NTCB Spotlight: Jisha Elizabeth Mathew

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NTCB Spotlight: Jisha Elizabeth Mathew

Curious how neonatal therapy services are delivered in other settings? What about in other countries? Join the NTCB as we celebrate our international Certified Neonatal Therapists, and take a closer look at neonatal therapy in Doha, Qatar.

Jisha Elizabeth Mathew is a Certified Neonatal Therapist (CNT) from Doha, Qatar. Qatar is located between Saudi Arabia and the United Arab Emirates, has a population of approximately 3 million, and has a rate of prematurity of 9.23 per 1,000 births. Jisha has practiced for ten years as a neonatal occupational therapist at Hamad Medical Corporation, where she strives to provide the best quality care for at-risk infants and families in her country.

Amanda has now moved to Arlington, Virginia. Her zip code may have changed, but her passion for neonatal therapy has not. She has not yet begun practicing occupational therapy in Virginia,

however continues to travel back to Delaware to work per diem. She hopes to find a NICU position in her current city once the pandemic is over and she can return to work.Jisha works in a 110-bed NICU which is split between two floors of the Women’s Wellness and Research Center (WWRC) at Hamad Medical Corporation. She works alongside three physical therapists and three occupational therapists. Three therapists work two days a week in the NICU. The other three therapists cover the other three days, but also spend a half-day at the follow-up clinic. Since there are no in-house speech-language pathologists, a referral for a speech-language pathologist is placed whenever the modified barium swallow test is indicated.

Every three months, physical therapists and occupational therapists rotate between the three units within the NICU. The 4 North and 4 South units are dedicated to babies born more than 28 weeks of gestation. The “Tiny Baby Unit” or the 5 South, cares after babies born less than 28 weeks of gestation and/or less than 800 grams. The South units have two beds per room with a curtain screen in between bedspaces for privacy. The 4 North is an open ward with four to five beds in each cubicle. Therapy orders are generated by the attending physician and often include services for infants born less than 32 weeks of gestation, on respiratory support (if the postmenstrual age is greater than 32 weeks), with congenital or genetic conditions, with feeding problems, or diagnosed with macrophage activation syndrome or hypoxic ischemic encephalopathy.

In her NICU, occupational therapists focus on early feeding and all are certified in the Neonatal Oral Motor Assessment Scale and the Supporting Oral Feeding in Fragile Infants Method. They have access to specialized feeding equipment and use Dr. Brown’s Ultra-Preemie and Preemie nipples, Pigeon Slow Flow nipples, and the Haberman Feeder for infants with cleft palate. For positioning, they use the Z-Flo, Zaky hand, Phillips prone positions, and head positioners.

The General Movement Assessment is used for infants born less than 28 weeks and for babies showing red flags in their movement patterns. Videos are taken at 34, 37 and 40 weeks corrected age to monitor their writhing movements. In the follow-up clinic, an expanded repertoire of assessments is administered, including the General Movement Assessment, the Abnormal Involuntary Movement Scale, the Bayley Scales of Infant and Toddler Development, and the Test of Infant Motor Performance. All occupational therapists and physical therapists are certified in the General Movement Assessment and the Test of Infant Motor Performance. 

Parent involvement in care looks a little different in Qatar. Parents are not allowed to stay overnight in the hospital, but are welcome to visit any time. While parents are allowed to visit at any time, many of the mothers are expatriates and are working. Siblings are not allowed in the unit. Jisha shares, “We don’t have many parents coming in frequently.”

Qatar has many resources, including access to specialized training and education to optimize the care provided. In an effort to gain more support for neonatal therapy, Jisha and her colleagues discovered the resources from the National Association of Neonatal Therapy website. They also recognized the value of neonatal therapy certification in better establishing their presence in practice and pursued CNT status. After studying using the NTCB’s various resources available to candidates, they took the Neonatal Therapy Certification Exam at a testing location in Qatar. Today, Jisha utilizes the knowledge she gained in preparing for the CNT exam to continue to make meaningful differences in the lives of infants and their families. The designation of CNT represents her commitment to achieving excellence in neonatal therapy. Jisha serves as a great example of how neonatal therapy practice standards are expanding across the globe. Jisha is currently one of three CNTs in the country of Qatar!

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Testimonials

See what others have to say about their experience with us!

