This free Praxis Audiology (5343) study guide teaches to ETS’s test — every content category the exam measures, organized the way the test is built.[1] The 5343 is the national examination in audiology and is required by ASHA for the Certificate of Clinical Competence in Audiology (CCC-A); it replaced the retired 5342.[3]
The test is 120 selected-response questions in 120 minutes, computer-delivered, with a scaled score from 100 to 200 and an ASHA passing score of 162.[4] This guide is interactive, not a wall of text: every category has a built-in checkpoint quiz, hover-able glossary terms, and labeled clinical diagrams — audiograms, tympanograms, the auditory pathway — so you learn by doing.
Read this guide category by category, test yourself at each checkpoint, then round out your free Praxis 5343 prep with our practice questions and flashcards.
Praxis 5343 Exam Snapshot
| Detail | Praxis Audiology (5343) |
|---|---|
| Questions | 120 selected-response questions |
| Time | 120 minutes (2 hours), computer-delivered |
| Content | Foundations (~24, 20%), Prevention & Screening (~12, 10%), Assessment (~42, 35%), Intervention (~30, 25%), Professional & Ethical (~12, 10%) |
| Score scale | 100–200 scaled; ASHA CCC-A passing score 162 (state boards may set their own) |
| Test fee | $146 (subject to change — verify on ETS) |
| Retake wait | Minimum 28 days before retaking the same test |
| Guessing penalty | None — answer every question |
| Required for | ASHA Certificate of Clinical Competence in Audiology (CCC-A) |
| Publisher | ETS (Educational Testing Service) |
One test of 120 selected-response questions in 120 minutes, computer-delivered. Scores scale 100–200; ASHA’s CCC-A passing score on the 5343 is 162.
- I · Foundations of Audiology≈ 24 questions (20%). Acoustics & psychoacoustics, anatomy/physiology of the auditory & vestibular systems, pathophysiology, and psychometrics & instrumentation.
- II · Prevention and Screening≈ 12 questions (10%). Patient education, exposure/risk mitigation and hearing conservation, and screening — including newborn hearing screening.
- III · Assessment≈ 42 questions (35%) — the heaviest category. Behavioral & physiologic evaluation (pure-tone, speech, immittance, OAE, AEP/ABR), balance/vestibular testing, and integrating results.
- IV · Intervention≈ 30 questions (25%). Treatment planning, device selection, verification & validation (real-ear measures), and audiological (re)habilitation.
- V · Professional and Ethical Responsibilities≈ 12 questions (10%). Scope of practice, codes of ethics, confidentiality, evidence-based practice, documentation, and professional liability.
120 questions · 120 minutes. The 5343 is the national examination in audiology and is required by ASHA for the Certificate of Clinical Competence in Audiology (CCC-A).
Because Assessment is 35% of the exam — the single heaviest category — and Intervention adds another 25%, those two areas alone make up 60% of your score. Spend time across all five categories, but lead with the heavy hitters:
ETS groups the test into five scored categories.[1] This guide teaches all five as study modules, in the official 5343 order, with the core skill clusters of each as checkable subsections.
1 · Foundations of Audiology
About 20% of the exam. Acoustics and psychoacoustics, anatomy and physiology of the auditory and vestibular systems, pathophysiology of hearing and balance disorders, and the psychometrics and instrumentation behind the measurements you make.[1]
Auditory & Vestibular Anatomy & Physiology
Sound travels outer → middle → inner ear. The pinna and canal collect sound; the and impedance-match it to cochlear fluid; and the transduces vibration to neural signals via hair cells.
The act as the cochlear amplifier. The vestibular labyrinth — semicircular canals plus utricle and saccule — senses head motion and gravity.
Sound path: pinna → ear canal → eardrum → malleus → incus → stapes → oval window → cochlea → auditory (VIII) nerve. Outer/middle problems cause conductive loss; cochlear/nerve problems cause sensorineural loss.
- 1. CochleaHair cells transduce vibration into neural firing (place-coded by frequency).
- 2. Auditory (VIII) nerveSpiral ganglion afferents carry the signal centrally; site of acoustic neuroma.
- 3. Cochlear nucleusFirst brainstem relay (Wave III region of the ABR).
