Guidance for Including Children with Disabilities in Navy CYP

Navy CYP
Inclusion Guidebook
Guidance for Working With Children
With and Without Disabilities
July 2010
Developed by Kids Included Together for
Navy Child and Youth Programs

Navy CYP Inclusion Guidebook
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Table of Contents
I. Inclusion in Navy Child and Youth Program (CYP)..................................................... 1
1. Philosophy............................................................................................................... 1
2. Benefits of Inclusion............................................................................................... 1
3. Elements of Inclusive Programs ............................................................................. 2
4. Understanding the Law........................................................................................... 2
4.1 Section 504 of the Rehabilitation Act......................................................... 2
4.2 Americans with Disabilities Act................................................................. 4
4.3 Defining Disability...................................................................................... 4
4.4 Major Life Activities................................................................................... 5
5. Additional Resources.............................................................................................. 5
II. Intake and Enrollment ..................................................................................................... 6
1. Intake Process ......................................................................................................... 6
1.1 Placement.................................................................................................... 6
1.2 Accommodations and Supports .................................................................. 7
1.3 Auxiliary Aides and Services...................................................................... 8
1.4 Emergency Action Plan .............................................................................. 8
2. Confidentiality ........................................................................................................ 9
III. Navy CYP Inclusion Support Systems.......................................................................... 10
1. Inclusion Action Team.......................................................................................... 10
1.1 IAT Team Structure.................................................................................. 10
1.2 Identifying IAT Resources for CYP Professionals and Families ............. 13
2. Referral Process .................................................................................................... 15
3. Inclusion Helpline................................................................................................. 17
3.1 Areas of Support ....................................................................................... 18
3.2 Sample Calls and Recommendations........................................................ 18
3.3 Follow-up.................................................................................................. 19
IV. Accommodations............................................................................................................. 21
1. Definition.............................................................................................................. 21
2. Types of Accommodations ................................................................................... 21
3. Examples of Accommodations ............................................................................. 22
3.1 Policies...................................................................................................... 22
3.2 Practices.................................................................................................... 22
3.3 Procedures................................................................................................. 23
3.4 Staffing...................................................................................................... 23

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3.5 Environment.............................................................................................. 24
3.6 Routine...................................................................................................... 24
3.7 Activities and Materials............................................................................ 25
4. Principles of Accommodations............................................................................. 25
5. Accommodations Versus Exceptions ................................................................... 26
6. Resources.............................................................................................................. 27
V. Disabilities and Special Needs........................................................................................ 28
1. Categories of Disability ........................................................................................ 28
1.1 Physical..................................................................................................... 28
1.2 Sensory...................................................................................................... 29
1.3 Speech and Language ............................................................................... 30
1.4 Developmental.......................................................................................... 31
1.5 Chronic Health Conditions ....................................................................... 32
1.6 Social-Emotional Disorders...................................................................... 33
1.7 Learning and Attention ............................................................................. 34
2. Children with Special Needs................................................................................. 35
3. Additional Resources............................................................................................ 36
VI. Behavior Support............................................................................................................ 37
1. Understanding Behavior ....................................................................................... 37
1.1 Temperament ............................................................................................ 38
1.2 Deployment............................................................................................... 39
1.3 Activities................................................................................................... 39
1.4 People........................................................................................................ 40
1.5 Environment.............................................................................................. 40
1.6 Physiological States .................................................................................. 41
2. CYP Behavior Support Policy .............................................................................. 42
2.1 Determining the Purpose of the Behavior................................................. 42
2.2 Identifying Strategies for Accommodations............................................. 44
2.3 Identify Teaching Strategies ..................................................................... 45
2.4 Outline Appropriate Responses and Consequences.................................. 45
2.5 Developing a Behavior Plan ..................................................................... 49
3. Supporting Positive Behavior ............................................................................... 50
3.1 Schedules .................................................................................................. 50
3.2 Transitions................................................................................................. 51
3.3 Setting Up the Environment...................................................................... 52

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VII. Partnering with Families................................................................................................ 54
1. Understanding Families ........................................................................................ 54
1.1 Concerns of Families with Children with Disabilities.............................. 55
1.2 The Role of Culture .................................................................................. 55
2. Communication with Families.............................................................................. 56
2.1 What CYP Professionals Need to Know .................................................. 57
2.2 Sharing Concerns...................................................................................... 59
2.3 Establishing Open Communication .......................................................... 61
Appendix A: Sample Emergency Action Plan......................................................................... 63
Appendix B: Inclusion Support Referral Form...................................................................... 67
Appendix C: Sample IAT Support Plan.................................................................................. 69
Appendix D: Environment Checklists ..................................................................................... 73

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I. Inclusion in Navy Child and
Youth Program (CYP)
The following guidebook provides guidance to Navy CYP Professionals on the policies and
standards in including children with disabilities and other special needs in Navy Child and Youth
Programs. CNIC regulations and policies in the guidebook must be adhered to in order to meet
standard requirements. In addition, guidance and assistance is provided in order to assist Navy
programs in supporting all children, regardless of ability or need, in Navy CYP.
1. Philosophy
Inclusion is an attitude and a philosophy that welcomes and supports all children. Inclusion is a
belief in every person’s inherent right to participate fully in society. Inclusion conveys the idea
that we appreciate each child, that we see each child’s gifts, and that we value children of all
abilities being together.
Inclusive programs are communities where children with and without disabilities live, learn, and
play together. The goal of inclusion in Navy CYP is to support the participation of children with
and without disabilities in child and youth activities and programs. Children with and without
disabilities are respected as contributing members and participate in all aspects of Navy CYP.
CYP professionals make respectful accommodations so that all children can be successful in
Navy child development centers, child development homes, school age care, and youth and teen
programs.
2. Benefits of Inclusion
One of the major misconceptions about inclusion is that it only benefits the children with
disabilities. Although children with disabilities do benefit, youth without disabilities, parents,
agencies, and the community all benefit from inclusion. Youth with and without disabilities
make new friends, have the opportunity to learn from peer models, build independence and
coping skills, notice similarities and differences amongst their peers, develop interpersonal skills,
and learn to accept others.
Inclusive programs where children with and without disabilities play and interact together lead to
the understanding of and acceptance of differences. Programs that promote inclusive practices
model an appreciation of ability difference as a form of diversity. These benefits have an impact

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on the greater society, as children in inclusive environments grow up viewing disability as a
natural part of life.
Access to inclusive child care enables parents to work, gives them the opportunity for respite,
helps them learn to accept their child’s strengths and challenges, allows them to share typical
parenting experiences and develop relationships with other families.
Navy CYPs benefit from inclusion by developing networks of professional services and
community resources and an overall awareness of how to support individual strengths and needs.
CYP professionals who learn to make accommodations for children as they need them develop
their skills as youth development professionals. The community benefits from having settings
that encourage understanding, flexibility, and acceptance of differences.
3. Elements of Inclusive Programs
Elements of inclusive programs include the following items:
• Policies, practices, and procedures that support the participation of children with and without
disabilities or other special needs.
• Accommodations to support the ability of all children to play, learn, socialize and participate
in daily routines and activities.
• Modifications to materials, activities, and the environment to accommodate the needs of all
children.
• Behavior support strategies to help children meet expectations and learn appropriate
behavior.
• Partnerships with families and ongoing interpersonal communication.
• Adult to child ratios that support child and program needs.
• Training and support for child and youth professionals to increase knowledge and skills.
4. Understanding the Law
In addition to understanding the philosophy of inclusion and its benefits, CYP professionals must
also understand the laws that protect the rights of individuals with disabilities and their families.
Since the Navy is a federal agency, both the Rehabilitation Act of 1973 (RA 1973) and the
Americans with Disabilities Act of 1990 (ADA 1990) apply to Navy Child and Youth Programs.
4.1 Section 504 of the Rehabilitation Act
Section 504 of the RA 1973 is a national law that states that “no qualified individual with a
disability in the United States shall be excluded from, denied the benefits of, or be subjected to
discrimination under" any program or activity that either receives Federal funding or is

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conducted by any Executive agency. Section 504 is an anti-discrimination, civil rights law that
requires that the needs of children with disabilities be met as adequately as the needs of children
without disabilities in federally funded programs. Under Section 504, Navy CYP cannot exclude
or deny children and youth with disabilities an equal opportunity to receive program benefits and
services. Prohibitions against discrimination apply to CYP service availability, accessibility,
delivery, and CYP administrative activities and responsibilities.
Title 45: Part 84
Under Title 45: Part 84, nondiscrimination on the basis of disability in programs or activities
receiving federal financial assistance, a CYP cannot:
• Deny a qualified child or youth the opportunity to participate in or benefit from CYP.
• Provide a child with a disability an opportunity to participate in CYP that is not equal to the
opportunity of others.
• Provide different or separate programs to children with disabilities unless such action is
necessary to provide services that are as effective as those provided to others.
• Otherwise limit a child with a disability in the enjoyment of any right, privilege, advantage,
or opportunity enjoyed by other children and youth in CYP.
Navy CYP is not required to produce the same level of achievement for children with and
without disabilities. However, CYP must provide children with disabilities an equal opportunity
to obtain the same result, to gain the same benefit, or to reach the same level of achievement, in
the most integrated setting appropriate to the child’s needs.
§84.37 Nonacademic Services
Navy CYP must provide extracurricular services and activities in such a manner as is necessary
to afford children with disabilities equal opportunity for participation in such services and
activities. Nonacademic and extracurricular services and activities may include sport and fitness
programs, transportation, special interest groups or clubs. In providing sport and fitness
programs, CYP may not discriminate on the basis of disability. Any sport or fitness program
must provide qualified children with disabilities (those children who meet basic age and
eligibility requirements) an equal opportunity for participation.
§84.38 Preschool
Any program that receives federal funding or is conducted by a federal agency that provides
preschool education or day care may not, on the basis of disability, exclude qualified children
with disabilities and shall take into account the needs of such children in determining the aids,
benefits, or services to be provided.

