Staff photo by Tim Barber/ Derek Bullard is CEO of the Siskin Children's Institute.

More than 2,000 children with special needs from six different states walked through the doors of the Center for Developmental Pediatrics at Siskin Children's Institute in the past year.

Many of them come seeking treatment and support for developmental delays and disorders, while others come with families seeking answers.

About half of the kids will have a diagnosis of Down syndrome, cerebral palsy or a genetic disorder. The other half will be diagnosed with autism or suspected of autism.

Siskin houses the area's only board certified developmental behavioral pediatrician specially trained to treat these disorders. And although those 2,000 children benefit greatly from the service, Derek Bullard, president and CEO of Siskin Children's Institute, said it's not enough.

"We've traditionally had a long waitlist in the clinic, as do most clinics that do developmental pediatrics," Bullard said. "We have families that come from six, seven hours away to get a diagnosis or because they don't know what's going on with their child."

An estimated one in six children in the United States have development disorders such as autism, cerebral palsy or another disorder, according to the U.S. Centers for Disease Control and Prevention.

But with only about 1,000 doctors who specialize in treating them, long waits and geographic barriers mean too few children get the early intervention and care they need, according to a 2017 study in the Journal of Developmental and Behavioral Pediatrics.

The national study found the average wait time to see one of these doctors was 5.4 months, and many programs don't offer services for Spanish-speaking families.

Bullard took the helm at Siskin just over a year ago, and using his entrepreneurial background has made it his mission to expand access by recruiting more developmental pediatricians to the region.

Siskin has already added one new physician, doubling its force, with a third hired and scheduled to start next year.

Bullard believes that within 12 to 18 months Siskin will double the amount of patients seen at the clinic and cut the waitlist in half.

"That's really important, because those families that need the services and are not sure what's going on with their child, they'll be able to get in and get the diagnosis they need so they can have a path forward," he said.

Bullard said the biggest challenge is recruiting talent to the area when most physicians have never heard of Chattanooga or Siskin.

"Our vision is to be sure that every child in this region has access to their expertise," he said. "A big part of the battle is just getting them here and having them learn what Chattanooga is about."

Dr. Cindy Chestaro — the newest hire — said she "came to Siskin to serve as a resource to this charming community."

"My greatest desire is to help each child be the best they could be, highlighting their strengths while supporting their challenges," Chestaro said in an email. "I would also like to serve as a resource for primary care practitioners, community professionals and agencies serving children with developmental-behavioral and complex medical conditions."

Chestaro, who is bilingual, said Siskin's affiliation with the University of Tennessee College of Medicine Chattanooga and Children's Hospital at Erlanger also contributed to her decision to join the organization.

"This collaboration increases the access to a wide range of services that are needed to provide high-quality comprehensive care to our patients," she said.

To keep building momentum, Bullard said, Siskin is restructuring patient encounters to reduce wait times, hiring more staff and expanding therapy services — which help fund the clinic.

"Our largest service is the medical clinic, but in the community that's the one that most people are least aware of," he said. "By increasing access to care, increasing our physicians and reaching more kids, we're able to grow therapy, which helps offset a large part of those costs."

They're also working toward national accreditation and planning to open a Nashville clinic within a year. That will help serve the hundreds of patients who travel each year from Nashville to Chattanooga and give Siskin visibility in a bigger city, which will help with recruiting, Bullard said.

Fundraising will continue to be essential, since Siskin doesn't make money on its services, he said. But at the end of his first year, Bullard said he's still blown away by the city's "spirit of collaboration."

"People really want to solve these problems," he said. "I've yet to meet a person who hasn't been genuinely interested in helping us help the children that we serve."

Contact Elizabeth Fite at or 423-757-6673.