- 4. Superior olivary complexFirst binaural convergence — interaural time & level cues for localization.
- 5. Lateral lemniscus → inferior colliculusAscending midbrain relay (Wave V, the most robust ABR peak).
- 6. Medial geniculate body (thalamus)Thalamic gateway routing to the cortex.
- 7. Auditory cortex (temporal lobe)Heschl's gyrus — conscious perception and processing of sound.
The ABR tracks this pathway: Wave I = distal VIII nerve, Wave III = cochlear nucleus region, Wave V = lateral lemniscus / inferior colliculus — the peak used for threshold estimation.
Acoustics & Psychoacoustics
Frequency (Hz) is perceived as pitch and intensity (dB) as loudness. Master the three decibel scales: (physical reference), (referenced to normal hearing, so the audiometer reads 0 dB HL as normal), and (above an individual’s own threshold). The decibel is logarithmic: , so every 20 dB is a tenfold change in pressure.
Hearing-Loss Types & Etiologies
The classifies the loss. (outer/middle ear — cerumen, effusion, otosclerosis) elevates air conduction but spares bone conduction. (cochlea or nerve — presbycusis, noise, ototoxicity) elevates both with no gap. Mixed loss combines the two.
Checkpoint · Category · Foundations of Audiology
Question 1 of 10
The speed at which sound propagates through a medium is determined primarily by which two physical properties of that medium?
2 · Prevention & Screening
About 10% of the exam. Educating patients about causes and prevention of hearing and balance disorders, assessing and mitigating exposure risk (hearing conservation, fall risk), and screening — including newborn hearing screening and risk identification.[1]
Newborn Hearing Screening (EHDI)
sets the 1-3-6 benchmarks: screen by 1 month, diagnose by 3 months, and enroll in early intervention by 6 months. Screening uses and/or automated (AABR). NICU infants get AABR because it catches that OAEs alone would miss.[3]
Noise Exposure & Hearing Conservation
Noise-induced hearing loss is preventable. Hearing-conservation programs combine exposure assessment, engineering and administrative noise controls, hearing protection (with a real-world derated noise reduction rating), and audiometric monitoring to catch a standard threshold shift early. The classic noise-notch sits at 3000–6000 Hz, often deepest at 4000 Hz.
Ototoxicity, Cerumen & Tinnitus
agents — aminoglycosides, cisplatin, loop diuretics, high-dose salicylates — typically cause high-frequency sensorineural loss, so monitoring uses high-frequency audiometry and OAEs. Cerumen management is within the audiology scope. For tinnitus, evidence-based options include sound therapy, tinnitus retraining therapy (TRT), and cognitive-behavioral approaches.
Checkpoint · Category · Prevention & Screening
Question 1 of 10
What is the primary purpose of ototoxic monitoring in audiological prevention and screening?
3 · Assessment
The heaviest category — about 35% of the exam. Behavioral and physiologic evaluation (pure-tone, speech, immittance, OAE, evoked potentials), balance and vestibular testing, pediatric assessment, and integrating results into a diagnosis and recommendations.[1]
Pure-Tone & Speech Audiometry
Pure-tone air- and bone-conduction thresholds build the . the non-test ear prevents cross-hearing. In speech audiometry the should agree with the pure-tone average (validating the audiogram), while the gauges clarity at a comfortable level.
Immittance, Tympanometry & Acoustic Reflexes
probes the middle ear — Types A, As, Ad, B, and C each map to a condition. The (stapedius contraction to loud sound) and its decay help separate middle-ear, cochlear, and retrocochlear sites of lesion. Equivalent ear-canal volume distinguishes the causes of a flat Type B.
Tympanometry probes the middle ear: peak pressure (daPa, x-axis) and compliance (height, y-axis). A flat Type B with normal canal volume suggests effusion; with large volume, a perforation or patent tube.
OAEs & Auditory Evoked Potentials
measure outer-hair-cell function — present with near-normal cochlear status, absent above roughly 30–40 dB of loss. The measures neural synchrony and estimates threshold when behavioral testing isn’t possible; it also screens for retrocochlear pathology. Present OAEs with an absent/abnormal ABR is the signature of .
No single test stands alone. The cross-check principle: each result must agree with at least one independent measure (e.g., SRT should agree with the pure-tone average within ≈ 6–10 dB).
