III. Domain-Specific Content on the Exam

Domain 1: Foundations for Neonatal Therapy Practice

This domain outlines the foundational knowledge required by neonatal therapists to underpin their practice in the NICU. An understanding of neonatal care principles, infant development and theories of neonatal practice, are important in supporting the advanced clinical reasoning necessary for the provision of neonatal therapy for high-risk infants and their families in the NICU.

Knowledge required:

  • Scientific knowledge – Degree/depth of knowledge required varies by component. Some topics require only conceptual understanding while others require full integration of the component – i.e. able to teach, analyze, and reflect upon.
  • Atypical and typical preterm infant development including neurobehavioral, sensory, feeding and swallowing development
  • Basic anatomy & physiology of the neonate
  • Embryology
  • Environment (including equipment)
  • Fetal/Neonatal brain development/Theory of neuronal group selection
  • Medical equipment/Commercial infant products (hospital and retail)
  • Medical procedures
  • Medical terminology and diagnoses
  • Models of care and theory in the NICU: attachment theory, dynamic systems theory, synactive theory
  • Neurodevelopment (motor, sensory, autonomic)
  • Neurobehavior
  • Typical neurodevelopmental outcomes of preterm infant
  • NICU environment and culture

Domain 2:  Neonatal Screening, Assessment, Evaluation and Diagnosis

This domain outlines the core knowledge required for the development of appropriate approaches for the screening, assessment and evaluation of infants in the NICU setting. It considers the clinical reasoning interplay of individualized evaluation of the infant with the development of appropriate intervention strategies.

Knowledge Required:

  • Acute and chronic pain
  • Assessment/Evaluation – standardized, observational, non-standardized, continuous /ongoing
  • Interpreting results
  • Maternal risk factors, exposures & complications (medical, psychosocial)
  • Medications – potential impact on infant
  • Musculoskeletal assessment
  • Neurobehavioral assessment
  • Neuromotor assessment
  • Oral feeding and swallowing (non-instrumental assessment)
  • Pain assessment and management
  • Pre-feeding skills
  • Sensory
  • States of arousal
  • Synthesize information
  • Treatment planning
    • Determine frequency and duration of treatment
    • Set discipline-specific goals
  • Utilizing critical thinking skills

Domain 3: Neonatal Therapy Interventions and Family-Centered Care

This domain outlines the core knowledge required to deliver evidence-based interventions with infants and their families in the NICU setting; both in terms of providing neuro-protective support and intervention for the infant, as well as promoting the delivery of family-centered care.

Knowledge Required:

  • Evidence-based interventions with neonate and family
  • Impact of the NICU stay on the family unit
  • Family-centered care
    • Educate/Guide/Promote parental participation and independence in early parenting skills through transition to home.
    • Provide psychological support.
    • Facilitate bonding and attachment.
    • Parent engagement
  • ADLs
    • Feeding
    • Facilitate/Support
      • Oral-sensory-motor development
      • Pre-feeding skills
      • Transition to oral feeding (not including instrumental assessment)
      • Breastfeeding support
    • Sleep
      • Protecting sleep
      • Facilitate/support
        • Transition to sleep
        • Safe sleep practices
    • Bathing
      • Facilitate
        • State regulation
        • Self-regulation
        • Neuromotor stability
    • Play/Interaction
      • Assist with attainment of age appropriate developmental skills through guided exploration of and interaction with the environment
      • Infant communication
      • Parent-infant interaction
  • Environment
    • Modify and adapt the environment
  • Neurobehavioral
    • Facilitate/Support
      • Autonomic regulation
      • Motor regulation
      • State transition/regulation
      • Attention/interaction
      • Self-regulation
  • Neuromotor
    • Facilitate/Support
      • Neurodevelopmental positioning
      • Neurodevelopmental handling/positive touch
      • Development of normal movement patterns
      • Normal reflex development
      • Normal tone development and tonal changes

II. Content of Examination

IV. Self-Assessment of Domain-Specific Content