Audiology Praxis Exam Information

Content Categories / Approximate Percentage of Examination
Foundations of Audiology / 20%
Prevention and Screening / 10%
Assessment / 35%
Intervention / 25%
Professional and Ethical Responsivities / 10%

Topics Covered

The following list represents the topics covered in the Audiology Praxis Exam that is currently being administered. These topics are consistent with standards for clinical certification set by ASHA.

Foundations of Audiology

Acoustics and psychoacoustics
- physics of sound and acoustics
- sound measurement
- physiological and psychological acoustics
- speech perception and acoustics
Anatomy, physiology, and behavior over the lifespan
- auditory system
- balance and the vestibular system
- neuroanatomy and neurophysiology
- embryology and development of hearing and vestibular mechanisms
- normal processes of auditory behavior over the lifespan
- development of language and speech
- age-related changes in the auditory and vestibular systems
Pathophysiology
- genetics and associated syndromes
- nongenetic systemic health conditions
- infectious pathologies
- pharmacology, ototoxicity, and vestibulotoxicity
Psychometrics and instrumentation
- psychometrics and psychophysical methods
- calibration, function, and use of measurement equipment

Prevention and Screening

Education
- education about causes, effects, and prevention of auditory and balance disorders
Prevention
- exposure assessment and analysis
- risk mitigation, including:
  - selecting and fitting hearing protection devices
  - identifying opportunities for noise controls
  - identifying falling risk factors
- audiometric and balance monitoring
Screening and Risk Assessment

for auditory and balance disorders
newborn hearing screening programs
speech language disorders
cognitive deficits
other conditions that may compromise communication, health, quality of life, education, and psychosocial function

Program Performance
- monitoring the effectiveness of screening and prevention

Assessment

Clinical Preparation
- gather and evaluate referral and background information; select procedures based on age, developmental level, functional status, behavior, cultural and linguistic diversity, physical, sensory, and cognitive abilities
- verify proper function of equipment
Audiological Evaluation—Behavioral
- pure-tone air and bone conduction testing
- speech audiometry
- specialized tests for organic and nonorganic hearing loss
- developmentally appropriate tests for infants and children
- modify tests based on age, functional status, behavior, cultural and linguistic background, physical, sensory, and cognitive abilities
Audiological Evaluation—Physiologic
- immittance: tympanometry, acoustic reflex testing, wideband acoustic immittance
- otoacoustic emission testing
- auditory evoked potential (AEP), including electrocochleography (ECOG), auditory brainstem response (ABR) threshold testing, ABR for neurodiagnostic evaluation, auditory steady-state response (ASSR), and other electrophysiological measures
Balance and Vestibular Assessment
- videonystagmography (VNG) and electronystagmography (ENG)
- rotary chair tests
- vestibular evoked myogenic potentials (VEMP)
- video head impulse test (vHIT)
- posturography
Other Assessments and Evaluations
- patient history
- otoscopy
- self-report measures of auditory and balance problems
- assessment of functional hearing ability and auditory processing
  - speech in noise testing
  - spatial testing
  - temporal processing
- assessment of tinnitus
  - impact questionnaires
  - psychoacoustic testing, including pitch and loudness matching
- evaluation of sound tolerance
  - loudness discomfort levels
  - questionnaires and interviews
- integrating Assessment Results
  - integrate findings
    - determine type and severity of auditory and balance impairment
    - develop recommendations for further evaluation, intervention, and/or referral
    - distinguish among hearing, tinnitus, and sound tolerance problems
- documentation and communication
  - document the procedures and results of evaluations
  - generate recommendations based on all clinical findings and patient preferences, including appropriate referrals
  - communicate results and recommendations to patients, families, and other appropriate individuals; interact effectively with interpreters and individuals involved in interprofessional practice

