Navy CYP Inclusion Guidebook

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.

http://www.childcarelaw.org/

http://www.ed.gov/about/offices/list/ocr/index.html

http://www.usdoj.gov/

http://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

http://www.ataccess.org/

http://www.thearc.org/

http://www.ncd.gov/

http://www.autism-society.org/

http://www.ucp.org/

http://www.nfb.org/


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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 [email protected] 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

mailto:[email protected]


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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 ([email protected]) 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.

http://www.ccdh.org/act/young_children

http://www.nichcy.org/

http://www.circleofinclusion.org/


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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:


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• 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.


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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.


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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:


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• 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.

http://www.adda-sr.org/

http://www.vanderbilt.edu/csefel

http://www.disabilitystatistics.org/

http://www.ldonline.org/

http://www.nichcy.org/

http://www.specialneeds.com/

http://www.childanxiety.net/


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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.


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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


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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.


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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.


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• 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.


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2. CYP Behavior Support Policy Navy CYP uses a proactive, positive, and skill-building approach to teaching successful age-appropriate behavior. Navy CYP professionals work with the child, the child’s family, the IAT, and outside resources where appropriate to develop individualized supports to promote pro-social behavior and effective communication. The process involves determining the purpose of the behavior, identifying strategies for accommodations, identifying strategies to teach new skills, and outlining appropriate CYP professional responses to the behavior.

2.1 Determining the Purpose of the Behavior When a child is exhibiting behaviors that interfere with performance or participation in daily activities and routines, it is necessary to conduct an informal review to determine the purpose of the behavior. The review should provide a clear description of the behavior and identify variables that predict or influence the occurrence of the behavior (i.e. the environment, routine, certain activities or interactions). Behavior reviews should utilize a team approach which includes the CYP Director, Training & Curriculum Specialist, Lead, and direct care staff.

Two strategies for reviews are interviews with individuals who know the child well (i.e. family members, previous teacher or youth provider, IAT members) and direct observation. The purpose of an interview is to identify events that are associated with challenging or negative behavior. For example, if the negative behavior is hitting, questions might include “what usually happens right before he hits?” and “have you noticed anything that seems to make it more likely for him to hit?” Interviews allow CYP professionals to gather information about the child in different environments and gain perspectives from different people.

Direct observation involves objectively looking at the situation and can range from informal (jotting down what happened) to highly structured (using a checklist to determine possible antecedents, behaviors, and consequences). Objective observers do not allow their personal feelings to color the information, and they remain open to a myriad of possible influences on behavior. When objectively observing the environment or a child’s behavior, emotions are kept out of the equation. For instance, the statement “Jacob gets angry when it is time to go home” is subjective. The assessment that Jacob is angry is based on the observer’s interpretation of his behavior. Focus on observable actions that can be seen or heard: “Jacob sits on the floor with his arms crossed when it is time to go home.” Jacob may very well be angry, or he may be feeling some other emotion. It is difficult to determine the purpose of a behavior without stepping back, objectively observing and looking for the influences on the behavior.


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The ABCs of Behavior

The ABCs of behavior help us to see the big picture. Behavior must be understood in combination with the Antecedent (what happened before the behavior) the Behavior itself (something you can see or hear), and the Consequence (what happened after the behavior). An antecedent may be a specific feature of one of the influences described above (temperament, environment, activities, people, and physiological states). For example, an antecedent may be a CYP professional asking a child to complete his homework, a sudden, unexpected noise, a difficult activity or an interaction with a peer (i.e. peer excluded the child from a game). A consequence may be that the child avoids an activity or task, obtains a preferred item, or receives attention from an adult. The observation form in Exhibit 10 illustrates objective observations on the ABCs of one child’s behavior.

EXHIBIT 10: OBSERVATION FORM

Activity/Context Antecedent Behavior Consequence

Date: July 28 Time: 9:00am Circle time

Nathan was asked to sit down after his turn miming his favorite animal.

Nathan looked down, walked toward the teacher and kicked him in the shin.

