VitalStim® Therapy and Beyond: DINES Specialty Certificate Program

"FIRST FIVE" - The first 5 paid registrations at each course gets $100 off the early price of $795! Be sure to register today so you don't miss out!

This is an ADULT FOCUSED COURSE. Click HERE for Pediatric Focus.



Welcome to the UPDATED VitalStim Therapy course!
The VitalStim Certificate Program was introduced to the professional dysphagia community in 2003 as the competency course for the only FDA-cleared NMES device for dysphagia treatment. The program, then known as the VitalStim Certification Program, revolutionized dysphagia therapy! The popular course has gone through multiple revisions since its inception, incorporating the latest findings from the research and clinical communities. This new course update is the most significant to date. It is the result of several converging trends in the field of NMES for dysphagia treatment. The new content reflects significant growth of scientific research, an increase in available treatment protocols and an expansion of available equipment options.

Course Description
VitalStim Therapy and Beyond: DINES (Dynamic Integration of NMES and Exercise for Swallowing) This accredited hands-on competency course will focus on the muscle physiology, kinesiology, and pathology of the normal and abnormal swallowing mechanisms. The principles of NMES will be taught in tandem with active dysphagia exercise therapy. NMES for Dysphagia protocols, using FDA cleared devices, will be covered against the backdrop of neurophysiology of the swallowing mechanism and available research. Adjustments to NMES parameters - frequency, phase duration, duty cycle, and more - will be incorporated in specific treatment protocols and extensively practiced in hands-on lab sessions. Cases will be evaluated using the impairment model (pathology; symptoms; signs; dysfunctions; and impairments) and treatment planning will be practiced.

Participants will receive one-on-one attention from two experienced instructors, a dysphagia expert and an electrical stimulation expert. Instructors will deliver relevant information on FDA clearance and clinical options relevant to different equipment options available today to better equip clinicians in the ever-changing world of NMES for dysphagia.

Participants who successfully complete this course will leave as a skilled VitalStim Provider and DINES Provider with the confidence and building blocks needed to implement a successful NMES for dysphagia therapy program.

"I learned more about dysphagia in this course than I did in all of grad school!"

Conflict of Interest
None. This is the only NMES for Dysphagia training course not affiliated with the sale of any equipment or electrode. The content and administration of this course is wholly independent of any manufacturer.

Provider Benefits
This is an intermediate level course. Requirements for the course are as follows: DINES Specialty recognition will be awarded to those who: NOTE: If these criteria are not met at the course, additional opportunities to successfully complete the process will be available.

Use of Certificate and Title
Participants who successfully complete this course will hold a Specialty Certificate in VitalStim/DINES Therapy and receive the title VitalStim/DINES Provider. This title may be used in signature lines. Certificate holders should not refer to themselves as being “certified” nor add acronyms to their name as a result of the Specialty Certificate. Providers who wish to receive the letters NDC (Neuromuscular Electrical Stimulation for Dysphagia Certified) behind their name must pass the national exam. Dysphagia University

Rescinding the Certificate:
CIAO maintains the right to rescind or nullify the Specialty Certificate and VitalStim Provider status in the event the Provider has violated program requirements, policies, or professional board ethics related to the VitalStim Specialty Program.

CIAO offers the VitalStim Specialty course for two populations (adult and pediatric). Either course may be taken to become a VitalStim Provider. VitalStim Providers may treat either or both populations.


VitalStim Therapy and Beyond is now a Specialty Certificate Program!
This program is the only accredited NMES for Dysphagia program. After successful completion of this program, participants receive their Specialty Certificate as a specialist in the use of NMES for the treatment of dysphagia. On April 3, 2015, the Institute for Credentialing Excellence (ICE) granted accreditation to CIAO Seminars' VitalStim Therapy Specialty Program for demonstrating compliance with ICE 1100 - Standard for Assessment-Based Certificate Programs. ICE 1100 was first published in January 2009 to ensure that assessment-based certificate programs adhere to modern standards of practice for the credentialing industry. More information about ICE is available online at www.credentialingexcellence.org.

