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Katie Beckett Waiver

March 15th, 2019

In 1981, President Reagan personally intervened when a mom reached out to him to share the story of her daughter, Katie Beckett. Katie contracted viral encephalitis at just five months old and spent the better part of three years in an Iowa hospital. Katie had Medicaid that covered her while she was an inpatient, however, when she was ready to go home, she was dropped from Medicaid simply because her parents made too much money. Therefore, their only option was to remain in the hospital. 

Impassioned that any parent could face this situation, President Reagan created the Katie Beckett Waiver with help from Congress through the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) which allowed Katie, and children like her, to retain their Medicaid coverage regardless of their parent’s income. This gives parents the option of taking care of their children at home instead of them remaining hospitalized. 

Currently, there is no program in Tennessee designed as a pathway to Medicaid for children with complex medical needs and long-term disabilities. Lacking options, some families have been forced to give up custody of their child just to get them the care they need. Other parents have gotten divorced just to reduce their household income and make their child eligible for TennCare. Some desperate families have permanently moved from Tennessee to a state with a program that covers their child. 

A Katie Beckett/TERFA Program in Tennessee would make Medicaid benefits available to children (age 18 or under) who qualify with a diagnosis of complex medical needs or a long-term disability. Representative Sam Whitson and Senator Kerry Roberts have filed a bill HB0498/SB0476 and are working on additional language to create this program through legislative action. Governor Bill Lee could include this in his budget proposal or our state legislature could include it. 

Do you have a child, or know of a child, with complex medical needs or a long-term disability that has been directly affected by Tennessee’s lack of coverage for children of middle-income families? Tell your story, and tell your legislators.

Join the movement alongside Family Voices of Tennessee at: 

To share your story directly, please call: (615) 383-9442 or email:

To contact our Siskin Children’s Institute Family Voices Coordinator, Lisa Spurlock, please call: (423) 648-1700 or email: 

Check out our local NewsChannel 9 station’s coverage of the Katie Beckett Waiver here.

Meet Jane, a Board Certified Behavioral Analyst in our Center for Developmental Pediatrics Program. Below, Jane describes what a day looks like for her here at Siskin:

"As a Board Certified Behavior Analyst (BCBA) with Siskin, my day usually consists of going to families’ homes for Applied Behavior Analysis (ABA) sessions to work with children and meet with their families. ABA sessions are often conducted by behavior therapists (Registered Behavior Technicians) who work under the BCBA. When I go see a child for an ABA session, I spend time observing the therapist’s session, providing feedback and on-going training and support, as well as working 1:1 with the child. I review the data collected in previous sessions and make updates as needed based on the child’s progress. Parents are encouraged to participate in their child’s therapy sessions, so oftentimes we are all working together during sessions. I also check in with parents to see how their child is doing, and if they have any concerns or recent successes they would like to discuss. I talk with parents about their child’s behavior plan, and how they are doing in school and in their other therapies."

Have questions about our ABA program? Contact us at 423.490.7710 for more information or visit the ABA Therapy page on our website. You can also visit the Autism Speaks ABA page to learn more about ABA Therapy.

* Please note- a physician referral is required for ABA therapy services.

ABA Therapy

February 8th, 2019

What is ABA Therapy?

Applied Behavior Analysis (ABA) is an evidence-based form of therapy that focuses on increasing positive and helpful behaviors while also decreasing unwanted behaviors. It can help increase language and communication skills, improve focus, memory, and academic performance, and enhance social skills with peers and adults. ABA is oftentimes a primary tool when working with children with Autism Spectrum Disorders (ASD) and other developmental disabilities.

ABA therapy is customized to meet the needs and goals of each child. Our team will work with each family to help develop these goals and strategies based on the child's interests and skills in order to increase positive and helpful behaviors.

Our growing ABA therapy program is ideal for children 18 months old to 12 years of age. Our team of Board Certified Behavior Analysts and Registered Behavior Technicians will work with each child and their family to develop an ABA program to meet the needs of that individual child.

* Please note- a physician referral is required for ABA therapy services.

Have Questions? Contact us at 423.490.7710 for more information or visit the ABA Therapy page on our website. You can also visit the Autism Speaks ABA page to learn more about ABA Therapy.