Nathan was told “no” and to sit down next to the teacher.

Date: July 28 Time: 9:45am Free play

Nathan walked up to peers at the water table and began playing. A peer told him to wait his turn.

Nathan wrinkled his eyebrows and pushed the peer out of his way.

Nathan was told to find another area to play in.

Date: July 28 Time: 3:15pm Transition to outdoor play

The teacher told the class to line up for outdoor play.

Nathan sat in his chair with his arms crossed.

One teacher stayed behind to prompt Nathan to stand up and come outside.

Date: July 29 Time: 11:50am Art

The teacher told the children to start cleaning up the art materials.

Nathan picked up the paint container, looked at the teacher, and poured the paint onto the table.

Nathan was told to go to another area.

Date: July 29 Time: 12:30pm Rest time

The teacher asked Nathan to stop talking.

Nathan continued to talk to himself.

The teacher did not follow through on his request.

Date: July 30 Time: 12:46pm Rest time

Nathan waited for the teacher to come read him a story.

Nathan flipped his cot over and got underneath.

The teacher came over to Nathan to ask him to fix his cot.


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Using an observation form helps keep observer feelings and projections out of the documentation. In the form above, the observations focus on what happened right before the behavior, what the actual behavior looked like, and what happened immediately afterwards. It seems that a common antecedent to Nathan’s negative behavior is being asked to do something by adults and peers. He may have difficulty following directions and complying with requests and demands. Using this information, CYP professionals can develop accommodations to help Nathan learn expectations, support him in following directions, and develop skills in meeting demands.

2.2 Identifying Strategies for Accommodations Once CYP professionals have gathered enough information to determine the purpose of the behavior, including the nature of the behavior, events that influence the behavior, and what the child gains or avoids through behavior, they also have the information they need to identify strategies for making accommodations. Accommodations include material, environmental, and activity modifications to prevent the behavior and supports to help the child meet the demands of the CYP.

For example, a CYP professional determines that a child uses negative behavior and seems frustrated during art activities. The child may have a difficult time using fine motor skills and may be communicating that art activities are not enjoyable for her. An accommodation might be to place crayons or other drawing materials inside foam hair curlers to make them thicker and easier to grasp. This material adaptation may make art activities more enjoyable and prevent the negative behavior from occurring.

Using Nathan (described on the previous page) as an example, support for helping him meet the demands of his classroom may involve clearly explaining what to expect during an activity and preparing him for changes. He kicked his teacher after being asked to sit down once his turn was over. A support may be to approach Nathan individually and let him know that during circle the children are going to take turns pretending to be their favorite animals. Explain that each child will stand up, act like the animal, and then sit back down. An activity modification might include a picture sequence to reinforce the steps in taking a turn (stand up, act like an animal, sit down) or having the children pick the next child to have a turn once they have sat down. Nathan might need a reminder such as “First sit, then pick a friend.” Preparing Nathan for changes might involve asking him to show the teacher which activity is coming up next on the schedule and providing individualized cues or involving him in the transition (i.e. “Nathan, you can hold the sand toys when we line up to go outside”).


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2.3 Identify Teaching Strategies Many children who consistently use challenging behavior are not doing so as a matter of will. Many children have difficulty using skills in areas such as working memory, sensory integration, social interaction and language processing. Complying with requests and demands is a skill and consequences do not teach children the skills they are lacking. However, Navy CYP professionals can identify strategies for teaching new skills and behaviors to use in place of the challenging behaviors. Areas to consider for teaching skills include the following:

• Waiting for a turn. • Following step-by-step directions. • Taking a break. • Asking for help. • Communicating frustration. • Interacting with peers.

The areas identified for teaching strategies and the method for teaching new skills will vary depending on the child. It is important to consider the child’s unique strengths and interests in designing the strategies for teaching skills. For example, if Nathan loves cars, teaching about waiting for a turn might involve explaining that a mechanic cannot fix several cars at once – each car has to wait for its turn. Perhaps Nathan could keep a small car in his pocket and learn to hold it while he is waiting for a turn. New skills should be taught while the child is calm and in a positive frame of mind. Attempting to teach skills when the child’s behavior has escalated or when the child is engaging in negative behavior will not be effective.

