Certified Neonatal Therapists


A Multi-Disciplinary Neonatal Therapy Certification

Neonatal Therapists: Who are we?

Neonatal therapists are an essential part of the NICU team. A neonatal therapist is an occupational therapist, physical therapist or speech-language pathologist who delivers holistic direct patient care and consultative services to premature and medically complex infants in a neonatal intensive care unit (NICU). Using an integrated, neuroprotective, family-centered model, neonatal therapists provide highly specialized and individualized therapeutic interventions in the NICU. These interventions support optimal long-term development, prevent adverse sequelae, and nurture the infant-family dyad. Neonatal therapists also provide education to the family and to the NICU team. The American Physical Therapy Association, the American Occupational Therapy Association, and the American Speech Hearing Association all recognize neonatal therapy as an advanced area of practice, requiring specialized education and skills to enable safe and effective interventions with fragile high-risk infants in a highly complex environment.

NTNCB: All Great Things have Small Beginnings

The Neonatal Therapy National Certification Board (NTNCB) is a multidisciplinary board comprised of experienced neonatal therapists who work in NICUs throughout the United States and abroad as occupational therapists, physical therapists, and speech-language pathologists. Neonatal therapy certification identifies physical therapists, occupational therapists and speech-language pathologists who have demonstrated the time, knowledge, and commitment to serve high-risk infants in the neonatal intensive care unit. The NTNCB has established an evidence-based, psychometrically-tested and professionally administered certification exam that was first administered on March 1, 2017. We now have over 200 Certified Neonatal Therapists (CNTs) across 41 of the 50 states in the United States, as well as in Canada, the United Kingdom, Puerto Rico, and Qatar. There are more than 100 additional therapists currently in the certification process who will soon be added to the growing pool of Certified Neonatal Therapists.

The NTNCB, in accordance with credentialing guidelines, is an independently run and governed Board. This ensures impartial, unbiased oversight of the certification program and maintains the confidentiality and validity of the certification process. In July of 2018, the NTNCB became a proud member of the Institute for Credentialing Excellence (ICE). The neonatal therapy certification program developed by the NTNCB is the only certification process available for physical therapists, occupational therapists, and speech-language pathologists to validate requisite experience, education and knowledge to practice in the NICU. The neonatal therapy certification is endorsed by the National Association of Neonatal Therapists. Recently, the American Academy of Pediatrics released updated perinatal guidelines for NICUs in the United States. They recommend at least one physical therapist or occupational therapist with neonatal expertise, as well as clinician who has expertise with neonatal feeding. The Certified Neonatal Therapist (CNT) status is a method to ensure neonatal expertise among clinicians working in the NICU.

Neonatal Therapy Certification Benefits

One question a potential neonatal therapist might have is, “Why would I want to become a CNT?” There are numerous benefits including:

  • To promote the advancement and integrity of neonatal therapy as an interdisciplinary subspecialty that engages in evidence-based practice
  • To be recognized for clinical excellence and gain credibility amongst peers and medical staff
  • To support positive outcomes of high-risk infants, reduction of co-morbidity related to NICU care, and lower costs of lifetime care for preterm infants

Hospital leadership might ask “Why is it important to have my staff engage in neonatal therapy certification?” There are numerous reasons, including:

  • To provide a standard framework for neonatal therapists who achieve the level of experience and knowledge needed to practice effectively with high risk infants in the NICU
  • To reduce risk associated with inexperienced personnel providing services to high risk infants in the NICU
  • To validate and standardize the field of neonatal therapy and support best practice to improve outcomes for infants and their families
  • To demonstrate that therapists working in a NICU have neonatal expertise

Identification and accomplishment of a career goal, such as becoming a CNT, can be quite rewarding in and of itself. Being credentialed as a CNT acknowledges expertise in the specialty of neonatal therapy and improves the level of care that premature and sick infants receive across the globe. CNTs have validated their expertise in providing safe and evidence-based interventions to high-risk infants, and such expert therapy services can optimize outcomes and make a large impact on the health care system.

Becoming a CNT: Core Requirements

In order to become a Certified Neonatal Therapist, the requirements are

  • A minimum of 3 years as a credentialed professional (physical therapist, occupational therapist, or speech-language pathologist)
  • A minimum of 3500 hours of work experience within the NICU environment
  • A minimum of 40 hours of education related to NICU-specific content within the last 3 years
  • A minimum of 40 yours of mentored experiences in the NICU
  • A passing score on the Neonatal Therapy National Certification Examination

Once all of the requirements for achieving Neonatal Therapy National Certification have been fulfilled, a candidate will have earned the credentials of a Certified Neonatal Therapist: CNT.

Certification is valid for 5 years from the date of certification. For therapists who continue practice within the NICU, and therefore remain updated on advances, the recertification process does not require retaking the exam.

A self-assessment, study materials, and practice test questions are provided to applicants. The passing rate is high among those who use the materials provided.

The Application Process

The NTNCB website has step-by-step information regarding the application process. All information can be accessed at www.ntncb.com. This includes an applicant checklist which can be downloaded to serve as a guide for preparing an application. Application deadlines are twice each year, on May 15th and on November 15th. The application portal opens 2 months ahead of each deadline, on March 15th and September 15th of each year. Within the portal, applicants create a professional portfolio where all required documentation for certification is submitted to the certification board. The cost of the application is $200. The application fee is due at the time the application is submitted. Once a completed certification application has been submitted, the applicant will be notified by the NTNCB if all of the requirements have been satisfied and the applicant is eligible to take the exam. This notification will come within 1 month of completing the application submission.

