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Dr. Chestaro specializes in the diagnostic evaluation, medical management, and family support for children with developmental and behavioral conditions – including Autism Spectrum Disorder, intellectual disability, complex ADHD, learning disorders, speech and language disorders, developmental delays, and behavioral disorders. Dr. Chestaro completed her residency, fellowship in Developmental Behavioral Pediatrics, and fellowship in Leadership Education in Neurodevelopmental Disabilities (LEND) in Chicago. She is a member of the Society of Developmental and Behavioral Pediatrics and the Academy of Child and Adolescent Psychiatry. She is also a fellow of the American Academy of Pediatrics. Dr. Chestaro has a wealth of knowledge and a passion for working with children of all backgrounds. She is committed to providing the best family-centered care for children in the area.

Q: What is the difference between a developmental behavioral pediatric provider and my child’s current primary care provider? 

A: Primary care providers have the acquired knowledge and experience to manage the health of your child, including physical, behavior, and mental health issues. They're trained to diagnose and treat childhood illnesses, from minor health problems to serious diseases. They can help you know what to expect in terms of growth and development and can help prepare you for the changes that will naturally occur in a child’s life. There are instances, though, where a more nuanced type of care may be necessary for your son or daughter. If you have questions or concerns about your child’s social, emotional, behavioral, or developmental growth, a developmental behavioral pediatric specialist should likely be consulted. These providers have additional subspecialty training focusing on developmental behavioral pediatrics.

Q: I have concerns about my child’s development and/or behavior what do I do first? 

A: First, talk to your Primary Care Provider about your concerns and get their input. Your provider has the special skills to take care of your child's health and can refer you to a specialist in developmental behavioral pediatrics if they think your child needs expert care. Developmental behavioral pediatric providers possess training and experience to consider, in their assessments and treatments, the medical and psychosocial aspects of children's developmental and behavioral concerns.

Q: I talked to my child’s doctor and they sent a referral, what happens next? 

A: Once your referral is received an individualized family intake specialist will contact you, help you navigate our intake process, and answer any questions you may have. The intake specialists assigned to your referral will also help with any needed paperwork and help connect you with additional resources.

Q: How soon can my child be evaluated? 

A: Early intervention is key to a child’s successful developmental outcome and we are engaging with our families as soon as the initial provider referral is received. The Institute has worked hard to reduce wait times for new patient appointments and in many cases a patient can see a developmental pediatric provider in just a few weeks due to our new intake process. Depending on the types of resources needed, we will connect you with a Family Voices coordinator who can help you navigate your current concerns and help you find the appropriate resources, even before your evaluation. 

Q: I thought Siskin Children’s Institute was a school for children with special needs? 

A: Siskin Children's Institute was founded as a school for children with special needs by Mose and Garrison Siskin over 70 years ago. Since 2009, the Institute has been offering medical services in addition to occupational therapy, physical therapy, speech therapy, applied behavior analysis therapy, family resource services through our Family Voices program, and now many of our services are available via telehealth.

Q: What makes Siskin Children’s Institute different from other agencies? 

A: Siskin Children’s Institute takes an interdisciplinary approach to early identification and intervention for developmental and behavioral concerns. The team consists of specialists under one roof in the areas of developmental pediatrics, speech pathology, occupational therapy, physical therapy, behavior psychology, applied behavior analysis, nursing, and administrative support staff. These professionals work collaboratively with the family to support the unique needs of each child, applying evidence-based practices, and connecting with community resources. We have a new individualized family navigation intake process that guides you through the Siskin experience and beyond! Siskin Children's Institute has been serving children with special needs for more than 70 years and we are honored to walk and celebrate your child’s beautiful journey! 

COVID-19 Update
Siskin Children's Institute is currently providing medical and therapy services by appointment only and via telehealth services. We have implemented mitigation strategies, staff training, and safe patient flow traffic measures to protect our patients, families, and staff. This is a multi-phased approach to diminish risks associated with COVID-19. For timely updates on our transition plan please visit this LINK or follow us on social media.