2.4 Outline Appropriate Responses and Consequences Behavior that persists over time is working for the child. If a child screams while a CYP professional is redirecting her to a new activity and the CYP professional leaves her alone, she is likely to scream in the future to avoid being redirected. It is necessary for Navy CYP professionals to outline appropriate responses to ensure that a negative or challenging behavior is no longer effective for the child. Appropriate responses and consequences should be considered in the context of the purpose of the behavior. For example, if the child throws a tantrum to avoid an activity, an appropriate response may be to ignore the negative behavior and provide support for the child to complete the activity once the child is calm. The following outline of the appropriate responses and consequences assists CYP professionals with understanding how to react to the behavior and establishing consistency between all people working with the child.


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Tips for Responding to Negative Behavior

• Remain calm and in control: Recognize that you can influence the child, but you cannot control the child. You can only control yourself. Keep emotion out of your response.

• Use short sentences: Use only the words needed to get the point across. • Use a firm, clear voice with low intensity: Avoid yelling, screaming, whispering or

pleading. • Tell children what you want them to do: Use precise language (i.e. “Please walk” rather

than “Don’t run!”) • Give instructions in the appropriate environment: Explain playground rules on the

playground rather than inside. • Ignore children’s comments, backtalk, or efforts to engage you in an argument. • Avoid engaging the child: Focus on the child’s compliance and not the child’s attitude.

Children are allowed to have whichever attitude they choose, but they are not allowed to behave however they choose.

• Make it clear whether the child has choices or not: “Would you like to paint or play outside?” is a choice. “Come inside now” is not a choice. Do not offer a choice if there is not a choice available. For example, saying “Do you want to come inside now?” is a question that requires a “yes” answer. Many times adults phrase directions as questions, giving children the sense that they have a choice when there is not an opportunity for choice.

Time Away Procedure

Staff responses to behavior can sometimes reinforce the behavior or make the behavior more likely to occur in the future. Many times it is the interaction between the child’s behavior and the adult’s response that maintains and strengthens the pattern of behavior. For example, when Nathan had a difficult time waiting for the teacher during rest time, he turned his cot over and got underneath. The teacher came over to him and spoke to him. Nathan received the attention he was seeking and may use the same strategy to gain attention in the future. Disengaging from the child or using a time away procedure may be effective in stopping the interaction that is maintaining the problem behavior. In the situation described above, disengaging from the child may be effective (ignoring the behavior and waiting until Nathan has fixed his cot before giving him attention).

Generally, the time away technique is most appropriate for children between the ages of around two and a half to around 7 years old. It is important to consider each child as an individual and look at their development to determine whether the technique may help support them or not. For example, a child is two years and three months old and is able to process language at a higher level than most two-year-olds. This child understands the rules, processes directions and tends to


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engage with adults to get what she wants. A time away may help to interrupt this interaction with adults and help her learn to comply with demands and follow directions. Conversely, a six-year-old with a developmental disability and delayed processing skills may not benefit or learn from a time away. A more appropriate approach for this child would be to spend time breaking down rules and expectations and providing support for her to follow the rules. If CYP professionals are having trouble determining whether or not time away would be appropriate for a child, they may call the inclusion helpline for support.

An adult-directed time away from an activity provides time for both the adult and child to disengage from the situation and reflect on what happened. It is not designed to humiliate a child or make him or her feel badly. Time away should only be used if all of the following criteria are met:

1. The child did not comply with a request or rule.

2. The child did not respond to an individualized cue from an adult (i.e. adult moved close to the child and repeated the request with clear, simple language, using accommodations such as pictures or gestures where appropriate).

3. The adult is sure that the child understood the request and/or individualized cue and is able to process the information.

