Neuromuscular Electrical Stimulation

Certification Handbook

Dysphagia University | www.DysphagiaU.org v.041117

 NMES Certification Handbook

Handbook Content
16 million Americans have a swallowing disorder
Introduction………….....................3
(2,400,000 are children)
Eligibility Criteria..........................4
Exam Content and Outline............5
Sample Test………………………6
Nearly 60,000 people die each year from complications
Application to Test..........................7 associated with swallowing disorders.
Acceptance to Test.........................8
Exam Day and Post-Exam ……….9
General Information...…………….10 Only 39% of patients with dysphagia think it is treatable.

VISIT DysphagiaU.org for more information or to apply!

Questions about Certification?

Contact DU:

888-504-GoDU (4638)

Email us at info@DysphagiaU.org

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 NMES Certification Handbook
What is NDC Certification? About Dysphagia University and its commissions
The Neuromuscular Electrical Stimulation (NMES) for Dysphagia University (DU) is a not-for-profit entity incorporated
Dysphagia examination assesses the professional competence in the United States for the purpose of validation of specialized
of therapist practitioners who perform the skills taught in an skills using dysphagia treatment modalities, promoting patient
accredited NMES certificate course. The candidate should be safety and improving patient outcomes.
able to display a complete understanding and proficiency with
the application of knowledge and instruments. NDC The Dysphagia University Board of Directors has developed
bylaws, standing rules and goals, and works within a support
Certification is the formal recognition of those skills, ethical
role with its specialized commissions. The responsibility of a
values, and experience in the application of NMES for commission is to maintain a high degree of excellence as it
Dysphagia. It is demonstrated by achieving standards identified manages and maintains national accreditation values and
by the NMES for Dysphagia Commission to promote health competencies set forth by the National Commission for
outcomes. Certification assures the public a NMES provider has Certifying Agencies (NCCA), in its certification program.
completed all eligibility criteria to earn a specific credential.
Accreditation
All NMES certified practitioners are required to abide by the The National Commission for Certifying
NDC Standards of Conduct and policies and procedures. Agencies (NCCA) is an independent
organization that has identified the
essential components of a national
This NDC Certification Handbook describes the important
certification program. All Dysphagia
aspects of the certification process. It is designed to assist
University examinations follow NCCA
candidates in preparation for the examination. The handbook
standards.
contains an overview of the examination, eligibility criteria,
application procedures, Recertification information, and much
more. Sample questions are provided to familiarize candidates
Questionmark.com and B-Virtual:
with the types of questions appearing on the multiple-choice
Dysphagia University’s Testing Partners
examination.
Questionmark and B-Virtual are trusted test development and
delivery providers to organizations worldwide. They offer a
user-friendly online testing process that allows you to test from
Why You Should Be Certified
a location convenient to you. Using technology, we are able to
Certification in NMES for Dysphagia can:
reduce your time and cost, and give you greater flexibility to
• Validate your specialized knowledge
achieve your credentials in NMES for Dysphagia. Learn more
• Increase your confidence in your abilities
about how we deliver your exam by viewing the exam sections
• Contribute to your personal satisfaction
in this handbook.
• Demonstrate your commitment to your specialty and your
patients

Certification also may increase your professional opportunities,

lead to salary increases or bonuses, and enhance your career
mobility.

