- The NA-CLTM Blueprint at a Glance
- A Note on Which Blueprint Applies in 2026
- Domain 1: Patient Identification, Recording Period and Clinical Data (5%)
- Domain 2: Technical Description and Recording Parameters (5%)
- Domain 3: Analyzing, Classifying and Annotating EEG/Video, and Evaluating Semiology (70%)
- Domain 4: Writing the NeuroAnalyst Report (20%)
- How the Domains Show Up on Exam Day
- Turning the Weights into a Preparation Plan
- Domains and Your Eligibility Portfolio
- Frequently Asked Questions
- The NA-CLTM blueprint has four domains weighted 5%, 5%, 70% and 20%.
- Domain 3, EEG/video analysis and seizure semiology, carries 70% of the exam.
- Domain 4, writing the NeuroAnalyst report, is a separate 20% and needs its own practice.
- ABRET administers the exam in person, with live reviewable EEG/video clips in Persyst.
The NA-CLTM Blueprint at a Glance
The NeuroAnalyst-CLTM (NA-CLTM) credential from ABRET Neurodiagnostic Credentialing & Accreditation is the advanced-level step above the CLTM. It is built around a role ABRET describes as advanced EEG review and preliminary reporting. The exam objectives therefore follow the workflow of a NeuroAnalyst working through a long-term recording: confirm who the patient is and why they were monitored, check how the data were recorded, analyze the EEG and video, and write the report.
Those four steps are the four formal domains. Their published weights are lopsided on purpose, and the lopsidedness should drive almost every decision you make about preparation.
| Domain | Focus | Weight |
|---|---|---|
| Domain 1 | Validate patient identification and recording period; review patient history and clinical data and information | 5% |
| Domain 2 | Review the technical description and recording parameters | 5% |
| Domain 3 | Analyze, classify, annotate, and delineate the EEG and video data, and evaluate seizure semiology based upon clinical and electrographic findings | 70% |
| Domain 4 | Write the NeuroAnalyst Report | 20% |
If you are still orienting yourself to the credential itself, start with what NA-CLTM certification is and then return here. For a broader preparation framework built around these domains, the NA-CLTM study guide pairs well with this article.
A Note on Which Blueprint Applies in 2026
One more caution: the separate 2026 CLTM handbook is not the source for NA-CLTM scope. The CLTM is the prerequisite examination, and its specifications should not be assumed to apply here.
Domain 1: Patient Identification, Recording Period and Clinical Data (5%)
The first domain is small in weight but sets up everything that follows. Before you interpret a single waveform, you are expected to verify that the recording belongs to the right patient and the right time period, then absorb the clinical context. An EEG pattern means different things in a neonate-adjacent infant, a sedated ICU patient and an adult in an epilepsy monitoring unit, and the exam expects you to know the difference.
Domain 1 Topics to Master
The handbook's subordinate coverage for this domain is broad, so think of it as a clinical-context checklist.
- Indications for monitoring and why this patient was recorded
- Clinical history and examination findings, plus relevant terminology
- Neuroimaging and how it relates to EEG localization
- Patient age and its effect on expected background and patterns
- Neurologic and systemic comorbidities
- Medications and their EEG effects
- Implanted and external devices that can alter or mimic EEG activity
- Patient safety considerations during monitoring
Because this domain is only 5%, do not over-invest in rote memorization of drug lists. Instead, practice reading a history the way an analyst does: asking what findings the clinical picture predicts, and what findings would surprise you. That habit pays off far more in Domain 3 than in Domain 1 itself.
Domain 2: Technical Description and Recording Parameters (5%)
Domain 2 asks whether you can review how a recording was acquired and judge whether the technical setup supports a reliable interpretation. It is another 5% domain, but it contains the fundamentals that prevent misreads in the analysis domain.
Domain 2 Topics to Master
Expect questions rooted in acquisition and review technology, not just electrode placement.
