Deep Dive · 8 min read
Praxis 5331 Ethics Scenarios: 8 Case Studies with Reasoning
Ethics items are where candidates lose easy points. Here are 8 Praxis-style scenarios mapped to the ASHA Code of Ethics with the reasoning ETS wants you to apply.
Cross-checked against the current ETS Praxis 5331 Speech-Language Pathology Test at a Glance and ASHA CCC-SLP standards.
Ethics and professional issues account for a chunk of Praxis 5331 questions — and they're where candidates lose easy points. The content is straightforward, but ETS writes the items to punish "gut" answers. Here are 8 scenario-based questions modeled on the ASHA Code of Ethics with the reasoning ETS wants you to apply.
The ASHA Code of Ethics in 60 seconds
Four principles govern every ethics question:
- Principle I — Welfare of persons served: Client welfare above all else.
- Principle II — Professional competence: Only practice within your training.
- Principle III — Public statements: Honest, accurate representation to the public.
- Principle IV — Professional integrity: Honest interactions with colleagues, supervisors, and payers.
When you can't decide between two options, pick the one that most directly protects the client (Principle I).
Scenario 1 — Scope of practice
A pediatrician asks you to conduct a hearing screening because the local audiologist is on leave. You have general SLP training but no formal audiology certification. What do you do?
Answer: Decline and refer to another audiologist. SLPs may screen hearing under ASHA scope with proper training, but you must not practice outside your documented competence — Principle II.
Scenario 2 — Confidentiality
A parent runs into you at the grocery store and asks how another student on your caseload is progressing. What do you do?
Answer: Politely decline to share any information. This is a clear HIPAA/FERPA violation and violates Principle I. It doesn't matter that the parents may know each other.
Scenario 3 — Billing and Principle IV
Your school district asks you to document 60-minute sessions when you provided 30 minutes because Medicaid reimburses better for the longer code. What do you do?
Answer: Refuse and document only the services actually provided. Fraudulent billing violates Principle IV. If pressured, escalate to your supervisor and, if needed, ASHA's Board of Ethics. This is the highest-frequency ethics item on the exam.
Scenario 4 — Cultural competence
You're evaluating a bilingual Spanish-English 4-year-old for possible language disorder. You only speak English. What is the most appropriate next step?
Answer: Use a trained interpreter and dynamic assessment; consider consulting or referring to a bilingual SLP. Standardized English tests alone would misidentify a language difference as a disorder — Principle I plus scope of competence.
Scenario 5 — Supervision of an SLPA
Your SLPA asks to conduct the initial evaluation for a new student because your caseload is full. What do you do?
Answer: Decline. SLPAs cannot perform initial evaluations, interpret assessment results, or determine eligibility under ASHA scope. Delegate treatment tasks only, and stay actively supervising.
Scenario 6 — Dual relationships
A family member asks you to be their child's SLP because you're the only one in the family with the credential. What do you do?
Answer: Refer to another SLP. Treating family members creates a dual relationship that compromises objectivity — Principle IV.
Scenario 7 — Evidence-based practice
A parent brings you research on a non-evidence-based technique (e.g., auditory integration therapy) and asks you to use it. What do you do?
Answer: Respectfully explain the evidence base (Principle II), share peer-reviewed research, and recommend evidence-supported alternatives. Do not implement therapies not supported by evidence just to satisfy a parent.
Scenario 8 — Discontinuing services
A student on your caseload has met all IEP goals and no longer qualifies for services. The parent insists you continue therapy. What do you do?
Answer: Discontinue services following the IEP team process, document thoroughly, and provide resources for parent-led continued practice. Providing unnecessary services violates Principle I (welfare — includes not creating dependency) and Principle IV.
Ethics answer patterns ETS loves
- "Client welfare first" beats "team consensus" or "administrator preference" every time.
- "Refer or consult" is usually correct when the scenario stretches your competence.
- "Document" shows up in almost every correct answer to a billing/insurance question.
- "Evidence-based" beats "family preference" when the two conflict — but the SLP still explains and educates rather than dismisses.
- Never lie, never bill for services not provided, never practice outside your competence. These are always wrong.
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