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 NMES Certification Handbook
Eligibility Criteria—Initial NDC Certification provided by an approved provider of a professional board;
®
Any person who is not currently NDC certified is an initial can be a PT, OT or SLP modalities course) (teaching or
attending)
candidate, including candidates whose certification has lapsed. All
eligibility criteria must be met at the time of application and
Candidates must have an active license or an international
examination. A passing score on the examination is required for equivalent for 1 year prior to the application
an individual to earn the time-limited NDC credential. The NDC
credential is valid for up to 3 years from the time it is awarded and Candidates must be in good standing with professional
is maintained throughout the practitioner’s career by the boards
maintenance of the NMES certification.
Candidates must agree to abide by practice standards and
By meeting the standards below, candidates demonstrate that code of conduct (ASHA, AOTA or similar)
they have applied the highest level of ethical standards in their
practice. The expectation is that these applicants can Initial certification applicants must:
demonstrate advanced clinical and professional skills. Only • Create an account and apply online at www.DysphagiaU.org.
applicants who achieve high standards of excellence, display
professionalism, are committed to continuous advanced learning, • Enter information requested to meet eligibility criteria when
and display clinical skills and characteristics that reflect prompted during the application process. Candidates must
achievements above and beyond the standard practice are enter valid information and may be requested to attach
approved to sit for the credentialing exam.
documentation online.
Candidates must have:
• Submit full payment at the time of application.
Candidates must successfully complete a NMES for
Dysphagia competency training program or its renewal,
accredited through ICE/NCCA within five years prior to
application. To help ensure the health, welfare, and safety of
the public, ICE created its accrediting body, the National Renewal of NDC Certification
Commission for Certifying Agencies (NCCA) and set the first Certification is valid for three years. By meeting the standards
standards for professional certification programs in the below, candidates demonstrate that they continue to apply the
industry. highest level of ethical standards in their practice. The
expectation is that these renewing applicants demonstrate
Candidates must pass competency trainings which include advanced clinical and professional skills. Only applicants who
applications on the face and anterior portion of the neck and
achieve high standards of excellence, display professionalism,
other placements shown to be effective in the treatment of
are committed to continuous advanced learning, and display
Dysphagia.
clinical skills and characteristics that reflect achievements above
In order to avoid conflict of interest, the course may not be and beyond the standard practice are approved to renew.
provided by a manufacture or distributor of NMES for
Dysphagia devices or electrodes. Good standing w/ professional boards.

In addition, the training must: Agree to abide by practice standards and code of conduct
(ASHA, AOTA or similar).
• Include a minimum of 10 hours of anatomy/physiology
• Include a minimum of 10 hours of theory, safety, and 150 hours of treating with NMES-D within 3 years prior to
application renewal.
• Include two or more channel electrode placements
• Assess and document competency in application and 15 hours of continuing education within 3 years prior to
theory renewal on the topic of dysphagia (by an approved ASHA
• Be an evidence based training to include instruction in and/or AOTA provider) (teaching or attending).
current research in the use of NMES for Dysphagia.
5 hours of continuing education within 3 years prior to
Candidates must have 250 hrs. treating w NMES-D within 1 renewal on the topic of NMES for dysphagia (approved by a
year prior to the application professional board or provided by an approved provider of a
professional board; can be a PT, OT or SLP modalities
Candidates must have 5 hours continuing education (live or course) (teaching or attending).
online) within 1 year prior to the application, on the topic of
dysphagia (by an approved ASHA and/or AOTA provider)
(teaching or attending) not including the certificate course.

Candidates must have 2 hrs. continuing education (live or

online) within 1 year prior to the application on the topic of
NMES for dysphagia (approved by a professional board or

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 NMES Certification Handbook
Exam Content
The NDC exam is based on the NDC Test Content Outline (Test Page 6 has a free, 15-item NDC Practice Test. Practice tests
Blueprint). The Test Content Outline is based on the results of a provide examples of the type of items that you can expect to find
job analysis study of Neuromuscular Electrical Stimulation for on an examination; they are not intended to be study guides or to
Dysphagia practice completed in 2016. The NDC Test Content replace other forms of test preparation. Additional for-purchase
Outline is composed of seven major subject areas, each with a practice tests are also available at DysphagiaU.org.
percentage assigned to it. Each major subject area is
represented in every test with the appropriate percentage of Acceptable Providers/Approvers of CE Required for
items. However, not all content sub-areas are included on every Initial Certification
form of the test. The following is a list of acceptable providers and approvers
of continuing education required for initial NDC certification.
The NDC Test consists of 135 multiple-choice items (a question NDC contact hours must have been approved or provided by an
or incomplete statement followed by four answers or accredited provider/approver of continuing education listed below.
completions). Of those, 130 items count toward the candidate’s
score and 5 are “pretest” or experimental items. Candidates do
List Coming Soon!
not know which items are scored and which are pretest.