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4.2 Americans with Disabilities Act
The ADA 1990 is a federal civil rights law that prohibits discrimination against individuals with
disabilities and their families. The ADA is divided into sections, referred to as titles. Title II is
the legislation that pertains to government agencies. Title II requires that government agencies
conduct case-by-case assessments of what an individual with a disability needs to be fully
included in government programs.
Title II guarantees equal opportunities for individuals with disabilities Navy Child and Youth
Programs. The ADA outlines four primary types of accommodations:
• Inclusive admissions policies that do not tend to screen out children with disabilities.
• Changes to organizational policies, practices and procedures.
• Auxiliary aids and services to ensure communication.
• Removal of physical barriers in program facilities.
4.3 Defining Disability
The definition of disability is broad and includes all types of conditions. Section 504 of the RA
and the ADA legally define it in this way:
An individual with a disability is a person who:
• Has a physical or mental impairment that substantially limits one or more major life
activities.
• Has a record of such an impairment.
• Is perceived as having such an impairment.
Physical or mental impairments are further defined as any physiological disorder or condition,
cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems:
neurological; musculoskeletal; special sense organs; respiratory, including speech organs;
cardiovascular; reproductive; digestive; genitourinary; hemic and lymphatic; skin; and
endocrine; or any mental or psychological disorder, such as an intellectual disability, organic
brain syndrome, emotional or mental illness, and specific learning disabilities (US Department
of Education Office of Civil Rights).
The ADA provides guidance on the meaning of “substantially limits” as significantly restricted
as to the condition, manner, or duration under which an individual can perform a major life
activity when compared to the condition, manner, or duration under which the average person in
the general population can perform the same major life activity.

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4.4 Major Life Activities
Major life activities include but are not limited to caring for one’s self, speaking, hearing, seeing,
walking, standing, breathing, reading, concentrating, thinking, communicating, and working. In
a CYP, examples of major life activities include using the bathroom independently,
communicating with other children and CYP professionals, understanding directions, learning
the program routine, playing, and making friends.
5. Additional Resources
• For information and resources on how the law applies to child care settings, visit the Child
Care Law Center at www.childcarelaw.org.
• For information on Section 504 obligations, visit the US Department of Education Office of
Civil Rights at www.ed.gov/about/offices/list/ocr/index.html.
• For general information on disability rights, visit the US Department of Justice website at
www.usdoj.gov.
• Read the Electronic Code of Federal Regulations (e-CFR) at GPO Access, a Service of the
US Government Printing Office at www.gpoaccess.gov.

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II. Intake and Enrollment
A family’s first contact with CYP will set the stage for the family-CYP professional relationship
throughout the child’s participation in the program. The intake and enrollment process allows
both the family and the professionals to learn about what the child may need to be successful in a
child, youth, or teen program. It gives the family the opportunity to learn about CYP policies
and procedures. It also provides an opportunity for CYP professionals to share their philosophy
on inclusion and how they support children with and without disabilities in their programs. This
chapter outlines the CYP intake process and enrollment procedures and strategies for
maintaining confidentiality.
1. Intake Process
No child who meets the basic age and eligibility requirements may, solely based on disability or
special need, be excluded from Navy CYP. All families will complete the intake process for
enrolling their child in Navy CYP. When families identify their child as having a disability,
medical condition, or specific need, CYP professionals will work with the family to determine
the following:
• Placement in the most inclusive setting appropriate to the child’s needs.
• Accommodations and supports for participation.
• Auxiliary aides or services to ensure effective communication.
• Emergency action plan for medical or other health-related concerns.
• Method for ongoing communication between CYP and the family.
The process of identifying what the child needs to be successful in CYP is ongoing and a child
should not be denied enrollment pending the completion of the information gathering process.
1.1 Placement
CYP professionals will work with the family to gather information on the types of environments
that work well for the child in order to identify an appropriate placement. CYP professionals
should not assume that a child with a disability should automatically be placed in a Child
Development Home (CDH). A CDH may be the best fit for a child, but this determination must
be made by examining the needs of the child, the preferences of the family, and the resources
and supports available to the local CYP. A CDH may offer lower staff to child ratios and less
environmental stimulation; however, the CDH may also have fewer resources available to meet

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the child’s needs. In addition to general questions about the child’s interests and abilities, it is
recommended that the following questions be included to help identify an appropriate placement:
• Does your child seem excited about new environments?
• Does your child enjoy toys and objects with bright colors and visual effects or seem sensitive
to bright and stimulating toys and environments (may close eyes frequently)?
• Does your child like games and activities that make noise and enjoy making noise or seem
sensitive or upset by certain sounds (may cover ears frequently)?
• Does your child enjoy physical touch and a variety of textures or tend to avoid touching
certain textures or types of touch (may dislike people touching face and head)?
• Does your child enjoy jumping, running, and active play or does your child prefer quiet play?
(For an older child, the question may be phrased as ‘does your child enjoy sports or prefer to
play cards or other quieter activities)?
These questions will provide information on how the child interacts with and reacts to different
types of environments and materials, which may be helpful in looking at the environments in
available placement options. It is important to also consider accommodations that could be made
in each environment. For example, a child is sensitive to noise and prefers quiet play and an
available pre-K classroom in a Child Development Center (CDC) has 24 children and tends to be
loud and active. Possible accommodations include designating an area for active play, creating a
quiet area, scheduling a balance of quiet and active activities, and offering alternative activities
for small groups during active games and activities.
1.2 Accommodations and Supports
Navy CYP is required to make reasonable accommodations to policies, practices, and procedures
to support participation for children with and without disabilities. Accommodations are
discussed in detail in Chapter 4; however, families can offer insight into the types of
accommodations that may be necessary in supporting their child. Areas to focus on and sample
questions to ask families to gather information on the accommodations needed are listed below:
• Play behaviors: How does your child play? Does she play alone? With adults? With other
children?
• Physical development: How does your child move? Does he require any adaptive equipment
or supports for using fine motor skills?
• Emotional development: What does she do when she is upset? What helps to calm her
down?
• Social development: How does your child cope with changes in routines? How does she
react when she has to move from one activity to another?

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• Self-help skills: Does he need assistance when using the toilet? Are there specific things that
he needs help with (opening his lunch or blowing his nose)?
• Sensory needs: Are there any particular sounds or smells that bother him? Does he mind
being close to other children and people?
• Goals: What goals do you have for your child in the program?
1.3 Auxiliary Aides and Services
Navy CYP are required to provide auxiliary aids and services that are necessary to ensure equal
access to the programs offered for children and youth with disabilities who have physical or
mental impairments, such as vision, hearing, or speech impairments that substantially limit the
ability to communicate. CYP professionals must work with the family to determine the level of
support needed for effective communication. In many cases, more than one type of aide or
service can support communication. Discovering how a child communicates and what he or she
may need to support communication requires asking the following questions:
• How does your child communicate? Does she use gestures, speech, sign language, pictures?
• How do you and your family communicate with your child? Does your child communicate
best when others use verbal language, sign language, pictures, other?
• How does your child request what he wants?
• What does your child do to indicate what he does not want?
• What are some ways your child shares how she is feeling?
• What types of supports can we put in place to make sure we can effectively communicate
with your child and he can communicate effectively with us?
1.4 Emergency Action Plan
All children with chronic health conditions participating in Navy CYP must have a written
document outlining their healthcare and emergency plans or physician care plan. A sample
emergency action plan from the Asthma and Allergy Foundation of America is included in
Appendix A. The American Academy of Pediatrics recommends the following information be
included in the plan:
• Child’s needs.
• Medication or procedures required during care.
• Special dietary needs.
• Transportation needs.
• Possible problems, special precautions.
• Pediatrician’s name.
• Emergency plans and procedures (including who to contact).

