Meet the Professional: What Does a Neonatal Therapist Do?

April 27, 2017
neonatal therapy, neonatal therapist, NANT, Sue Ludwig

Sue Ludwig OTR/L, President and Founder of the National Association of Neonatal Therapists


When a baby is born premature or with special health care needs, they require immediate, intensive care. With all the medical interventions and monitoring it’s easy to start seeing your baby as a patient, instead of the little person that they are. But we know that what we do in the NICU has long-term impact. As we’re caring for this baby we’re also laying the foundation for their future health and development. This kind of care requires a multidisciplinary approach – and neonatal therapists have something unique to contribute.

While many NICU professionals specialize in one aspect as your baby’s health care, neonatal therapists treat the whole child. They understand that babies are shaped by their sensory experiences – what they see, smell, hear, taste, and feel. So neonatal therapists look at how the baby interacts with the NICU environment and how that affects their development. That is why their discipline is often referred to as “developmental care.” Developmental care recognizes that each baby requires an individualized approach that addresses their unique capabilities if they’re going to reach their full potential.

To find out more about what a neonatal therapist does and why a family would see one, we spoke with Sue Ludwig OTR/L, President and Founder of the National Association of Neonatal Therapists. Sue is also a guest on the NICU Now podcast. 


What is your title and what sort of qualifications do you have?

I am a OTR/L which means that I am a registered and licensed Occupational Therapist. I have a Bachelor of Science in Occupational Therapy from Eastern Kentucky University and have been a practicing occupational therapist since 1993 and a neonatal therapist at the UC Health University Hospital in Cincinnati since 1996. I achieved the Neonatal Developmental Care Specialist Designation through the National Association of Neonatal Nurses and I am an ex-officio member of their Education Provider Committee. I am also a member of the American Occupational Therapy Association (AOTA) and serve as AOTA’s media expert regarding neonatal therapy.

What is a Neonatal Therapist and what do they do?

A Neonatal Therapist is an occupational therapist, physical therapist, or speech language pathologist who provides direct patient care and consultative services for the premature and medically complex infants in a Neonatal Intensive Care Unit (NICU).

neonatal therapist, neonatal therapy, preemie, feeding preemie, preemie bottle, preemie in NICU

Photo credit: Whitaker Family

Working with babies in the NICU means being able to assess and address each individual patient’s needs. We’re not just trying to identify and treat developmental problems. We’re trying to prevent them by creating an environment that promotes healthy development and growth.

Practice in the NICU is not for entry-level therapists. Neonatal therapists need to be able to evaluate and treat infants with a variety of diagnoses. They also need to understand how the treatments and interventions babies receive in the NICU affect their development. Because of this, the consensus is that a therapist should have a minimum of 2 years of pediatric experience before working with high-risk infants in the NICU. The American Occupational Therapy Association (AOTA), American Speech Language Hearing Association (ASHA), and American Physical Therapy Association (APTA) all have position papers clearly stating the knowledge and skills required for practice in the NICU.

When would a family see you?

Sometimes I am asked to see a baby because of a specific concern related to their diagnosis, birth weight, or admission to the unit. Those babies may already have problems affecting their development that need to be addressed immediately. But my role as a neonatal therapist is to also prevent problems, so ideally I get to spend time with every baby and family who is in my NICU. All babies can benefit from the developmental care approach, and understanding how their baby experiences the world can help inform how parents care for their babies.

Tanya and her son

Read parents’ stories about bonding with their babies through kangaroo care. Photo credit: Clay Family

Some of the things I help families with are:

  • Understanding their baby’s language or “cues”
  • Understanding how to comfort their baby
  • Bonding with their baby through skin-to-skin care, also called “kangaroo care”
  • Learning about what their baby hears, sees, feels, tastes and smells
  • Knowing how to touch, hold, and handle their baby in safe, supportive ways
  • Learning how to feed their baby in a way that is enjoyable and supports lifelong development

When you are going home from the NICU I can:

  • Help caregivers understand safe sleep practices
  • Show parents the best ways to position their baby for healthy development
  • Provide information and referrals for therapy resources in the community 

What is the most important thing you want families to know?

YOUR experiences with your baby are vital to every stage of development.

Whether through prevention or support, everything we do as neonatal therapists lays the groundwork for the next stage of development. Our education and perspective make us consider what has to occur today in order to build on those skills tomorrow, next week, at age 7 and so on.

Your baby is meeting developmental milestones even in while the NICU. Ask us about them!

What resource would you recommend for parents who want to find out more about your field?

 I’d encourage them to visit the National Association of Neonatal Therapists website and to ask about neonatal therapy services in their NICU.

Click to listen to a webinar by Sue Ludwig OTR/L and Kara Ann Waitzman OTR/L, NTMTC about Infant-Driven Feeding® courtesy of Dandle-LION Medical.

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