NDC TEST CONTENT OUTLINE (TEST BLUEPRINT)

I. Clinical Evaluation: 12% V. Combining Electrotherapy with Conventional Dysphagia
A. Analyze swallowing disorders Therapy: 21%
A. Benefits and limitations of various electrotherapy protocols
B. Perform structured evaluation
B. Select appropriate electrotherapy protocol
C. Reviews and analyzes findings of assessments
C. Select appropriate electrode positions
II. Diagnosis: 14% D. Apply electrodes in correct anatomical location
A. Analyze evaluation results and formulate a list of impairments E. Observe precautions and contraindications
B. Analyze evaluation results identifying other contributing factors F. Effectively establish therapeutic intensity
C. Describe conditions that are indications G. Adhere to safe and ethical protocols
D. Describe conditions that are not indicators H. Appropriate exercises and bolus presentation
E. Describe conditions that are contra indicators I. appropriate exercises while NMES device is active
J. document details of treatment progression
III. Treatment Plan: 11% K. Effectively communicate treatment progression
A. Formulate a treatment plan based on evaluation results
B. Appropriate diet modifications, feeding strategies and exercises
C. Create a frequency of treatment sessions VI. Reassessment: 7%
D. Convey treatment approach through patient and family education A. Modify stimulation parameters appropriately
D. Document medical necessity B. Modify treatment plan based on periodic reevaluation
E. Treatment plan based on muscle physiology and kinesiology

VII. Professional Standard Ethics: 6%

IV. Electrotherapy Competence: 29%
A. Describe the effects of electrical stimulation A. Comply with professional board requirements
B. Observe precautions and contraindications B. Insure patients are only treated by trained coworkers
C. Problem solves common equipment issues C. Comply with NMES device limitations
D. Problem solves common electrode issues
E. Corrects common equipment issues
F. Versed in the Evidence based literature
G. Recognize the need to refer patient to other services
H. Properly exercise a standard of care
I. Basic theory of neuromuscular electrical stimulation

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 NMES Certification Handbook

Sample Test
Practice tests provide examples of the type of items that you can expect to find on an examination;
they are not intended to be study guides or to replace other forms of test preparation.

1. Once the swallow has gone from voluntary to involuntary control: 8. All of the following are components of evidence-based practice,
A. The remainder of the swallow is primarily controlled reflexively except for:
B. The risk of aspiration is diminished A. Clinical expertise
C. Cricopharyngeal tone increases until the bolus passes through the B. Personal opinion or bias
UES C. Patient values and preferences
D. The hyoid and thyrohyoid will approximate D. Best research evidence

2. The hyoglossus is primarily active during which function of the swallow? 9. The “biting” sensation caused by poor electrode contact can be
A. Lip closure explained by:
B. Tongue base retraction A. Increasing current amplitude
C. Pharyngeal constriction B. Increasing current density
D. UES opening C. Increasing voltage
D. Increasing current frequency
3. A patient 2 weeks post-extubation presents with signs of penetration
during the swallow. Which of the following is a likely key impairment? 10. When using electrotherapy, resistance is measured in:
A. Weakness of hyolaryngeal excursion muscles A. MilliVolts (mV)
B. Stiffness of the upper esophageal sphincter B. Milliamperes (mA)
C. Weakness of velopharyngeal musculature C. Ohms (Ω)
D. Stiffness of hyolaryngeal protractors D. Hertz (Hz)

