Our Standards

Whether you are a provider exploring this work or a parent trying to make sense of it, you deserve three answers before you go any further: what NeuralFORM actually claims, how a provider is trained to deliver it, and where the evidence stops.
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Those are fair questions, and we are glad you are asking them. Here are our answers, as plainly as we can give them.
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As providers and educators, we came to an uncomfortable realization: we, too, had filled gaps in our understanding with what we had been taught and told, even where it was not completely accurate. We believed those answers because that is how they were handed to us.
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This is where NeuralFORM was born.
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NeuralFORM is here to help all of us "buy a vowel," both in how a swallow develops and in how we think about it, so that when we have to make a guess, it is a more educated one.
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NeuralFORM looks at oral and airway function through six connected systems: structure, muscle function, fascial restriction, the oral–brainstem input circuit (cranial nerves V, VII, IX, X and XII), autonomic regulation, and cellular vitality.
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It grew out of something we saw again and again in practice: patients who did everything right, with good structural and myofunctional care, and still did not fully recover. Rather than look for someone to blame, we looked deeper.
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The six systems are how we organize assessment and treatment planning. They are not a claim that each one has been proven on its own. Some rest on primary research; others rest on anatomy, mechanism and clinical observation. Our references tell you which is which.
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NeuralFORM therapies are designed to support improvements in functional capacity and to create a better environment for the body to do its own healing. They do not claim to cure anything.
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Every NeuralFORM assessment has a name, a sequence and a scoring method, and every provider learns them the same way. That consistency is what lets one provider's findings mean the same thing as another's.
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• POST-IT — done at the start of every key visit (initial assessment, insertion, each adjustment or titration, and final records), before anything else happens.
• STOP — a subjective test of pain, scored on a three-level scale at set palpation sites.
• SWITCH — a four-step sequence within one visit, on both sides, with teeth apart and teeth together, before and after an intervention.
• Starfish — identifies retained primitive reflexes.
• ACORN — our infant assessment.
• CARE (Careful Assessment, Restriction Evaluation) — the thinking that ties it all together. First we look at the patient's function; then at the restriction itself, and whether it is likely to change. Densification responds; mature adhesion does not.
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Before any structural change begins, we read each patient's physiology a little like a stoplight:
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• Red — the body's signals say "not yet." Structural change waits.
• Yellow — we move forward with care, supported by the appliance or therapies.
• Green — the patient's neurophysiology is ready for swallow conversion and neurologic integration.
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We do not publish the full technique. It is learned through the hands, not from a page, and written instructions invite people to teach themselves without anyone there to check their hands. That is a deliberate choice, and one we are comfortable standing behind.
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There are two pathways, and providers who complete both hold a combined credential.
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Pathway One — Dental Device Therapy. The ALF Evolution course: hands-on, 21 AGD PACE credit hours, for providers with an active dental license. Ten documented cases for Certified, twenty-five for Advanced Certified. The examination is given online with independent proctoring.
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Pathway Two — Laser-Assisted Neuromodulation. The RestOralase course: 22 AGD PACE credit hours, or 28 with the BabyLase modules, preceded by a required virtual session that covers the didactic content, so our time together in person goes to hands-on work and live patient assessment. OraLase is the foundation, RestOralase the advanced application, and BabyLase the infant application for ages 0 to 2, offered as a rider with its own examination and ten documented infant cases. Ten documented cases for Certified, fifty for Advanced Certified. Open to dental, medical, physical therapy, chiropractic and speech-language pathology licensees where state scope permits Class 4 non-ablative laser therapy. Documented laser safety training and access to a qualifying platform are required.
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Dual Certification is recognized for providers who hold both, with no separate course or examination.
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Advanced Certified requires two years at Certified. Certification is current for two years; renewal requires ten hours of relevant continuing education and confirmation of active licensure.
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Trained somewhere else? You are welcome here. You will enter the same sequence as everyone else, and documented prior training plus the examination and cases is a recognized route.
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One thing we want to be clear about: this is a training credential. It is not specialty recognition, it is not board certification, and it is never a substitute for licensure. We say that on the pathways page too, because being clear matters more to us than sounding impressive.
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Instructors are appointed per pathway and per course, after holding Advanced Certified for a year and working through a sequence of observing, assisting, co-teaching, and teaching under observation.
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There are two lines we do not cross: instructors cannot confer certification, and instructors cannot appoint other instructors. All faculty also complete annual calibration on STOP, SWITCH and ACORN scoring.
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We built it this way on purpose. A method stays true to itself when everyone who teaches it comes through the same door.
