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Special Topic Course: Therapeutic Management of the Medically Complex NICU Infant: A Neonatal Therapist’s Unique Role.

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Speakers: Michelle Hicks, OTR/L, CNT

Topic: Therapeutic Management of the Medically Complex NICU Infant: A Neonatal Therapist’s Unique Role.

Course Description: Neonatal therapists have a unique role in the care of medically complex infants in the NICU, prioritizing a focus on long term outcomes and drawing on specialized training in function and adaptation in order to determine the infant’s neurodevelopmental, postural, and sensory needs both in the NICU and during the transition to home. In level IV NICUs, neonatal therapists are challenged and tasked with the responsibility of managing the care of infants with complex surgical interventions, rare congenital disorders and difficult to manage orthopedic conditions. Oftentimes, there is a desire for collaboration and a lack of evidence-based guidance when caring for the most rare and complex NICU infants and their families. This case report will follow the care of multiple infants from a 101 bed, Level IV NICU with complex needs, from NICU admission to discharge, as well as long term outcomes. Examples of conditions include osteogenesis imperfecta, arthrogryposis, VACTERL, omphalocele, co-joined twins, and the use of ECMO. Clinical reasoning regarding the evaluation of highly specialized positioning needs, the employment of orthotics and custom splinting for postural support, unique considerations for handling and care, specialty car seat considerations, parental involvement, and integration of interdisciplinary support will be of focus. With each case study, a foundational focus on neuroprotective positioning and the therapeutic support of infant developmental progression is integral. Neonatal therapists are an important part of the multifaceted approach necessary to meet the needs of intricate medical conditions. Learning and discussing the impact neonatal therapists have on the functional and safe integration of care for complex infants and their families is essential to ensure progress and specialization within the field of neonatal therapy. In addition, this case report provides neonatal therapists with the tools and information needed to advocate for the involvement of therapists in NICUs worldwide.

Speaker Bio: Michelle Hicks, OTR/L, CNT graduated from Indiana University with a BS in Occupational Therapy in 1992. She began her OT career in Acute Rehab with a focus on traumatic brain injury. Michelle currently works at Norton Children’s Hospital in Louisville, Kentucky. Initially Michelle treated patients all over the hospital, from 0-18 years of age. For the past 21 years, Michelle has worked specifically in the Level IV NICU. She received her designation as a Neonatal Developmental Care Specialist from NANN in 2013 and became a Certified Neonatal Therapist in 2017.

0-11 min: Introduction to medically complex intervention and speaker’s background
11-21 min: Discuss the unique role of the Neonatal Therapist as part of the team
21-55 min: Discuss specific case studies, clinical reasoning and decision-making, practical therapeutic interventions for each case
55-60 min: Learning Assessment

Michelle Hicks, OTR/L, CNT
Financial Disclosures: No relevant disclosures.

Nonfinancial disclosures: No relevant disclosures.

Conflict of Interest: There is no conflict of interest for anyone with the ability to control content for this activity.

Target Audience: OT, SLP, PT, RN, MD and Neonatal professionals

Level: Intermediate


  1. Evaluate adaptive ways to gain postural support that is individualized to specific infant needs.
  2. Identify barriers to discharge for medically complex infants and problem-solve creative solutions to those barriers.
  3. Describe effective approaches to involve parents in caregiving for their medically complex infant while in the NICU.

Instructional Method: Recorded webinar with lecture, videos, case studies, discussion, demonstrations and handouts. Learning assessment and course evaluation follow course.

Course Completion Requirements: The learner must view the entire webinar, complete the course evaluation and complete the post webinar learning assessment with at least 80% to receive education credit. Login and logout times will be recorded and documented.
Following completion of this course physical therapists, nurses and other disciplines will receive a certificate of completion and a zip file containing information necessary to submit to their individual state for education credit. Zip file will include course bibliography. Physical therapists are responsible for knowing and adhering to their state’s deadlines, rules and regulations.

Registration information:

In order to obtain access to the course, click the “Register now” button at the bottom of the screen. You are required to be a NANT member in good standing to have access to this course. You may also purchase this courses as a non-member by clicking the “Buy Now” button at the bottom of the screen.

For ADA accommodations, please call NANT Customer Service for more information at (866) 999-5524.

Cancellation Policy: Click HERE to review NANT’s Course Cancellation Policy.

Continuning Education Information*

AOTA CEUs: This course is offered for 0.1 AOTA CEUs (Intermediate level, Category 1: Domain of OT: Client Factors/Performance Skills, Category 2: Occupational Therapy Process: Activity and Occupational Demands, Category 2: Occupational Therapy Process: Approaches to Intervention). National Association of Neonatal Therapists (NANT) is an Approved Provider of Continuing Education through the American Occupational Therapy Association (AOTA). This activity has been reviewed and approved for 0.1 CEUs for occupational therapists. Approved Provider #7085. “The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.”

ASHA CEUs: This course is offered for 0.1 ASHA CEUs (Intermediate level, Professional area). Learners must complete the entire course in order to receive ASHA CEUs. No partial credit awarded.
ASHA CE Registry users: NANT will submit your ASHA CEU credit to ASHA on your behalf. ASHA CEUs may take up to 100 days to appear on your ASHA Transcript.

Non-ASHA CE Registry users: Maintain your course records and please keep your registry status current in your NANT account. Update your NANT account with your ASHA number if your registry status changes. NANT is not responsible for tracking your registry usage.

PT CEUs: This course is approved for 1.0 contact hour from the Ohio Physical Therapy Association (OPTA) for continuing education in Ohio.
NANT is recognized by the New York State Education Department’s State Board for Physical Therapy as an approved provider of physical therapy and physical therapist assistant continuing education.

* If you attended this presentation at NANT 9, you can still receive CE Credit by completing this online version.

Questions regarding CE credit should be directed to the National Association of Neonatal Therapists at or (866) 999-5524.

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