Renewal Options (Maintain your Specialty Certificate by completing a renewal course once every 3 years)

Live Renewal
Attend the live 2 day VitalStim course again (no online MBS required for renewal)
16 hrs. of continuing education credit will be awarded for successful completion of course.
Entire live course is required for this option.
Register above by selecting the date/city and clicking register.
Choose the price option labeled "Renewal (no online MBS course required)"

Online Renewal
8.5 hrs. of continuing education credit will be awarded for successful completion of course.
Activate course within 6 months of purchase
30 days to complete once activated

The VitalStim® Therapy and Beyond: DINES Specialty Certificate Program includes the online course, MBS: The Clear Picture (12hrs) and the two day hands-on "VitalStim® Therapy and Beyond: DINES Specialty Certificate Program" (16hrs) for a total of 28 hours of continuing education credit.

Do you have access to the VitalStim Plus device? The renewal alone does not satisfy the requirements to use the full components of the advanced VitalStim Plus device.  There is separate VitalStim Plus course to cover the additional functions and features that needs to be completed to protect your license. The advanced course covers sEMG, biofeedback, the additional channels, how to use the Bluetooth capability, and more.

VitalStim is a registered trademark of VitalStim, LLC.
VitalStim Therapy and Beyond: DINES Specialty Certificate Program© CIAO Seminars

AOTA Classification Codes
Domain of OT: Client Factors, Context Environment
OT Process: Intervention
Vital Stim, VitalStim, Vital Stem, VitalStim Certification, Vitastim, NMES for Dysphagia, ESwallow, Guardian, Tim Carrigan

Course Objectives

Upon successful completion of this course, participants will be able to:


Course Instructor(s)


Yorick Wijting

PT, DPT

Yorick received his Physical Therapy degree in the Netherlands and his DPT at the University of St. Augustine, Florida. He has extensive training and practical experience in biophysical agents and teaches nationally and internationally to medical professionals on their therapeutic use. Yorick has been instrumental in developing the use of electrical stimulation by Speech Language Pathologists in the treatment of dysphagia. Yorick currently lives in California and runs his private practice in Gilroy, CA.

Financial Disclosure: Yorick receives honoraria from CIAO Seminars for the presentation of his live course(s) and royalties for the sale of his recorded course(s). Yorick is the author and an instructor for the VitalStim Therapy Specialty Program.
Non-Financial Disclosure: no relevant relationships exist


Jen Carter

M.Ed. CCC-SLP, BCS-S

Jen is a medically-based speech pathologist with 24 years of experience evaluating and treating dysphagia and is a board certified specialist in swallowing and swallowing disorders. She currently lives in Denver and has a private practice, the Carter Swallowing Center, solely focused on dysphagia. She frequently presents at the local, state, and national level on the topic of swallowing treatment. When she’s not working, Jen enjoys hiking and backpacking in Colorado.

Financial Disclosure: Jen receives honoraria from CIAO Seminars for the presentation of her live courses and royalties for the purchase of her recorded course(s).
Non-Financial Disclosure: Jen uses VitalStim Therapy in her practice.



Jodie Dacy

M.S. CCC-SLP, NDC

Jodie graduated from Nova Southeastern University in Fort Lauderdale, FL with a Master of Science degree in Communication Disorders. She has been a practicing speech language pathologist since 1995 with extensive experience in the private sector, school settings and clinical experience in hospital settings which include long term care and outpatient rehab. Jodie became a VitalStim® Provider in 2005. Since then she has utilized this modality in the treatment of dysphagia with both her pediatric and adult patients. Jodie is also a licensed NOMAS® practitioner and certified in NDC (NMES for Dysphagia), MDTP (McNeil Dysphagia Therapy Program) and Myofascial Release. She has presented locally and nationally on various topics such as Best Practices, The Benefits of Oral Motor/Feeding Therapy on Articulation/Speech Clarity amongst others. Currently, Jodie serves the Speech Language Pathology profession as a therapist at Val Verde Regional Hospital in TX and as a certified instructor of the VitalStim® Therapy and DINES Specialty Certificate Program for CIAO Seminars.