To learn more about the services provided at Siskin Children’s Institute in our Chattanooga or Nashville offices, visit this LINK, or call 423.490.7710

Cindy chestaro, M.D., FAAP
Siskin Children's Institute

Posted by Siskin Admin  | Category: children, health

The first half of 2020 has been a difficult year. The murders of George Floyd, Ahmaud Arbery, and Breonna Taylor add to a long list of black Americans who lost their life based on their skin color. In between bouts of anger and sadness, I’ve spent a considerable amount of time in the last week pondering “how have these deaths affected our staff and those we serve at SCI?” 

Displaying empathy, being inclusive, listening, and understanding are all key attributes of our culture at Siskin Children’s Institute. It’s part of the rich legacy of our founders Mose and Garrison Siskin. As a mission driven organization that serves children and families from diverse backgrounds, we must acknowledge that systematic racism exists. Racism affects our employees, our communities, and the children and families we serve. Racism manifests itself in innumerable ways. Persons of color including our co-workers, friends, neighbors, brothers, and sisters need to hear unequivocally that we support them and stand by them in condemning racism. We also condemn antisemitism and discrimination in all forms. You matter, you are valued by me and by Siskin Children’s Institute.  

In the coming weeks I will work closely with our staff and those we serve by reaffirming our commitment to diversity and addressing any cultural blind spots we may have. We will have hard conversations; we will listen and learn from each other. Our commitment is to constructively address disparities, foster an inclusive culture, and take a firm stand against racism.

Please join me as we work to be part of the solution.

Yours Truly,

Derek Bullard

To hear how the pediatrics community is responding to this crisis visit AAP (American Academy of Pediatrics)

Derek Bullard, President & CEO Siskin Children's Institute

Posted by Siskin Admin

In response to Covid-19, Siskin Children’s Institute has begun implementing telehealth to carry out medical and therapy appointments for the kids we serve. We love being able to offer these services, but we understand that conducting appointments via phone, tablet, or laptop each week can quickly eat up a family’s mobile or internet data. 

The good news is that most carriers have made significant changes to their plans throughout the next few weeks, offering additional data and more hotspots while also working with individuals and families struggling to pay on time. 
Here is a list of some of the additional services offered right now in our area:

Waiving late fees
Suspending disconnects for those affected by Covid-19, but you need to call and let them know
Opening up Wi-Fi hotspots to anyone
Cricket and AT&T Prepaid Plans
Increasing data limits for new and existing customers for 2 months
Learn more.

60 days unlimited high-speed data for those with Legacy Plans, effective 3/13/20 
Smartphone plans for T-Mobile and Metro by T-Mobile plans with hotspot data get an additional 20 GB, effective 3/20/20
Free international calling 
Learn more.

Unlimited data for 60 days for customers with metered data plans, effective 3/18/20
Waiving per-minute toll charges for international calls to countries that are defined as Level 3 by the CDC (effective 3/17/2020)
Learn more.

Unlimited calls 3/18/20 – 4/30/20
300 additional minutes for prepaid customers
Waiving activation and upgrade fees for new lines or new devices
Waiving late fees and suspension to individuals and small businesses affected by Covid-19, but you must call to let them know
Learn more.

Comcast Xfinity
Pausing internet data plans for 60 days, offering unlimited data at no charge
No disconnects or late fees for those affected by Covid-19 but it is important to call and let them know
Use this map to locate a hotspot in your area
Learn more.

EPB Fiber Optics
Quick Connect EPB free Wi-Fi is available for students, necessary business, and telehealth.
No disconnects or late fees, but it is important to call 423.648.1372 to let them know if you can't pay your bill
Learn more.

CONENT PROVIDED BY: Rachel Green, Home and Community-Based Early Intervention

As the country experiences a time of crisis from the novel coronavirus, kids are not exempt from feelings of confusion or insecurity. It is important for kids to feel safe and secure while we strive to keep their bodies healthy during this pandemic. Here are some tips for parents and caregivers as they work to ensure that their kids stay healthy in both mind and body.

