Pediatric Audiology Specialty Certification (PASC®) Examination Content

The two-hour, 100-question Pediatric Audiology Specialty Certification (PASC®) examination – plus 20 additional questions that are beta-tested for future PASC exams – is developed through a collaborative effort between the ABA and HumRRO. A group of audiology experts drawn from a wide variety of work environments and geographical areas write the examination items. The examination consists of multiple-choice and multiple-response items (also known as multiple true-false or select all that apply). All questions have four response options. The content of the exam is shown in the test blueprint below (see Table 1). The breakdown of the exam is shown by content dimension and the number of scored items on the test in each dimension.

Table 1. PASC Test Blueprint

Content Dimension Percentage

  • Laws and Regulations - 10%
  • General Knowledge about Hearing and Hearing Loss - 20%
  • Child Development - 9%
  • Screening and Assessment Procedures - 21%
  • Counseling - 9%
  • Communication Enhancement Technology - 16%
  • Habilitation/Rehabilitation Strategies, Educational Supports - 15%

The detailed test blueprint is shown in Table 2 below. Specific knowledge areas included in each content dimension are indicated.

The number to the right of each dimension shows the total number of scored items on the test in that dimension.

Table 2. Specific Knowledge Areas on the PASC Test


  • The Americans with Disabilities Act (ADA)
  • Health Insurance Portability and Accountability Act (HIPAA) laws and regulations
  • Family Educational Rights and Privacy Act (FERPA) laws and regulations
  • Section 504 laws and regulations
  • Individuals with Disabilities Education Act (IDEA) laws and regulations
  • Newborn hearing screening policies and programs (e.g., state EHDI requirements)
  • American National Standards Institute (ANSI) standards and calibration requirements
  • American Academy of Audiology (AAA), Joint Commission on Infant Hearing (JCIH) and American Speech-Language-Hearing Association (ASHA) guidelines
  • Pertinent American Academy of Pediatrics (AAP) recommendations (e.g. hearing screening, audiologic evaluation for children suspected of being on the autism spectrum)
  • Pertinent Joint Commission guidelines (e.g., sedation, safety)
  • Local, state, and federal requirements (e.g., licensure, health, education) including reporting requirements
  • Child Abuse Prevention and Treatment Act (CAPTA)
  • Infection control protocols
  • Professional organizational codes of ethics (e.g., AAA, ASHA, ABA)


  • The anatomy and physiology of the head, neck, ear, and central nervous system (CNS)
  • Type, degree, and configuration of hearing loss and implications
  • Auditory processing disorders
  • Auditory neuropathy spectrum disorder
  • The role of ear canal acoustics in assessment and management
  • Embryological development
  • Disorders, syndromes, and conditions that may affect hearing (e.g., canal atresia, otitis media, Mondini malformation, kernicterus)
  • Genetics as it relates to hearing loss
  • Risk indicators for hearing loss
  • Vestibular problems in children and associated risk factors
  • Pseudohypoacusis
  • Tinnitus and hyperacusis
  • Noise-induced hearing loss and prevention strategies
  • Environmental acoustics and impact on communication
  • Phonetics and acoustical properties of speech
  • Pharmacology (e.g., ototoxicity, monitoring protocols)
  • Comprehensive medical examination components for hearing loss (e.g., otology, imaging, lab studies, EKG)
  • The roles of and criteria for referral to multi-disciplinary healthcare providers (e.g., otolaryngologist, geneticist, neurologist, ophthalmologist, speech language pathologist, medical home)


  • Auditory, speech, and language milestones
  • Stages of child development (e.g., motor, cognitive, social, and emotional)
  • The impact of communication disorders on psychosocial development
  • The impact of hearing loss on speech and language development
  • Bilingual language development
  • Common signs and symptoms of developmental disorders (e.g. autism spectrum disorder) and available screening tools


  • General screening principles
  • Hearing screening techniques and protocols for various populations (e.g., newborn, preschool, school-aged)
  • Comprehensive pediatric case history components
  • Test battery selection and cross-check principle
  • Techniques to involve the family in diagnostic test procedures
  • Principles of evoked responses and electrophysiological testing procedures and limitations
  • Age-appropriate behavioral audiometric procedures and limitations
  • Age-appropriate measures of speech perception
  • Testing techniques for differential diagnosis (e.g., conductive, sensory, auditory neuropathy spectrum disorder, auditory processing disorder)
  • Testing procedures for children with developmental delays and/or medical challenges
  • Test and test battery interpretation
  • Test result implications
  • Age-appropriate follow-up timelines for assessment and management of hearing loss
  • Follow-up procedures for high-risk populations (e.g., fluctuating, progressive or delayed-onset hearing loss)
  • Data collection and analysis to support clinical decision making and practice management for screening and assessment procedures