Financial Disclosure: Jodie receives honoraria from CIAO Seminars for the presentation of this course. She also receives royalties for the purchase of her recorded course(s)
Non-Financial Disclosure: Jodie uses VitalStim Therapy in her practice.


Julie DeVahl

PT, DPT, OCS

Julie DeVahl, PT, DPT, OCS was an Associate Professor and Director of Clinical Education in the Physical Therapy Department at the University of Texas Southwestern Medical Center in Dallas, TX from 2002 until she retired Dec 2022. A physical therapist since 1979, Julie brought her experience with electrical stimulation in clinical practice to the classroom. In addition to teaching, she maintained a clinical practice, working primarily with patients with temporomandibular dysfunction and facial paralysis. Julie is board-certified in orthopaedic physical therapy and an active member of the APTA and TPTA. She has been an instructor for CIAO since 2003 and adds an inviting style of teaching to the VitalStim Therapy Specialty Program. “I see my role as an instructor to enable the SLPs and OTs to feel as comfortable using electrical stimulation as they do giving verbal instructions for swallowing.”

Financial Disclosure: Julie receives honoraria from CIAO Seminars for the presentation of this course. She also receives royalties for the purchase of her recorded course(s)
Non-Financial Disclosure: No relevant disclosures.



Denise Dougherty

MA, CCC-SLP

Denise Dougherty, MA, CCC-SLP
Denise owns and operates a private practice in Indiana, PA, where she conducts therapy with both children and adults. She is a legal consultant/expert witness in wrongful death/negligence lawsuits involving dysphagia. Denise is a co-editor of Private Practice Essentials: A Practical Guide for Speech-Language Pathologists, published by ASHA Press. She has presented workshops and written numerous articles appearing in the ASHA Leader on the topic of private practice. Denise served as a consultant for The Arijah Children’s Foundation in Anguilla, BWI, providing evaluations and therapy programs for special needs children. Ms. Dougherty was an adjunct faculty member at York College of Pennsylvania and Wesley College in Dover, Delaware. She is a past President of the American Academy of Private Practice in Speech Pathology and Audiology (AAPPSPA), and received the Academy’s 2007 Honor Award and 2014 Award of Excellence for her achievements. Ms. Dougherty is a member of the Technical Experts Panel for Quality of Insights of Pennsylvania, working on initiating quality measures for CMS to improve effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. She received her bachelor’s degree in communication disorders from Marywood University in Scranton, Pennsylvania; a master’s degree in communication disorders from St. Louis University. Ms. Dougherty is certified in VitalStim® therapy and is a VitalStim® instructor, has completed additional training in orofacial myology, is a member of the American Speech, Language and Hearing Association and has received numerous ASHA ACE Awards. For more information, please visit www.dldspeechpath.com.

Financial Disclosure Denise receives honoraria from CIAO for the presentation of her live courses and royalties for the sale of her online courses. Denise is in private practice and receives legal consultant/expert witness fees
Non-Financial Disclosure: There are no non-financial relationships to disclose.


Joe Gallo

DSc, ATC, PT

Dr. Joe Gallo earned his BS in Physical Education and Athletic Training and his Master’s in Physical Therapy. He also holds a Doctor of Science degree in Physical Therapy. He currently serves as Director and Professor in the Salem State University Athletic Training Program. He also held faculty appointments in various physical therapy and physical therapist assistant programs in his over 20 year career as an educator. Dr. Gallo is currently a Certified Instructor for the VitalStim® Therapy Specialty Program teaching NMES for the treatment of dysphagia. He has taught over 300 continuing education workshops to rehabilitation specialists across the United States. Joe’s research on electrophysical agents has been published in the Journal of Orthopaedic and Sports Physical Therapy, and the Chinese journal of Sportsmedicine. In addition to his teaching and research, Joe has also maintained clinical practice in a variety of settings throughout his career.

Financial Disclosures: Dr. Gallo receives an honorarium for speaking/teaching live courses through CIAO Seminars. He also receives royalties for the purchase of his recorded courses and the purchase of his Ultrasound book.
Non-Financial Disclosures: Dr. Gallo uses modalities in his clinical practice.