Balance & Vestibular Assessment
VNG/ENG (including caloric testing), rotary chair, vHIT, and testing isolate which canal or otolith organ and which branch of the vestibular nerve is involved. , the most common cause of vertigo, is identified positionally (Dix–Hallpike) and treated with canalith-repositioning (Epley) maneuvers — within the audiology scope.
Together these isolate which canal/otolith organ and which branch of the vestibular nerve is involved. BPPV — the most common cause of vertigo — is identified positionally (Dix–Hallpike) and treated with canalith-repositioning (Epley).
Pediatric Assessment & Audiogram Interpretation
Match the method to the child’s developmental level: behavioral observation audiometry in infancy, visual reinforcement audiometry (≈ 6 months–2 years), and conditioned play audiometry (≈ 2–5 years), backed by physiologic measures. On the audiogram, read degree (mild → profound), configuration, and type, then apply the cross-check principle — every result must agree with at least one independent measure.
Threshold (softest tone heard) is plotted per frequency. Here a high-frequency sensorineural loss drops into the speech banana, so the patient misses soft, high-pitched consonants (s, f, th). Right-ear air conduction uses O; left uses X.
Checkpoint · Category · Assessment
Question 1 of 10
In audiological assessments, what is the primary purpose of using tympanometry?
4 · Intervention
About 25% of the exam. Treatment planning, device selection, verification and validation, and audiological (re)habilitation — translating the diagnosis into a patient-centered plan.[1]
Hearing Aids — Fitting, REM & Verification
Select features and coupling (earmold mods, dome and venting) from the audiogram and the patient’s needs, then verify with against a prescriptive target (NAL-NL2, DSL). REM is the evidence-based standard because ear-canal acoustics vary; the real-ear-to-coupler difference (RECD) individualizes pediatric fittings. Validate with outcome measures.
Cochlear & Bone-Anchored Implants, ALDs
A bypasses damaged hair cells for severe-to-profound sensorineural loss when appropriately fit hearing aids no longer provide adequate aided speech understanding. Bone-anchored (osseointegrated) implants serve conductive/mixed loss or single-sided deafness. Assistive listening devices (FM/DM systems, loops) improve the signal-to-noise ratio in difficult settings.
Aural Rehabilitation & Counseling
goes beyond the device: counseling on impact and realistic expectations, communication-strategy training for the patient and their partners, auditory training, and support for psychosocial adjustment, self-advocacy, and coping across the lifespan — delivered through interprofessional, person-centered care.
Checkpoint · Category · Intervention
Question 1 of 10
When considering cochlear implantation in adults, which factor is least likely to predict a successful outcome?
5 · Professional & Ethical Responsibilities
About 10% of the exam. Scope of practice, codes of ethics, confidentiality and informed consent, evidence-based practice, infection control, documentation, applicable laws, and professional liability.[1]
Code of Ethics, Scope & Infection Control
The ASHA Code of Ethics and the audiology define what you may do and when you must refer. Core duties include informed consent, avoiding conflicts of interest, cultural responsiveness, and standard infection-control precautions for equipment and patient contact. When a need falls outside your competence, the ethical course is referral.[3]
EBP, Laws & Documentation
integrates research, clinical expertise, and patient values. Know the laws that shape audiology: IDEA (early intervention and school services), the ADA (access and accommodations), and HIPAA (protected health information and confidentiality). Accurate documentation supports continuity of care, billing, and professional liability protection.
Checkpoint · Category · Professional & Ethical Responsibilities
Question 1 of 10
Which of the following best describes an audiologist's ethical responsibility when encountering a conflict of interest in professional practice?
How to Use This Study Guide
A study guide is a map, not the whole territory — use it alongside the official ETS study companion and full-length practice. Lead with the heaviest areas (Assessment is 35% and Intervention 25% — together 60% of the exam), but don’t neglect Foundations, which underpins every clinical decision. Spaced, mixed practice beats one long cram.
Scores are reported on a 100–200 scale in 1-point increments. ASHA requires 162 on the 5343 for the CCC-A. (The retired 5342 cut was 170 on a different scale — the two are not comparable.) Some state boards set their own cut — verify your state.