Time away periods are brief and designed to stop the interaction between the child’s behavior and the adult’s response. CYP professionals should select an area that is away from program activity and provides a minimum level of stimulation. Avoid placing the child in the corner or in a chair facing the wall. The area should be a quiet area of the room where the child can take a moment to refocus his or her energy. The following steps should be followed:

1. In a firm voice with low intensity, state the problem behavior and describe the consequence: “You kicked a teacher, take time away.” Avoid using lengthy explanations or engaging in arguments.

2. Send or lead the child to the time away area, saying nothing. If the child refuses to move to the designated area, do not force him or her. Simply state, “When you are ready, take time away,” and walk away. Ignore the child’s behavior (while monitoring the safety of the child and others) until he or she takes time away. There are some instances where a child will continue to refuse a time away after the adult has walked away from the situation. In these instances, do not force the child into a designated area or ignore him or her for more than 5 minutes. Recognize that the strategy was not effective for that particular child and consult with the Training and Curriculum Specialist, Director, or Inclusion Helpline as needed for ideas on different strategies to try with the child.


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3. The child remains in the area and remains quiet for 2-5 minutes (typically one minute per year of age, so a 3-year-old would remain in the area for 3 minutes). While the child is taking time away, ignore his or her behavior. Do not talk to the child or respond to behavior. If a child is not able to complete the 2-5 minutes, start with a shorter amount of time (30 seconds).

4. After the child has remained quiet for a period of time determined by the CYP professional, approach her and say, “You may join the group.” Direct her to what she needs to do and say nothing else. Refrain from discussing the situation or what the child could have done differently at this time.

5. Acknowledge the next positive behavior the child displays. Once the child has had some positive interactions and experiences and is in a positive frame of mind, discuss what happened earlier and what the child could do differently. This is the most appropriate time to teach new skills and guide the child to reflect on his or her behavior.

6. Document the child’s response to the time away. Exhibit 11 is an example of how to document the child’s behavior throughout the time away procedure.

EXHIBIT 11: OBSERVATION FORM

Activity/Context Behavior Time Away Reflection

Date: July 28 Time: 9:00am Circle time

Nathan looked down, walked toward Mr. John and kicked him in the shin.

Ms Maria said, “You kicked a teacher. Take time away.” Nathan walked to the designated area frowning. He sat with his head down for 2 minutes. Ms Maria told him “You may rejoin our circle”. He stood up and walked to the circle with his head down.

After the group sang Nathan’s favorite song during circle, he was smiling and seemed happy. Mr. John approached him after circle and talked with him about what happened. Mr. John gave Nathan some ideas about how to wait for his turn.


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2.5 Developing a Behavior Plan Information gathered from the positive behavior support process should be used to develop a behavior plan. The purpose of the plan is to provide a clear description of the behavior and the accommodations and teaching strategies being implemented. The plan should include a timeline and specific instructions for teaching strategies and appropriate CYP professionals’ responses to behavior. Some children already have a plan in place at school, perhaps through their Individual Education Plan (IEP). Having access to a child’s IEP will help you provide stability and consistency for the child, who will know exactly what to expect at school, at home and at your program. CYP professionals can ask the child’s parent if they have a behavioral plan or IEP at school, and ask for permission to use it in a CYP.

An inclusion specialist via the CYP Inclusion Helpline or the IAT can support CYP professionals in developing a plan that is appropriate for the child. Key features of the plan include the following:

• List of the child’s strengths and interests. • Clear description of the negative behavior. • Common antecedents or triggers for negative behavior. • Accommodations being used to support positive behavior. • Strategies to teach new skills or effective communication. • Clear description of the desired behavior. • Outline of how CYP professionals will respond to the negative behavior. • Timeline and follow-up plan.

Behavior plans will help CYP professionals remain consistent with how they individualize support, respond to the child’s behavior and apply methods they are using to teach the child new skills. A behavior plan also assists CYP professionals in remaining objective and focused on accommodations and supports rather than the negative behavior. It is important to choose one challenging or negative behavior to address at a time. CYP professionals should start with the behavior that is causing the child’s relationships to suffer. Using Nathan as an example, kicking and pushing are the behaviors that are negatively impacting his relationships with teachers and peers. The sample behavior plan in Exhibit 12 addresses how CYP professionals will make accommodations, teach new skills, and respond to the behavior.