Intervention

Treatment Planning
- integrate referral and background information
- select and modify treatment based on age, developmental level, functional status, behavior, cultural and linguistic diversity, physical, sensory and cognitive abilities, and patient and family preferences
- integrate results of assessments and other evaluations to support recommendations for treatment and/or referral
- establish short- and long-term goals
Device Selection
- evaluate communication and hearing challenges, motivation, and needs and expectations for the purpose of device selection
- hearing aids
  - evaluate speech recognition in noise and loudness discomfort for the purpose of hearing-aid selection
  - select hearing-aid coupling; e.g., earmold modifications, dome selection, venting
  - select features and processing strategies based on communication needs and preferences; e.g., noise reduction, directionality, compression, frequency
- cochlear implants, hybrids, and other implantable devices
  - determine candidacy
  - discuss benefits and limitations
  - ensure appropriate support systems and realistic expectations
- hearing assistive technology system (HATS); e.g., personal and group amplification systems, assistive listening, and alerting devices
  - determine candidacy based on needs and preferences
  - determine compatibility when used in conjunction with other devices
  - select features based on communication and hearing needs and preferences
Device Verification and Validation
- fitting and programming devices
- conduct quality control measures to ensure proper functioning of devices; e.g., electroacoustic analysis, confirm function of features
- conduct real ear measures to verify audibility, comfort, and tolerance
  - a. modify verification procedures to promote quality outcomes; e.g., RECD
- validate effectiveness of intervention using outcome measures
- repair and modify devices, when appropriate
Audiological (Re)habilitation and Intervention
- monitor progress of goals for the audiological (re)habilitation plan and revise as necessary
- provide instruction on communication strategies to patients and key communication partners
- facilitate communication development and/or auditory learning
- provide services and support across the lifespan
  - counsel regarding peer pressure, stigma, and other issues related to psychosocial adjustment, behavioral coping strategies, and self-advocacy skills
  - participate in interprofessional care
  - provide audiological (re)habilitation
  - incorporate implications of comorbidity in treatment plan
  - for children, participate in IEP or IFSP process, and plan and implement
Tinnitus Management
- implement or recommend evidence-based intervention methods
  - cognitive-behavioral therapy (CBT) and other methods
  - sound-based therapy, including hearing aids, combination (hearing aid and sound generator) instruments, and other sound sources
  - self-management education
Decreased Sound Tolerance, i.e. Hyperacusis, Misophonia
- treatment consistent with different severity levels
- sound desensitization procedures
Vestibular Rehabilitation
- determine candidacy and appropriate treatment plan
- provide and monitor treatment for benign paroxysmal positional vertigo (BPPV) and peripheral and central vestibular disorders
Counseling for Auditory and Balance Impairment
- provide informational counseling regarding hearing and balance, communication development, modes of communication and device use and safety
- address interpersonal, psychosocial, educational, and vocational implications of auditory and balance impairment for the individual, family members, and/or caregivers to enhance their well-being and quality of life
Documentation and Communication
- document intervention processes and outcomes; generate recommendations resulting from intervention; communicate outcomes and recommendations to individuals involved in interdisciplinary practice
- communicate outcomes and recommendations to individuals involved in interprofessional

Professional and Ethical Responsivities

Professional Practice

Service delivery models across different settings (e.g., hospital-based clinic, community-based clinic, private practice, school-based practice, industry/conservation)
Management and business practices, including
- financial planning (e.g., budgeting, cost analysis)
- coding, billing, and reimbursement
- risk management, including activities, policies, and procedures, to reduce risk and liability from both patient safety and financial perspectives
- patient management
Effective and appropriate communication; selecting a means of communication; e.g., formal reports, notes, electronic mail, telephone calls, and using appropriate verbal and written language for recipient(s)
Use of instrumentation and calibration to current standards and equipment specifications
Standard safety precautions and infection control to reduce transmission of disease(s); e.g.,
- cleaning/disinfection/sterilization of equipment
- discarding disposables (otoscope specula, immittance and OAE probe tips, earmold impression syringe tips, insert receivers, etc.) and infectious waste
- determining necessity for gloves and/or protective apparel
Legal and Ethical Practice and Advocacy
- standards for professional conduct, ethical principles, and decision making
- protection of patients’ rights and informing patient(s) of their privacy rights with respect to their personal health information
- legislative and regulatory mandates
- advocacy for individuals served and for the profession
Evidence-Based Practice
- apply translational research findings from science to clinical application to maintain current (best practice) models of care
- maintain up-to-date knowledge on research principles and practices; e.g., experimental design, statistical methods, and application to clinical populations
- assessment of screening, diagnostic and treatment efficacy and/or effectiveness

Interprofessional Practice

Importance, value, and role of interprofessional communication and practice
The role, scope of practice, and responsibilities of audiologists and other related professionals

Principles and Practice of Supervision