4. NMES is indicated for: 11. According to I=V/R, when resistance increases and voltage stays
A. Decreasing pain the same, intensity will:
B. Muscle strengthening A. Increase
C. Wound healing B. Decrease
D. Peripheral nerve lesions C. Stay the same
D. Match the resistance
5. Decreased UES opening is noted on an MBS of a patient. Which of
the following interventions may promote UES opening? 12. Which anatomical electrode placement is indicated in a patient
A. Shaker exercise presenting with a primary impairment of tongue weakness?
B. Head turn A. Between hyoid bone and mandible
C. Chin tuck B. Between TMJ and corner of the mouth
D. Double swallow C. Over the thyrohyoid musculature
D. Over the anterior belly of the digastrics
6. Which of the following best characterizes ALS?
A. Primarily upper motor neuron involvement
13. Which of the following electrode placements is most likely to
B. Primarily lower motor neuron involvement
provide optimal recruitment of the orbicularis oris muscle?
C. Mixed upper and lower motor neuron involvement
A. Placement over the ocular branch of the facial nerve
D. Primarily peripheral nerve involvement
B. Placement over the mandibular branch of the facial nerve
C. Placement over the cephalic branch of the facial nerve
7. Which of the following physiological rationales is most responsible
D. Placement over the buccal branch of the facial nerve
for promoting muscle strength and reverse atrophy during NMES
therapy?
14. The clinician is delivering NMES for the treatment of dysphagia
A. Promote decreased of sensory input and feedback to the
using 25MA of current. All of the following are likely to
patient
responses except:
B. Promote reduction of adipose tissue in the anterior neck
A. The patient will experience a maximum level contraction.
musculature
B. The patient will likely experience a submaximal
C. Promote Type I fiber recruitment and produce an asynchronous
contraction.
contraction
C. The patient will not be able to superimpose a functional
D. Promote Type II fiber recruitment and produce a synchronous
swallow
contraction
D. The patient will report discomfort

15. Based on FDA clearance, which of the following is considered

an off-label application for NMES for dysphagia?
A. An application to muscles required for pharyngeal
contraction
B. An application to muscles required for hyolaryngeal
excursion
Answer Key C. An application to stimulate tongue base retraction
1A, 2B, 3A, 4B, 5A, 6A, 7D, 8B, 9B, 10C, 11B, 12D, 13D, 14B, 15D D. An application to elicit stronger vocal quality

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 NMES Certification Handbook

STEP 1
Assess Your Learning Needs
ARE YOU ELIGIBLE? Review the Test Content Outline (Test Blueprint page 5) to
familiarize yourself with the content areas that will be on the
Eligibility to take the NDC exam requires several steps. To take test. Pay attention to how each content area is weighted, as the
the NDC examination for initial certification, applicants must meet weight corresponds with the percentage of scored items on
requirements as listed in the Eligibility Criteria section (Page 4). that topic. Identify which areas are your strengths and
weaknesses, and focus your studies on your weaker areas.

STEP 2 APPLY TO TAKE THE EXAM

Confirmation Your Application Has Been Received
NDC uses email as its official form of communication.
Applicants must supply a valid email address. The approval to
Once you have determined that you are eligible to take the
test and exam confirmation notices are sent to applicants via
certification exam, the next step is to apply for the NDC
email. They contain important instructions for contacting
examination. Candidates must:
Questionmark.com to schedule a testing appointment and for
Review this NMES For Dysphagia Handbook. completing a testing session. The notices also identify the time
period for which the test schedule and test window are valid.
Create an account on DysphagiaU.org, and then complete
the exam application. Applicants who do not have a valid email address should
contact the NDC Executive Office prior to application.
Submit application with all requested eligibility requirement
documentation. An approval Exam Authorization Letter (EAL) is generated by
the NDC after an application is reviewed and approved for
Complete and submit the exam application and pay using
eligibility. The notice is emailed to the candidate and contains
a major credit card (Visa, MasterCard), Check or E-Check.
proof of acceptance, a statement showing payment of the
The exam application is available in three versions; as an exam fee, allowed timeframe for you to schedule your test,
online form that can be completed on your computer, as a contact information to schedule a testing appointment with the
savable PDF that can be emailed, or as a paper application test proctoring agency B-Virtual as well as any additional
that can be printed and filled in by hand. information that may be of importance to the exam candidate.

