- How the PASC Blueprint Is Built
- Domain Weights at a Glance
- Domain 1: Assessment and Diagnosis
- Domain 3: Case Management and Counseling
- Domain 2: Habilitation/Rehabilitation
- Domain 4: Medical Audiology
- Domains 5 and 6: Professional/Regulatory and Educational Audiology
- Question Format and Exam Mechanics
- Sequencing Your Preparation by Domain
- Eligibility, Fees and Timing That Shape Your Plan
- Frequently Asked Questions
- The PASC blueprint has six domains; scored items split 24, 21, 22, 16, 9 and 8 out of 100.
- Assessment and Diagnosis (24%) and Case Management and Counseling (22%) together carry nearly half the scored items.
- The exam has 120 questions in 2 hours 30 minutes; 20 are unscored beta items.
- Multiple-response items have two or three correct answers among four options, so partial recall is risky.
How the PASC Blueprint Is Built
The Pediatric Audiology Specialty Certification (PASC), offered by the American Board of Audiology (ABA), leads to the designation Board Certified in Pediatric Audiology (BC-PA). Its exam is organized around six formal content domains. These are the domains the exam itself is scored against, so they are not just study headings; every scored item maps to one of them.
The domain allocations come from the ABA Pediatric Audiology Specialty Certification Handbook, Edition 23 (November 2025), in its test blueprint summary and detail. The ABA's November 13, 2023 revised-blueprint announcement publishes the matching percentage weights, so the percentages below are the issuer's own figures. One small wording note: the 2023 announcement added "patients with" to the Domain 1 title, but this guide uses the current handbook and live-page wording, which controls.
If you are new to the credential itself, start with What Is PASC Certification? and then return here for the content breakdown. This article focuses on what each domain asks of a working pediatric audiologist, and how to allocate your time against that structure.
Domain Weights at a Glance
The handbook publishes scored-item allocations out of 100 scored items. The exam also includes 20 unscored beta items, which you cannot tell apart from scored ones, so treat every question as if it counts.
| Domain | Name | Scored Items (of 100) | Weight |
|---|---|---|---|
| 1 | Assessment and Diagnosis of Auditory and Vestibular Disorders | 24 | 24% |
| 2 | Habilitation/Rehabilitation | 21 | 21% |
| 3 | Case Management and Counseling | 22 | 22% |
| 4 | Medical Audiology | 16 | 16% |
| 5 | Professional and Regulatory Issues | 9 | 9% |
| 6 | Educational Audiology | 8 | 8% |
Three observations follow from the table. First, Domains 1, 2 and 3 together account for 67 of 100 scored items, so they deserve the majority of your attention. Second, Domain 3 (Case Management and Counseling) outweighs Habilitation/Rehabilitation even though many audiologists spend more of their day on device fitting. Third, the two smallest domains, Professional and Regulatory Issues and Educational Audiology, together make up 17 items. That is small, but not trivial when passing depends on your overall raw score.
Domain 1: Assessment and Diagnosis of Auditory and Vestibular Disorders (24%)
This is the largest domain, with 24 scored items. It is where the exam tests whether you can obtain, interpret and integrate diagnostic data in infants, children and adolescents, including those who are difficult to test.
What candidates must be able to do
Expect scenario-based items that ask you to choose, sequence or interpret assessments for a given age and developmental profile, and to reconcile conflicting results.
- Select age-appropriate behavioral and physiologic test batteries, from neonatal through school-age and adolescent patients.
- Interpret results from electrophysiologic and otoacoustic measures, and recognize when findings conflict with behavioral responses.
- Apply cross-check principles so no single result drives a diagnosis in a child who cannot reliably respond.
- Recognize presentations that suggest auditory processing, neuropathy spectrum or vestibular involvement, and know when to refer or expand the evaluation.
- Adjust protocols for patients with additional disabilities or limited cooperation.
The strongest preparation is case-based rather than list-based. Take a clinical scenario you have handled, change one variable (age, middle ear status, a missing test), and ask how your battery and interpretation would change. That mirrors how scenario items are framed. Our difficulty guide covers why integrative reasoning items tend to feel harder than recall items.