Gina Gallo

M.S. CCC-SLP, NDC

Gina E. Gallo was educated at the University of Rhode Island where she received her B.S. in Communication Disorders and her M.S. in Speech-Language Pathology. Gina has worked as a medical Speech-Language Pathologist since 1998 across various levels of care, concentrating in swallowing and voice disorders. She is a Certified VitalStim Instructor and uses Neuromuscular Electrical Stimulation in her clinical practice at Spaulding Outpatient Center. Gina recently became one of the first SLPs to earn the NDC credential (NMES for Dysphagia Certified). She has worked extensively with patients diagnosed with head and neck cancer, and previously served on Head and Neck Tumor Board at Rhode Island Hospital. She has also served as a guest lecturer for the Southern New England Rehab Center annual conference, and as Adjunct Faculty at the University of Rhode Island in the area of Voice Disorders.

Financial Disclosure: Gina receives honoraria from CIAO Seminars for the presentation of this course. She also receives royalties for the purchase of her recorded course(s)
Non-Financial Disclosure: Gina uses VitalStim Therapy in her practice.


Penny Head

PT, PhD, SCS, ATC

Penny Head is an ABPTS Board Certified Specialist in sports physical therapy and an NATABOC Certified Athletic Trainer. With over 17 years’ experience Penny is currently the Clinical Director of Sports Medicine at Baptist Rehab Hospital in Tennessee. She has also worked as a Sports Medicine Coordinator and Director of Physical Therapy in a clinical setting. Penny is currently a guest lecturer and lab instructor at the University of Tennessee, her alma mater. Penny is also currently a Certified Instructor for the VitalStim® Certification Course teaching NMES for the treatment of dysphagia. She has served as Certified Athletic Trainer, Team Physical Therapist and Rehab Consultant to several athletic programs including the Memphis Redbirds. Penny is a member of APTA, Tennessee PT Association, and Tennessee Athletic Trainers Association.

Financial Disclosure: Penny receives honoraria from CIAO Seminars for the presentation of this course. She also receives royalties for the purchase of her recorded course(s)
Non-Financial Disclosure: No relevant relationships



Tom Holland

PhD, PT

Dr. Tom Holland received his physical therapy education and his PhD degree from the Physical Therapy Program of NYU. He is an Assistant Professor at the City University of New York - Hunter College/Program in Physical Therapy. In addition, he is an Adjunct Instructor at New York University, Columbia University, and Dominican College. His practice includes per diem work at Kessler Institute (Saddle Brook NJ). Tom's physical therapist practice and specialty areas include physical modalities and kinesiology. Tom has been a Certified VitalStim Instructor since 2002 and has co-taught dozens of VitalStim Certification Courses across the country.

Financial Disclosure: Tom receives honoraria from CIAO Seminars for the presentation of this course. He also receives royalties for the purchase of his recorded course(s)
Non-Financial Disclosure: no relevant relationships


John Kelly

M.P.T.

A graduate of the University of St. Augustine’s graduate Physical Therapy Program. John has over 17 years’ experience with acute inpatient and hospital-based outpatient rehabilitation and currently an outpatient clinical director for Siskin Rehabilitation Hospital in Chattanooga, Tennessee. John continues to balance full time patient care with administrative responsibilities. John is NDT certified and an experienced manual orthopedic therapist working toward his clinical doctorate and manual therapy certification. John is a certified VitalStim® Instructor and has taught orthopaedic and electrotherapy courses across the country. John is an accomplished clinical instructor and consistently is recognized for his exceptional patient rapport and strong evaluations from course participants.

Financial Disclosure: John is a salaried employee for his position at Siskin Rehabilitation Hospital. John Kelly receives honoraria from CIAO Seminars for the presentation of his live courses. He also receives royalties for the purchase of his recorded course(s)
Non-financial Disclosure: No relevant non-financial relationship exists.



