorders
C17. Verifying efficacy of interventions for tinnitus, hyperacusis, and other sound tolerance disorders
C18. Providing strategies to optimize room acoustics
C19. Evaluating effectiveness of auditory interventions across the lifespan
C20. Developing, implementing, and evaluating a person-centered intervention plan based on the individual’s situational communication needs.

Standard II-D: Balance Assessment and Intervention

Applicant has demonstrated knowledge of and skills in the following areas:

D1. Selecting, administering, interpreting, and making recommendations based on the results of

• clinical screening tools (e.g., dynamic visual acuity test, head thrust test, Romberg test);
• vestibular evoked myogenic potentials (VEMPs), including ocular (oVEMPs) and cervical (cVEMPs);
• videonystagmography and caloric testing; and
• evaluation for benign paroxysmal positional vertigo using appropriate techniques (e.g., Dix-Hallpike maneuver, roll test).

D2. Providing services or referrals for vestibular rehabilitation and verifying effectiveness

Applicant has demonstrated knowledge in the following areas:

D3. Knowledge of administration and interpretation of

• rotary chair testing;
• subjective visual vertical/horizontal testing;
• posturography; and
• video head impulse testing (vHIT).

Standard II-E: Screening and Prevention

Applicant has demonstrated knowledge of and skills in the following areas:

E1. Identifying individuals with risk factors associated with

• hearing loss;
• balance impairment;
• speech and language impairment;
• ototoxicity/vestibulotoxicity;
• cognitive impairment; and
• tinnitus and decreased sound tolerance.

E2. Administering screening procedures and tools to identify individuals who require further evaluation, including for co-occurring conditions
E3. Administering newborn hearing screenings, maintaining records, and managing referrals
E4. Conducting hearing assessment as part of an occupational hearing conservation program

Standard II-F: Care Management and Audiologic Rehabilitation Across the Lifespan

Applicant has demonstrated knowledge of and skills in the following areas:

F1. Providing counseling related to implantable and non-implantable device use, care, and safety
F2. Providing counseling and referrals for tinnitus and decreased sound tolerance
F3. Providing individual/family/group counseling on hearing loss and associated communication, psychosocial, behavioral, vocational, and educational needs
F4. Providing communication and listening strategies to individuals served and their communication partners
F5. Providing information regarding the impact of hearing status on

• speech, language, and auditory perception;
• literacy, education, and vocational considerations; and
• psychological well-being and cognitive development.

F6. Providing individuals and families with resources that address a variety of communication modalities (e.g., listening and spoken language [auditory/verbal and auditory/oral], total communication, cued speech, American Sign Language [ASL], and other sign languages and systems)
F7. Making referrals to facilitate auditory, communication, and learning development using the preferred mode(s) of communication
F8. Providing and/or recommending resources for auditory training
F9. Making referrals to other audiologists and professionals
F10. Coordinating plans of care with individuals who are involved with person-centered care (e.g., individuals served, caregivers, care partners, agencies, school personnel, and other health care professionals)
F11. Engaging in interprofessional collaborative practice to ensure the highest quality of person-centered care
F12. Providing support toward achievement of educational, social, and vocational goals in accordance with legislation/regulation requirements (e.g., individualized family service plans [IFSPs], individualized education programs [IEPs], Section 504 plans, Americans with Disabilities Act [ADA])

Standard II-G: Clinic Management and Professional Activities

Applicant has demonstrated knowledge of and skills in the following areas:

G1. Verifying that equipment and instrumentation undergo appropriate calibration and regular biological checks
G2. Applying infection control practices and managing bioelectric hazards in adherence with facility and/or manufacturer guidelines
G3. Maintaining confidentiality and security of records, in accordance with legislative requirements, (e.g., HIPAA, Family Educational Rights and Privacy Act [FERPA])
G4. Adhering to local, state, and federal regulations and ethical standards
G5. Complying with regulations related to electronic health records, billing, coding, and reimbursement
G6. Providing information to the public and other professionals about the function of the auditory and vestibular systems and related disorders
G7 .Advocating for the profession and individuals served
G8. Engaging in effective business practices (e.g., business development, billing and reimbursement, and fiscal and resource management)

Standard III: Supervised Clinical Practicum Experience

The applicant’s supervised clinical practicum experience must sufficiently demonstrate all of the acquired knowledge and/or skills as identified in Standard II.

Implementation: The applicant’s doctoral program director or designated signatory must verify that the applicant has acquired and demonstrated all of the knowledge and/or skills as identified in Standard II. All supervised clinical practicum experiences (also known as “practicum” or “practicum experiences”) must meet CAA standards, which include a minimum of 12 months’ full-time equivalent of supervised clinical experiences. These practicum experiences include short-term rotations and longer-term externships and should be distributed throughout the graduate program.