1. Communicate. For younger kids and kids with ASD, it may be a good idea to implement visual tools to explain why they have to stay at home. We like this free printable social story for explaining the virus. Reassure kids that these changes in their routine won’t last forever.

2. Teach good hygiene. The CDC recommends these practices for staying healthy during the Covid-19 crisis. Teaching good hand-washing skills is imperative. For kids, we really like social stories like this one to print and hang near the sink. Also, try singing some fun songs for 20 seconds to ensure that right amount of time is spent washing.

Kids should stay home right now, but if they have to be in public for medical treatment of grocery shopping kids over two may wear a mask. There are many DIY options for making protective face wear, but please remember that babies and toddlers under 2 years-old should not wear masks.

3. Establish a routine. Most kids have experienced a disruption in their routine lately. While all children thrive with routine, kids with ASD may be more negatively impacted by the changes. While strict schedules are not usually necessary, it is a good idea to find a routine that works and stick with it. You can read more about our suggestions for quarantine routine here

4. Take advantage of telemedicine. Siskin Children’s Institute, along with many other offices across the nation have transitioned to telemedicine. It is important to continue any therapies or treatments your child typically receives. Reach out to your child’s healthcare provider for more information on telemedicine.

CONTENT PROVIDED BY: Rachel Green, Home and Community-Based Early Intervention

Posted by Siskin Admin  | Category: Coronavirus, Kids, Wellness

During the past few weeks, we have been thrown into unprecedented times with the arrival of Covid-19 in the United States. Most of us will be spending much of the spring season in quarantine, working from home, and homeschooling kids. In addition to the sudden change in routine, many of us are also experiencing stress from the economy and worrying about our loved ones’ health. 

According to the CDC, everyone responds differently to stress and different events can trigger stress in individuals. Some common triggers for stress and anxiety can include:

   • Worrying about our health and our family’s health
   • Worrying over finances
   • Having kids at home
   • Changes in sleep and eating 
   • Feelings of isolation
   • Increased substance abuse

It is important to practice self-care during stressful times.
Try some of these ideas that may curb stress and promote overall well-being.

1. Take breaks from the news. Now, it is important to stay informed, especially in times of uncertainty. However, when we are constantly seeing and hearing negative messages and sad stories, it can take a toll on us mentally and emotionally. Try limiting time spent watching the news to just a few minutes per day to stay informed without feeling overwhelmed.

2. Take breaks from social media. During a quarantine, it is easy to feel isolated and turn to social media for a sense of community. However, social media is also flooded with sad stories and even inaccurate information about Covid-19. Limiting social media to just a few minutes a day, or even taking breaks from it for entire days, may help manage stress and anxiety. 

3. Take care of your body. It sounds cliché, but we really should eat right and exercise. Eat foods that are filling, as well as nourishing. Activities like yoga or Zumba can promote the production of endorphins (the stress-reducing hormone!) to benefit physical and mental health. 

4. Revisit an old hobby. Many of us have activities that we enjoyed before our lives were so busy. Quarantine may be a good time to take up a hobby that we have not had time to enjoy in a while. Pull out the paint brushes, tennis rackets, knitting needles – whatever brings you joy – and set aside some time to decompress with that hobby. 

5. Connect with others. This may seem contradictory to our advice on limiting social media, but we are referring to the old-fashioned ways of connecting – by phone, or even mail! Try picking up the phone and checking on loved ones individually. Ask an elderly friend or relative to tell you stories about when they were younger, make cards for the sick, or write letters to soldiers overseas. 

6. Go outside! Take advantage of nice weather to go on a walk or hike (of course, while adhering to social distancing guidelines). Vitamin D and fresh air are good for the body and spirit!

It is important that anyone with a preexisting mental health condition continue with their normal treatment, including taking medications, while also watching out for any new or worsening symptoms. Visit SAMHSA for more information.

