Hey everyone! Today we are discussing the CNS, or Certified Neuro Specialist certification. As I mentioned in my last post, I had so many wonderful therapists reach out to help me with this series, and John Chan offered to discuss his certification in neuro rehab with us! He is also certified in NDT (Neuro Developmental Treatment) and is a CSRS (Certified Stroke Rehabilitation Specialist) which he discusses towards the end of the interview.
As always, I will share the facts and figures on the CNS, and then we will get into our interview! Enjoy!
The CNS is an internationally recognized certification geared to equip practitioners with advanced, evidence-based interventions for the stroke and brain injury population. The skills are taught through a hybrid course (online and hands on).
Course content includes: Neurological Foundations; Evaluation Tools, Clinical Measures, and Imaging; The Physical System; The Perceptual System; The Cognitive System; The Psychosocial System; The Environmental System; and Technologies and Devices.
The process to become certified includes:
- CNS Certification Course
- Certification Exam
This certification is yours for five years, and then must be renewed every 5 years by paying a $65 fee and completing various continuing education requirements.
Total Cost: $895 + Travel costs to in-person class
Total Time Committed: 30 hours
John Chan is a licensed COTA who graduated from Santa Ana College and has been practicing for over 25 years. John currently works in outpatient and home health, specifically with neuro patients. John lives and works in Las Vegas, NV and loves playing poker when he’s not working with clients! Thanks for doing this interview and sharing your experiences as a certified neuro specialist, John!
Why did you choose OT?
My mom had a stroke many years ago and passed away only a few years after the incident. She passed away due to secondary complications, i.e. infected pressure sores from a hand contracture instead of the stroke itself. I felt that if she received the proper care, she would still be with me today. I pursued OT because I wanted to help people get back to doing all the things that they love to do, and have them receive the best possible care.
Why and when did you choose to become a CNS?
When PDPM came along, my job was in jeopardy. There were major budget cuts at our facility and I wasn’t a priority being a COTA (even though I was one of the more senior therapists). I pleaded with my boss to let me stay. I had an NDT and CSRS certification, and figured I could be valuable in our neuro settings. In reality, no one in my facility cared about those certifications. The referring MDs didn’t have good experiences with NDT or CSRS therapists, so they didn’t see the value there. They told me if I was a Certified Neuro Specialist (CNS), I could work in the neuro unit. They even offered a promotion to anyone who became CNS.
I was so lucky that a course was being offered that same year and I jumped on it! It’s crazy, because I was the ONLY one in my facility who jumped on it. Long story short, I became CNS certified, started working in our outpatient neuro department, and I was promoted to supervising therapist. Never in my dreams did I think that was all possible as a COTA, but as I mentioned, no one else took the initiative to become certified when the opportunity presented itself. I also started my own side hustle treating private clients at home, and I market myself as a Certified Neuro Specialist (CNS). There are some months where my side hustle is more profitable than my full-time job. Not only did CNS save my career, it gave it new life.
Can you briefly explain what a CNS is?
A CNS therapist is a Certified Neuro Specialist. It’s a certification available to any licensed healthcare professional, although it’s dominated by OTs and PTs. We treat clients with any neurological condition (stroke, brain injury, Parkinson’s, MS, etc.). CNS therapists treat the patient holistically and look at multiple systems (motor, sensory, cognitive, environmental, etc.). Unlike other certifications (e.g. NDT for motor), we focus on treating all the systems because the brain is dynamic. Also, the interventions are rooted in evidence and neuroscience (instead of theory), which is why my referring MDs preferred this certification over others.
What settings have you worked in? Do you have a favorite? Why?
I’ve worked inpatient, outpatient, and home health. I love home health because I see the client in their natural setting. It allows my therapy to be more client-centered.
What does a typical day with clients look like for you?
My morning schedule…I do rounds with the medical team, I debrief with my rehab team, and I check in and supervise all the therapists and students. It’s mainly meetings and administrative responsibilities. In the afternoon, I have a 4-hour treatment schedule, about one patient per hour for outpatient therapy. After that, I do home visits for my private clients, about 2-3 clients a day for 45 minutes each. Every session is pretty much neuro-rehabilitation. To reiterate, I don’t focus on the motor system alone. I also do a lot of cognitive retraining, psychosocial intervention, and I incorporate a lot of different technologies.
How do you stay client-centered and occupation-based in your practice?
Everything I do is centered around the client’s long term goal. Whatever it is they want to work on (usually returning to work or some occupation), we focus on restoring those systems to make them successful. Every session looks different, and every session we get feedback from the client to see what works or doesn’t work.
How often do you use the skills you learned from acquiring this certification in your practice?
Literally all the time. Even when I treat non-neuro clients, the foundational concepts are very much applicable.
What are the steps to acquiring the credentials? Is there a renewal process?
There’s the certification course, which I believe is 30 hours. This includes hands-on labs where you have to demonstrate competency to the instructors. The same day, you take the certification exam. Once you pass the exam, you become a Certified Neuro Specialist. You renew every 5 years by taking an advanced course and other continuing education in neuro.
Do you get paid more for having this certification?
Yes, absolutely! As I mentioned, I got promoted to supervising therapist and my salary increased somewhere between 30-40%. This was a huge blessing, especially since I was almost let go a few months prior.
Can you name the various settings that a CNS can practice?
If you have neuro clients, this certification is relevant. So anywhere from acute to inpatient to outpatient to home health. There’s also an advanced pediatrics course on the horizon, so it’s not limited to adults.
Do you believe acquiring the credentials is worth it?
Yes, well worth it. As I mentioned, it saved my job and it helped kickstart a new job. The course can be pretty rigorous and it takes a bit of time and preparation, but the knowledge and credentials are worthwhile. I’ve been a COTA for 25+ years and have taken many CE courses. Nothing compares to CNS. Not only are all the instructors knowledgeable, they also have a few on staff who have experienced their own stroke or brain injury! They bring a unique perspective that no other course does because you learn directly from someone who recovered from a neuro condition themselves!
Do you have any other OT interests that you would like to pursue, or do you have any other certifications?
I am interested in acquiring CBIS, but I hear it’s not really a course…just a certification exam you take to become certified, so I’m not really sure if it’s worthwhile if I don’t learn anything. In terms of other certifications, I have NDT and CSRS. I loved NDT – it’s very hands-on and I’ve used it for a long time. However, it gets criticized for not being evidence-based. CSRS wasn’t all that helpful for me. I know a lot of people have taken it, but it didn’t cover anything I didn’t already learn in OT school. Not sure if I can endorse it, it was too basic of a course.
Do you have any words of advice for someone wanting to pursue the CNS credential?
You have to love neuro and you have to be open to learning all the different things about neuro. When it comes to NDT, we’re very much set in our ways. It’s almost like we follow a very specific formula and we become closed off to everything else. To be a true specialist, you have to be humble enough to know that there are things you don’t know, and there are different methods and techniques that can be used at any given movement. Knowing how to navigate these tools will help your clients in the best possible way. CNS therapists don’t pretend to have the answer to everything, but they look at the evidence and neuroscience to help find the most optimal paths.
To find out more about CNS, they have a website and Instagram page: