- How the Praxis Audiology Exam Is Organized
- Domain 1: Foundations of Audiology (20%)
- Domain 2: Prevention and Screening (10%)
- Domain 3: Assessment (35%)
- Domain 4: Intervention (25%)
- Domain 5: Professional and Ethical Responsibilities (10%)
- Building a Study Plan Around Domain Weight
- Registration, Fees, and Exam-Day Mechanics
- Why These Domains Matter Beyond the Exam
- FAQ
- Assessment is the largest of the five domains at 35%, so it deserves the most study hours.
- The 120-question Praxis Audiology (5343) exam is scored on a 100-200 scale; ASHA requires 162 to pass.
- Foundations of Audiology and Intervention together make up 45% of the exam - nearly as much as Assessment alone.
- Prevention and Screening and Professional and Ethical Responsibilities are each 10%, but skipping them risks losing easy points.
How the Praxis Audiology Exam Is Organized
Every candidate pursuing the Certificate of Clinical Competence in Audiology (CCC-A) through ASHA's Council for Clinical Certification in Audiology and Speech-Language Pathology must pass the same national exam: Praxis Audiology (5343). The test is currently owned and administered by ETS, and it consists of 120 computer-delivered, selected-response questions completed in a two-hour window. Some of those items may be unscored field-test questions that don't count toward your result, though you won't know which ones during the test.
Rather than testing randomly across audiology topics, the exam is built around five weighted content domains. Understanding those weights isn't just trivia - it should directly shape how you allocate study time before exam day. A candidate who spends equal hours on all five domains is almost certainly under-preparing for the domain that carries more than a third of the total score. For a broader walkthrough of pacing and preparation strategy, see our CCC-A Study Guide 2026: How to Pass on Your First Attempt.
Domain 1: Foundations of Audiology (20%)
Foundations of Audiology anchors the exam in the basic science that everything else builds on. This domain covers the anatomy and physiology of the auditory and vestibular systems, the physics of sound, and the fundamental principles that explain how hearing and balance function normally - and how disorders disrupt that function.
Foundations of Audiology
Candidates need working command of structural and functional knowledge before they can interpret any clinical finding.
- Anatomy and physiology of the outer, middle, and inner ear and central auditory pathways
- Vestibular system structure and function
- Acoustics, psychoacoustics, and properties of sound relevant to clinical measurement
- Etiologies and characteristics of hearing and balance disorders across the lifespan
Because this domain represents a fifth of the exam, it's tempting to treat it as "background" material and rush through it. In practice, foundational errors compound - a shaky grasp of cochlear physiology, for example, makes it harder to reason through assessment items later. Candidates who consistently miss items on How Hard Is the CCC-A Exam? Complete Difficulty Guide 2026 often trace the difficulty back to under-reviewed foundational science rather than the more heavily tested clinical domains.
Domain 2: Prevention and Screening (10%)
Prevention and Screening is the smallest domain by weight, but its content is highly practical and often features straightforward, protocol-based questions. This is where hearing conservation, early identification programs, and population-level screening approaches live.
Prevention and Screening
Expect questions on identifying risk and applying screening protocols before full diagnostic assessment begins.
- Newborn and school-age hearing screening protocols
- Occupational and recreational noise exposure and hearing conservation programs
- Risk factor identification for hearing loss across age groups
- Referral criteria that route a patient from screening into full assessment
Key Takeaway
Because Prevention and Screening is only 10% of the exam, treat it as a high-efficiency review area - a focused pass through screening protocols and referral criteria can lock in most of the available points without a large time investment.
Domain 3: Assessment (35%)
Assessment is, by a wide margin, the largest domain on the exam. More than a third of the 120 questions draw from this content area, which covers the full range of diagnostic audiologic evaluation.
Assessment
This domain tests your ability to select, administer, and interpret the diagnostic tools that define clinical audiology practice.
- Pure-tone and speech audiometry, masking, and test interpretation
- Immittance testing, otoacoustic emissions, and auditory evoked potentials
- Vestibular and balance function assessment
- Differential diagnosis based on integrated test-battery results
- Pediatric and behavioral assessment approaches across the lifespan
Given that Assessment alone carries roughly the same weight as Prevention and Screening, Professional and Ethical Responsibilities, and half of Intervention combined, this is the domain where study time should be front-loaded. Candidates evaluating whether they're on track often compare their practice performance against published benchmarks - our CCC-A Pass Rate 2026: What the Data Shows article breaks down what the available data actually indicates about outcomes.
Domain 4: Intervention (25%)
Intervention is the second-largest domain, covering the treatment and rehabilitation side of clinical practice once assessment has produced a diagnosis.
Intervention
This domain shifts from diagnosis to management - how audiologists treat, fit, counsel, and rehabilitate patients.
- Hearing aid selection, fitting, and verification
- Cochlear implant candidacy and post-implant management
- Aural rehabilitation and auditory training approaches
- Tinnitus and vestibular rehabilitation strategies
- Counseling techniques for patients and families
Assessment and Intervention together account for 60% of the exam, which means clinical practice-heavy content - as opposed to purely academic recall - dominates the test. Candidates who built strong clinical externship hours often find this pairing intuitive, while those further from active clinical rotations may need deliberate review of amplification technology and rehabilitation protocols.
Domain 5: Professional and Ethical Responsibilities (10%)
The final domain covers the professional practice framework surrounding audiology service delivery - the rules, standards, and responsibilities that govern how audiologists operate, independent of any specific diagnostic or treatment skill.
Professional and Ethical Responsibilities
This domain tests judgment about scope of practice, documentation, and ethical decision-making rather than clinical technique.