CONTENT PROVIDED BY: Rachel Green, Home and Community-Based Early Intervention

We’re sure your family is reeling from the events of the past few weeks due to closures and social distancing. All the uncertainty can be very overwhelming. However, it is evident that parents have jumped into caring for and teaching their children at home marvelously.

While it is easy to be overwhelmed with what “should be taught,” take a moment to remember how young children learn best, before we allow ourselves to be pulled into finishing one more assignment. There are a few things children can teach us to help us move forward with our new normal. Below are a few tips to help you enhance learning opportunities at home and in any environment.

First, children feel that play is always a good idea, and they are correct! For children, learning happens everywhere. They learn by doing, using their senses, exploring their environments of people, things, and places. Play itself is vital to healthy brain development. It’s a natural stress reliever and empowers choice-making. Play helps children learn to regulate their feelings, delay gratification, and negotiate with others.

Second, children usually go with the “I have an idea!” rather than the “what-ifs.” Going along with an idea is the essence of a child’s intellectual development. They may not always say it aloud, but you can see ideas churning in testing buildings, looking at nature, fixing or taking apart things, or making music with pots and pans.

Third, we grown-ups have great faces! Your children have spent countless hours studying your expressions and responses and they love to have your attention. Take some time throughout your day to give them undivided attention. After all, young children learn best when they have warm, engaged and responsive relationships with their adults. You have a vital role to play in helping your child learn through these early years. You are your child’s first teacher, and your child will keep learning from you as they grow. Your family’s rhythm will emerge. Give it time and make some memories. 

CONTENT PROVIDED BY: Janet Parks, Siskin Early Learning Center

Here is a list compiled of activities and games you, as guardians, could implement in your daily schedule to keep you and your kids engaged over the next few weeks or any time your kids need something to do. 

While this list is directed towards children 1-3 years of age, these activities can be adapted to meet you and your child’s needs.

Put-in Games
Toddlers love Put-in Games. You can make them out of anything. Use an old Gerber Puffs container, or something similar, cut a slit in the lid and add coins, poker chips, popsicle sticks, etc. This can keep them entertained for hours. You can also use fruit/vegetable pouch lids or cut a hole in the top of a cool whip container. These types of games are great for fine-motor skills and problem solving. Be creative! Plus, you do not need any new supplies to make them! 

Messy Activities
Painting – Try the big campfire marshmallows, tape them to popsicle sticks, and let them paint on paper! It is a new tool to use. You can also use flowers, leaves, sticks, trains, yarn, etc. The children can learn about color mixing, shapes, and other motor skills. You can also try freezing water and paint together to make paint blocks, add these to water or let it be a separate activity.

Water-play – babies/toddlers LOVE water, stick them in the bathtub and make the bathroom your office for a while! The kids are supervised, entertained, and if you are working from home, you could (hopefully) get a little bit of work done. Or, lay a towel or sheet down and a bowl of water, add things like scoops and bowls for dumping and pouring. You could even add cars for a “car wash”, plastic animals, baby dolls. Etc.

Oats/Rice/Potato Flakes – New textures! Mix them together or use as a separate activity, add spoons, scoops, cups, extra bowls, etc. The children will play with this forever. You could also include the fake fishing worms from dads tackle box, plastic cups, and tongs to this activity! The goal is to use the tongs to pick up the worm and get it in the cup.

Shaving Cream – This has been a big hit in our classrooms this year. Put shaving cream on a table before and the kids play hours. OR add paint, the children will learn about new textures, cause and effect and color mixing. Make sure it is paint that will not harm your table.

Oobleck – so messy! This one may be an outside activity; take 2 cups of cornstarch to 1 cup of water, mix them together and pour it directly onto a table! I have had 12 toddlers play with this for 30 minutes to an hour before. Oobleck dries to a powder, making the clean up a little bit easier.

Non-Messy Activities
Legos, Magnet Tiles, Puzzles, Blocks, and DANCING

Let the kids “paint the walls or doors”. Grab a container and fill it with plain or soapy water, give the child a paint brush or whatever you have on hand and let them “paint” with the water. It does not hurt the walls or doors. Great if you need lots of giggles and a break from work. Unless you are wanting this to be a very messy activity, make sure you are in control of the water container! This activity can also be used in place of sidewalk chalk! 

