Personal profile


Dr. Knoll is an Associate Professor of Nursing at Illinois Wesleyan University School of Nursing, specializing in Neonatal Nursing.  Dr. Knoll is a past President of the OSF St Joseph Medical Center Community Advisory Board and OSF Quality, Safety and Service Council and a current founding member of Women Empowered, OSF Foundation.   

Dr. Knoll is the founder/author of the Premature Infant Oral Motor Intervention (PIOMI), which she developed for use on premature infants as young as 29 weeks gestation (approx. 2.2 pounds) to prepare them for oral feeding, thus earlier discharge. The intervention is a sequential series of 8 steps that target the tongue, palate, cheeks, and lips to "train the brain" to key a neuromuscular response to touch and pressure within their mouths, thus preparing them for future bottle or breast feeding. The PIOMI requires no equipment (other than a person's pinky finger) and only 5 minutes to administer. The fidelity (reliability) of the intervention was formally tested and published in 2015, establishing it as a tool with a sound training program and 98% reliabilities among users. 

Dr. Knoll  worked with a professional media team including a producer, videographer, audio engineer and graphic designer to produce a PIOMI Training Bundle of printed materials and film a training video. The video demonstrates the techniques of the PIOMI step by step on a live preterm infant. This resulted in 7 published and copyrighted (2012) materials collated into a Training Bundle: a professional instructional video (TwinStar Media, Inc., 2012); a “Trailer” of the video; two versions of the PIOMI instruction tool (a professional version and parent version); a Quick Reference Guide; and a Reliability Rating Tool. These training materials (including video) are available for download through  The video is a streaming capable file that can be loaded onto programs such as "Healthstream" for broader training purposes.  The professional version of the tool  is also available for download in 10 languages ( Mainland Chinese, Taiwanese, Italian, Portuguese, Spanish, Persian, Thai, Turkish, English and Hindi.) This Training Bundle is used both at on-site competency-based training visits to NICU's who wish to implement PIOMI, and/or for download for therapists already familiar with oral motor practices on preterm infants.

The dissemination of Dr. Knoll's work through presentations and publications has sparked worldwide interest by clinicians to use PIOMI as their standard of practice for oral motor therapy in their NICUs. There are over 36 publications (26 are Randomized Controlled Trials) published that have tested PIOMI on various ages of preterm infants, at different frequencies per day, different numbers of days it is continued, and with several adjuvant therapies (adding a vibratory stimulus, adding breast milk to the lips, using it within an infant driven feeding framework, having parents do the therapy, etc.). These RCTs have tested PIOMI across several different countries and cultures of care, including in the USA, China, Italy, Thailand, Iran, India, Turkey, Brazil, Egypt, and Canada. All studies have shown positive improvement in feeding skills and a subsequent decreased length of hospital stay. Most recently, infant neurological batteries have shown that PIOMI results in improved neurobehavioral organization and function six months after discharge, revealing a sustainable neurological benefit beyond just  feeding. 

Dr. Knoll travels to do on-site competency-based training on PIOMI, assists in protocol development, and serves as a consultant or advisor on thesis/dissertation committees internationally. She also offers virtual live PIOMI Training Webinars with international participants through


  • Maternal and Child Health
  • Maternal, Child Health and Neonatal Nursing
  • Public Health Education and Promotion