Domain 3: Case Management and Counseling (22%)
With 22 scored items, this is the second-largest domain, and candidates routinely underestimate it. It covers the work that happens between and around tests: coordinating care, communicating results and supporting families through decisions.
Core themes
Items typically place you in a conversation or coordination problem and ask for the best next step.
- Communicating diagnosis and prognosis to caregivers in a clear, culturally responsive and appropriately paced way.
- Shared decision-making around amplification, implantation candidacy discussions and communication approaches.
- Coordinating with pediatricians, otolaryngologists, early intervention programs, schools and other specialists.
- Follow-up planning, including monitoring for progressive or late-onset loss and loss to follow-up after screening.
- Counseling that addresses family adjustment, expectations and adherence.
The PASC eligibility requirement of 50 pediatric case-management hours, alongside 550 pediatric direct-patient hours, signals how seriously the credential treats this work. If your case-management hours came mostly from administrative coordination, deliberately review the counseling side of the domain, since both halves are examined.
Key Takeaway
Treat Domain 3 as a near-equal partner to Domain 1. At 22 versus 24 scored items, an hour spent on counseling and coordination scenarios is almost as valuable as an hour on diagnostics.
Domain 2: Habilitation/Rehabilitation (21%)
This domain carries 21 scored items and covers the technology and intervention side of pediatric care.
What the domain emphasizes
Think in terms of selecting, verifying and managing technology, then monitoring outcomes over a child's development.
- Pediatric hearing aid selection, fitting and verification, with attention to the limits of behavioral feedback in young children.
- Candidacy considerations and management for implantable and bone conduction devices and for remote microphone and other hearing assistance technology.
- Validation and outcome monitoring over time, including developmental progress and device use.
- Support for spoken language, listening and communication development, and coordination with intervention providers.
- Troubleshooting and device management across home, school and community settings.
Because children grow and their ears change, expect items where the right answer depends on timing, such as when to reverify, reassess candidacy or adjust technology. Anchor your review to the child's developmental stage, not just the device category.
Domain 4: Medical Audiology (16%)
Sixteen scored items fall in this domain. It tests the medical context around pediatric hearing and balance: etiologies, associated conditions and when medical evaluation is warranted.
Areas to master
Questions here usually ask you to connect an audiologic finding to a likely cause or to a necessary referral.
- Congenital and acquired causes of hearing loss, including genetic, infectious and syndromic contexts.
- Otitis media and other middle ear conditions and their effect on testing and management.
- Risk indicators that call for diagnostic follow-up or surveillance.
- Ototoxic exposures and monitoring considerations.
- Recognizing red flags that require urgent medical referral and knowing which specialist to involve.
Study this domain as a bridge to Domain 1: a finding on a test only becomes clinically useful once you can say what might explain it and who else needs to know.
Domains 5 and 6: Professional and Regulatory Issues (9%) and Educational Audiology (8%)
These two smaller domains together contribute 17 scored items. They are easier to prepare for in a short, focused block, but they should not be skipped.
Domain 5: Professional and Regulatory Issues (9 items)
This domain addresses the rules and responsibilities that frame pediatric practice.
- Scope of practice, ethics and professional conduct, including obligations specific to working with minors and families.
- Applicable laws and regulations that shape service delivery, documentation and consent.
- Standards of care and the responsibilities that come with specialty practice.
Domain 6: Educational Audiology (8 items)
This domain links clinical findings to the school environment.
- The educational impact of hearing loss and how audiologic data translate into classroom needs.
- Coordination with schools, educational audiologists and teams that support students with hearing loss.
- Classroom acoustics and access technology as they relate to learning.
One practical point: the ABA application includes an ethics agreement, and renewal requires 3 professional-ethics hours, so ethics is a recurring thread of this credential, not a one-time topic. Candidates who work outside school settings should give Domain 6 a few deliberate sessions, since it is least likely to appear in daily clinic routines.
Question Format and Exam Mechanics
Knowing the domains is only half the picture; you also need to know how they are tested.
- Length and time: 120 questions in 2 hours 30 minutes, of which 100 are scored and 20 are unscored beta items.
- Options: Every question has four options. Single-answer items have one correct answer; multiple-response items have two or three correct answers.
- No guessing penalty: Leaving an item unanswered gives no scoring advantage, so answer everything.