- 10-10 and 10-20 electrode placement, and how montage changes alter what you see
- Filters, gain, epoch length, amplifier behavior, polarity and common-mode rejection
- Trends and automated detection, including the limits of algorithms
- Post-acquisition review tools
- Networks and audio-video systems
- ACNS guidance relevant to recording and technical standards
As a CLTM-credentialed technologist you already know much of this from the acquisition side. The shift for NA-CLTM is perspective: you are now reviewing someone else's recording parameters and deciding whether they distorted the data. A filter setting that hides high-frequency activity, or a montage that obscures a focal finding, becomes an interpretive problem rather than a technical footnote.
Domain 3: Analyzing, Classifying and Annotating EEG/Video, and Evaluating Semiology (70%)
This is the exam. At 70% of the blueprint, Domain 3 is larger than the other three domains combined by a wide margin, and ABRET's live-clip format means you will be demonstrating this skill on real recordings rather than describing it in the abstract.
Key Takeaway
If you have limited preparation time, allocate it in proportion to the blueprint. Seven of every ten points of exam content depend on how well you can analyze and classify EEG/video data and evaluate semiology. Passive reading will not build that skill; repeated, timed review of real recordings will.
What Domain 3 Covers
Recognition and Delineation
You must identify what is on the screen and mark where it begins and ends.
- Urgent EEG changes that require prompt attention
- Activation procedures and their expected responses
- Artifact recognition and removal, including separating physiologic, environmental and device artifact from cerebral activity
- Waveform localization across montages
- Cardiac and EEG associations, such as ECG artifact versus true rhythm-related findings
Clinical Correlation and Semiology
The exam links the electrographic findings to what the patient is doing on video.
- Behavioral and consciousness changes during the recording
- Standardized electroclinical semiology, meaning the organized description of seizure manifestations and their EEG correlates
- Evaluating whether an event is epileptic, and how clinical and electrographic evidence agree or conflict
The Terminology Frameworks You Need to Know Cold
Classification questions reward precise use of the correct reference system. The handbook points to specific ones, and your answers should use them rather than older habits.
- ACNS 2021 terminology: ABRET's FAQ sets an exam-specific rule requiring ACNS 2021 terminology from January 2023. Although a report-template line on the same page still mentions 2012 or 2021, use the 2021 rule for exam preparation and do not present the 2012 version as current exam terminology.
- ACNS 2015 continuous-EEG consensus: the handbook names this critical-care continuous-monitoring consensus as an exam reference.
- ILAE 2017 classifications: the handbook names these for seizure and epilepsy classification. That is a statement about what the exam references, not a claim about the newest ILAE classification in general.
- Pattern-associated syndromes in patients at least one year old, tying EEG patterns to their clinical syndromes.
Preparing for Domain 3 Specifically
Because the exam presents live, reviewable EEG/video clips in Persyst with adjustable sensitivity and montages, your preparation should include scrolling, changing montages and reviewing video, not only looking at static screenshots. ABRET publishes a Persyst Mobile Guide and public sample questions on its practice page; use them to get comfortable with the interface before you encounter it in the exam room. For the broader question of how demanding this is, see how hard the NA-CLTM exam is.
Domain 4: Writing the NeuroAnalyst Report (20%)
Domain 4 is the second-largest slice of the blueprint and the one candidates most often underestimate. Reading an EEG fluently does not automatically translate into writing a clear, standards-compliant report. This domain tests whether you can turn your analysis into a document another clinician can rely on.
Domain 4 Topics to Master
The handbook's subordinate coverage ties reporting to the same classification frameworks used in Domain 3.
- EEG-pattern and ILAE seizure/epilepsy classification as expressed in report language
- ACNS critical-care terminology and continuous-monitoring consensus
- Pattern-associated syndromes in patients at least one year old
- Reporting guidance, including report structure and required elements
Required Report Elements
ABRET's FAQ indicates that candidate reports require a history, a technical description and an EEG description. An impression and clinical correlation are optional only where facility protocol permits. In other words, the three core sections are non-negotiable, while the impression depends on your facility's rules.