Coming soon: “A Day in the Life of a Board Certified Behavior Analyst”!

Posted by Siskin Admin  | Category: ABA, ABA Therapy

The Project Approach

January 23rd, 2019

Perhaps you’ve heard this term thrown around in the Early Learning Center (ELC) here at Siskin Children's Institute, but what does it actually mean? According to the Project Approach’s website, it “refers to a set of teaching strategies that enable teachers to guide students through in-depth studies of real-world topics. Projects have a complex but flexible framework within which teaching and learning are seen as interactive processes. When teachers implement the Approach successfully, students feel highly motivated and actively involved in their own learning, leading them to produce high-quality work and to grow as individuals and collaborators. A project, by definition, is an in-depth investigation of a real-world topic worthy of a student’s attention and effort. The study may be carried out with an entire class or with small groups of students—most often at the preschool, elementary, and middle school levels. Projects typically do not constitute the whole educational program; instead, teachers use them alongside systematic instruction and as a means of achieving curricular goals.” 

To learn more about the Project Approach, click here.

Below you will find several first-hand accounts of how our teachers in the Early Learning Center use the project approach in their classrooms as well as some of the projects they’ve been working on. 

One thing I quickly learned when I started working at Siskin Children's Institute was that we do things a bit differently!  You may have heard that we often do provocations, but what are they? Put simply, provocations provoke! They provoke thoughts, discussions, questions, interests, creativity, and ideas. They can also expand on a thought, project, idea and interest. Provocations provide an invitation for a child to explore and express themselves. They should always be open-ended and provide a means for expression where possible. We make provocations inviting in the classroom by using fabrics to “set” the table, arranging materials in new or interesting ways, and adding new materials. The images below show a provocation that was set up for the fall. The materials were simple: leaves, rocks, and acorns.  The book Leaf Man was also displayed. This provocation worked on social skills (emotions on faces that they created, sharing with friends, etc.), fine motor (small pieces), math (shapes of face/features, how many, etc.), literacy (using/appreciating books) and daily living skills (clean up after yourself so that someone else can enjoy the space).
- Ms. Jazmine, ELC Teacher

The children in my classroom consistently had “pizza” marked in the “ALL” category during lunches, they consistently made each other pizza in the home living center, and they all were thoroughly engaged during our Fancy Friday Cooking Experiments. The staff and I all kept notice of this and realized that we could introduce a Pizza Project into the classroom. We already knew that the full class participated in most of the activities pertaining to pizza and cooking so it seemed like a no-brainer. We developed a web to brainstorm with each other as staff members and then afterwards with the children (this part of the project-approach lets the teachers see what the children know about the topic). From that we realized that we could venture into discussing where cheese is made, how tomatoes are grown, and how to measure ingredients to name a few- this would allow us to teach all of the TN-ELDs. From there we explored pizza boxes, cooking with yeast, cutting pizza, delivering pizza, and even going to Community Pie for a field trip (this part of the project allows us to “ask the experts”). The project has really been amazing. The children have fully engaged in the project and a lot of individual education goals have been met. We are concluding our project with a class written and illustrated book entitled, If You Give a Kid a Pizza. After reading and re-reading If You Give a Mouse a Cookie, the children all contributed ideas for the sequencing of the book. They then became the illustrators and drew pictures for each page as well as having an individual picture in the book. We will be reading the book to Classroom 5 and the Administration in the coming week. As you can see, the project-approach allowed us to take something as simple as pizza and create something so much larger and educational.  
- Ms. Maddie, ELC Teacher


My classroom has worked on several projects as a team this year! Once our class learned about working as a team, we planned a special project for our grandparents. The children chose poems, created posters about the poems, made and wore costumes, practiced the "show" and presented their "welcome to Grandparent's Day" project to a roomful of pleased and proud grandparents. The children chose a project about owls and nocturnal animals after reading the book Owl Babies. They were curious about owls so they asked questions to learn more. They expressed their interest in owls by building nests out of boxes and used branches to create a habitat for owls. An expert brought a real owl to our classroom so we could see a real owl and find out more! One of the most meaningful projects my classroom worked on was the project to help a classroom friend "give back" to the Make a Wish group. They decorated boxes with Disney characters for donations, made posters to ask for donations, explained the project to other classes, counted the donations and made a colorful artistic card for our friend when he left for his trip. The children keep asking questions, exploring solutions and working together as we learn.
- Ms. Ann, ELC Teacher