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EXHIBIT 12: SAMPLE BEHAVIOR PLAN

Child’s Name: Nathan Jones, Age: 4, Date: 7/30/09

Child’s strengths and interests: sensory play, cars and trucks, pretend play, gross motor skills, early literacy skills. Description of behavior: Nathan looks down and/or wrinkles his eyebrows, moves toward a teacher or peer and makes contact with his foot or hands. Common antecedents: Being asked to stop doing something, wait for a turn or clean up. Accommodations being used: A teacher explains activities to Nathan ahead of time and clearly states the behavior that is expected. Teachers provide cues for transitions when there are 5 and 2 minutes remaining for an activity. Strategies for teaching skills: Teachers are teaching Nathan how to wait for a turn using stories and small objects to hold while waiting. Teachers are also using breathing techniques to teach Nathan how to take a break and refocus. Desired behaviors: Nathan will take three deep breaths and take a break when he feels upset and hold his cars while waiting for a turn. CYP professional responses: Using firm, clear language, teachers will respond to Nathan’s behavior with understanding “I know it’s hard to wait. You may not push.” He will be reminded of his cars and expected to continue waiting. If Nathan uses the behavior to avoid cleaning up, teachers will say, “I understand you are not ready to clean up. You may not kick,” and “When you are ready, clean up.” Nathan will not participate in any activities until he has finished cleaning up his area. Teachers will watch for Nathan’s cues (looking down and wrinkling his eyebrows) and say, “Take three deep breaths” and ask him if he needs a break. Follow-up: Teachers will meet with the family in 30 days to share information on Nathan’s behavior and reaction to the accommodations and teaching strategies.

3. Supporting Positive Behavior There are many tools and strategies that will support positive behavior for all children in CYP. Some of the most effective tools that can be easily implemented are using a schedule, managing transitions, and setting up the environment for success. All children will benefit from these kinds of supports, but children with disabilities and other special needs, especially children with challenging behavior, require them.

3.1 Schedules Schedules provide a sense of control for both adults and children. Children respond well when they know what is coming next and what to expect. Children can be more independent and self-directed when they have knowledge of the daily schedule. They are also more secure in their environment when it is stable and consistent.


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Schedules can be presented in a number of ways. They can be written or drawn and should be posted in clear view of children. Using photographs of children in specific activities like outdoor play, snack, and music time will be helpful for all children. Consider sending the schedule home with families so they can discuss and reinforce the schedule at home, particularly for a new child entering the program or a child who has difficulty moving from one activity to another.

It is important to think about the children participating in the program while designing the schedule. This may be a place where an accommodation is needed. A child who cannot read will need a schedule with pictures. A child who is visually impaired will require a schedule with large print. The schedule can be on a white board, for all to see, or can be an individual schedule board that is carried by one of the staff members. A Child Development Home may need different types of schedules to account for children of different ages. If the schedule is going to change for some reason, children should be notified in advance to reduce undue stress that may turn into negative behavior.

3.2 Transitions Transitions can be the toughest part of the day for a child with special needs. Making the shift between locations, staff people in charge, or types of activities can provoke a meltdown in children with social/emotional disorders or developmental disabilities. Plan your transitions as activities, being mindful of the beginning, middle and end. Make sure that this is clear to the children so they will be able to manage their own stress levels.

Many times it is the uncertainty of the transition period that is stressful to the child. Reviewing the daily schedule in advance may alleviate some of the uncertainty, as well as clearly communicating with children about what is coming up and when. Minimize the number of major transitions, if necessary, and make sure to allow enough time to move from one location or activity to the next. Children can take vastly different amounts of time to complete the same task. This presents a challenge for the child who finishes quickly and has trouble waiting for the rest of the group to catch up, and the child who needs more time to complete an activity and feels pressured by the time constraint. Either one of these situations can create negative behavior.