The candidate may track the application review process on Application Approval
their DU account. The eligibility window begins on the date of
DU does not consider approval of an application until ALL the
payment for the exam.
required documents and a complete application are received. If
the application is incomplete or required documents are
Have with questions regarding the application, fees, or
eligibility? Please contact us at info@ndc.org. missing, DU will inform the candidate they will have up to 90
days to provide the missing information. Following the 90 days
the application is void. The exam fee is refunded minus the $50
Proof of Education application fee.
Acceptable forms of proof of education include a Certificate of
completion for the entire NMES Certificate education program. If an EAL, or request for additional information is not received
within 5 business days after submission of an application,
Applicants Acknowledgements applicants should look in their junk/trash email folders before
Agree to the NDC Standards of Conduct and policies and contacting the NDC office to investigate.
procedures. Exam candidates are required to sign a statement
as part of the exam application process to acknowledge their
understanding of and consequences for violations to the NDC Fees
Standards of Conduct and/or policies and procedures. Application and examination fees are due at the time of
scheduling.
Special Testing Accommodations Due to Disability The application fee of $50.00 is non-refundable. The
NDC will provide reasonable accommodations for test examination fee of $300.00 is refundable should your
candidates with disabilities that are covered under the application be denied or you do not attempt to schedule the
Americans with Disabilities Act (ADA), as amended. To exam within One year. Candidates must pay the fees in United
request special accommodations, submit the Special States dollars. The exam fee is valid for six months from the
Accommodations Request Form (available at date of payment and for only one examination session within
www.info@dysphagiau.org) by mail/fax within five business those six months.
days of applying online. Dysphagia University uses The fees, when completing the online or paper application form,
information submitted as part of a request for Special require payment with a major credit card or e-check payment
Accommodations only to make a determination regarding the (direct from a checking account). The NDC accepts MasterCard
need for special accommodations. DU does not share this and Visa. Credit cards are charged as soon as the secure credit
information. card payment processing is complete. See the FEE SCHEDULE
on page 7.
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 NMES Certification Handbook: From Application to Test Day

STEP 3 ACCEPTANCE Change of Plans?

Canceling/Rescheduling an Appointment
Authorization to Test Candidates may cancel an application and receive a refund
The candidate will receive their Exam Authorization Letter (EAL) via of the exam fee ($300). To receive a refund, candidates
email, which will provide information on how to schedule or change a must cancel their application with the NDC Executive Office
test appointment, including ID and password information. within six months of the date of payment of the initial exam
fee.
Making a Test Appointment/Planning for Test Day
Exam fees that are still pending and not used for a testing
On receipt of the notification the candidate will follow prompts to
session six months from the date of payment are forfeited by
complete these steps the candidate. The forfeited fees may not be refunded or
applied toward another examination.
1. Follow the provided link to B-Virtual.com and log in using the
provided username and password. There is no fee to reschedule or cancel a scheduled exam.
To cancel or reschedule, simply return to the link provided
2. Once completed, the candidate will be able to run a “system and click on the re-schedule tab, and choose a new day and
check” on their computer. time.

3. Scheduling is flexible. Choose a date and time. Failure to Test

If you fail to sign-in and take your exam on the scheduled
4. Once scheduled, you’ll receive a confirmation email including date and time without notice, you will not be eligible for a
your appointment details and a step by step guide of what you’ll refund. You may schedule a second attempt without a fee.
need to complete. To reschedule an exam after TWO no-shows, the candidate
will be required to pay full registration and test and fees
Plan for a three-hour exam session time. There are no ($350), however a new application will not be necessary if
scheduled breaks during the test session. within that calendar year. After that calendar year, revert to
Initial application process.

Extraordinary Circumstances
You do not need to have computer experience to The NDC considers a refund or transfer of fees for no-show
take a NDC Exam. Our proctoring partner, B-Virtual candidates if they make a request to NDC in writing within
20 days of the no-show date. The request must include an
will assist you with technical issues that may arise.
explanation and supporting documentation of the
You will use the computer mouse to point and click
extraordinary circumstances that lead to the no-show status
on the desired answer for test items.
Failure to Pass
The user has two attempts to pass the test. If the second
attempt is unsuccessful, the candidate must wait six (6)
months to reapply and take the test. The second attempt
must be completed within the initial six-month window.