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2. Confidentiality
CYP professionals will only be able to gain a family’s trust if they can guarantee that all
information shared about a child’s disability or special need will be kept confidential. Details
about a child may only be given to staff members for whom the information is absolutely
necessary. In order to share any information with community agencies or organizations outside
of CYP and/or CYP contractors, written permission must be obtained from the parents. Each
CYP shall develop a system that will protect confidential information and communicate that
system to parents during the intake process. Systems for maintaining confidentiality should
include the following:
• Process for keeping all records, forms and other information about the child’s disability in a
secure location (i.e. locked cabinet in the director’s office).
• Designation of a discreet area (not visible to all children and families) to post allergies or
other life threatening conditions where CYP professionals can easily access the information.
• Training for staff on keeping information confidential during the program day and outside
program hours.
• Plan or sample response for staff when parents of children without disabilities ask questions
about other children in the program. For example, “We maintain every child’s
confidentiality in our program, and so I am sorry that I cannot answer your question or
concern. You can be assured that we do everything possible to ensure that all children have a
positive experience in our program.”
Families should be notified that general information about their child may be shared with CYP
contract organizations (i.e. Kids Included Together (KIT), the Inclusion Action Team (IAT), or
Military Life and Family Consultants (MLFCs) in order to receive customized recommendations
for accommodations and supports. CYP professionals working directly with the child should ask
parents how they would like their child introduced to others and what information is okay to
share (if any). The answer to this question will be different for every family. As CYP
professionals respect the family’s right to privacy, the family will respect and value the CYP’s
commitment to their family.

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III. Navy CYP Inclusion Support
Systems
Navy CYP is dedicated to supporting the inclusion of children with and without disabilities.
Navy CYP also recognizes that CYP professionals need guidance and support in designing
accommodations, interpreting and responding to behavior, and partnering with families. Each
child and family will present a unique situation and will require a customized approach. The
IAT and the Navy CYP Inclusion Helpline are supports for CYP professionals as they work to
meet the needs of a diverse population of children and families. This chapter will describe the
process for CYP professionals in accessing and maximizing support from IAT and the Inclusion
Helpline.
1. Inclusion Action Team
The purpose of the IAT is to support CYP professionals in accommodating the needs of children
and youth in CYP and to assist the program in securing the necessary support and resources from
the chain of command and CNIC. The process for referring children for IAT support is detailed
in Section 2, Referral Process.
1.1 IAT Team Structure
The Installation CYP Director or CYP Director designated with installation oversight
responsibilities is responsible for assembling an IAT for their installation or coordinating with
the region. Duties for assembling the IAT include identifying an appropriate IAT leader,
recruiting members, and interim leadership of IAT as needed.
IAT Leader
Appropriate IAT leaders include Fleet & Family Services Program (FFSP) Directors, all
installation CYP Directors, Resource and Referral Directors, Regional CYP Managers,
Exceptional Family Members Program (EFMP) Managers and Navy medical professionals.
Duties of the IAT leader include but are not limited to the following:
• Recruiting IAT members.
• Orienting IAT members to CYP policies and procedures.
• Ensuring that all appropriate parties are present to assist the team in having a clear picture of
the child’s needs.

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• Communication with members.
• Coordinating schedule and agendas for meetings.
• Managing meeting caseloads.
• Facilitating the meetings.
• Submitting IAT support plans, recommendations and meeting minutes to the commanding
officer or designee.
IAT Members
IAT members may include professionals working in the field of child and youth development,
early intervention, medicine, family support services, therapy, special and general education, or
related fields. The number of IAT members will vary by region or installation according to the
size of the installation, resources available, and community involvement. The structure of the
team will depend on what works best for each installation. CYP professionals are encouraged to
examine local resources, as well as resources available through the region when deciding which
option will work best: an installation IAT or a regional IAT. The team must be comprised of
members who have relative information about the child’s case and the perspective needed to
assist the team in developing a plan to best include the child successfully in the program.
Although the members will differ by region and installation, the following perspectives should
be represented on the IAT. Perspectives may be presented in written form (i.e. recommended
emergency action plan from a medical authority):
• CYP Director.
• Medical personnel such as navy medical or civilian pediatricians and nurse practitioners.
• CYP professional who has objectively observed the child and can provide documentation
(may be the child’s teacher, youth leader, training & curriculum specialist or other relevant
position).
• Family support services representative examples include MFLCs, FFSP representatives,
EFMP managers, school counselors, or marriage and family therapists (MFTs)
• School district representative possibilities include School Liaison Officers (SLOs), and
general or special educators
• Therapeutic specialist could include an occupational therapist (OT), speech therapist (ST),
physical therapist (PT), certified therapeutic recreation specialist (CTRS), behavioral
therapist or board certified behavior analyst (BCBA)
• KIT inclusion specialist (as needed) that has been working with the CYP professionals to
develop supports and accommodations for the child. KIT inclusion specialists will
participate via phone.

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Depending on the region, some IAT leaders may want to consider recruiting several individuals
from each perspective to account for scheduling conflicts and other logistical issues. The CYP
professional perspective will vary by meeting, depending on the cases being presented. Some
meetings may include several CYP professionals from different installations. IAT leaders are
encouraged to develop their own guidelines on whether the CYP professionals must attend the
entire meeting, call in to discuss the child they have observed, or attend for only the applicable
portion of the IAT meeting. IAT leaders should schedule the date of the next IAT meeting
before adjourning the meeting to maximize member participation and minimize scheduling
conflicts.
Parents or guardians of the children participating in CYP may attend the portion of the IAT
meeting that applies to their child. Parent participation is not required and the IAT chairperson
or helpline inclusion specialist may help the CYP professionals determine whether parent
participation would be beneficial. If a parent does participate in their child’s discussion, he or
she may not be present for the discussion of other children participating in CYP. It is critical that
the IAT maintain the confidentiality of the children and families supported by the IAT. Some
regions or installations may recruit a parent of a child with a disability to participate in their IAT.
Although a parent IAT member may serve on the team, he or she cannot have a child currently
enrolled in a CYP.
IAT Responsibilities
In order to support CYP professionals in accommodating the needs of children and youth in
CYP, the IAT has the following responsibilities:
• Identify the needs of the child within the CYP.
• Recognize areas where accommodations and individualized supports are necessary.
• Contribute to the design of individualized accommodations and supports.
• Review emergency action plans and health management plans.
• Make recommendations for behavior plans.
• Collaborate with CYP professionals as they develop IAT Support Plans for each child-
specific case.
• Communicate IAT meeting minutes to the commanding officer or designee, which shall
include summary information about the accommodations being provided in CYP (does not
have to include the full IAT Support Plan for each child).
• Assist CYP professionals in identifying local resources and services.
• Recommend CNIC supports where appropriate (including requesting funding for additional
staff to increase adult to child ratios).
• Organize resources for CYP professionals and families.

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• Discuss inclusion-related issues within the region (i.e. physical access, community
collaboration, staff training).
• Follow-up on child-specific cases and inclusion-related topics in the region.
IATs are not limited to the responsibilities above and may outline further responsibilities that
address regional needs.
IAT Support Plan
An IAT Support Plan must be completed for each child-specific case presented at IAT meetings
and kept in the child’s file. The support plan must include the following:
• Information from IAT referral form.
• Emailed list of recommendations from the inclusion specialist.
• Outline of strategies and accommodations being implemented in the CYP.
• Emergency action plan, health management plan or behavior plan (if applicable).
• Description of how information will be shared with CYP professionals working directly with
the child and any necessary training.
• List of recommended resources for CYP professionals and the child’s family.
• Outline of follow-up (i.e. how often CYP professionals will check in with the family, KIT
Inclusion Helpline, IAT).
A sample IAT Support Plan is included in Appendix C.
1.2 Identifying IAT Resources for CYP Professionals
and Families
Identifying local and regional resources for CYP professionals and families is a central role of
the IAT. IAT members represent multiple perspectives and may be connected to different
systems of support within the region or community. In working toward organizing resources,
both military and community supports should be considered. Common agencies or systems to
consider include the following:
Military System Support
• CNIC N91 provides support to Navy CY professionals and programs. CYP professionals can
request funding for accommodations, training and additional staff as determined by the IAT.
• The Navy’s FFSP supports sustained mission and Navy readiness. FFSP provides services to
strengthen personal and family competencies to meet unique challenges of the military
lifestyle. Services include deployment readiness, new parent support, transition assistance,
relocation assistance, family advocacy, life skills, and clinical counseling.