The Project Approach looks different in every classroom and every age. Since I have younger students (2-3 y/o), a lot of the ideas are thrown out to them by us teachers and they build off of those ideas. Whatever their response is gives us an idea of if the interest is high enough to start a project on it. We might do different activities every day of the week and observe them and take notes on what they say, if they take interest in it and how much interest shows in order to make the decision on if we will make this our next project or not. Once we’re in a project, I find it really important for me when creating the lesson plan, to not do a project related activity every single day of the week. I’ve found that if you do nothing but activities on that project, the children can sometimes get burned out. I will put no more than 2 project related activities on my lesson plan for the week. Some of these activities take more than one day to complete.  Sometimes your class is working on the same one activity for the entire week. Example: If you want to make instruments for your music project, it might take a whole week to gather up materials, ask parents for supplies, make the actual instrument, see if it works, decorate the instrument etc. Also, every activity that we do still meets the state standards for their age and we make sure to include a lot of documentation in the hallways as well as hanging up in the classroom. One of my favorite projects we ever did was a music project. We had the Chattanooga Symphony lend out their instruments to us and let us check them in and out whenever we wanted. The Creative Discovery Museum came and did a lesson on rhythm and the science behind it. The school had the UTC Marching Band come and play songs on the playground, and to close out our project we held a Christmas Concert Fundraiser. Parents brought in all kinds of supplies for the children to make their own music instruments, and our parents also suggested different non-profits in the community to choose to donate all of our proceeds from the concert to. The entire ELC and families from our own classroom were invited to come hear our class sing “Jingle Bells” and give a donation. It was such an amazing experience to see our project come full circle. Each step of the way we made sure to include the community in some way, whether that was hanging up bell charms in the trees on the playground for all of the classrooms to enjoy, or raising money for another school that needed new musical instruments.
- Ms. Cristina, ELC Teacher

Michael's Story

December 13th, 2018

"It is this unique experience of the staff at Siskin that helps special needs parents on their child’s journey. I will miss them all when Michael goes on to his next step, but I know that he will be ready due to Siskin’s dedication to kids like my Michael."      

-- Patty, Michael's mom 

Michael was born in September of 2013. He had some signs of Down syndrome at birth but the doctors told us not to be alarmed and that they were ordering the tests just as a precaution. We received a positive diagnosis of Down syndrome four days after he was born. We found out three days later that he had a congenital heart defect which would require a major heart surgery to repair by the time he was 6 months old. It was a week of shocks to say the least.

Michael’s new diagnosis threw me immediately into research mode to try to find out the best way to help my new son. I had not up until that point been around anyone that had Down syndrome so I was really in the dark about what to do. A nurse in the hospital and my pediatrician had told me about the Tennessee Early Intervention System (TEIS) and Siskin Children’s Institute. I called TEIS a few weeks after Michael was born. I was quickly set up with a case manager to discuss Michael’s immediate needs and what we may need in the coming weeks and months. The heart defect was of course the determining factor in how much intervention he needed to receive right away. I was immediately assigned a physical therapist to call whenever I felt he was going to be ready for some assessments. We started in-home physical therapy when Michael was about two months old. Physical therapy and occupational therapy continued weekly along with some feeding therapies along the way, until Michael was about eight months old when he went to Cincinnati Children’s Hospital for a heart surgery to repair his Atrioventricular Septal Defect. The surgery was a great success and he started back on his normal therapies in our home until he was almost two years old.

As Michael was approaching his second birthday, we had stepped up his physical therapy in the home and even in the therapist’s outside office in Hixson, but Michael was still not walking. His therapist suggested that Michael had nothing physically preventing him from being able to walk. He did have one piece that was missing in his therapies which was that he hardly ever was around other children his own age. She felt that he would greatly benefit from being in a classroom with other children his own age. I started to send him to a mother’s day out a couple of times a week, but Michael did not do very well in this setting. No matter how hard the teachers tried Michael cried almost constantly and was not able to really integrate with the other toddlers because he was so upset all the time. Luckily in those first few weeks I had sent him to the mother’s day out, Siskin’s Early Learning Center called me to tell me a spot had opened up for Michael in a classroom. 