Here are a few songs my class loves and requests
- We Are the Dinosaurs- Laurie Berkner
- Freeze Dance- The Kiboomers
- Fire Truck- Ivan Ulz
- Baby Shark 
- Animal Action- Greg and Steve
- Bear Hunt- Greg and Steve
- Anything from the Trolls soundtrack- Can’t Stop the Feeling is a fan-favorite! 

I hope this list helps you and your family make it through these challenging times, but I also hope that it brings you closer together as a family to enjoy the smaller things in life. That maybe for just a second, you get to experience the world through the lens of your child. It is quite magical. Please remember, spending quality time with your children, listening, and engaging can sometimes be better than anything else you could do. 

DISCLAIMER:  Please make sure to provide adequate supervision with these activities! We are looking for fun and SAFE play here, no hospital visits! Have fun, be safe and wash their hands.

CONTENT PROVIDED BY: Carlee Long – Early Learning Center Teacher, Classroom 9

Posted by Siskin Admin  | Category: Games, Kids, Home,

The threat of Covid-19 has caused an abrupt change to family routines because of work and school closures in the Tennessee Valley. For many families who rely on school meals for their kids, this sudden change in plans has also caused extra financial stress as parents and caregivers scramble to feed growing kids during the hours they are normally at school. 

Fortunately, there are community resources in place to help alleviate the stress of food insecurity. 

Kids’ Breakfast and Lunch Options

Hamilton County Schools announced that several of their locations will host breakfast and lunch drive-through pick ups each week day beginning Tuesday, March 17, 2020. Cold meals will be provided for children ages 0 - 18. Parents and guardians do not need to show proof of income or enrollment to qualify. Children do need to be present at the time of pick-up, however. 
Find out more here

The YMCA is distributing cold breakfast and lunches at these locations while supplies last:

Northside Neighborhood House Coffee Community Collective, 10161 Dayton Pike, Soddy Daisy. 

Call 423-605-2892

Northside Neighborhood House, 211 Minor Street, Chattanooga 37405. 

Call 423-267-2217.

Some local restaurants are offering free kid meals, as well.

New York Pizza Department, 5731 HWY 153, Ste B, Hixson 37343. 

Call 423-531-8830

Wine Down, 9431 Bradmore Lane, Ooltewah, 37363. 

Call 423-531-9463. 

Family Food Boxes  |  Hamilton County

First Baptist Church, Soddy Daisy, 37379. Available on Wednesdays. 

Call 423-332-2814. 

Grace Food Bank, Calvary Chapel Hixson. Available Fridays. 

Call 423-505-4962

Northside Neighborhood House, North Chattanooga location. By appointment only. 

Call 423-267-2217

Red Bank Food Pantry, Red Bank United Methodist Church. Drive through Thursday, May 19, 5:00-7:00 pm. 

Call 423-877-2281

Soddy Daisy Food Bank, 11370 Backvalley Road, Soddy Daisy 37379. Mondays 3:30 - 5:15, Thursdays 9:00 - 10:45. For residents of northern Hamilton County. 

Chattanooga Area Food Bank, 2009 Curtain Pole Road, Chattanooga, 37406. 

Call 423-622-1800.

Family Food Boxes  |  Sequatchie County

The Vine, Friendship Baptist Church, March 18-25. One box per family, per week. 

Call 423-385-4113.

Additional Services

For additional information and services, Dial 2-1-1 for resources regarding food insecurity, housing, childcare, and transportation.


As the Covid-19 virus spreads throughout the country, many school districts are temporarily closing to help minimize the sickness’ effect within their communities. While these proactive measures are a great way to help keep our kids healthy, many parents are scrambling for ways to keep kids entertained during a quarantine. Here are a few tips for filling up those long days while still avoiding crowded public places and limiting screen time. 