Heidi Stubb
OT, CNT
Vanessa Nimon
PT, CNT
“As a new therapist, I was passionate about achieving certification to demonstrate competence and promote our profession as an advanced area of practice. Following extensive mentorship in the NICU, and after meeting the minimum requirements for certification, I became a certified neonatal therapist! I am thrilled to be a part of a growing profession who now has a successful pathway for developing competency that will continue to establish our profession as an essential component of NICU care.”
Lisa Olsen
OTDR/L, CNT
“As a speech pathologist in the NICU, I was initially hesitant to become a CNT because I thought it would be more geared towards OT/PT studies. What I learned in my journey towards the certification is that everyone who comes in contact with an infant in the NICU benefits from the complex knowledge of neuro development. A different mindset, apart from simply “safe feeding” engulfed my daily practice. My OT coworker (and also CNT) and I began to tag-team ways to incorporate gentle, kind touch into each interaction with the infants. Often our efforts “rubbed off” on other coworkers and parents. My feeding skills have been enhanced by my all-in focus when encountering each baby. It’s not just safe feeding with no aspiration, it’s enjoyable experiences at each feeding time, whether bottle feeding or tube feeding. It’s preventing severe oral aversions in complex cases instead of undoing negative feeding experiences for years to come. I am a better therapist because of my studies to become a CNT.”
Cynthia Armstrong
M.S., CCC-SLP, BCS-S, CNT
“I was so worried that I would fail the exam (and be embarrassed) that I did not tell my boss I was taking it. Then I took it and found out right away that I aced the exam.It helped me be more confident in myself as a clinician. Reading the literature that was provided was great in helping me prepare and helped me understand what parts of my practice are evidence based.”
Ruth Wilkerson
OTR, CLC, NTMC, CNT
“I have spent many days fighting for respect and proving myself to other professionals in the NICU. Earning the title of Certified Neonatal Therapist has helped minimize that fight.”
Casey Manning
M.S. CCC-SLP, CNT, NTMTC
“The process of preparing for the neonatal therapy certification exam was as beneficial as taking the examination because of the knowledge gained. The resource list is invaluable and I refer to it almost daily.”
Lauren Adams
PT, PCS, CNT
“I feel like I come to the NICU with a wider breadth of knowledge and appreciation for all the aspects of developmental care.”
Julie Ecclestone
MA, CCC-SLP, CNT
Before the exam:
“The Neonatal Therapy Certification process has made me a more well rounded developmental care specialist. It has forced me to step out of my feeding/dysphagia bubble and I have been able to apply my new knowledge every time I interact with a baby and their caregivers.”

After the exam:
“The test was a challenging yet fair representation of what an advanced NICU therapist should know. I strongly encourage every NICU therapist to pursue certification. You owe it to your patients to be the best therapist you can be!”
Chelsea Moss
MA, CCC-SLP, IBCLC, CNT
“I pursued the Certified Neonatal Therapist Certification because working with infants in the NICU is a passion of mine. It has grown exponentially through the years and I felt the time was right to prove to myself, my team, and my management staff that I had the skills and competency to lead in the NICU.”
Cameron Harris
OTR/L, NTMTC, CNT
“I am extremely grateful for the opportunity to become a Certified Neonatal Therapist (CNT) in 2018, through the Neonatal Therapy Certification Board (NTCB).I believe this qualification is very relevant to practice in the United Kingdom (UK) as it helps raise the profile of neonatal therapy and also promotes a core knowledge base and practice. I truly believe that all neonatal therapists should have the same theory and knowledge base when working with this high-risk population, their intervention and level of involvement for each patient may well be slightly different. The certification process requires collaborative working. I am extremely fortunate in my setting to have a speech and language therapist who was prepared to relentlessly ask me questions on neonatal feeding, until she felt I was competent enough to the take the exam. I hope that more neonatal therapists in the UK consider taking this examination, the more people who talk about neonatal therapy, the louder our voices will be. I hope that one day every family and their baby who enter the neonatal unit continue to have access to good medical and nursing care, but also have access to all neonatal therapy; occupational therapy, physiotherapy and speech and language therapy. I hope that every therapy discipline has the credentials to highlight their specialty and knowledge and that no family is asked to choose between receiving occupational therapy or physiotherapy or speech and language therapy again. I believe that becoming certified in neonatal therapy is definitely a step in the right direction.”
Emily Hills
OT, MSc, CNT, NTMC

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