We started sending Michael to Siskin three days a week. From the first day in classroom four, Michael really blossomed in his growth and learning.  The teachers and students in the classroom went above and beyond to help me and Michael with the transition. Within a few days Michael did not cry hardly at all after I left. He started to receive in-house physical therapy and began walking within two or three weeks of starting at the Institute. 

Michael just turned five years old in September of 2018 and has been in four different classrooms at Siskin since he started. The therapists, teachers, administration and students have been just awesome. They have been our family’s partner through this journey from the first few weeks that Michael was born to his transition this coming spring to kindergarten in a public school. I am a parent of four children and Michael is my youngest. When he was first born, the fears that I had for him centered on the transitions in his life. I worried about his transition from baby to toddler and then to young child getting ready for the big public school. I also worried all the time that I was not doing enough for Michael because of my obligations with my other children. 

Although it is normal human emotion to worry about your children, the worry of a special needs parent is sometimes overwhelming. The staff of Siskin is always learning and gaining more experience through working with generations of special kids growing up there. It is this unique experience of the staff at Siskin that helps special needs parents on their child’s journey. I will miss them all when Michael goes on to his next step, but I know that he will be ready due to Siskin’s dedication to kids like my Michael.     

- Patty, Michael's mom

Early Intervention & Addiction

November 30th, 2018

Unfortunately, it’s an experience most of us on the home-visiting team have had—working with a parent who is struggling with addiction. Most often, these are parents who love their child very much, but they are trapped in an addiction cycle that prevents them from responding to their child as they should, implementing interventions to teach their child new skills, and sometimes, even caring for the basic needs of their child. As developmental therapists who visit weekly in families’ homes, we know that the emotional health and stability of a parent has a great impact on a child’s development, and this past week, one of our home visitors was able to help a parent access help she desperately needed at the time she was ready. 

A couple of months ago, one of our Siskin developmental therapists, asked to attend a training focused on understanding opiod addiction and learning techniques to offer help to those affected. She learned so much about the truth of addiction, including how it affects a person’s brain and their ability to make logical decisions, even in the interest of their child. She also learned about helpful resources that are available and how to respond when a person is ready to seek help.

At the same time, this team member had spent months building rapport and trust with a young mother in our early intervention program, understanding that this mom was struggling with addiction, but not judging her. Many home visits felt to be wasted time, as she could not participate well in discussion about her child, practice new teaching ideas or brainstorming to solve concerns regarding her child. Our developmental therapist waited patiently and continued making her weekly visits, also reaching out to a grandparent who was helping to care for the child. This past weekend, this mom contacted our staff, sharing that she could not go on living the way she has been and asking how she could get help for her addiction. We were ready to offer a resource for addiction recovery, as well as encouragement, and we learned this morning that this mom is on her way today, traveling to get the in-patient treatment help she desperately needs.

In early intervention, we know that supporting and helping young children with special needs begins with supporting their parents and caregivers. What will impact a young child more than any specialized intervention or therapy will be having a mother who is emotionally and physically healthy, stable, and able to respond to her child on a daily basis. As a team, we are grateful and honored to be able to visit families in their homes, build trust through the process, and then, be available to support a young family like this one in such a life-changing way when we have the opportunity.

Author: Deidra Love, Director, Home & Community-Based Early Intervention

Extended Hours

November 19th, 2018

We know scheduling appointments for your child isn't always easy. Especially, if you are trying to limit the amount of time missed from work and school. That's why we're excited to announce that the Center for Developmental Pediatrics we will be offering extended hours for speech and occupational therapy. 

These changes are in direct response to parent feedback requesting late afternoon and early evening appointments to better accommodate family schedules. 

Extended hours will be available Tuesday, Wednesday, and Thursday from 7:30 am- 7:30 pm. Parents can call us at 423.490.7710 for more information and to schedule an OT or Speech therapy appointment for these new extended hours.

In addition, our new speech and language social skill groups will be available after hours on Mondays and Wednesdays.