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• The EFMP is designed to provide support to military family members with special needs.
The EFMP is a multidisciplinary assignment tool that interfaces with other military and
civilian agencies to provide comprehensive support to families.
• The MFLC program uses licensed clinicians with Masters Degrees and at least five years
experience in Social Work, Counseling, or related clinical discipline. Consultants are
trained on military specific topics including basic orientation to the deployment cycle,
military culture, the chain of command, and reporting requirements in accordance with the
Army’s Family Advocacy Program. MFLCs also receive KIT training on inclusion within
their first two weeks of service in CYP.
• Educational and Developmental Intervention Services (EDIS) is an overseas program that
works with and provides support for children from birth to 21 years, who experience
developmental delays that restrict their ability to learn. EDIS provides a variety of options to
help nurture a child’s development including physical, occupational and speech therapy, a
social worker and a psychologist.
Community Support
• The Alliance for Technology Access (ATA) provides information and referrals on
technology resources, outreach and public awareness, and training for professionals. The
ATA website (www.ataccess.org) lists 40 assistive technology resource centers nationwide.
• The Arc of the United States advocates for the rights and full participation of all children
and adults with intellectual and developmental disabilities. Using a network of members and
affiliated chapters, the Arc improves systems of supports and services; connects families;
inspires communities and influences public policy (www.thearc.org).
• Disability.gov is a federal website that provides easy access to comprehensive disability-
related information and resources on programs, services, laws and regulations.
• The National Council on Disability website (www.ncd.gov) offers resources that include
links to local parent training and information centers and state vocational and rehabilitation
centers.
• National Disability Agencies: Many national disability organizations have local chapters in
nearly every state. For example, the Autism Society of America (www.autism-society.org)
and United Cerebral Palsy (www.ucp.org) have chapters in every state.
• The National Federation for the Blind (www.nfb.org) improves the lives of people who are
blind or have low vision through advocacy, education, research, technology, and programs
encouraging independence and self-confidence and has affiliates in all 50 states.
• National Association of Child Care Resource and Referral Agencies (NACCRRA):
Local resource and referral agencies often offer free training to early childhood and school
age child care providers and may have programs specific to supporting children with

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disabilities in childcare. Search for local resource and referral agencies online at
www.naccrra.org.
2. Referral Process
The IAT is structured to organize resources and develop strategies for supporting children with
disabilities and other special needs in CYP. The referral process is designed to standardize IAT
procedures, identify which children need the support of the IAT (regardless of whether they have
a diagnosed disability or medical condition), and provide child-specific recommendations for
CYP professionals. It may be difficult for the IAT to provide customized recommendations for a
child who has not yet entered the program or is new to the program. Every child with a disability
will need different types of support depending on their individual strengths, needs, and the CYP
environment. The referral process will allow KIT inclusion specialists to provide initial support
to CYP professionals in identifying needs and planning for accommodations (i.e. evaluating
available placement options and suggesting environmental accommodations). The IAT will
provide ongoing support to CYP professionals in designing individualized supports and
evaluating supports and accommodations as the child’s needs change over time.
Prior to referring children for IAT support, CYP professionals have a responsibility to approach
the child’s family as the first line of support. The child’s family may be able to provide the
information needed to support the child and design accommodations for participation in the
program. The referral process should not replace conversations with parents or guardians
regarding concerns about the child’s behavior or participation in the program.
CYP professionals will follow a three-step referral process to refer children for inclusion support
through KIT. The Inclusion Support and Referral Form (see Appendix B) and the Inclusion
Referral Decision Tree (see Appendix B) will help CYP professionals in determining whether a
child will need to be referred to KIT. When a child has a disability, special need or condition
that results in limitations to major life activities (breathing, walking, talking, playing, etc.), the
CYP Director is required to complete the Inclusion Support and Referral Form.
Challenging behaviors that threaten the safety of the child or others qualify as a condition that
limits the child’s major life activities. It is recommended that children who display aggressive
behavior be referred to KIT. If a child has a life-threatening condition, the child’s case may
proceed directly to the IAT with a copy of the referral form submitted to KIT.
A life-threatening condition puts the child in danger of death during the program day without
medication or treatment and an emergency action plan in place. Examples of life-threatening
conditions include (but are not limited to) the following:
• Cardiac/heart conditions.

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• Severe allergies (i.e. bees, peanuts, etc.).
• Severe asthma.
• Severe hemophilia.
• Some seizure disorders.
• Type I diabetes.
• Any condition documented by a physician as putting the child in danger of serious injury or
death during the program day.
The three-step process for referrals is described below:
• Step One: A child is identified as having a disability, special need or condition that limits
major life activities and requires accommodations or supports to participate in the CYP. The
CYP professional completes the Inclusion Support Information and Referral Form (see
Appendix B).
• Step Two: If all four of the answers under section 2 are NO, the form is placed in the child’s
file. Ensure that any necessary documentation for children with medical needs is included in
the file (i.e. medication administration form, emergency action plan) and kept in the child’s
classroom or general program area for CYP professionals’ reference. If any of the answers
under section 2 are YES, the CYP professional submits the form to KIT via email at
navycyphelp@kitonline.org and continues to step three.
• Step Three: The CYP professional follows recommendations from a KIT inclusion specialist:
o Option 1: KIT recommendations without a referral to the IAT. A copy of the signed
Inclusion Support Information and Referral form and recommendations must be kept in
the child’s file along with any other necessary documentation.
o Option 2: KIT recommendations with a referral to the IAT. A copy of the signed
Inclusion Support Information and Referral form and recommendations must be kept in
the child’s file and forwarded to the IAT chairperson to be included in the next IAT
meeting agenda. Once a child has been referred to IAT, the IAT must meet within 30
days. If the condition is life-threatening or there is a question about the program’s ability
to accommodate the child, the IAT meeting must be held as soon as possible.
Once KIT receives a referral form, an inclusion specialist will contact the Navy CYP
professional who made the referral to schedule a time to discuss the child’s case. CYP
professionals may or may not need the support of IAT to include children with disabilities and
other special needs. The inclusion specialist will help the CYP professional determine whether
IAT support is needed and outline the supports and accommodations that are necessary for the
child’s participation in CYP. The inclusion specialist will provide customized recommendations
for CYP professionals on developing accommodations and support strategies and a
recommendation for whether the child’s case should be presented to the IAT. The CYP

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professional will receive the customized recommendations and a signed recommendation for
referral to the IAT via email.
Some cases will not require a referral to KIT. For example, a child is identified by the parent as
having a non-life threatening food allergy and does not eat dairy products. The CYP
professional would complete the Inclusion Support Information and Referral form and maintain a
copy in the child’s file. The program would follow the policies outlined in Chapter 4 of the
OPNAV and post the child’s food allergy in a location viewable by staff that protects the child’s
privacy and develop a plan for food substitutions if necessary.
Many cases will require the support of the IAT. For example, a child is identified by the parent
as having autism and the parents and CYP professionals are not sure what the child’s needs may
be in the program. The inclusion specialist will work with the CYP professionals on gathering
information from the family about the child’s strengths and needs. For a child with autism, the
inclusion specialist might provide initial recommendations on structuring the program
environment and routine and introducing the child to the routine and structure. The IAT will
review the case at the next IAT meeting and identify where the child is doing well and where
additional supports or accommodations may be necessary. The IAT will provide
recommendations for CNIC support and community resources and the child’s case will be
reviewed at IAT meetings on an ongoing basis as the child’s needs change.
If the child is not initially recommended for IAT support, CYP professionals are responsible for
making additional referrals as the child’s needs change. For example a child with asthma was
not originally recommended for IAT support and begins to have an adverse reaction to his
asthma medication.
3. Inclusion Helpline
The Inclusion Helpline is staffed by inclusion specialists at KIT. CYP professionals can access
the helpline via phone (866-930-0931) or email (navycyphelp@kitonline.org) and an inclusion
specialist will respond during published hours. Any CYP professional can utilize the helpline,
from operations clerks to CDH providers and regional staff, without going through the chain of
command. The inclusion specialist will record information from the CYP professional including
name, contact information, role and region. An individual may call the helpline to speak with an
inclusion specialist or schedule a time for a group of individuals (i.e. center director, lead
teacher, and teacher) to discuss a case or situation. Requests to speak with an inclusion specialist
may also be made via the helpline email address. Overseas installations should email to schedule
a time for a call that works for their time zone.

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3.1 Areas of Support
A CYP professional may access the inclusion helpline, operated by KIT, to make a referral or
discuss any case or situation related to a child’s participation in a program or supporting a group
of children in an inclusive setting. A helpline inclusion specialist can help provide customized
suggestions, resources, tips and tools on the following:
• Accommodations including physical, material, and environmental adaptations.
• Behavior support techniques and suggestions for creating behavior plans.
• Communication strategies and supporting communication for children with and without
disabilities.
• Developmental expectations and designing activities to support a child’s development.
• Disability specific information.
• E-Learning technical support for self-paced modules and webinars on inclusion-related topics
• Guidance on working with families.
• Ideas for staff training and follow-up activities for online training.
• Strategies for supporting sensory needs.
• Suggestions for encouraging peer interactions and facilitating friendships.
This list is not designed to be exhaustive and a CYP professional may access the helpline with a
specific or general question about any topic related to inclusion.
3.2 Sample Calls and Recommendations
Two sample calls and recommendations are described in Exhibit 1 to provide CYP professionals
with an overview of a typical helpline call and recommendations.