- Closed book, English only: No calculators, notes, dual monitors or ordinary breaks under standard testing.
- Delivery: Testing uses Prolydian with Proctor360 live remote proctoring. You need a desktop or laptop, webcam, microphone, a private room, and current government photo/signature ID matching your registered name. Tablets, phones and Chromebooks do not meet the device requirements.
- Results: Expect results approximately eight weeks after the administration.
Multiple-response items deserve special practice. Because each has two or three correct answers among four options, they reward complete understanding of a concept rather than recognition of one plausible choice. When you review practice questions, ask yourself not only why the right answers are right but why each remaining option fails.
Sequencing Your Preparation by Domain
Rather than studying domains in numerical order, sequence them by weight and by how much each depends on the others. The plan below assumes an eight-week runway; adjust it to your window. For a fuller framework, see the PASC Study Guide 2026, and keep the PASC cheat sheet handy for last-week review.
Domain 1: Assessment and Diagnosis
- Largest domain, and the foundation for medical and rehabilitation reasoning.
- Work through cases by age group and by conflicting-result scenarios.
Domains 3 and 2
- Case Management and Counseling first, then Habilitation/Rehabilitation.
- Practice counseling and coordination scenarios aloud; review verification and outcome-monitoring logic.
Domain 4, then Domains 5 and 6
- Link medical etiologies back to Domain 1 findings.
- Short blocks on ethics, regulation and educational audiology.
Mixed practice and timing
- Full-length sets of 120 questions in 2 hours 30 minutes, with multiple-response practice.
- Rework the domains where your misses cluster.
Eligibility, Fees and Timing That Shape Your Plan
Your study calendar should be anchored to the application and exam windows, not the other way around. The next exam window is May 3-17, 2027, with an application deadline of March 9, 2027 and exam registration open January 12-April 13, 2027. Full scheduling detail is in PASC Exam Dates 2026.
On eligibility, the program requires a graduate audiology degree from a regionally accredited institution, appropriate licensure or work authorization, paid post-degree professional experience, 550 pediatric direct-patient hours and 50 pediatric case-management hours over two consecutive years within the preceding five years, two professional references including a supervisor, an official transcript, documented experience and an ethics agreement. Externship hours do not qualify. Note a wording difference between sources on the experience requirement: the live application specifies a minimum of 2,000 professional hours within two years, while the handbook phrases it as two years of post-degree, full-time (2,000) hours. Confirm with the ABA before you submit. The full checklist is in PASC Requirements 2026. The certification is voluntary and independent of other credentials; general ABA certification, CCC-A and professional membership are not prerequisites under the current handbook.
| Fee Item | Academy Member | Non-Member |
|---|---|---|
| Exam registration | USD 395 | USD 440 |
| Application (separate) | USD 125 | USD 160 |
| First application plus exam, combined | USD 520 | USD 600 |
Membership is excluded from these figures, and a second-certification application receives a USD 50 application-fee reduction. Renewal is every three years with 60 CE hours, a USD 360 fee for either membership group, and continued ethics and licensure compliance. For the full breakdown, see PASC Certification Cost 2026.
Key Takeaway
The current handbook allows testing and retakes for five years starting the first day of the next testing window after application approval. An older FAQ counts from the first test date; follow the handbook, and confirm with the ABA if your timeline is tight.
Frequently Asked Questions
Assessment and Diagnosis of Auditory and Vestibular Disorders is the largest, with 24 of 100 scored items (24%). Case Management and Counseling follows at 22 items (22%).
No. Passing is based on your overall raw score on the 100 scored items, set through a criterion-referenced, modified Angoff process with difficulty adjustment. There is no fixed universal passing percentage.
There are 120 questions in 2 hours 30 minutes. Only 100 are scored; 20 are unscored beta items that look identical, so answer every question carefully.
The issuer reported a Spring 2026 first-time pass rate of 82.6%, with 20 of 25 candidates passing overall; these use different denominators. The 2025 first-time rate of 86.9% describes a different cohort. See PASC Pass Rate 2026 for context.
Use the PASC Exam Prep practice tests to drill each domain and rehearse the four-option, single- and multiple-answer format before your window opens.