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Every reference we publish is labeled with its publication type (primary study, review, hypothesis paper, animal study, case report or simulation) so you never have to open a paper just to find out it is a review.
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A few specific limits we hold ourselves to:
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• Cranial suture mechanobiology describes the force ranges that light-wire, cyclic appliances are designed to work within. On its own, it does not show what any particular appliance delivers. Measuring that is part of our research agenda, not something we claim ahead of time.
• Translingual neurostimulation research shows that input at the tongue reaches the brainstem and can produce measurable change elsewhere in the body. That research uses electrical stimulation, measures gait and balance rather than oral function, and pairs the device with structured exercise. A different device. The same nerve. We cite it for the principle, never as an equivalent.
• The published research on photobiomodulation in newborns and children is small, was not done at the wavelength we use, and measured wound healing rather than neurological or functional outcomes. What it does show is that this kind of therapy has been used in small clinical series without reported adverse events. That is the absence of a safety signal, not a claim that it works, and we do not make one.
• Expansion with an ALF is real, and with thoughtful case selection and design, results in growing children can be excellent. What is different from conventional expansion is how it happens: the appliance lets the natural forces of the swallow do the work. That means expansion depends on swallow function. In older patients, or when the swallow is compromised, it should never be promised, and we do not teach it that way.
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A framework that cannot be wrong is not really a framework. So here are two of our positions, stated as predictions, along with what would prove us wrong.
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Tongue posture. A controlled study found that holding the tongue on the palate on purpose raised muscle activity under the chin and lowered heart rate variability. That is the cost of effort, and we take it seriously. Our view is that the tongue should want to rest on the palate rather than be held there. We predict that a natural, reflexive posture, reached after a restriction is released, will look different from instructed posture in two ways at once: low suprahyoid activity, with heart rate variability preserved or improved. If reflexive posture turns out to look the same as instructed posture, the distinction we draw is wrong. That study has not been done yet, and we look forward to seeing it done.
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SWITCH. We believe the assessment picks up a real change in motor output. Because it comes from inside our own framework, it needs to be tested against tools that do not share our assumptions: instrumented force measurement rather than an examiner's judgment, along with measures such as suprahyoid EMG and heart rate variability. Whether it is reproducible, and whether two examiners get the same result, are the first questions we are asking, not the last. A formal research study is underway.
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The Synergy Academy gives its providers the following forms for documenting a patient's baseline and progress:
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• The Goal Attainment Scaling worksheet
• The NeuralFORM daily diary
• The global change item
• The NeuralFORM clinical measures form
• The POST-IT, STOP, SWITCH, Starfish and ACORN recording forms
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These are our own forms, not licensed instruments. Providers receive them as part of their course materials, as do clinicians taking part in the NeuralFORM research program.
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Why does standardization matter so much to us? When every provider assesses differently, no two results can be compared, and a field ends up with plenty of confident clinicians and very little shared knowledge. Using the same assessments, the same scoring and the same timepoints is what makes it possible to ask whether something worked, and to answer honestly when it did not. The first thing standardization gives us is results we can compare.
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That is why our certification pathways include case requirements, and why we record outcomes the same way every time rather than relying on impressions. We would rather find out than assume. It also means the providers we train are the people who will help test this framework over time.
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Patients are the reason for all of it. Better questions, asked consistently over time, are what turn into better care, and we would rather build toward that steadily and be able to show our work.
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The Synergy Academy sets and maintains the framework. Our provider community moves it forward and, through our research network, will be the people who put it to the test.
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The ALF appliance and the OraLase sequence were originated by Dr. Darick Nordstrom, and we say so wherever that work appears.
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NeuralFORM, RestOralase, BabyLase and NINJA were developed by Dr. Angie Tenholder. The NINJA evolved from the ALF-NLA, which came out of Dr. Nordstrom's work.
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Over the years, ALF education has been inconsistent and fractured, and that fracture created real problems for providers and patients alike.
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NeuralFORM is our answer: a standardized curriculum, clear case-selection criteria, a credentialing pathway and a research program.
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We are honoring our roots while growing our wings.
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The Synergy Academy, LLC holds federal trademark registrations for OraLase, BabyLase, RestOralase and ALF (both the word and the logo). The Synergy Academy is also a commercial education provider, and anyone reading our clinical statements should know that.
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We believe the best response to a commercial interest is not to look past it. It is to publish the evidence, label it honestly, state our limits, and be specific about what would prove us wrong. That is what the rest of this website is here for.
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You will find our literature references, each one labeled with its publication type, using the button below.
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Registration and course information: thesynergy.academy · admin@thesynergy.academy
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Reviewed October 2026.