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EXHIBIT 1: SAMPLE HELPLINE CALLS
Summary Recommendations
• CYP professionals concerned about a child’s social-
emotional development and coping skills.
• Behaviors described included crying frequently and
using aggression with peers.
• Child seems to become frustrated easily and have a
difficult time managing frustration.
• Strategies for preparing the child for activities ahead
of time.
• Recommendations for teaching the child to identify
when he is feeling out of control.
• Suggestions for creating a quiet area.
• Examples of calming toys and items to try.
• Guidance on providing choice and control.
• CYP professional reports child seems angry and is
difficult to soothe when upset.
• Child does not play with toys in a way similar to his
peers.
• Child has been observed hitting other children and
teachers, spitting, and throwing chairs.
• Suggestions for developing a plan to teach play
skills.
• Recommendations on responding to hurtful
language.
• Ideas for appropriate responses to aggressive
behavior.
3.3 Follow-up
CYP professionals should develop a written plan for follow-up on a helpline call. An inclusion
specialist will provide several recommendations via email. It is the responsibility of the
professional who receives the email (typically the Director or Training & Curriculum Specialist)
to share the information with the CYP professionals working directly with the child. It may not
be possible or reasonable to implement all the recommendations at once. It is also difficult to
identify which supports or accommodations work when there are several strategies being
implemented simultaneously. Follow-up plans will also help CYP professionals remain
consistent in supporting the child. The process for follow-up should include identifying which
strategies or supports the CYP professionals will try first, how the child’s behavior and response
to strategies will be documented, and a plan for following up on progress and whether new
strategies should be implemented. In some cases, the recommendations will be brought to an
IAT meeting, where CYP professionals can work with IAT members to develop a follow-up
plan. See Exhibit 2 for a sample follow-up plan.

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EXHIBIT 2: SAMPLE FOLLOW-UP PLAN
Child’s Name
Date of helpline call: May 25
Recommendations:
• Strategies for preparing the child for activities ahead of time.
• Recommendations for teaching the child to identify when he is feeling out of control.
• Suggestions for creating a quiet area.
• Examples of calming toys and items to try.
• Guidance on providing choice and control.
Strategies being implemented:
• CYP professionals will talk to the child about possible solutions to a conflict prior to free play activities and help
him identify which strategy to use that day. Visuals will be used when available.
Documentation of child’s behavior:
• The Lead teacher will observe the child during free play periodically for two weeks (i.e. 3 times per week) and
document the child’s behavior and response to teacher-guided selection of possible solutions.
Plan for follow-up:
• CYP professionals will meet in three weeks to discuss observations and identify new strategies. CYP
professionals will decide whether a follow-up call with the inclusion helpline is necessary at that time.
An inclusion specialist will also call to check in with the CYP professionals approximately 3
weeks to 1 month after the initial call. This purpose of this call is to see if CYP professionals
have questions, and to follow-up on progress and whether the child’s needs have changed.

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IV. Accommodations
In collaboration with the child’s family, the Navy CYP Inclusion Helpline, and the IAT, Navy
CYP professionals will make accommodations to policies, practices, and procedures in order to
support the participation of children with and without disabilities in CYP. This chapter will
define the term accommodation, share information about different types of accommodations and
provide examples of accommodations in child, youth, and teen programs.
1. Definition
A respectful accommodation is an individualized support that promotes access to learning,
recreation, leisure or work. It is a change or modification made to expectations, requirements,
materials, activities, or the environment. The purpose of an accommodation is to physically,
socially, or emotionally support a child’s participation in a program. Designing accommodations
involves finding out specifically what each child will need or not need in order to succeed. This
is accomplished with case-by-case assessments in collaboration with the family and IAT to
determine the child’s needs and available supports and resources.
2. Types of Accommodations
Although accommodations are individualized supports and will vary by child, there are four
types of accommodations that are helpful to consider when developing supports.
• Interpersonal accommodations may support effective communication or support a child
during interactions with others. Examples include speaking slowly and clearly for a child
who has difficulty processing verbal language, modifying expectations for a child who has a
hard time sitting for quiet activities, and modeling turn-taking for a child learning how to
play cooperatively with others.
• Material accommodations may support a child’s participation in play, motor, and academic
activities or interaction with games and program items. Examples include adding Velcro™
to blocks for a child who has trouble stacking, making a card holder for a child who needs
assistance holding playing cards, and adding picture instructions to a board game for a child
learning to read.
• Environmental accommodations may support a child’s sensory or social-emotional needs
or navigation within the physical space of the program. Some examples are providing
increased opportunities for sensory play for a child who is soothed by tactile play and placing
colored tape around the edges of the furniture for a child with low vision.

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• Behavioral accommodations may support a child in learning age-appropriate behavior or in
adjusting to the routine and schedule of the program. Behavioral supports include creating a
personalized schedule for a child who has trouble transitioning from one activity to another,
breaking down rules and expectations and providing concrete examples, and teaching a child
coping strategies such as counting to three.
3. Examples of Accommodations
In including children and youth with disabilities and other special needs, there are several areas
Navy CYP will have to consider in determining what kinds of accommodations and supports are
needed: policies, practices, procedures, staffing and the program’s environment, routine, and
activities and materials. The examples presented do not represent all possible accommodations
for the area described. For more examples or case-specific information, contact the Inclusion
Helpline.
3.1 Policies
In general, Navy CYP policies support the participation of children with disabilities and other
needs. Program-specific policies may need to be adapted on a case-by-case basis to ensure
maximum participation from children and youth of all abilities. Examples of accommodations to
policies are listed below:
• Modifying the orientation process to include a site visit for parents during program hours or
allowing the parents to spend time in the classroom with the child so they can get a sense for
the program, anticipate where their child may need support, and help the professionals get to
know the child.
• Adapting a pool safety policy to make an accommodation for a child with low muscle tone
who needs to use a flotation device in order to swim.
• Developing a policy on assisting with toileting in a school age care program and adapting it
as necessary as the needs of the children in the program change.
• Reviewing policies on medication administration to make sure they allow for a child to
receive adequate care.
3.2 Practices
Many times accommodations involve modifications to general CYP professional practices.
Practices are based upon what is developmentally appropriate for the age of the children
participating and the structure of the program. Some examples of accommodations to practices
include the following:

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• Breaking the classroom’s circle-time activities into smaller chunks of time for children who
have difficulty staying with the group (i.e. 2 minute book, 2 minute song, 2 minute
movement activity) or facilitating smaller group circle-time activities instead of facilitating
large group activities with 24 children.
• Allowing children to sit, stand, lay down, or to work individually or in groups during
homework hour to support different learning styles.
• Modifying a community service learning project by presenting one step at a time for a teen
with an intellectual disability.
• Providing structured activities in a teen club for teens that have a difficult time engaging with
peers in unstructured environments.
3.3 Procedures
Procedures identify specific actions or series of actions designed to carry out policies.
Accommodations to procedures may involve making changes to steps or the sequence of steps.
Some examples include:
• Adding a step to the procedure for scheduling field trips in which CYP professionals research
the accessibility of the location and secure accessible transportation if necessary.
• Modifying the serving procedure during snack to limit the children’s access to extra food for
a child with a metabolic condition that causes a food compulsion.
• Adapting the timeline for a child who may need additional support to transition from one
classroom to another (toddler room to preschool room) by beginning the transition earlier and
allowing for a more gradual transition.
3.4 Staffing
The ratio of adults to children plays a large role in supporting the needs of the children in a
program. Many children need additional adult support when they first enter a program until they
get used to the routine and schedule. Some children need additional adult support as they
transition to a new program (from a CDC to a SAC) and others need additional adult support
during certain times of the day. A limited number of children may require ongoing one-on-one
support. In order to meet the needs of the children in their care, programs may consider the
following:
• Shifting staffing schedules to provide additional support to a group of children during a
challenging part of the day (an active group of 7 year olds need additional support during
quieter activity times, i.e. art project).
• Partnering with another CYP within the installation to provide support (a CDC may partner
with a Youth and Teen program to get teen volunteers for part of the day).

