The Eastside's population growth has brought more medically fragile infants, more troubled families to counsel, more demand for foster care. During Siegel's tenure, for example, the center's daytime "early intervention" therapy enrollment has increased from 11 to 120 children a week.

What hasn't changed is Siegel's enthusiasm. Instead of feeling burnout, the 52-year-old director says she still enjoys working with fragile youngsters.

"I don't think it's stressful. I think it's hopeful. What we see every day are little victories," she said. "There's not a day you don't see a child sit up for the first time or speak their first word. The whole building revels in it. Or they take their first step, and someone parades them down the hall."

Now she's proposing a $1 million addition to serve a new clientele:

• school-age children who need physical therapy or help with behavioral disorders.

Siegel says older children need more attention than public schools can provide. The new 7,000-square-foot wing would accommodate children with behavioral disorders four to five days a week, and provide after-school physical therapy and speech therapy. It would also provide offices and space for autistic children.

The cities of Bellevue, Redmond, Kirkland and Issaquah have already donated $130,000 for architectural and engineering work. Siegel expects fund raising to begin in six months and hopes to open the wing within two years.

It would be the latest of several new missions. Other recent innovations include:

• The Feeding Team, which acclimates children to food after they've been fed through tubes, refused to eat or lacked ability to swallow. Children might finger-paint with peaches or play with a tub of dry lentils.
  
  
• Night classes in English and other languages for adults at risk of neglecting or abusing their children.
  
  
• Foster-care referrals under state contract. Sometimes birth parents share child-care duties with the foster parents.
  
  
• A support group for fathers.

When other services are included, Siegel estimates that 750 families per year participate in center activities.

The Kindering Center is one of seven neurodevelopmental centers in King County, and others operate around the state.

The agency started in a church basement in 1962 as Eastside Pre-School for the Special Child. Later it became known as Merrywood School. When Siegel arrived in 1978, there were 11 children using the vacant Ashwood Elementary School in downtown Bellevue. Merrywood moved to Crossroads in 1983 and changed its name to the Kindering Center five years ago.

About 2 percent of the $1.6 million budget comes from parent fees, with the rest covered by insurance, donations and multiple levels of government, Siegel said.

The University of Washington's Center on Human Development and Disability, Children's Hospital & Regional Medical Center, Group Health Cooperative, the Bellevue School District and Child Protective Services are among agencies that refer children there.

The Kindering Center 's early-intervention program is based on national studies that show IQ and language gains for disabled children who start training early. Classes typically include practice learning to speak, listen, sit or walk. A classroom of 11 children has a teacher, two aides, a physical therapist and a speech therapist.

For the first time, there's a waiting list with five families.

Two-year-old Ellie Harris, whose language development is delayed, practiced drinking orange juice with her group last week, then saw a speech therapist for individual training in food words and colors. Mothers and fathers watch through a window and pick up training tips.

Staff members use a sign language called "see-sign" so children can develop vocabulary even if their mouths and brains aren't coordinated enough to talk. Ellie was saying "baby" aloud and using hand gestures for "red" and "orange." Her mother, Kathleen Harris of Woodinville, said they practice signing at home.

An estimated 4 percent of American children are developmentally delayed, 6 percent are abused, and 15 percent have a health problem.

"One of the things we're seeing a lot of is children with a disability due to prematurity. We're keeping kids alive who are born a pound-plus," Siegel said. "The technology is contributing to preemies living, but then they need services."

To celebrate Siegel's 20th anniversary, co-workers last month held a surprise party and gave her trinkets for a charm necklace. "She loves challenges," said office manager Sue Willey. "It's real to her. She knows what she does is making a difference."

Siegel said she draws inspiration from her own daughter Elizabeth, who was born legally blind and remained so until surgery at age 9. Nothing like the Kindering Center was available in North Carolina, where they lived at that time, Siegel said.

"I would have yearned for the support and professional expertise guiding those early years," she said.