FEE SCHEDULE Cost Refund Time

Application/ Exam fee $350 --- Expect response within 5 business days for application

Incomplete Application --- $300 After 90 days without receiving the requested additional information

Exam scheduled $0 ---- Must take exam within 6 months of date of Exam Acceptance Letter

Exam Never scheduled --- $0 After 6 months’ post Exam Acceptance Letter

Exam Reschedule $0 --- No limit in time between re-scheduled dates

Applies to candidates that applied, but not scheduled an exam within
Cancellation Refund --- $300
six (6) months
Exam (fail) Retest Fee $50 --- Retests must wait 5 days in between tests. Max 1 retest.

Refund for No-show --- $0 See above for Extraordinary Circumstances

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 NMES Certification Handbook: From Application to Test Day

STEP 4 EXAM DAY STEP 5 POST EXAM

Login to the ONLINE Exam and Check In Score Reports
➢ You should login to exam portal at your chosen exam start
time. If you have any technical difficulty or any other You will receive an official score report v i a e m a i l . You will
problems preventing you from logging in at your scheduled NOT receive a score report by mail. Your score report will
exam time, please call B-Virtual technical support at 877- indicate PASS/FAIL, and illustrate your performance in each of
238-0245. the test subject areas. Your score report will not include the
number or percentage of items answered correctly.
➢ Once logged in to the testing session the candidate will be
joined by the proctor to verify your ID and the testing Retain your score report for future reference. Successful
environment. candidates will need the information to prepare for certification
renewal. Failing candidates should use the information to identify
➢ Plan for a three-hour exam session time. There are no areas where additional study may be needed before retesting.
scheduled breaks during the test session.

What you’ll need to have on exam day

➢ One form of photo ID (i.e. driver’s license, passport, school
ID, etc.) to show to your proctor

➢ Your proctor needs to verify that you are the person who is
taking the test. They will check your photo ID to make sure
the picture in the photo and the name on your ID is correct.
We do not allow any non-photo IDs whatsoever.

➢ A reflective device such as a mirror or DVD to show your

proctor what is in front of you.

General Information
➢ Written notes, published materials and other testing aids are
strictly prohibited.
➢ You will need a working webcam, microphone and speakers.
(many laptops have this equipment built-in)
➢ You may not access any notes or electronic devices during the
exam, including cell phones.

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 NMES Certification Handbook
GENERAL INFORMATION

NDC Standards of Conduct

Candidates are required to be professional, civil and respectful at Candidates who do not agree to the terms of the confidentiality
all times while in the online test center. All exams are agreement will have their test session terminated. Candidates
continuously monitored by video and audio recording. The whose test session is terminated will not receive a refund of test
Proctor is authorized to dismiss you from the test session for a fees.
violation of any of the testing regulations. If you are found to have
violated any of the regulations during your exam, the Proctor is
required to notify Dysphagia University. Questionmark.com alone Applications
or in conjunction with Dysphagia University shall then take any • NDC adheres to all deadline dates, as published in this NMES
further action necessary to sanction your conduct, up to and Certification Handbook and on the NDC web site.
including invalidation of your test score and/or pursuit of civil or
criminal charges. • Incomplete applications will not be processed. Candidates
whose applications are incomplete will not be permitted to test,
Retesting
or have their renewal processed.
There is no limit on the number of times a candidate may take an
NDC examination. However, candidates who do not pass the
examination after two attempts are required to wait a minimum of Cancellation of Test Results
6 months before retaking the examination and pay a $50 re-test NDC reserves the right to cancel the score of any candidate who
fee. violates the Candidate Rules or to cancel scores resulting from any
testing irregularity.
Confidentiality of Exam Content/Systems
The computer-based test delivery system, tutorial, exam Nondiscrimination
content, are the unpublished, confidential, and proprietary Dysphagia University and the NDC Commission do not
materials of QuestionMark and/or Dysphagia University. discriminate against candidates based on age, gender, ethnic
Communicating, publishing, reproducing, or transmitting any origin, religion, race, disability, marital status, or sexual
part of an exam, in any form or by any means (e.g. verbal, orientation.
electronic, written, etc.) for any purpose is strictly prohibited.
ANY reproduction or disclosure will result in the immediate Release of Information
filing of civil and/or criminal charges against you and anyone Names of providers holding current NDC certifications shall be
directing or conspiring with you. available to the public upon written request.