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• With approval from the IAT, programs are authorized to utilize additional staff to help a
child adjust for a period of time, not to exceed 30 days. In the majority of cases, additional
staff will only be needed short-term as the child adjusts to the program. In the rare case that
additional staffing for a period of time longer than 30 days is recommended by IAT, a
funding request may be submitted to CNIC (N91). All requests for long-term additional staff
will be re-evaluated after 90 days. After 90 days, programs must re-submit documented
justification for continued additional staffing to CNIC (N91).
3.5 Environment
The main aspects to consider within the environment are adjustments or accommodations to the
physical, sensory, and social-emotional environments. Examples for each are described below:
Physical
• Creating a quiet area within the program where children can take a break from environmental
stimulation – this area should not contain a lot of visual stimulation and be far away from
active areas.
• Placing program materials on lower shelves and making sure there is adequate space between
areas so a child using a wheelchair can easily access materials and navigate the space.
Sensory
• Providing non-latex gloves for a child who does not like touching art materials or a damp
cloth near tactile activities so children can easily remove materials from their hands.
• Allowing a child to hold a heavy object on his lap during homework to help him focus.
Social-Emotional
• Writing a story about a CYP professional getting transferred to another installation to prepare
the children for a major staffing change.
• Incorporating yoga poses and stretches into the program day to help a child manage stress
and anxiety.
3.6 Routine
Children and adults benefit from having a consistent routine and schedule and being prepared for
program activities. Many children need support in learning the routine and managing behavior
when the routine changes unexpectedly. Ideas for accommodations to the routine include the
following:

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• Using “First, then” statements to prepare a child for activities throughout the day (“First
wash hands, then snack”).
• Helping a child get used to the routine and schedule using an object sequence: book for story
time, can of play dough for sensory play, soap for washing hands, and toy apple for snack.
• Pairing transitions with a calming noise or sound (i.e. soft chime) to signal a change to a new
activity.
• Providing an optional early snack for a child with low blood sugar.
3.7 Activities and Materials
Many children need activities presented in a different way or adapted for their abilities. Children
with physical disabilities or low muscle tone may require adaptations to materials to support their
independence. Examples of activity and material accommodations are listed below:
• Using Velcro™ to attach larger buttons or knobs to existing buttons a video game controller
for a teen who has difficulty using fine motor skills.
• Pairing pictures with verbal directions to help explain the rules of a game.
• Spending time preparing a child for an activity ahead of time (teaching the child how to play
Go Fish 1:1 before playing Go Fish with a group of children).
• Using wax string to create raised-line coloring pages for a child who is blind.
4. Principles of Accommodations
CYP professionals have available resources to assist in designing supports and accommodations.
Ideas for accommodations may come from the family, CYP professionals, a KIT inclusion
specialist, or IAT members. Trial and error and personal experience and creativity are also key
sources of ideas for accommodations. Successfully including all children involves advance
planning and each child must be considered in curriculum and program planning. For example,
if a program is including a child who is sensitive to noise and the CYP professionals have
planned a drum circle for music and movement, they need to have a plan for making an
accommodation for this child during music. Perhaps the child may be offered ear plugs or an
alternate activity is planned for a small group of children to use scarves in a separate area and
move to the music while the larger group is drumming.
Accommodations may need to be adjusted or faded over time as the child’s needs change. Many
times an accommodation created for a child will work initially and then seem to lose its
effectiveness. Making accommodations requires solution-orientated individuals who can
recognize when an adjustment is necessary or when the child’s needs have changed. It is
important to acknowledge that inclusion is a process and that CYP professionals learn just as
much from what does not work for a child as they do from what does work.

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5. Accommodations Versus Exceptions
An accommodation is an individualized support that helps a child to participate whereas an
exception is excusing a child from participation or changing rules or behavioral expectations for
the child’s participation. An example of an accommodation is to provide extra time for a child to
complete an art activity. Using the same example, an exception would be allowing the child to
do art activities throughout the program day instead of providing support for the child to
transition to the other activities offered at the program. At times, CYP professionals may feel as
though they are making exceptions instead of accommodations. It is helpful to remember an
accommodation as a support for children so that they can follow the same rules and behavioral
expectations put in place for all children, rather than as an excuse or exception.
CYP professionals may also be concerned that making an accommodation for a child will seem
unfair to the other children in the group. There are several ways to address this concern. Finding
a way for all children to be involved in the accommodation will work in some instances. For
example, if a child needs to hold a small object in her hands to help keep her focused during an
activity, perhaps it is acceptable to allow all the children to hold something in their hands. It
may help the child who needs it and other children may enjoy being part of the solution. Clear
and simple explanations to the group can usually appease inquisitive children. An explanation
for why one child is allowed to do something differently might be that it helps him learn more
easily, enjoy the activity, or participate more easily.
Fairness means that everyone gets what they need, not everyone gets the same. When CYP
professionals consistently address the needs (physical, sensory, social and emotional) of all
children, the children will come to understand that when they need an accommodation (they are
not feeling well, hot, tired, or sad), it will be made for them. CYP professionals that treat all
children with respect and model appreciation for differences create environments where children
respect and appreciate differences. When a child does voice a concern about fairness, CYP
professionals can address the concern calmly, confidently, and kindly and move on to the next
topic or activity. When a parent voices a concern about a child or an accommodation, CYP
professionals can address the concern with a simple explanation: “We routinely make
accommodations for children in our program to support their participation. We keep all
information about individual children’s needs confidential. I would be happy to discuss general
information about accommodations; however, I cannot discuss a specific child’s supports or
accommodations.”

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6. Resources
• All Children Together’s website offers resources and information on adaptation and
accommodations for young children, including printable samples, at
www.ccdh.org/act/young_children.
• Find information on supports, modifications, and accommodations for students on the
National Dissemination Center for Children with Disabilities website www.nichcy.org.
• The Circle of Inclusion website is designed for early childhood providers and parents of
young children, www.circleofinclusion.org, and offers information on accommodations,
accessibility and awareness.

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V. Disabilities and Special Needs
Children with disabilities and other special needs can be found in every community worldwide.
They are children of all ages, colors, socio-economic backgrounds and come from various types
of families. Children with disabilities have all kinds of interests, abilities, and unique strengths
and challenges. Having a disability is only one characteristic among many that make up the
whole child. This chapter provides definitions for disability terms and information on the
different types of disabilities. However, it is important to realize that each child with a disability
or special needs is a child first and more similar to children without disabilities than different.
1. Categories of Disability
Most disabilities fall into one of seven general categories: physical, sensory, speech and
language, developmental, chronic health, social-emotional, and learning and attention. Each
category of disability is described below with areas to consider for supporting children with
different types of disabilities. It is important to keep in mind that the information is general in
nature. Each child with a disability is a unique individual with his or her own strengths and
different areas where he or she may need support. The tips for CYP professionals are also
general in nature and will need to be individualized for each child needing additional support in a
CYP.
1.1 Physical
Physical disabilities include orthopedic impairments and conditions such as spina bifida, juvenile
rheumatoid arthritis, scoliosis, osteogenesis imperfecta, amputations, and hip dysplasia. Some
children with physical disabilities have limited mobility and use adaptive equipment such as a
walker or a wheelchair. Other children with physical disabilities do not use adaptive equipment
and may experience limited mobility or difficulty with one area of the body (i.e. limited range in
the left arm). See Exhibit 3 for tips for working with children with physical disabilities.

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EXHIBIT 3: PHYSICAL DISABILITIES
Areas for support Tips for CYP professionals
Safely navigating the physical environment. Become familiar with handling and positioning techniques
so that the child is moved safely. The child’s family or
therapists working with the child may be able to
demonstrate proper techniques.
Positioning himself or herself close to other children (i.e.
on the floor, at the sensory table).
Give all CYP professionals working with the child
opportunities to hold and position the child so that
everyone is comfortable providing physical assistance.
Always ask the child before you touch their equipment or
move them. Remember to tell the child where you are
taking him.
Using and caring for specialized equipment. Respect the personal space of children who use
specialized equipment. Do not hang or lean on a child’s
wheelchair.
Completing activities such as dressing, toileting,
interacting with sports equipment, or doing art projects.
Provide a piece of adaptive equipment such as a card
holder, a wheelchair lap tray or universal utensil holder
for a crayon, fork or spoon.
Encouragement to complete activities independently
where appropriate.
Know the child’s strengths and areas where
independence can be encouraged and supported.
Adapting the environment (i.e. lowering the sensory table
so a child using a wheelchair can easily access it).
Modify the environment and materials to maximize
participation for all children.
1.2 Sensory
Sensory impairments include children who are deaf and/or hard of hearing, blind or have a visual
impairment. It is important to know what a child is able to hear or see if she has a sensory
impairment. Many people assume that children who are blind cannot see anything when many
children are able to see outlines, shadows, or certain colors and contrast of light. Similarly,
many children who are deaf are able to hear certain pitches or tones. See Exhibit 4 for tips for
working with children with hearing and vision disabilities.