ABRET also publishes sample reports, which are one of the most useful public resources for this domain. Study their structure, level of detail and phrasing, then practice writing your own from recordings you have reviewed.
The same reporting skills also support your eligibility portfolio, since candidates must document 50 technical reports. More on that below.
How the Domains Show Up on Exam Day
ABRET administers and proctors the NA-CLTM examination in person on its announced dates. It is not delivered remotely and should not be assumed to run through a PSI or Prometric booking channel. The exam combines computer-based questions with live, reviewable EEG/video clips in Persyst, with adjustable sensitivity and montages and two platforms used simultaneously. ABRET standardizes the laptop, second monitor and mouse.
| Exam Detail | What Is Verified |
|---|---|
| Administrator | ABRET, in person |
| Fee | USD 700, no member/nonmember tier |
| Question type | Public samples are four-option multiple choice; a full item-type distribution was not published |
| Total questions / timer | Not stated in the retrieved handbook or live exam/FAQ pages |
| Numeric passing score | Not verified; the Board sets a minimum-competence standard |
| Allowed materials | No personal devices, books, notes, references or calculators; supplied scratch material/whiteboard permitted |
| Leaving the room | Not permitted while the test is in session |
| Results | FAQ: unofficial within 72 hours, official about 2-4 weeks; the handbook says 3-4 weeks |
Take the unknowns seriously rather than guessing. Vendor claims about a fixed question count are not supported by ABRET's published pages, so do not plan your pacing around a number you cannot verify. Instead, practice working steadily through clip-based items so that pacing is a habit, not a calculation. For details on scoring, see the NA-CLTM passing score article, and for fees and rescheduling costs see the NA-CLTM certification cost breakdown.
Dates and Scheduling
The posted 2026 sitting was October 3 in Irving, Texas, with a September 1 application deadline, and both dates have already passed. A subsequent 2027 date was not verified. Check the NA-CLTM exam dates page and ABRET's live exam page rather than treating the elapsed sitting as upcoming. The handbook lists rescheduling fees of USD 225 at least 30 days before the appointment and USD 300 within 30 days, with no refunds, extensions or fee transfers.
Turning the Weights into a Preparation Plan
Generic study advice is easy to find. What is specific to NA-CLTM is how to map the 5/5/70/20 split onto your calendar. Here is one way to do it, framed as a sequence rather than a rigid schedule.
Frame the Context (Domains 1 and 2)
- Review clinical-context topics: indications, imaging, age, comorbidities, medications and devices
- Refresh acquisition fundamentals: filters, gain, amplifier behavior, montages and automated detection limits
- Keep this block short, since these two domains total 10%
Build Analysis Skill (Domain 3)
- Spend the largest block here, reviewing real recordings with video
- Drill artifact recognition, localization, activation responses and urgent findings
- Practice semiology descriptions using standardized electroclinical terms
- Rebuild terminology on ACNS 2021 and the ILAE and ACNS references named in the handbook
Write and Revise (Domain 4)
- Write full reports from reviewed recordings with history, technical description and EEG description
- Compare against ABRET's public sample reports
- Check that classification wording matches the exam's terminology rules
Integrate
- Practice in the Persyst environment using ABRET's guide
- Run mixed clip-and-question review without notes
- Confirm logistics, ID and travel for the in-person sitting
Notice that this plan intentionally front-loads the small domains briefly and then lingers on analysis. If your daily work already gives you heavy exposure to Domain 3 material, shift some of that time to report writing, which many analysts practice far less than they read EEG. For a one-page memory aid once you have covered the content, the NA-CLTM cheat sheet is a useful companion.