Be the 1 in 6

November 12th, 2018

One in six children is diagnosed with a developmental delay or disability in the United States according to the Center for Disease Control. Thanks to our founders, Mose and Garrison Siskin, families in the Chattanooga region have access to the highest quality programs and services to ensure children with special needs meet their full potential.

 “As parents of a child with special needs, one of the things we desire most is a sense of normal life. Siskin helps us to feel like Michael can go to school with typically developing children and interact with all the children in everything they do. He learns and grows just like the other child, but with some extra help from some special folks. And most of all, he’s having fun and loving school. We can’t thank them enough,” says Patty Casey, Michael’s mom. 

“From the first moment we walked in the door at Siskin, we could tell everyone, from the receptionist to the therapist and up to the CEO, want the best for Joel. 
Joel sometimes needs creative solutions to keep making progress. His therapist is always willing to go the extra mile to find what will work best and help Joel reach his full potential” says Wendy Westbrook, Joel’s mom. “Our family is thankful to have Siskin Children’s Institute.  When Joel meets a goal, it is not time to quit, it is just time to set a new goal. Every visit to Siskin brings Joel closer to being fully independent.  Extraordinary, life changing, incredible, and indispensable are all ways that we describe Siskin.  We are so glad to have these resources available locally.“

You can help children with special needs in our community by becoming the 1 in 6 Chattanooga area residents who give $20 or more to ensure children have the resources and services they need. If one in six Chattanooga area residents gave just $20, incredible things could happen for children with special needs. With your help, we can impact more kids than ever before. 

Click here to learn how you can help!

According to experts babies are “telling” us more than we realize. Infants do communicate through their behavior. They tell us how they feel, what they need and how the environment is impacting them with their own set of signals or cues. 

Stressed babies often have subtle or strong signs such as avoiding eye contact or gaze/looking away, stiffening of the body, arms and legs, crying, irritable and possibly inconsolable. These cues/behaviors let infants inform us that they are stressed, tired or overloaded. When parents have methods to respond to these cues/behaviors the infant can improve his/her ability to self- regulate and begin to learn how to calm himself. Some ways to assistant your baby when you recognize these cues are reduce the activity (stop bouncing, rocking etc), provide quiet comfort, modify environment such as reducing the noise, dim the lights decrease activity or tuck the babies arms across their chest and gently hold. Your patience and these systematic measures will allow time for your baby to respond and calm.

What does a baby look like when they are stabilized? Some of those cues can be as simple as bringing their hand to their mouth, grasping their shirt or other hand or simply having a quiet moment with alert eyes. These moments can signal to you that your baby is in an available state to make eye contact, listen to your voice, or other engaging activities. By acknowledging infant cues as authentic communication and responding to what your baby is trying to convey to you, you will be taking important steps toward meeting your baby’s needs while supporting their ability to regulate their own behavior.

Author: Lisa Spurlock, Physical Therapy Assistant

Posted by Siskin Admin  | Category: Early Childhood Development

It’s a fair question. Wouldn’t it be better for a therapist to bring out special toys/materials and teach a toddler new play skills or new words? Maybe even work with the child alone, so he/she won’t cry for the parent? Current research in the field of early intervention says no—caregivers should actually be the focus of intervention sessions. In our Siskin Home and Community-Based Early Intervention (HCBEI) program, developmental therapists spend their one hour each week brainstorming ideas with families based on the their priorities, supporting parents/daycare teachers with needed information, and offering feedback as caregivers practice teaching new skills to their child in the everyday activities where the child needs to use those skills—at bath time, meals, diaper changing, dressing and play times. We know that young children learn new skills best through repetition in the natural environments where they need to use those skills and with the people who are familiar and important to them. Also, while a developmental therapists only has one hour to spend during a session, caregivers have up to 84 waking hours that they spend with their child—much more opportunity to use interventions they have learned within the activities they do with their child every day! Plus, through this evidenced-based method, families build greater confidence as their child’s best and most influential teacher. This is a win-win for both children and families and is truly the goal of the home visiting program here at Siskin!

Learn more about the Home & Community-Based Early Intervention program here.

Author: Deidra Love, Director, Home & Community-Based Early Intervention

Posted by Siskin Admin  | Category: Early Intervention

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Holiday Giving

Meet the heroes of Siskin and support children with special needs this holiday season.