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EXHIBIT 4:
HEARING DISABILITIES
Communicating with other children and CYP
professionals.
Know the degree of hearing loss and how the child
communicates (i.e. sign language, lip reading). Speak in
full sentences at a normal speed. Provide visual cues
such as pictures and symbols.
Following verbal directions. Make sure to get the child’s attention before giving
instructions. Demonstrate tasks and activities in addition
to providing verbal directions.
Following conversations and activities. Give the child a signal to use if he does not understand
something.
Active participation in games and activities. Provide opportunities for the child to communicate.
VISION DISABILITIES
Safely navigating the physical environment. Be aware of sharp edges on tables, curled up edges on
rugs, and other physical obstacles in the program. Pay
attention to decreasing and increasing room light to avoid
glares.
Following verbal directions. Use specific language when giving directions. Avoid using
words such as this, that, or over there.
Following conversations and activities. Address children and CYP professionals by their names
so the child knows who is speaking to whom.
Active participation in games and activities. Incorporate hands-on experiences to learning and other
activities such as touching, tasting, smelling, and
manipulating. Purchase or borrow audible sports
equipment.
Encouragement to complete activities independently
where appropriate.
Ask the child if she needs assistance before assuming she
needs help.
Adapting materials. Use print materials that are clear and easy to see.
1.3 Speech and Language
Speech and language disorders are conditions involving difficulty with the voice or producing
speech sounds, trouble understanding others (receptive language), or sharing thoughts ideas, and
feelings (using expressive language). Examples include apraxia, articulation disorder,

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dysfluency, stuttering, speech impairments, and delays in the acquisition of language. .See
Exhibit 5 for tips for working with children with speech and language disorders.
EXHIBIT 5: SPEECH AND LANGUAGE DISORDERS
Completing sounds, syllables, and words. Provide opportunities for the child to practice coordinating
speech (i.e. play a game making sounds in front of the
mirror).
Articulating sounds and combining consonant sounds
(i.e. “th” or “gr”).
Model the correct usage and pronunciation of words rather
than correcting the child.
Speaking fluently . Be a patient listener. Give the child the time she needs to
say what she wants to say.
Understanding questions and following directions. Keep directions simple and present them in complete
sentences. Encourage the child to repeat directions.
Learning words to rhymes or songs. Provide frequent and concrete visual reinforcement during
new activities (i.e. use a felt board and characters for new
songs)
Expressing ideas clearly. Expand on what the child says and ask specific questions.
1.4 Developmental
Developmental disabilities are defined as severe, chronic disabilities that occur any time between
birth and 21 years of age that are expected to last a lifetime. Developmental disabilities are not
always visible and may be cognitive, physical or a combination of both. Developmental
disabilities include autism spectrum disorders, Fragile X syndrome, Downs syndrome, cerebral
palsy, and intellectual disabilities. .See Exhibit 6 for tips for working with children with
developmental disabilities.

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EXHIBIT 6: DEVELOPMENTAL DISABILITIES
Remembering and following directions. Present directions one at a time with visual cues (i.e.
pictures or objects). Speak slowly and clearly and provide
written directions where appropriate.
Applying skills to new situations or new people. Prepare a child for a new situation by talking about it
beforehand, sharing pictures and other relevant information.
Making decisions. Limit choices to two or three options and help the child
decide what to do first, second, and third during free choice
activities.
Developing communication and social skills. Plan cooperative activities to create opportunities for the
child to interact with peers.
Using self-help skills (i.e. eating snack, washing
hands).
Break tasks down into small, manageable steps.
Solving problems. Help the child think through possible solutions to a problem.
Transitioning from one activity to another. Give extra cues about impending timelines and help
prepare the child for the next activity. Keep activities
structured with a clear beginning, middle, and end.
1.5 Chronic Health Conditions
Chronic health conditions are defined as conditions which last at least 12 months and are severe
enough to result in limitations to daily activities. Examples include allergies, asthma, cystic
fibrosis, diabetes, and hemophilia. The Council for Children and Adolescents with Chronic
Health Conditions outlines four contributing factors:
• Biologically-based.
• Lasts for an extended period of time.
• Brings about significant change in the child’s life.
• Requires more than the usual amount of medical care.
Chronic health conditions can be treated but not cured. Children with chronic health conditions
visit the doctor more frequently than other children and their wellness may fluctuate. Clear
communication with the family and written health and emergency plans are critical to providing
support for a child with a chronic health condition:

33
• Talk to the family. Some families may worry about sharing information about their child’s
condition. Explain how the CYP keeps information confidential. Ask for permission to
contact the child’s pediatrician (written permission from the family is also needed for the
pediatrician to discuss the child with CYP).
• Make an emergency plan. A parent may suggest that CYP professionals contact the child’s
pediatrician for detailed information about the child’s condition. In this case, it is
recommended that programs obtain written permission from the family to contact the child’s
pediatrician. Make sure CYP professionals know how to reach the family and pediatrician in
case there is an emergency.
• Make a health plan. If the child takes medicine during program hours, inform the parents of
policies for storage and self-usage. Make sure the child is able to take her medicine in a
comfortable place.
• Plan ahead. Meet with the child’s family regularly to talk about how the child is doing in
CYP. Share observations about any changes in behavior (especially when the child is
changing medications or dosage).
1.6 Social-Emotional Disorders
Social-emotional disorders affect a child’s mood, energy, thinking, learning and behavior.
Social-emotional disorders include attachment disorders, emotional disturbance, bipolar disorder,
depression, anxiety disorders, and oppositional defiant disorder. Children with social-emotional
disorders often have a difficult time controlling their moods, reactions, impulses, anxiety, and
interactions with others. See Exhibit 7 for tips for working with children with social-emotional
disorders.

34
EXHIBIT 7: SOCIAL-EMOTIONAL DISORDERS
Controlling mood cycles. Teach children relaxation techniques such as breathing and
visualization exercises. Remind the child of the exercises when he
seems to have a difficult time controlling his mood.
Stopping or limiting anxious thoughts. Help the child learn to identify and change anxious thoughts (i.e. use
positive self talk “I can do this.”)
Inhibiting impulsive behaviors. Teach the child to identify when she is feeling out of control. Point out
her body signals (i.e. hands in fists) and have her practice taking a deep
breath or stretching to help alleviate impulses.
Meeting behavioral and environmental
expectations.
Provide routines and structure for the child. Predictability may assist
him in developing strategies to meet expectations. Remain consistent
with expectations and support the child in learning strategies to meet
them.
Coping with sudden changes or
unexpected events.
Do not change activities or the schedule abruptly. Allow adequate time
for the child to adjust to change by preparing her ahead of time.
Regulating emotions. Allow the child to take a break from a stressful activity or situation in a
quiet area. Support the child with proximity – offer reassurance and
encouragement as needed.
Participating in group games and
activities.
Provide time for the child to practice new activities before they occur or
allow children to watch new activities before they participate.
1.7 Learning and Attention
Learning and attention disabilities are neurological disorders that vary from child to child and
include attention deficit hyperactivity disorder (ADHD), dyslexia, dysgraphia, nonverbal
learning disabilities, and sensory processing disorders. Children with learning disabilities have
differences in the way their brains process information (i.e. language, motor and executive
function). Children with attention disabilities have a difference in the level of neurotransmitters
in the brain resulting in age-inappropriate symptoms of hyperactivity, distractibility, and
impulsivity. See Exhibit 8 for tips for working with children with learning and attention
disabilities.

35
EXHIBIT 8: LEARNING AND ATTENTION DISABILITIES
Participating in academic activities (i.e. circle
time or homework hour).
Use multi-sensory activities that include auditory, visual, and
tactile components (i.e. play a song and use pictures). Assist a
child with staying on task during homework (i.e. make a list and
check off tasks as they are completed).
Managing impulsive behaviors. Be tolerant of interruptions during group games and activities.
Use visual cues to signal when it is time to share out loud (i.e.
use a “talking stick”). Ignore negative behavior when possible.
Transitioning from one activity to another. Use personalized cues to signal a transition (i.e. hand signal, silly
song). Remind the child of behavioral expectations for the next
activity. Allow the child to bring a comfort item from one area to
another.
Keeping track of personal belongings. Help the child organize personal belongings and keep them in a
consistent place. Provide a list of materials for activities.
Regulating responses to the sensory
environment.
Observe how the child reacts to different types of sensory
stimulation (i.e. light, sound, touch, movement). Offer the
preferred stimulation when the child seems overwhelmed.
Releasing energy in appropriate ways. Establish an area indoors where it is okay for a child to get up
and move (i.e. place a hula hoop on the ground where children
can jump).
Maintaining attention and interest. Incorporate the child’s special interest into a game or activity.
Provide something to do while children are waiting for a turn.
Reduce the amount of time for an activity when needed.
2. Children with Special Needs
Children with special needs are children who require more than routine and basic care including
children with or at risk of disabilities, chronic illnesses and physical, developmental, behavioral,
or emotional conditions that require health and related services of a type or amount beyond that
required by children generally (Federal Maternal and Child Health Bureau). Approximately 14%
of children have special needs and 1 in 5 households with children in the United States have at
least one child with special needs. The 2005-2006 National Survey of Children with Special
Healthcare Needs identified the following functional difficulties as the most common difficulties
for children with special needs:

36
• Respiratory problems.
• Learning, understanding or paying attention.
• Feeling anxious or depressed.
• Managing behavior and meeting behavior expectations.
• Speaking, communicating or being understood.
• Making and keeping friends.
Children with special needs are protected by the RA 1973 Act and Navy CYP is required to
make reasonable modifications to support their participation in CYP.
3. Additional Resources
• Attention Deficit Disorders Association, www.adda-sr.org.
• Center for the Social and Emotional Foundations for Early Learning,
www.vanderbilt.edu/csefel.
• Disability Statistics and Information, www.disabilitystatistics.org.
• Learning Disabilities Online, www.ldonline.org.
• National Dissemination Center for Children with Disabilities, www.nichcy.org.
• Special Needs Project, www.specialneeds.com.
• The Child Anxiety Network, www.childanxiety.net.

