The CNS Course: My Experience

When I embarked on a new blog series about 2 years ago, interviewing clinicians with specialty certifications, I never expected that one of the credentialing institutes would ever read the interview, comment on the post, and then invite me to take their almost $1,000 course for free- no strings attached. Shortly after posting an interview with a COTA who is a Certified Neuro Specialist, a little over a year ago now, I received the education scholarship from the Neuro Specialist Institute, and was completely blown away!

This past weekend I finally finished this course, passed the exam, and officially became a Certified Neuro Specialist! I had such a great experience, even just being a pediatric clinician (I was the only outpatient pediatric therapist in my group of acute care and inpatient rehab therapists haha).

Before getting into the experience, I am going to share some logistics of the course, which you can also find on my original interview with a CNS therapist here.

What is the CNS?

(description from The Neuro Specialist Institute website)

“The CNS  (Certified Neuro Specialist) Certification Course is an advanced-level continuing education course that covers evidence-based interventions for the stroke and brain injury populations. This is a hybrid course that takes place online (SELF-STUDY, 20 hours) and in-person (LAB, 10 hours). Course participants have indefinite access to the SELF-STUDY portion of the course.”

“CNS is an internationally-recognized certification available to healthcare professionals from all nations. Specialists are equipped with certifiable knowledge and skills to provide effective interventions based on current, high-level evidence. Participants of the course will receive hands-on education on treating multiple systems, including the physical, cognitive, perceptual, psychosocial, and environmental systems. Moreover, participants will be introduced to new technologies and devices in neurological rehabilitation such as EMG technology and virtual reality.”

Target Audience:

(per CNS documentation/lab manual)

“This certification course in intended as an advanced-level course for all licensed healthcare professionals. For continuing education, the course is intended for occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and post-professional students who have obtained their professional license at time of registration.”

Those who work in adult settings that cater to neurological populations, more specifically stroke and TBI populations, would benefit most from this course.

Logistics:

Hours: 30 hours total = 20 hours self-study online + 10 hours in-person lab and exam (in Los Angeles, California)

Cost: $865 + travel and housing expenses for in-person lab portion

Topics covered in the course: 

• Neurological Foundations
• Evaluation Tools, Clinical Measures, and Imaging
• The Physical System: Motor Control and Movement
• The Perceptual System: Sensation, Sensory Re-Education, and Vision
• The Cognitive System: Attention, Memory, Executive Functions and Communication
• The Psychosocial System: Emotion, Social Cognition, and Mental Health
• The Environmental System: Home, Work, and Community Integration
• Technologies and Devices: Physical Agents, Orthotics, EMG, and Virtual Reality 

Materials Received:

• CNS Course Book
• CNS Course Videos (20 hours total)
• CNS Lab Manual
• Various materials we used during the in-person lab, including:
  • 1 5’ long Theraband strip (used during the lab)
  • Partial roll of K-tape (leftovers of the roll I used during the taping portion of the lab)
  • ACE wrap (used during the wrapping portion of the lab)
  • Electrodes (used during the EMG/E-stim portion)
  • Measuring tape
• Certificate of completion, including the addition of “CNS” to my name

Instructors:

Dr. Michael Ang is an amazing occupational therapist, with basically the whole alphabet behind his name (he has an incredible number of certifications). He created this course in addition to an entire outpatient therapy program at a medical center. He specializes in neurological and upper extremity conditions and has a vast amount of experience in so many settings. He is also a professor, and recently received the inaugural NBCOT Impact Award.

Additional instructors include therapy students and practicing clinicians with years of experience and many of them have lived experience with the very conditions we learn about and work with (cerebral palsy and stroke). 

CEUs Earned:

It is 30 contact hours (3.0 AOTA CEUs) for Occupational Therapists and Occupational Therapy Assistants

How to Sign-Up:

Sign-up is completed through The Neuro Specialist Institute website, here. Currently, all lab dates are sold out, so it would be a good idea to continue to check the website if you are interested in signing up!

Maintaining the Certification:

From the CNS website:

“After the initial five year certification period, a renewal application and application fee ($65.00) is required to maintain certification status every five years. Individuals must provide documentation of the following continuing education (CE) requirements (24 hours total):

• Minimum of 8 hours from any CNS Advanced Course.
  Note: Practitioners who complete any CNS Advanced Course will earn the designation “CNS-Advanced.”
• Remaining 16 hours of continuing education may be completed from any course related to neurological conditions or deficits.
• If audited, applicants must submit evidence of continuing education hours. Approved documentation may include continuing education transcripts, letters, or certificates from organizations, courses, seminars, workshops, etc.”

