NTCB Spotlight: Shelly Ann Sherwood and Tamlyn Tan, CNTs in Singapore

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NTCB Spotlight: Shelly Ann Sherwood and Tamlyn Tan, CNTs in Singapore

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 Singapore.

“Neonatal therapy certification has made me more confident of the work that I do. In some ways, it has validated my role, our roles as physiotherapists in the NICU and special care nursery. In the future, neonatal therapy certification will hopefully become standard practice and a prerequisite for all therapists entering the NICU and special care nursery too. It is an integral part of a therapist’s competency.

Shelly and Tamlyn are currently the only Certified Neonatal Therapists working in Singapore

 

Shelly is originally from Trinidad and Tobago, the dual-island country in the Caribbean. She started studying and working in Canada and then moved to the United Kingdom, where she continued with school and started her career as a therapist. She was first introduced to early intervention/neonatal therapy when she was working at the Bobath Center in England. Pediatrics and a love for the NICU has stuck with her ever since. She has now been practicing as a physiotherapist for 10 years, with the last eight years working in her current NICU units in Singapore.

Tamlyn studied at Glasgow Caledonian University and has worked as a physiotherapist in Singapore for six years. For Tamlyn, it was almost ‘by chance’ that she got into neonatal practice. A physiotherapist had recently resigned, and Tamlyn had the opportunity to provide physiotherapy in the special care nursery. She entered NICU practice under the mentorship of Shelly, who continues to provide mentoring to her today.

“Shelly is one of the reasons why I fell in love with providing physiotherapy in the NICU and special care nursery. She cares for these babies and families with such passion, always going above and beyond for them. I was inspired and compelled to know, learn, and do better for the babies and their families.”

Shelly and Tamlyn work at the largest NICU unit in South East Asia. Their NICU (equivalent to a Level III and IV NICU according to US designations) has 40 beds. The special care nursery (Level II) has 60 beds. At their hospital, automatic orders for neonatal therapy occur for all of very low birthweight babies (< 1500 grams) or those born < 29 weeks gestation. Neonatal therapy services commence once they turn 32 weeks postmenstrual age. Babies with diagnoses such as hypoxic ischemic encephalopathy, Trisomy 21, torticollis, and other congenital disorders are also referred to therapy by physicians. Every year the neonatal therapy team provides services to 250 to 300 very low birth weight babies.

” When I started in the NICU units many years ago, there was no structured learning program, and things were very much on-the-job learning. I would go for courses here and there and read up as much as I could in my spare time, all in the hope that we were on track and doing the ‘right’ things and providing the best care we could for the babies. Completing the [NANT] Ignite program helped me realize that we were doing okay”, but yet there is still so much more that we could be doing. So, I decided to do the neonatal therapy certification with Tamlyn. First, to consolidate what we knew (and what we should know). Secondly, to give us that extra boost in confidence to pursue better treatment strategies for our babies.“

Shelly and Tamlyn have a great partnership, but they also have other physiotherapists and several other speech language pathologists on the units. Referrals for occupational therapists are reserved for when an infant requires upper limb assessment and treatment. Shelly and Tamlyn’s physiotherapy team has 1.5 full-time therapists to cover the units daily. The rest of their time is spent at the follow-up preemie clinics and outpatient rehabilitation clinics.

Physiotherapists in their NICU often work alongside the music therapists to optimize treatments. Different from the US practice, physiotherapists are not involved in any feeding/ swallowing assessments or intervention. Physiotherapists have an active role in optimizing positioning. After trialing several products over the years, they have settled into using the NeoHug for positioning. When considering which positioning device to use, they highly consider the ease of use for the nurses and parents’ affordability. For older babies, Boppy® Feeding & Infant Support Pillows and Tumble Forms are commonly used. In the special care nursery, nurses have become very creative and use blanket rolls to form a nest with another blanket over to tuck in the babies. 

They use standardized assessments including the Test of Infant Motor Performance and the General Movement Assessment. They also use the Neonatal Behavioral Observations, to aid in engaging parents with their babies for the first time. They follow infants and children along their journey until they discharge or transition into the community.

“Neonatal therapy certification definitely gave me more confidence! Confidence to speak up, advocate for new treatment ideas (it’s great to have access to the latest evidence without having to do massive searches), and push harder for more training for our therapists rotating into the area. In fact, right after I got certified, we took the plunge and applied for a large national grant!”

Welcome to the CNT community, Shelly and Tamlyn. And, thank you to all therapists who are not afraid to go above and beyond to make a difference.

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Testimonials

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

“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 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
Vanessa Nimon
PT, CNT
Heidi Stubb
OT, 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 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
“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
“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
“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
“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

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