37
VI. Behavior Support
Sometimes the most challenging children to include are not the children with the most severe
disabilities. It can be much more straightforward to make accommodations for a child who is
blind, or a child who uses a wheelchair. Sometimes, the greatest challenge to child and youth
professionals is the child with disruptive behaviors. Accommodations can be harder to find, and
may need to be changed over time. It can also be harder to guide a child with challenging
behaviors in developing friendships with other children in the group. This chapter will address
how to understand and interpret behavior, the positive behavior support process, how to develop
and implement behavior plans, and techniques and procedures to support more positive behavior
for all children.
1. Understanding Behavior
All behavior is communication. Children’s actions often communicate the way they feel and
what they want. There are two main ways to describe behavior: by its type and by its purpose.
Behavior is something you can see, hear, and measure. Observable actions such as crying,
screaming, hitting, and spitting are all types of behavior. The purpose of the behavior is why the
child is acting in a certain way. Sometimes, the purpose of the behavior is to get something the
child wants, other times it is an attempt to avoid a situation or activity. The important thing to
remember is that all types of behavior communicate the child’s needs. The need may be “I need
a drink”, or the need may be “I don’t want to participate”.
When we begin to design behavior support and intervention strategies, we must consider both the
type of behavior and its purpose. There are several factors to consider with behavior, so one
approach or a “cookie cutter” approach to dealing with behaviors will not work. Behavior is
influenced by a variety of factors including the child’s temperament, what is happening at home,
and sensory and environmental stimuli, all of which in combination can present a clear picture of
both the purpose of the behavior and how to respond. There are many events that influence
behavior for any given child. These events fall broadly into six categories:
• Temperament.
• Deployment.
• Activities.
• People.
• General environmental features.
• Physiological states.

38
1.1 Temperament
A child’s temperament can be described as his or her general outlook on life. It is an emotional
reaction or way of responding that is also sometimes referred to as a “disposition.” All children
have a temperament that is natural to them. It defines who they are and how they react in certain
situations. It is something that they are born with, and something that can be observed in
behavior patterns of childhood. Temperament involves three areas that can be viewed on a
continuum of low to high:
• Energy level: the child’s average level of activity in daily life.
• Adaptability: how the child adjusts to sudden changes or transitions. Some children adapt to
the environment easily and for others it takes longer to adapt.
• Approach: how the child approaches new situations and people. It can range from eager to
more hesitant to slow-to-warm up.
Thomas, Chess and Birch (1968) first described characteristics of temperament and suggested
that most children will be clumped into three basic types of temperaments. These three types are
described in Exhibit 9.
EXHIBIT 9: TYPES OF TEMPERAMENT
Type Behaviors Tips
“Easy” or flexible. Adaptable, approachable and
positive in mood.
Be cautious of asking the child to be the
“helper” all of the time.
“Difficult” or active. Adapts slowly to change, is often
negative in mood and may exhibit
intense reactions to environmental
demands.
Remain responsive, flexible, patient and
understanding and balance active activities
with quiet activities.
“Slow to warm up” or
cautious.
Tends to withdraw from or exhibit
negative responses to new
situations.
Provide extra time for the child to adapt to
novel situations and prepare her for changes
in routine.
CYP professionals can and should reflect on their own temperaments and coping styles and
while it would be ideal to match caregiver temperaments with children’s temperaments, that is
not always realistic. .It is the responsibility of the adult to support and influence the child’s
interactions so that difficult temperamental traits can be modified by giving the child the skills
and confidence to manage environmental demands. .Avoid insulating children from all stressful
situations. It is important to know how and when it is appropriate to make certain demands on a

39
child, knowing that the child can meet them successfully. .The ability to present just right
challenges will help develop coping skills and successful mastery.
1.2 Deployment
The three phases of deployment: pre-deployment, deployment, and reunion create unique issues
for children and youth (Military Child Education Coalition). The stress of deployment manifests
differently according to the age of the child. The distress experienced by infants is influenced
largely by the remaining caregiver’s sadness and anxiety. Behavior changes in infants may
include irritability, unresponsiveness, difficulty sleeping and eating, and excessive crying.
Toddlers, who are at a period in their development where they normally experience separation
anxiety, may cling more to the remaining parent and resist their daily routine. Preschoolers with
a deployed parent may start to regress to behaviors that they have previously outgrown (i.e. may
have frequent accidents when they were previously able to use the bathroom independently). In
a CDC or CDH, preschool-aged children may become more aggressive and demanding or cry
often while they are experiencing the phases of deployment (Lincoln, Swift, & Shorteno-Fraser,
2008).
School-age children and teenagers may worry about the threats associated with war and their
loved one’s safety. Behavioral changes that CYP professionals may notice are excessive worry,
difficulty paying attention, defiance, aloofness, and a loss of interest in activities. Children and
youth with anxiety and depression may be more vulnerable to poor adjustment during a parent’s
deployment. It is important for CYP professionals to document and monitor any changes in
behavior and pay close attention to the behavior of children and youth who have social-
emotional disorders. Close communication about any behavioral changes with the remaining
parent is crucial to supporting the child and family during the phases of deployment.
1.3 Activities
A child’s day is comprised of a number of different activities and routines. Some activities may
be unpleasant and influence challenging behavior. An activity may be unpleasant if it is difficult
for the child to complete. Activities become problematic if they are not matched to the child’s
skill level or exceed a child’s endurance level. For example, a child may avoid art activities due
to difficulty using fine motor skills. Another child may avoid sports because he has low muscle
tone and tires easily. Activities can also influence challenging behavior if the child does not like
doing them. A child may be capable of using the bathroom independently but does not enjoy the
task.

40
1.4 People
People, and more specifically the presence or actions of another person, also influence behavior.
Unpleasant interactions such as directions issued in a harsh tone, can influence negative
behavior. Using choice (“Would you like to color or read?”) and conditional choice (“When you
are ready, please come join us”) are more effective than using direct imperatives (“You need to
color your picture now”) or indirect imperatives (“Do you want to color?”). Children are also
influenced by a lack of interaction. A child may use a negative behavior as a way to receive
attention from other people in the environment.
1.5 Environment
Although behavior always has a purpose, the purpose of a child’s behavior is not always clear to
parents, CYP professionals or other professionals working with the child. General
environmental features often play a role in influencing behaviors that do not seem to have a clear
purpose. The environment in a CDC, CDH, or CYP includes the physical location of the facility
or home, the sensory stimuli in the space, the materials available, and the children and adults
participating in the program. The children in CYP have their home environment, their school
environment, and the CYP’s environment. For a child, all these environments have different
demands, and the adaptation that it takes to move from one environment to the next may be very
difficult. Children in the Navy’s CYP may also experience a lot of instability in where their
family is stationed and may have to adjust to several home environments and neighborhoods.
Each environment has different rules, different people who inhabit it, different noises, smells and
a different level of visual stimulation.
CYP professionals should routinely evaluate the following elements of the program and modify
as necessary. The environment has a tremendous impact on all the children in CYP, and can
have an especially big impact on children with disabilities.
Physical Environment
• Physical structure of space including size of rooms, size of outdoor space, physical
placement of fixed furniture, physical placement of moveable objects, toys, equipment, type
and placement of playground equipment.
• How children and youth are grouped (examples include small groups, large groups, in circles,
in lines, seating on the floor, sitting in desks, sitting on carpet squares, sitting on chairs).
• Spatial arrangement of activity centers and adequate space between centers as well as clearly
defined pathways.
• Organization of and accessibility to materials.
• Amount of materials and duplication of materials/equipment/toys.

41
• Ratio of adults to children, particularly in areas where more support and supervision is
needed (for example, in the block area of a classroom including several active children who
tend to knock over blocks frequently).
Sensory Environment
• Amount and type of visual stimulations or visual distractions.
• Level of noise in the environment (including background or “white” noise).
• Amount and type of tactile activities in the environment (textures such as finger paint or
foods, or certain types of touch such as brushing up against someone or giving a high five).
• Opportunities to experience a variety of movement activities from playground equipment,
physical play, games and recreation, music and dance.
Social-emotional Environment
• Consistent, predictable caregivers and staff who promote social emotional growth.
• Use of routines and rituals, particularly for children who experience stress or anxiety during
transitions.
• Minimal changes in the schedule and preparation for children when there are changes in the
schedule, environment or staff.
• Attention to transitions and use of appropriate cues and signals when a transition is going to
occur.
• Adults who are physically and emotionally available to children and not caught up in
conversations with other adults.
• Adults who are clearly telling children what behaviors are expected and attentive and
responsive to children.
1.6 Physiological States
A child’s physiological state also has an influence on their behavior. If the child is not feeling
well, has low blood sugar, eczema, or other health-related concerns, he may be communicating
how he feels using behaviors like yelling or aggression. Children who have a difficult time
communicating with words will often use behavior to tell adults that they are in pain or feeling
out of sorts. Teen girls may have differences in behavior during periods of menses. When a
child’s behavior changes or is difficult to interpret, encourage the family to take the child to the
doctor in order to consider medical or physiological influences on behavior.

Guidance for Including Children with Disabilities in Navy CYP

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