B-Virtual will secure your computer during the exam, it cannot Confidential information that will not be released includes names
access your computer files without your knowledge. With of candidates for certification; names of nurses who fail the
permission from the test taker, proctors have the ability to examination; and individual test scores. NDC will discuss an
view the screen and move the mouse and keyboard as if he individual candidate’s certification-related issues only with the
or she were sitting next to the test taker. Once the test starts, candidate.
the proctor will monitor everything but can no longer move the
test taker's mouse and keyboard. During the entire process, a DU and NDC does not sell or rent email addresses of applicants.
chat box is running on the test taker’s computer, and they can
see what permissions the proctor currently has at any time. Verification of Certification
The entire chat session log is saved, and there is a DU provides a free, online service for immediate credential
permanent record of what actions the proctor took while verification.
accessing the test taker's computer.
Review and Appeals Process
Confidentiality of NDC Examinations (Non-Disclosure) A review and appeals process is available to individuals seeking
Before the test session begins, candidates will be presented with an amendment of a decision regarding eligibility for certification,
the following Confidentiality Agreement regarding test content. failure of the examination, sanction or revocation of certification.
This examination and the test questions contained herein are the Requests for review must be sent in writing to Mark Toof,
exclusive property of Dysphagia University. This examination and Program Director of Dysphagia University, 77 Bay Bridge Rd,
the items (questions) contained herein are protected by copyright Gulf Breeze, FL, 32561,. NDC will provide a written response to
law. No part of this examination may be copied or reproduced in the request for review. Candidates may appeal the decision of
part or whole by any means, whatsoever, including the review. Candidates may request a copy of the Dysphagia
memorization. Future discussion or disclosure of the contents of University appeal process.
this examination orally, in writing, or by any other means is
prohibited. Your participation in any irregularity occurring during
this examination, such as giving or obtaining unauthorized aid, as
evidenced by observation or subsequent analysis may result in
termination of your participation, invalidation of the results of the
examination, or other appropriate action.

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 NMES Certification Handbook
RENEWAL OF NDC CERTIFICATION
❖ Certification renewal is due every three years.

❖ It is the candidate’s responsibility to apply for renewal of Contact Dysphagia University at:
certification by the required application deadline date as
posted at www.DysphagiaU.org. Although NDC Email: info@dysphagiau.org
attempts to provide candidates with multiple renewal
notices, failure to receive a renewal notice does not
relieve the candidate of the responsibility to apply for Phone: 888-504-GoDU (4638)
renewal prior to the application deadline date.

❖ Those who do not renew their certification by the 3 year

deadline may not continue to use the certification
credential

❖ Those who do not renew their certification within the

calendar year of its expiration, will be considered initial
candidates, and must meet the eligibility criteria for initial
certification should they apply to become certified in
subsequent years.

❖ Can submit within 60 days of the expiration date. The

term to continue from the end date of the prior term.

By meeting the standards below, candidates demonstrate

that they continue to apply the highest level of ethical
standards in their practice. The expectation is that these
renewing applicants demonstrate advanced clinical and
professional skills. Only applicants who achieve high
standards of excellence, display professionalism, are
committed to continuous advanced learning, and display
clinical skills and characteristics that reflect achievements
above and beyond the standard practice are approved to
renew.

❖ Good standing w/ professional boards.

❖ Agree to abide by practice standards and code of

conduct (ASHA, AOTA or similar).

❖ 150 hours treating w NMES-D within 3 years prior to

renewal.

❖ 15 hours continuing education within 3 years prior to

renewal on the topic of dysphagia (by an approved
ASHA and/or AOTA provider) (teaching or attending).

❖ 5 hours continuing education within 3 years prior to

renewal on the topic of NMES for dysphagia (approved
by a professional board or provided by an approved
provider of a professional board; can be a PT, OT or SLP
modalities course) (teaching or attending).

RECERTIFICATION
Cost Refund Time
Can submit within 60 days prior to the expiration date. Term to
Recertification Application $125 ---
continue from the end date of the prior term.
Late Recertification Application $75 --- From expiration to 60 days late.

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