1. Set aside learning time. While classes may be cancelled, many schools are sending home classwork or posting assignments online for kids to complete. Don’t panic – parents will not need to spend seven hours a day on instruction time. But it is a good idea to set aside some time each day to work on school assignments. This will add a little bit of structure to the day while also keeping students in a mindset that encourages learning. 

2. Get crafty. Crafts can be a great way for kids to have fun at home. Coloring, sticker books, or watercolors may be good, inexpensive options for younger kids. For school-aged kids, try getting creative with items you may already have around the house.  We like these fun coffee filter crafts and these fun construction paper craft ideas.

3. Go outside! While it is important to avoid crowds, getting outside in the open air is a great way for kids (and their parents!) to expel some energy while also getting a good dose of sunshine and vitamin D. While playing with outdoor toys at home may be a good option, it is best to avoid the playground equipment at public playgrounds. Try going for a walk or taking a hike on those nice days. 

While it may be tempting for parents to get together and host play dates for bored kids, it is important to create social distance during a pandemic of this type. Individuals can be infected with Covid-19 before they experience any symptoms or develop a fever. Avoid places like libraries, restaurants, playgrounds, sporting events, and anywhere else crowds of people may gather. 


Posted by Siskin Admin  | Category: Children, Families, Home

Tips for Navigating the Holidays

December 16th, 2019

The holidays have come around again, a time which we usually associate with happiness, family, and togetherness.  But we also know that sometimes when you have a child with Autism Spectrum Disorders  (ASD), the moments that should be peaceful, feel anything but.  Whether it’s because of changes to routine, the stress of travelling, or the pressure of family gatherings, we’ve compiled some strategies that you can use to help keep the happiness in your holiday.

Changes to Routine
Some children benefit from following a routine.  If you know your child’s routine is going to be disrupted (school closures, attending events or gatherings), you can help prepare your child for that change.  You can verbally prepare your child for the upcoming change, or you may choose to use a visual schedule.  Examples of visual schedules can be found here.  

Each child is different, so it may take some practice to figure out how much preparation your child needs.  One child may need to know days in advance about a routine change, whereas another child might handle the information better as the change is nearer.

Travelling Tips
If you are anticipating a long drive, it may help to plan breaks into your trip.  Plan ahead and bring activities that are comforting and calming for the ride.  If you are travelling by plane, do your best to avoid being rushed in the airport.  If you need any special considerations, contact the airline’s disability assistance department.  This could include early boarding, or even a visit before the trip to learn what to do in the airport. 

Family Gatherings
Plan ahead.  If you know your child won’t eat the food at a particular gathering, is there something you can pack ahead to bring for him?  Identify places your child can go if she needs a break from the noise or stress of family events.  Noise-cancelling headphones may be an option if you cannot identify a quiet room or calming area.  Do your best to make sure that family members know how to respond if your child engages in challenging behavior.  

Holiday Experiences
Sometimes holiday experiences can be overwhelming to a child with ASD.  If your child seems overwhelmed by the Christmas tree, consider using fewer decorations or adjust the lighting to one that is comfortable for your child.  Consider adding decorations to your house a few at a time so that your child can get used to the changes.  For visits with Santa:  If your child has difficulty waiting in lines, a spur of the moment visit to Santa may not be ideal.  Some malls allow you to schedule your visit with Santa to prevent having to wait in line.  You may also consider using an app to have a video chat with Santa instead.

Start Early
Don’t wait until the holidays arrive to identify challenges and skill deficits.  If you feel like you need assistance addressing certain challenging behaviors, or that your child lacks important skills, you may discuss Applied Behavior Analysis (ABA) therapy with your pediatrician.  During ABA therapy, a Board Certified Behavior Analyst will use assessments to identify challenging behaviors or skill deficits, and then develop a plan to teach replacement behaviors or new skills.  ABA therapy is an intensive therapy, and many providers have wait lists, so it’s important to seek help early.  Learn More about ABA Therapy at Siskin Children's Institute. 

Author: Rebecca Brooks, LBA, BCBA | Siskin Children's Institute