Karin Mitchell

M.A. CCC-SLP

Karin Mitchell is a worldwide respected Speech Language Pathologist specializing in the care and treatment of pediatric feeding and swallowing, developmental care of the medically fragile infant and child, and pediatric traumatic brain injury. Her love of teaching and helping others drives her to create and deliver fun and empowering continuing education courses across the nation and internationally. Areas covered are Developmental Care in the NICU, Cue Based Feeding, pediatric feeding and swallowing analysis and treatment, including the use of VitalStim, swallow studies, enhancing decision making and clinical analysis, breast feeding the medically fragile infant and child, and developmental milestones supporting feeding skill acquisition. Beginning her practice in 1995, Karin sought out learning opportunities and creative ways to teach others. She now serves as a lead therapist for the NICU and Feeding Teams at CHOC Children’s Hospital in Orange, CA. With a clinical practice formed by a strong theory base in NDT and SI therapies, Karin is also NOMAS trained and VitalStim certified. She provides ongoing education in-services and hands-on labs for appropriate developmental care, positioning, handling, and feeding skills for clinical staff including medical residents, nurses, physical therapists, occupational therapists, and speech pathologists. Karin was a key player in the development of unit protocols and care plans for evidence-based developmental care in the highly specialized Small Baby Unit (ELBW) at CHOC which includes an ongoing education series required by all medical and support personnel. She is an active committee member for multiple qualities of care committees including Skin to Skin Care, Developmental Care, Infant Driven Feeds, Breast Feeding Coalition, Palliative Care, Neuro NICU Team, Trauma Team, and Family Centered Care. A dedicated leader, Karin devotes much of her time to the support and development of clinicians, serving as a mentor committed to building therapist's skills in clinical analysis and therapeutic effectiveness with medically fragile patients. She is a strong advocate for her patients and their families and speaks at local associations, community centers, local universities, and school districts to support medically fragile infants and children.

Financial Disclosure: Karin receives an honorarium from CIAO for the presentation of this course. She also receives royalties for the purchase of her recorded course(s)
Non-financial Disclosure: Karin uses VitalStim in her clinical practice.


Jon Rose

MS, PT, SCS, ATC

Jon received his Master of Science from Eastern Illinois University in 1992 and his Certificate of Physical Therapy from Ohio State in 1997. Jon currently holds an academic appointment as an Assistant Professor at the University of Tennessee Health Science Center in Memphis, TN. He teaches courses in anatomy, pathology, orthopedics, and sports medicine. He continues to treat patients and conduct research at Campbell Clinic. He is pursuing a Ph.D. in educational research at the University of Memphis. Formerly the director of rehabilitation for Samaritan Regional Health System in Ashland, Ohio, Jon has also worked as the Director of Physical Therapy and Sports Medicine Coordinator for Campbell Clinic in Memphis, TN. Jon is currently a Certified Instructor for the VitalStim® Certification Course teaching NMES for the treatment of dysphagia. Jon’s professional appointments include Team Physical Therapist and Rehab Consultant for several semi-professional and professional sports teams. He is an NATABOC certified Athletic Trainer and a member of the APTA, Ohio PT Association, and Tennessee Athletic Trainers Association.

Financial Disclosure: Jon receives honoraria from CIAO Seminars for the presentation of this course. He also receives royalties for the purchase of his recorded course(s).
Non-financial Disclosure: There are no financial relationships to disclose.