Choosing Practice Resources Honestly
Several organizations offer NA-CLTM-adjacent preparation, including webinars on ACNS ICU terminology and cEEG report writing from groups such as Stratus/EEG U and the Central Society of Electroneurodiagnostic Technologists, plus broader EEG education from ASET. Those descriptions were reviewed, but not all paid lessons or question banks, and ASET's broader courses should not be mistaken for a complete NA-CLTM mock exam. ABRET's October 2025 examination-security statement is a reminder to use original or authorized preparation rather than alleged recalled exam content. Use official public materials first, then add practice that tests the clip-based skills the 70% domain demands. You can also try the NA-CLTM practice tests to build familiarity with the question style.
Domains and Your Eligibility Portfolio
The domains are not only an exam outline; they mirror the work you must document to qualify. Eligibility requires one of two alternatives, not both:
- Pathway I: at least a bachelor's degree, two years as a CLTM technologist, 30 advanced-practice LTM CEUs and 50 documented technical reports.
- Pathway II: no degree requirement under the practice track, three years as a CLTM technologist, 50 advanced-practice LTM CEUs and 50 reports.
Current CPR/BLS is additionally required, and the practice track is subject to annual continuation review. Cases must be distinct recording sessions of at least 12 hours, reviewed and reported by you after earning the CLTM and within five years. Multiple daily reports from one continuous recording do not count as multiple cases. Patients must be at least one year old. The Documentation Form also requires 10% of cases within the last 12 months, caps normal recordings without patient events at 20%, and needs a signature on each page from the medical director or an actively ABRET-credentialed supervisor. Full details are in the NA-CLTM requirements guide.
Key Takeaway
Building your 50-case portfolio is also Domain 3 and Domain 4 practice. Every case you review and report is a rep at classification, semiology and report writing, so treat documentation and exam preparation as one continuous effort rather than two separate projects. Note that the 30 or 50 advanced-practice CEUs needed for eligibility are distinct from the 50-hour continuing-education requirement used later for renewal.
Because retrospective review can qualify, you do not need a current NeuroAnalyst job title to build cases. If you are weighing whether the credential fits your career, see whether NA-CLTM certification is worth it, and for salary context read the NA-CLTM salary guide, keeping in mind that no defensible credential-specific 2026 salary figure was established.
Frequently Asked Questions
There are four domains: patient identification and clinical data review (5%), technical description and recording parameters (5%), analysis, classification, annotation and semiology of EEG/video data (70%), and writing the NeuroAnalyst report (20%). These come from the 2025 NA-CLTM candidate handbook.
Domain 3, which carries 70% of the exam. It covers artifact recognition, localization, activation, cardiac associations, behavioral and consciousness changes, and standardized electroclinical semiology, all assessed on live, reviewable EEG/video clips in Persyst.
The retrieved handbook and live exam/FAQ pages do not state the total question count, the scored/pretest split or the timer. Do not rely on vendor claims of a fixed number; plan for steady pacing through clip-based and multiple-choice items instead.
ABRET's exam-specific rule requires ACNS 2021 terminology from January 2023. The handbook also names the 2015 ACNS continuous-EEG consensus and 2017 ILAE classifications as exam references, so build your vocabulary around those rather than older 2012-era wording.
ABRET's 2024 statistics reported 60% for ten NA-CLTM candidates, excluding repeat examinees. That cohort is small and is not a reliable estimate of any individual's chance of passing, and it should not be treated as a 2026 result. See the NA-CLTM pass rate article for context.
Not necessarily. Pathway I requires at least a bachelor's degree with two years as a CLTM technologist, while the practice-track Pathway II has no degree requirement but requires three years as a CLTM technologist and more advanced-practice CEUs. Both require 50 documented reports and current CPR/BLS.
The four NA-CLTM domains describe one connected workflow: confirm the context, check the technical setup, interpret the recording, and communicate your findings in writing. Weight your preparation toward the 70% analysis domain, give report writing the dedicated attention its 20% deserves, and verify live logistics with ABRET before you apply.