Comparing Course Content to my OT Education:

During OT school I learned about many of the interventions and foundational work that we covered in the CNS course, but of course it is not always possible to actually practice and go further in-depth for specific interventions. I feel much more comfortable with many intervention strategies, and plan to utilize these strategies in my practice!

Interventions I learned in school that were also covered in the lab include:

• E-stim
  • In my OT program we spent a lot of time covering e-stim, so this was definitely a review for me. But what made it unique is the EMG portion. We utilized a specific machine to learn an intervention called EMG triggered E-stim – something I had never heard of before.
• Car transfers
• Cognitive training
• Environmental assessment and ADA compliance
• Orthotics
  • I learned a lot about orthotics in my grad program, but something unique about the CNS course is that we had access to Saebo products

Interventions that I heard about in school but did not learn, and were covered in the lab:

• Taping
  • We spent an entire lab learning how to apply tape for a few specific conditions, and were given instructions on how to apply tape in many other ways
  • I feel very comfortable with taping now and am not afraid to bring it into my practice (check with your state laws though!)
• Traction
  • A portion of one lab was spent on traction techniques and we were able to practice these techniques under the supervision of the instructors
• Virtual Reality
• Gait Training
  • This included working with specific gait conditions like foot drop, hip hiking, and circumduction
  • We learned how to facilitate a normal gait during walking and while ascending/descending stairs
  • We also learned how to wrap the ankle/foot/leg to prevent foot drop using Ace bandages and therabands
• EFPT-specific cue-based cognitive training
• Therapeutic handling specific to neuro conditions

There were also a ton of different interventions talked about in the online portion of the course that we did not get to practice in lab, but that I had never heard of prior to the course.

Something unique about this course is that it does not focus strictly on one intervention type, like just NDT, or just taping, etc. We cover a wide range of interventions that target most, if not all, skills that are impacted by neuro conditions.

Who should take the course:

As I stated earlier, those who work in adult/neuro populations would benefit most from this course. And you may ask, “but Caroline, don’t you work in outpatient pediatrics? How does this course apply to you?” Well, I asked myself that when I was first offered the scholarship. But the more I thought about it, a good 1/3 of my pediatric patients are neurologically focused (cerebral palsy, various types of strokes at/before/after birth, TBI) neurological conditions impact the pediatric population as well! I also happen to treat a few adults with neuro conditions as well (2 to be exact lol). I learned so many new skills that I will definitely be applying to my neuro patients, and even my non-neuro patients.

The Neuro Specialist Institute is also creating a pediatric advanced-level course, and you can bet that I will be taking that course!! They are also creating advanced courses for: neuro-degenerative conditions, vestibular rehabilitation, and orthotics. Before completing these advanced courses, you will need to complete the CNS course.

My tips for when you take the course/lab:

• Take your time watching the videos, don’t wait 2 weeks before the lab to watch them all! There are a lot and if you’re taking this course to truly learn how to be a better clinician and to bring neuro interventions into your practice, then take your time to soak it all in: take notes, re-watch lectures, and prepare questions for when you are in the in-person lab!
• When you are at the lab, volunteer for anything you can! I learn best by being hands on, and this is a one-time opportunity to learn from some amazing clinicians.
• Ask questions! Quite a few of the instructors have lived experience with various neurological conditions, such as cerebral palsy and stroke. This is a unique opportunity to learn from individuals with expert knowledge in this area – as both clinician’s working with neuro populations on a daily basis, and as individual’s who have experienced/currently experience these conditions themselves.
• Wear comfy clothes! I didn’t know what to expect so I went in business casual-type clothing lol, you can say I was overdressed…. Most people attending wore leggings, joggers, t-shirts, or a little nicer in jeans or khakis.
• If you are out of state, and if you can, try to take a day off work before or after the weekend course (preferably the day after). I flew into California from Florida on that Friday, took the lab all day on Saturday, then flew out early Sunday morning back to Florida, and was at work the next morning at 7am… That was *this* morning, the day I’m typing this, and work was rough because I was so tired haha.