Standard III-A: Graduate Program Practicum

Practicum experiences must:

• include a variety of professional interactions and opportunities to validate knowledge and skills across the scope of practice in audiology, including clinical and administrative duties, and
• be appropriate to the student’s level of training, education, experience, and competence.

As defined in Standard II, the applicant’s graduate program should include interprofessional education and interprofessional collaborative practice (IPE/IPP). These IPE/IPP experiences must be under the direction of their clinical instructor/supervisor. Students/applicants should seek experiences that include working with other professionals who are appropriately credentialed in their area of practice. Doing so enhances the student/applicant’s knowledge and skills in an interdisciplinary, team-based, comprehensive health care delivery setting.

The on-site and in-person portion of the practicum—where the clinical instructors/supervisors and individuals receiving care are present—must account for at least 50% of the practicum.

Telepractice (in which the individual receiving care is at a distance) to deliver clinical care may be used for up to 40% of the practicum experiences. For hours obtained within the graduate program, telesupervision is permitted only in the context of telepractice. For the safety of clients/patients and students/applicants, a supervisor cannot remotely telesupervise a graduate student providing in-person services to a patient unless another audiologist is on site to provide support if needed.

Clinical simulation (CS) may be used for up to 10% of the practicum in accordance with the guidelines for audiology CS experiences. An applicant can count their CS experiences for ASHA certification only when the experiences are obtained within the graduate program.

Up to two students/applicants can participate in the same session and count the full experience of the session, provided that both are actively engaged in the session.

Standard III-B: Post-Graduate Practicum

Any portion of the student/applicant’s practicum that was not completed under an ASHA-certified audiologist within the doctoral program can be completed post-graduation. The post-graduation practicum may be telesupervised.

The applicant’s post-graduation clinical instructor/supervisor can verify the student/applicant’s experience after the student/applicant has completed the balance of their practicum.

Students/applicants who apply for certification without having completed their practicum will have 24 months from their application-received date to initiate the remainder of their experience and will have 48 months from the initiation date of their post-graduation practicum to complete the balance.

Standard III-C: Clinical Instructor/Supervisor Requirements

All applicants for certification must have completed their clinical practicum experiences under ASHA-certified audiologists who hold an active Certificate of Clinical Competence in Audiology (CCC-A) status for the duration of any practicum that they are supervising and who

• have completed at least 2 professional development hours (PDHs) in clinical instruction/education/supervision after earning the CCC-A and
• have completed, at minimum, 9 months of full-time direct client/patient clinical care (or its part-time equivalent)* after being awarded the CCC-A or after 9 months of practicing with a full/unrestricted license.

If a student/applicant completed practicum under a clinical instructor/supervisor who did not meet the above requirements, they cannot use that practicum for ASHA certification.

*Potential clinical educators may count their experience as being “clinical” if they (a) have worked directly with clients/patients who have a hearing or balance disorder and (b) have been the clients’/patients’ recognized provider and have been ultimately responsible for their assessment and management. Individuals whose experience has been limited to classroom teaching, research/lab work, or working only with CS cannot count this experience as clinical unless it meets the criteria in (a) and (b).

Standard IV: Examination

The applicant for certification must pass the national examination adopted by ASHA for purposes of certification in audiology.

Implementation: Results of the Praxis® Examination in Audiology must be submitted directly to ASHA from the Educational Testing Service (ETS). A student/applicant must earn a passing exam score no earlier than 5 years prior to submitting the application and no later than 2 years following receipt of the application. If the student/applicant does not successfully pass the exam and/or does not report the results of the exam to ASHA within the 2-year application period, then the student/applicant’s certification file will be closed.

Standard V: Maintenance of Certification

Individuals holding certification must earn and report at least 30 PDHs, which are equivalent to 3.0 ASHA continuing education units (CEUs), during their 3-year certification maintenance interval; adhere to the ASHA Code of Ethics; and pay annual dues and fees to renew their certification.

The 30 PDHs must include the following:

• Content Area 1: 1 PDH in ethics
• Content Area 2: 2 PDHs in topics that strengthen the ability of ASHA-certified individuals to
  • provide services that align with the unique histories, values, and circumstances of individuals, families, and communities and/or
  • enhance capacity for self-reflection, adaptability, and collaboration with colleagues, students, externs, Clinical Fellows, assistants, professionals, caregivers, care partners, and others, as appropriate.

Individuals who do not renew their certification can reinstate their certification by meeting the reinstatement requirements that are in place at the time of their reinstatement application. 

Citation

Cite this document as follows:
Council for Clinical Certification in Audiology and Speech-Language Pathology of the American Speech-Language-Hearing Association. (2027). 2027 Standards and implementation procedures for the certificate of clinical competence in audiology. https://www.asha.org/certification/2027-audiology-certification standards