Christine Cayo, OTR/L, C/NDT


Chris is an occupational therapist (OT) with over 35 years of experience and a pediatric OT instructor for the NDTA. She currently works at Children’s Hospital of Wisconsin, two days in the outpatient department and two days in the cardiac intensive care unit with children ages 2 and under. Working at a hospital with a large variety of departments allows Chris to encounter many therapists of varying backgrounds. At the Children’s Hospital, some of her coworkers are NDT trained and others have taken NDT courses. Other therapists have backgrounds in pain management, cranial sacral therapy, myofascial release, and orthopedics. Some of the therapists refer to themselves as generalists. Chris states, “I am always amazed at how much they know about so many different diagnoses that I have never heard of.” She has developed an appreciation for working with therapists who have a variety of skill sets, as there are so many ways to approach practice.  

Chris developed her interest in NDT at her first job as an occupational therapist where she worked at a nursing home with a physical therapist who had been trained by the Bobaths. “She taught me a lot, as we had the opportunity to work together often.” In her next job, she worked with a child who was diagnosed with spastic quadriplegia, and her colleagues suggested that she may benefit from an NDT course. She realized they were right and applied for the Milwaukee course and was accepted. Chris took her certificate course from March to May of 1985. Chris was later encouraged by Regi Boehme and Barbara Cupps to become an instructor. “I decided to do this after having a conversation with Lezlie Adler at one of her short courses. She said that if I love to learn I should work on becoming an instructor. That is what sold me, I love to learn, always have - still do. Being an instructor equals constant learning.”

Being an OT instructor provides Chris with this opportunity to continually learn “from researching and writing up lectures, breaking down treatment to try to figure out best ways to share information, attending conferences, learning from therapists who take the courses, the group brainstorming, meeting the amazing children and families who take their valuable time to participate in courses, and working with so many other instructors who are passionate about the work they do.” 

Chris encourages other occupational therapists to become NDT trained. She states, “For me it was a necessity. I truly did not know how to treat children diagnosed with cerebral palsy. After I took the course, I had tools to problem solve and handling skills to develop. The assessment skills, the information of typical motor development, the team approach, and the treatment strategies helped me gain confidence in my ability to provide intervention that was meaningful to the children and families that I worked with.

Some of the tools Chris learned and still uses are related to neuroplasticity. “Neuroplasticity makes a lot of sense. It offers us information that helps us structure treatment - how we can be more effective. I’m excited to learn more about critical periods in development and critical windows of opportunity in rehabilitation.”  She recently read an article that she highly recommends: Kolb B, Harker A, Gibb R. Principles of plasticity in the developing brain. Dev Med Child Neurol. 2017;59:1218-1223. It discusses developmental plasticity, reviews animal and human research regarding sensation, movement, language and cognition, and poverty. It also briefly addresses the potential impact of prenatal, perinatal, and postnatal stress, attachment, gut bacteria, and the immune system to the developing brain.

In addition to being a dynamic OT, instructor, and mentor, Chris spends a significant amount of time volunteering for NDTA.  “We don’t just instruct. We all work with children and adults, as we have a requirement to provide treatment hours as well as teaching hours.” She has been very actively involved in Curriculum Committee, the NDT Definition Group, the Implementation Committee co-chaired with Pam Ward, and the Reliability Project. Implementation and reliability committees strive to create more flexibility in scheduling the basic certificate courses while ensuring that performance evaluation of course participants is consistent across courses.

Chris can be reached at





NDTA™ Neuro-Developmental Treatment Association 

1540 S. Coast Highway, Ste 204
Laguna Beach, CA 92651 

Phone: 800-869-9295 Fax: 949-376-3456