Assessment is the single largest slice at 35% (≈ 42 questions). Together, Assessment and Intervention make up 60% of the exam — lead your study there.
- 1
Read a category here
Work through one content category at a time — Foundations, Prevention & Screening, Assessment, Intervention, then Professional & Ethical.
- 2
Take the checkpoint
The quick check at the end of each category exposes what didn't stick.
- 3
Drill the gaps
Send your weak area straight into the free practice questions and flashcards.
- 4
Take full, timed practice
Sit a full 120-question, 120-minute set to build pacing and stamina, then review every miss.
Praxis 5343 Concept Questions
Common Praxis 5343 clinical concepts the test actually measures — across all five content categories, weighted toward Assessment. Tap any card for a short, exam-ready answer backed by the official ETS study companion or ASHA, then test yourself on them as flashcards.
Praxis 5343 Glossary
Quick definitions for the terms you’ll see most across the Praxis Audiology (5343):
- Acoustic reflex
- The reflexive contraction of the stapedius muscle to loud sound; its presence, threshold, and decay help localize middle-ear, cochlear, and neural disorders.
- Air-bone gap
- The difference between air-conduction and bone-conduction thresholds at a frequency; a significant gap indicates a conductive component.
- Audiogram
- A graph of hearing thresholds (in dB HL) across frequencies (Hz). Air-conduction symbols are O for the right ear and X for the left; the pattern shows degree, configuration, and type of loss.
- Auditory brainstem response
- ABR — an auditory evoked potential reflecting neural synchrony along the VIII nerve and brainstem, used for threshold estimation and retrocochlear screening.
- Auditory neuropathy spectrum disorder
- A disorder with present OAEs but absent or abnormal ABR — outer hair cells function but neural transmission is disordered.
- Aural rehabilitation
- The person-centered process of counseling, communication-strategy training, auditory training, and technology that supports adjustment to hearing loss.
- BPPV
- Benign paroxysmal positional vertigo — the most common cause of vertigo, caused by displaced otoconia, diagnosed with Dix–Hallpike and treated with canalith repositioning (Epley).
- Cochlea
- The snail-shaped inner-ear organ of hearing, containing the organ of Corti and hair cells that transduce vibration into neural signals.
- Cochlear implant
- A surgically implanted device that bypasses damaged hair cells and stimulates the auditory nerve directly, for severe-to-profound loss when hearing aids are insufficient.
- Conductive hearing loss
- Loss originating in the outer or middle ear, with elevated air conduction but normal bone conduction, producing an air-bone gap.
- dB HL
- Decibels hearing level — a decibel scale referenced to average normal-hearing thresholds at each frequency, so 0 dB HL means normal hearing. The audiometer is calibrated in dB HL.
- dB SL
- Decibels sensation level — decibels above an individual's own threshold for a given signal; speech testing is often done at a set SL above the SRT.
- dB SPL
- Decibels sound pressure level — a decibel scale referenced to a fixed physical pressure (20 micropascals), used to describe the physical intensity of a sound.
- EHDI
- Early Hearing Detection and Intervention — the 1-3-6 framework: screen by 1 month, diagnose by 3 months, enroll in early intervention by 6 months.
- Evidence-based practice
- Integrating the best external scientific evidence with clinical expertise and the patient's values and circumstances when choosing assessment and intervention.
- Masking
- Presenting noise to the non-test ear to prevent it from responding to a signal that crosses the skull (cross-hearing), so the test ear's true threshold is measured.
- Ossicles
- The three middle-ear bones — malleus, incus, and stapes — that transmit and amplify vibration from the eardrum to the oval window.
- Otoacoustic emissions
- OAEs — low-level sounds generated by healthy outer hair cells, recorded in the ear canal; present with near-normal cochlear function, absent with loss above ~30–40 dB.
- Ototoxicity
- Damage to the cochlea or vestibular system from drugs or chemicals (e.g., aminoglycosides, cisplatin), typically starting as high-frequency sensorineural loss.
- Outer hair cells
- Cochlear hair cells that act as the cochlear amplifier, sharpening tuning and sensitivity; their function is measured by otoacoustic emissions.
- Praxis 5343
- ETS's Audiology test — 120 selected-response questions in 120 minutes, the national examination in audiology required by ASHA for the Certificate of Clinical Competence in Audiology (CCC-A).