- Scope of practice and interprofessional collaboration
- Documentation, billing, and regulatory compliance basics
- Ethical decision-making frameworks applied to clinical scenarios
- Cultural responsiveness and person-centered practice principles
Although this domain is only 10% of the exam, its themes extend well beyond test day. Once certified, CCC-A holders must complete 30 professional-development hours every three years to maintain the credential, including 1 ethics hour and, effective in 2026, 2 hours in designated person-centered, reflective, or collaborative practice topics. Studying this domain seriously now builds habits you'll need for ongoing maintenance requirements later - a topic covered in more depth in CCC-A Certification Cost 2026: Complete Pricing Breakdown.
Building a Study Plan Around Domain Weight
A domain-weighted study plan simply means allocating review time roughly in proportion to how much of the exam each domain represents, then adjusting based on your own clinical strengths and weaknesses. Assessment (35%) and Intervention (25%) together should consume roughly the majority of your prep hours, with Foundations of Audiology (20%) close behind, and Prevention and Screening plus Professional and Ethical Responsibilities (10% each) treated as focused, time-efficient review blocks near the end.
Foundations of Audiology
- Review auditory and vestibular anatomy/physiology
- Refresh acoustics and psychoacoustics concepts
Assessment
- Drill pure-tone, speech, and immittance test interpretation
- Practice differential diagnosis from integrated test batteries
Intervention
- Review hearing aid and cochlear implant management
- Study aural rehabilitation and counseling approaches
Prevention, Screening & Professional/Ethical Responsibilities
- Consolidate screening protocols and referral criteria
- Review scope of practice and ethical decision-making scenarios
This structure is a starting point, not a rigid rule - candidates with recent clinical externship experience in a given domain may compress that block and reallocate time to a weaker area. For a full breakdown of how this fits into an overall preparation timeline, revisit CCC-A Study Guide 2026: How to Pass on Your First Attempt, and use timed practice sets on our practice test platform to check retention across all five domains at once rather than studying them in isolation.
Registration, Fees, and Exam-Day Mechanics
Praxis Audiology (5343) costs $146 to sit for, and the exam is scored on a 100-200 scale, with ASHA setting the passing score at 162. Passing this exam is one of several requirements for the CCC-A - candidates must also meet ASHA's doctoral-degree standard, complete required knowledge and skills, and finish supervised clinical practicum hours before certification is granted. A full rundown of these prerequisites is available in CCC-A Requirements 2026: Eligibility, Prerequisites & How to Qualify, and the exact score mechanics are explained further in CCC-A Passing Score 2026: Exactly What You Need to Pass.
An important administrative change is coming: ETS administers the exam through 2026, but on January 11, 2027, administration transitions to PSI. The exam content and the 162 passing score remain unchanged through that transition - only the administering organization changes. If your testing timeline stretches across that date, check current scheduling windows in CCC-A Exam Dates 2026: Testing Windows, Deadlines & Scheduling before registering.
| Domain | Weight | Core Focus |
|---|---|---|
| Foundations of Audiology | 20% | Anatomy, physiology, acoustics, disorder etiology |
| Prevention and Screening | 10% | Screening protocols, hearing conservation, referral |
| Assessment | 35% | Diagnostic testing and interpretation |
| Intervention | 25% | Amplification, rehabilitation, counseling |
| Professional and Ethical Responsibilities | 10% | Scope of practice, ethics, documentation |
Once you pass the exam and meet the other standards, initial ASHA certification costs $490 with membership or $446 without membership. After certification, maintaining the CCC-A requires annual dues or certification fees plus 30 professional-development hours every three years. For the full financial picture across initial certification and ongoing maintenance, see CCC-A Certification Cost 2026: Complete Pricing Breakdown.
Why These Domains Matter Beyond the Exam
The five domains aren't arbitrary test categories - they mirror the actual scope of clinical audiology practice that employers expect from a CCC-A holder. Hospitals, ENT practices, pediatric clinics, hearing aid dispensing offices, and school-based audiology programs all rely on the same core competencies tested across Foundations, Prevention and Screening, Assessment, Intervention, and Professional and Ethical Responsibilities. If you're weighing whether pursuing the credential makes sense for your career path, Is the CCC-A Certification Worth It? Complete ROI Analysis 2026 and CCC-A Salary Guide 2026: Complete Earnings Analysis go into that decision in more depth, while CCC-A Jobs outlines the kinds of settings that typically require or prefer the certification.
Because the domains map so closely to daily clinical responsibilities, treating exam prep as an extension of clinical training - rather than a separate memorization exercise - tends to produce better retention. Running full-length practice sessions on our CCC-A practice exam platform lets you experience the same 120-question, two-hour format under real time pressure, which builds the pacing skill you'll need on exam day itself.
Frequently Asked Questions
Assessment carries the most weight at 35% of the exam, making it the single largest content area on Praxis Audiology (5343).
There are five content domains: Foundations of Audiology (20%), Prevention and Screening (10%), Assessment (35%), Intervention (25%), and Professional and Ethical Responsibilities (10%).
No. When administration transitions from ETS to PSI on January 11, 2027, the exam content and the 162 passing score remain unchanged.
No. Since Assessment (35%) and Intervention (25%) together make up 60% of the exam, they warrant more study time than the smaller 10% domains, even though every domain should still be reviewed.
No. Passing Praxis Audiology with a score of 162 or higher is one requirement; candidates must also meet ASHA's doctoral-degree, knowledge-and-skills, and supervised clinical practicum standards before certification is awarded.