Unexpected Surprises from Becoming a CNT

Unexpected Surprises from Becoming a CNT

When physical therapist Graham Miller became a Certified Neonatal Therapist™ (CNT™) in 2021, she had 2 unexpected surprises: 1) improved confidence as a NICU therapist and 2) receiving a promotion that came with a 7.5% pay raise. Read on to learn about her journey. 

“Becoming a Certified Neonatal Therapist was a personal goal, but I had two wonderfully pleasant surprises following.”

Graham Miller is a physical therapist at Children’s Hospital Colorado (CHCO), a 90 bed Level IV NICU in a suburb of Denver, Colorado. After 32 years as a physical therapist and 10 years in the NICU, she applied for Neonatal Therapy Certification™ and became a CNT™ in 2021. She works full time in the NICU and is part of a team consisting of 6 PTs, 3 OTs, and 2.5 SLPs. Since she became a CNT™, two other NICU therapists on her team have become CNTs™ as well.

“I have my Pediatric Certified Specialist (PCS) through the American Physical Therapy Association, and I learned a great deal preparing for that exam. I wanted the CNT™ so that I would focus my energy and time learning the latest evidence and increasing my understanding of the multidisciplinary therapy care of the NICU baby. “

Graham decided to seek CNT™ credentialing when she was ready for the next career advancement and had the time to invest in preparing for the CNT™ exam. For many years, she was learning and challenged in her day to day life in the NICU. She wanted to focus her time and energy on her passion and learn even more than she already knew about how to optimize her care with infants and families in the NICU. 

“Skills, education, hard work, sweat and tears are all required to be a neonatal therapist. I love my work in the NICU so very much, and am still humbled and amazed that I am trusted to care for these important and meek little people and their fragile families. So, taking the next step to advance my knowledge to bring to the families I serve was important to me.”

Graham, like every other expert in the field who realizes the significant amount of knowledge needed to optimize outcomes of high-risk infants and their families, was concerned about taking an exam again, especially since it had been 32 years since her PT board exam. 

“The stress of the exam and the thought of not passing was the hardest part.”

To prepare for the exam, she read and reread chapters and/or full books and many articles; she participated in the journal club; she asked her NICU OT and SLP colleagues as well as her fellow NICU PTs a lot of questions. Additionally, she attended 4-5 continuing education courses virtually. 

“I’m sure I over-prepared for the exam, but I wanted to do that!”

On July 19, 2021, she went to a testing center that was 6 miles away from her home and on her way to work. She found out immediately after the test that she could use the CNT™ credential behind her name. Her first surprise related to becoming a CNT™ was realizing just how much she expanded her knowledge in evidence-based practice and how going through the process increased her confidence.

“I gained such a wealth of knowledge regarding current evidence based practices in treating NICU babies that I felt much more confident treating the babies and educating/guiding the families, discussing observations with members of the medical team, answering questions of shadows/orientees/my mentee. My experience allowed me knowledge, but the time outside of the treatment sessions reading, studying and learning afforded me more confidence to share my passion with everyone. I didn’t even know that I lacked confidence until nearing my testing and following when I had been exposed to and learned so much about therapy in the NICU.”

Graham paid for the neonatal therapy application and testing fees out of her own pocket. However, her second unexpected surprise in becoming at CNT™ came in the form of her hospital introducing a career ladder last year. She had been working as a Physical Therapist I at the time. Becoming a CNT™ and providing formal mentorship combined allowed her to be promoted to Physical Therapist III (the highest level for clinical therapists on the career ladder)! This came with a 7.5% increase in her pay and the recognition that she deserves. 

“Becoming a Certified Neonatal Therapist was a personal goal.  My increased confidence and promotion were surprise gifts that were given as a result.”

Graham joins 40% of the almost 900 CNTs who have indicated that they received an incentive from their employer after achieving CNT™ status.

A letter that all CNTs™ can use to advocate for an incentive is available on the website at:


Join the growing number of CNTs™ by applying for certification, so that you too can increase your confidence and receive the recognition you deserve.