Praxis Audiology common mistakes
Praxis Audiology · Understand the traps and how to avoid them.
On items asking which audiometric configuration or degree of loss is present, the candidate selects the option matching only one frequency (for example, the threshold at 2000 Hz) instead of classifying the whole audiogram across the tested octave range.
Candidates read the audiogram left-to-right and anchor on the most visually dramatic point rather than applying the standard classification rules (degree based on PTA or the worst frequency, configuration based on slope across 250-8000 Hz).
What to do instead
Before answering, compute PTA from 500, 1000, and 2000 Hz and separately note the shape trend across all frequencies; reject any option that describes only a single frequency unless the item explicitly asks about that frequency.
The candidate treats a type B tympanogram with large equivalent ear-canal volume as identical to a type B with normal volume, missing the perforation/patent-tube interpretation.
Type B is memorized as 'flat = effusion,' and the volume value is ignored as a separate column of numbers rather than integrated into the interpretation.
What to do instead
Adopt a two-step rule: read shape first, then always check ear-canal volume against age norms; a flat trace with high volume points to perforation or patent tube, low volume to probe occlusion, and normal volume to middle-ear fluid.
The candidate applies adult behavioral testing procedures (raising hand, conventional pure-tone audiometry) to a 2-year-old or uses visual reinforcement audiometry for a 5-year-old, mismatching method to developmental stage.
Candidates memorize one preferred pediatric method and apply it broadly, forgetting that the method must track the child's developmental, not chronological, level.
What to do instead
Memorize a developmental ladder: behavioral observation for infants, visual reinforcement audiometry roughly 6 months to 2-3 years, conditioned play audiometry roughly 2-5 years, conventional audiometry from about 5 years; select the method matching the described developmental level in the vignette.
When an item presents a screening protocol, the candidate confuses screening criteria with diagnostic criteria (for example, applying a 25 dB HL diagnostic threshold to a school screening that uses 20 dB at specified frequencies).
Screening and diagnostic thresholds are both expressed in dB HL, and candidates collapse them into a single remembered number.
What to do instead
Keep a separate screening reference card: know the specific pass/fail criteria, frequencies tested, and rescreen rules for the screening context named in the item, and check whether the item says 'screen' or 'evaluate' before choosing a number.
The candidate selects an intervention (hearing aid, cochlear implant, FM system) based on degree of loss alone while ignoring the item's stated audiometric shape, speech recognition scores, or medical history that would contraindicate or redirect the recommendation.
Candidates pattern-match 'severe loss = cochlear implant' and stop reading the remaining case details once a familiar keyword appears.
What to do instead
Read the entire stem and list every audiologic and medical finding before evaluating options; eliminate any option that conflicts with a stated finding such as a conductive component, normal word recognition, or a medical red flag.
The candidate mixes up retrocochlear and cochlear indicators, labeling rollover, abnormal acoustic reflexes, or poor speech recognition relative to pure-tone thresholds as cochlear signs.
The signs are taught as lists without a unifying principle, so candidates memorize labels rather than the underlying reason (cochlear damage preserves loudness growth; retrocochlear lesions disrupt it).
What to do instead
Learn the underlying logic: cochlear loss typically shows recruitment and no rollover, while retrocochlear involvement shows rollover, reflex abnormalities, and speech scores poorer than predicted; test each option against that logic rather than memorized labels.
The candidate answers ethics and scope-of-practice items by choosing the clinically helpful action rather than the action permitted by the audiologist's scope, licensure, and referral obligations.
Clinical training rewards solving the patient's problem, so candidates pick the option that helps most rather than the one that stays within professional boundaries.
What to do instead
For professional-practice items, first ask 'is this within audiology scope and does it require referral or supervision?' and eliminate options that involve practicing outside scope, skipping required referral, or breaching confidentiality even when they seem helpful.
The candidate confuses the purpose and referral criteria of universal newborn hearing screening with those of diagnostic auditory brainstem response evaluation, treating a 'refer' screening result as a diagnosis of hearing loss.
Both involve ABR and both occur in infancy, so candidates merge the screening and diagnostic stages into one concept.
What to do instead
Separate the two stages explicitly: screening is a pass/refer decision using automated ABR or otoacoustic emissions, while diagnosis uses frequency-specific ABR and other measures; any option that treats a screening refer as a confirmed loss is wrong.
The candidate recommends classroom accommodations without first establishing the acoustic and educational rationale, choosing a personal FM system for a child whose stated difficulty is noise in a large, reverberant classroom where a sound-field or classroom system is indicated.
FM systems are memorized as the generic answer for 'child with hearing loss in school,' so the specific listening environment and the child's needs are overlooked.
What to do instead
Match the device to the stated environment and need: identify whether the problem is distance, noise, or reverberation, whether the child uses personal amplification, and whether the goal is direct input or whole-class access before selecting among personal FM, sound-field, or classroom amplification.
The candidate calculates or interprets masking incorrectly, accepting an unmasked threshold when interaural attenuation is exceeded or applying masking when it is not needed.
Candidates memorize the interaural attenuation numbers but do not apply the comparison rule (air-conduction threshold of the test ear versus bone-conduction threshold of the non-test ear) under time pressure.
What to do instead
Work the masking decision as a fixed sequence: compare the test-ear air threshold to the non-test-ear bone threshold, apply the appropriate interaural attenuation for the transducer, and mask only when the difference exceeds it; rehearse this sequence on both air and bone before answering.