- Real-ear measurement
- REM — probe-microphone verification of the sound-pressure level a hearing aid produces in the patient's own ear canal, compared to a prescriptive target.
- Scope of practice
- The range of professional activities an audiologist is qualified and authorized to perform; practicing outside it, or beyond one's competence, requires referral.
- Sensorineural hearing loss
- Loss originating in the cochlea or auditory nerve, with air and bone conduction both elevated and no significant air-bone gap.
- Speech-recognition threshold
- SRT — the lowest level at which a listener repeats 50% of spondee words correctly; it should agree with the pure-tone average, validating the audiogram.
- Tympanic membrane
- The eardrum — the boundary between the outer and middle ear that vibrates in response to sound and drives the ossicular chain.
- Tympanometry
- An immittance test that measures eardrum mobility against changing ear-canal pressure, classified as Types A, As, Ad, B, or C.
- VEMP
- Vestibular evoked myogenic potential — cVEMP tests the saccule/inferior vestibular nerve; oVEMP tests the utricle/superior vestibular nerve.
- Word-recognition score
- WRS — the percent of monosyllabic words repeated correctly at a comfortable suprathreshold level, measuring speech clarity rather than detection.
Free Praxis 5343 Study Materials & Resources
Everything you need to prepare for the Praxis Audiology (5343) is free here — no paywall, no sign-up. This guide is the foundation; pair it with the rest of our free Praxis 5343 study materials for active recall, timed practice, and last-minute review:
- Praxis 5343 Practice Test — exam-style questions across all five content categories, with explanations.
- Praxis 5343 Flashcards — active-recall decks for the high-yield clinical facts, tests, and definitions.
Praxis 5343 Study Guide FAQ
The Praxis Audiology (5343) has 120 selected-response questions and a testing time of 120 minutes (2 hours). It is computer-delivered. Some questions may not count toward your score, but you should answer every item because there is no penalty for guessing.
ASHA requires a scaled score of 162 on the 5343 for the Certificate of Clinical Competence in Audiology (CCC-A). Scores are reported on a 100–200 scale. The retired 5342 cut was 170 on a different scale and is not comparable. Some state licensing boards set their own cut score, so verify your state.
Five ETS content categories: Foundations of Audiology (20%, ~24 questions); Prevention and Screening (10%, ~12); Assessment (35%, ~42 — the heaviest); Intervention (25%, ~30); and Professional and Ethical Responsibilities (10%, ~12). Assessment and Intervention together make up 60% of the exam.
The 5343 is recognized as the national examination in audiology and is required by ASHA for the CCC-A. Most state licensing boards also require it. The 5343 replaced the retired 5342; ASHA still accepts a passing 5342 score only where a state board still requires that older version.
The test fee is $146 (subject to change — always verify on the ETS site). Rescheduling costs $40, and canceling at least three days before the test date refunds 50% of the fee. You must wait a minimum of 28 days before retaking the same test.
The 5343 is the current Audiology test and replaced the 5342 (formerly 0342). Because the 5343 is a new form on a new 100–200 scale, its 162 ASHA passing score is not numerically comparable to the 5342's old 170 cut. All test takers are encouraged to take the 5343.
Work through the five content categories in order — Foundations, Prevention & Screening, Assessment, Intervention, then Professional & Ethical. After each module take the checkpoint quiz to find gaps, then drill that area with our free practice questions and flashcards, leading with Assessment and Intervention since they total 60% of the exam.
Yes — the full guide, the checkpoints, the glossary, the practice questions, and the flashcards are 100% free, with no account required.
References
- 1.ETS. “The Praxis Study Companion: Audiology (5343).” ETS. ↑
- 2.ETS. “Audiology (5343) Test Overview.” ETS. ↑
- 3.American Speech-Language-Hearing Association. “About the Audiology Praxis Exam.” ASHA. ↑
- 4.American Speech-Language-Hearing Association. “Praxis Exam Scores.” ASHA. ↑
- 5.ETS. “Understanding Your Praxis Scores.” ETS. ↑
Sources for the concept answers
Every answer in the Praxis 5343 concept questions above is drawn from an official primary source:
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