  • The social/emotional aspects of childhood hearing disorders
  • How emotions associated with grief impact acceptance of diagnosis and treatment plan
  • Child/parent/caregiver learning styles including the impact of family’s culture
  • Family empowerment as a key component of family-centered care
  • Family/patient rights (e.g., to choose communication options and services)
  • Personal adjustment counseling including patient- and family-centered counseling
  • Conveying test results
  • Referral indicators for mental health services


  • Candidacy criteria for nonsurgical amplification devices (e.g., hearing aids, HATs)
  • Selection criteria for hearing aids and HATs including type, style, and compatibility with other devices
  • Features and signal processing selection (e.g., WDRC, bandwidth, directional microphones, feedback, and noise management systems)
  • Age-appropriate programming options for different listening environments
  • Wireless (e.g., FM, infrared, and Bluetooth) and induction transmission technology and applications
  • Prescriptive fitting methods
  • Verification procedures (e.g., real-ear measures, RECD)
  • Device orientation and training
  • Validation procedures and outcome measures
  • Earmold materials and styles
  • Earmold impression-taking techniques
  • Signaling and alerting devices
  • Augmentative communication devices
  • Data collection and analysis to support clinical decision making and practice management for screening and assessment procedures for communication enhancement technology
  • Candidacy and referral criteria for surgically-implanted devices (i.e., cochlear implant)
  • Candidacy and referral criteria for surgically-implanted devices (i.e., bone conduction)


  • Informational and advocacy resources (e.g., written and web-based sources, parent and peer support groups, including financial and social assistance)
  • Candidacy for habilitative/rehabilitative services
  • Modes of communication and communication continuum
  • Early intervention service options (e.g., natural learning opportunities in everyday activities, center-based services)
  • School-aged placement options (e.g., general education, special education, school for the deaf)
  • Educational service delivery models (e.g., consultative, itinerant, direct instruction)
  • Communication access accommodations (e.g., proximity, noise reduction, language facilitators, interpreters, note takers, captioning)
  • Strategies that promote auditory/linguistic/literacy development
  • Inter-disciplinary and multi-disciplinary team approaches
  • Personal responsibility and self-advocacy
  • IDEA process and Individualized Family Service Plan/Individual Education Plan (IFSP/IEP) development (e.g., multi-disciplinary planning and implementation, parent participation)
  • Resources (e.g., itinerant teacher of the hearing impaired, educational audiologist) and strategies (e.g., team teaching, in-services) for implementing educational recommendations

Sample Examination Questions

Following are sample questions in the same style and similar content as on the examination. Use the sample questions to verify your understanding of the topics in the examination. Answers are provided below.

  1. A two-month old was referred to you because of failed ABR newborn hearing screening at the birth hospital. The most appropriate diagnostic test would be:
    1. BOA
    2. VRA
    3. OAE
    4. ABR
  2. You have identified a five-year-old as having severe unilateral sensorineural hearing loss. As you discuss potential impact of this hearing loss on the child’s educational development, you would tell the parents:
    1. With preferential seating, the hearing loss will probably have no impact the child’s educational development.
    2. A hearing aid for the affected ear would be the best strategy for alleviating problems that the hearing loss may cause.
    3. A much higher risk for educational difficulties exists for this child than for children with two normal hearing ears.
    4. A binaural FM system would be the best strategy for alleviating problems that the hearing loss may cause.
  3. A ten-year-old child with bilateral moderate sensorineural hearing loss has been referred to you for case management and hearing aid fitting. Your primary objective for the hearing aid fitting is:
    1. Selecting a hearing aid color acceptable to child and parents to encourage acceptance and usage.
    2. Selecting hearing aids that will allow the child full access to the speech spectrum.
    3. Selecting hearing aids that will accommodate the greatest variety of HATs.
    4. Selecting hearing aids that your use with a history of having very low maintenance requirements.

Sample Questions – Answer Key

  1. D
  2. C
  3. B