The Final Step: Examination

Once an applicant receives notice of eligibility to take the exam, he/she has 6 months to pay for and take the Neonatal Therapy National Certification Exam. The examination fee is $400. The exam is computer-based and administered by an independent third party at a professional testing center. Testing centers are located throughout the United States and abroad, and applicants can choose a local testing center that is convenient to them. A list of testing locations can be accessed via the NTNCB website. The examination is comprised of 100 questions, and the applicant has up to 2 hours to complete it. To meet the final requirement for certification, applicants must receive a passing score on the examination.

After less than 2 years of administering the neonatal therapy certification program, the NTNCB is proud to have more than 300 physical therapists, occupational therapists, and speech-language pathologists who have engaged in the certification process. Visit our website or Facebook page for more information and to hear news stories and testimonials by CNTs.


  1. American Speech-Language-Hearing Association. Knowledge and skills needed by speech-language pathologists providing services to infants and families in the NICU environment. 2004.
  2. Sweeney JK, Heriza CB, Blanchard Y. Neonatal Physical Therapy. Part I: Clinical Competencies and Neonatal Intensive Care Unit Clinical Training Models. Pediatric Physical Therapy. 2009;21(4):296-307.
  3. Sweeney JK, Heriza CB, Blanchard Y, Dusing SC. Neonatal Physical Therapy. Part II: Practice Frameworks and Evidence-Based Practice Guidelines. Pediatric Physical Therapy.2010;22(1):2-16.
  4. Vergara E, Anzalone M, Bigsby R, Gorga D, Holloway E, Hunter J, et al. Specialized
    knowledge and skills for occupational therapy practice in the neonatal intensive care unit.
    American Journal of Occupational Therapy. 2006;60(6):659-68.
  5. Ludwig S. Neonatal Therapy National Certification Board: Call for board members 2014 [Available from: http://neonataltherapists.com/neonatal-therapy-national-certification-board-call-for-board-members.
  6. Riley L, Stark, A., Kilpatrick, S. Guidelines for perinatal care. 7th ed. Elk Grove Village: American Academy of Pediatrics; 2012
  7. Neonatal Therapy National Certification [Available from: https://www.ntncb.com/.]

1328 words

About Author


Dana Hobby has worked as an SLP in both outpatient and inpatient pediatric rehabilitation and in a level III NICU since 2003. She is actively involved in neurodevelopmental follow-up clinic. Her career has been focused on implementation of developmentally supportive and family centered care along with continual collaboration with and education for NICU staff. She is NOMAS trained and is a Certified Lactation Counselor through the Academy of Lactation Practice and Policy. She is a certified Neonatal Touch and Massage Therapist and has achieved designation as a Developmental Care Specialist through NANN. She has presented locally and previously worked with Powers Medical Devices as a clinical specialist for the Pacifier Activated Lullaby (PAL) system.

Kati Knudsen, PT, MPT, CNT, PCS, DCS, CLE
Kati Knudsen, PT, MPT, CNT, PCS, DCS, CLE

Kati Knudsen, NTNCB Co-Chair, has practiced as a pediatric physical therapist since 1996 and as a therapist in the NICU since 1999. Kati is lead therapist for two NICUs at sister hospitals in Portland, OR. She has provided extensive education in developmental care and has obtained certifications in pediatric physical therapy, lactation education, neurodevelopmental treatment, infant massage, developmental care and transportation of children with special needs in order to better support infants and families. She has spoken locally and nationally on support for infants in the NICU and participates in Vermont Oxford Network Quality Improvement work for care of micro-preemies. Kati also sees patients in NICU follow-up clinic where she has helped to redesign care to make it more accessible for families.

Bobbi Pineda, PhD, OTR/L, CNT
Bobbi Pineda, PhD, OTR/L, CNT

Dr. Bobbi Pineda, NTNCB Co-Chair, has been an occupational therapist in the NICU since 1992. Since 2007, she has been a research scientist at Washington University School of Medicine with an interest in developing, implementing and testing interventions that can optimize neurodevelopmental outcome in high risk newborn infants, specifically infants born prematurely. Dr. Pineda is certified as a trainer on the NICU Network Neurobehavioral Scale (NNNS). She is certified in the Neonatal Oral Motor Assessment Scale (NOMAS) and has advanced training in Prechtl’s General Movement Assessment. Dr. Pineda has developed a new neonatal feeding assessment, the Neonatal Eating Outcome (NEO) assessment. She has a patent on a new bottle technology that is under development. She speaks regularly at national conferences and educational platforms, has published multiple articles on neonatal therapy topics in pediatric and therapy journals, and mentors occupational therapy students who want to work in the NICU setting. Dr. Pineda feels privileged to serve on the NTNCB that oversees the process of ensuring that therapists working within the NICU receive advanced training and achieve a standard of knowledge to guide them in providing safe and developmentally appropriate therapeutic interventions in the NICU.

Leave A Reply

Log in or register to comment on this article.