Kelly Salmon

SLPD, CCC-SLP, BCS-S, CLT-LANA, NDC

Kelly is a speech-language pathologist (SLP) specializing in the treatment of adults with communication and swallowing disorders across the continuum of care. She has been a Board Certified Specialist in Swallowing and Swallowing Disorders (BCS-S) since 2011 and is one of the only SLPs in the U.S. to earn designation in 2014 as a Lymphology Association of North America Certified Lymphedema Therapist (CLT-LANA) specializing in the treatment of head and neck lymphedema. Over the past several years of her career, Kelly has focused on becoming an expert in the treatment of swallowing disorders resulting from many medical conditions including head and neck cancer, stroke, and progressive disease and recently became one of the first SLPs to earn the NDC credential (NMES for dysphagia certified). She also works with individuals following total laryngectomy to rehabilitate and restore communication and swallowing function. Kelly was awarded her bachelors degree in speech pathology and audiology at Stockton University in New Jersey, her masters degree in speech pathology at New York University, and is currently completing her clinical doctorate in speech pathology at Nova Southeastern University. Kelly takes pride in contributing to the field of speech-language pathology through teaching a graduate-level dysphagia course at Temple University in Philadelphia, supervising speech-pathology students, presenting posters and lectures at national conferences, publishing articles on various topics related to swallowing and communication disorders, and engaging in multidisciplinary research initiatives. She is currently in the process of completing a clinical research study examining swallowing-related outcomes for individuals undergoing specialized robotic surgery for head and neck cancer. Kelly works in an otolaryngology practice at a large academic medical center in Philadelphia, PA and is dedicated to providing the highest level of evidence-based care for all of her patients.

Financial Disclosure: Kelly receives honoraria from CIAO Seminars for the presentation of this course. She also receives royalties for the purchase of her recorded course(s)
Non-Financial Disclosure: Kelly uses VitalStim Therapy in her practice.


Course Agenda

Day 1

07:30 - 08:00
Registration (snack/refreshments provided)
08:00 - 08:15
Introduction, program overview, objectives
08:15 - 08:45
Physiology, anatomy, neurology review
08:45 - 10:00
Palpation of head and neck structures (lab)
10:00 - 10:15
Break
10:15 - 12:00
Exercise and Dysphagia
12:00 - 01:00
Lunch (on your own)
01:00 - 02:30
Electrical stimulation: theory & lab demonstration
02:30 - 02:45
Break
02:45 - 05:30
Electrical stimulation: theory & lab demonstration continued
05:30 - 06:30
Written Exam

Day 2

07:00 - 07:30
Sign-In (snack/refreshments provided)
07:30 - 08:00
Review of material day 1, Q&A
08:00 - 08:30
Exam review and scoring
08:30 - 10:00
NMES protocols (lab)
10:00 - 10:15
Break
10:15 - 11:30
NMES protocols (lab) continued
11:30 - 12:30
Lunch (on your own)
12:30 - 03:15
Integration: case studies, problem solving
03:15 - 03:30
Resource Network for Registered Providers
03:30 - 03:45
Q & A

Contact hours pre-approved for:

  • 16 Hours
  • CIAO is an Approved Provider for ASHA #AAWA (1.6 ASHA CEUs)
  • CIAO is an Approved Provider for AOTA #4119 (1.6 AOTA CEUs)
  • This course meets PDU requirements for NBCOT (20 PDUs Clinical Lab Assessment)
  • ASHA CE Provider Approval and use of the Brand Block does not imply endorsement of course content, specific products, or clinical procedures.
  • CIAO is authorized by IACET to offer 1.6 CEUs for this program
  • As an IACET Accredited Provider, CIAO offers CEUs for its programs that qualify under the ANSI/IACET Standard
  • This course is approved by the CA Board of OT for Advanced Practice
  • - 11.25 hrs Physical Agent Modalities CABOT#25-P4
  • - 7.0 hrs Swallowing CABOT#25-S1
  • 16 hrs. OTs in FL (CE Broker #20-515988)

Course meets requirements for:

  • OT/COTAs in AL, AZ, AK, AR, CA, CO, CT, DE, DC, GA, HI, ID, IL, IN, IA, LA, KS, KY, ME, MD, MA, MI, MN, MS, MO, MT,
  • OT/COTAs in NE, NV, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY


  • CIAO is recognized on the NBCOT Provider Registry (meets PDU requirements for NBCOT)



    The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.



    CIAO is accredited by the International Association for Continuing Education and Training (IACET). CIAO complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, CIAO is accredited to issue the IACET CEU.




    CIAO Automatically reports to CE Broker for Florida Occupational and Physical Therapists and Assistants. Florida SLPs can either use the ASHA CE Participant Form (Bubble Sheet) or self-submit through CE Broker.



    This course is offered for 1.6 ASHA CEUs (Intermediate level, Professional area)..