Creativity and fun activities can ease anxiety and stress during transitions. If the children are engaged during the transition, they will be less likely to feel stressed. Ways to involve the children can range from singing a song while waiting to wash hands to coming up with a progressive story while waiting for the group to finish homework (each child says one line of the story).


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Strategies for Easing Transitions

• Use a visual cue like turning the lights on and off once or an auditory cue such as beating a drum or ringing a bell to signal the beginning of a transition.

• Ask the children to do something while transitioning: sing a song, write a silly poem, move like a snake, etc.

• Give concrete cues: “We have 10 minutes to finish…We have 5 minutes…We have 2 minutes”. (Avoid using the word “warning” when giving cues as a “warning” conveys alarm).

• Ask a child who has difficulty transitioning to be the schedule manager and let the CYP professionals know what is coming up next.

• Use “First, Then” statements to remind a child about a preferred activity (“First clean up, then soccer”).

• Plan transition activities for children who finish activities quickly (i.e. collage materials for children who finish their homework).

• Check in with the children before going on a break or transitioning staff members. Let them know how long the break will be and perhaps what you will be doing during the break. Prepare them for staffing changes throughout the day (for example, one teacher goes to lunch and another covers for him).

• Remain present and engaged during a transition to support children when they need it most. (Avoid using a transition to prepare for the next activity, talk with co-workers, or use the restroom.)

3.3 Setting Up the Environment The environment plays a large role in how children experience a CYP. Environments can be welcoming and calming or cause stress. The following tips may help CYP professionals in designing an environment that will support all children. An environment checklist is included in Appendix D and should be used in combination with the Creative Curriculum Continuum when designing and evaluating the program environment.

Physical Environment

• Activity centers are clearly defined so children know what to do in the area. For example, the aquarium observation area is labeled with a sign that includes a picture and the word “aquarium”, has two chairs, two magnifying glasses, two clipboards with paper and pencils, and a visual marker that indicates where the space begins and ends (i.e. a rug, colored tape, furniture).


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• There are areas that allow for small groups of children and large groups of children. Areas that are designed for large groups have adequate adult supervision.

• Materials are labeled and accessible to all children (labels may include pictures depending on the age groups and abilities of children in the space).

• There is a moderate level of visual stimulation in the physical space (there is not too much hanging on the walls or too many materials).

• The room set up is accessible for children using adaptive equipment and consistent for children with low vision.

Sensory Environment

• White noise coming from lights, fans, and equipment is minimal. • Non-latex gloves are available for children who avoid art materials. • Lighting can be adjusted (and/or there are areas with lower light). • There is a quiet corner or area where children can take a break from program activity. • Sound devices are used to get children’s attention or signal a transition (drums, bells, etc.). • There are several opportunities for children to explore different types of tactile experiences. • There is a balance of physical, gross motor, fine motor and sensory motor play, as well as a

balance of quiet and active activities.

Social-Emotional Environment

• CYP professionals for each group of children are consistent (day to day). • Children are prepared for changes in staffing or staff transitions (i.e. one staff goes on break

and another staff enters). • There is an activity schedule posted at eye level for children. • CYP professionals refer to the schedule several times per day to prepare children for

transitions and what will happen next. • Alternative small group activities are offered for children who have a difficult time

participating in large group activities.

4. Additional Resources • Center for Effective Collaboration and Practice, www.cecp.air.org. • Center for Evidence-Based Practice: Young Children with Challenging Behavior,

www.challengingbehavior.org. • Center on the Social and Emotional Foundations for Early Learning “What Works Briefs

Series” Issues 7-10, www.vanderbilt.edu/csefel. • The Behavior Coach, www.behavior-coach.com.

http://www.cecp.air.org/

http://www.challengingbehavior.org/

http://www.vanderbilt.edu/csefel

http://www.behavior-coach.com/


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VII. Partnering with Families

The children served by Navy CYP come attached to parents and extended families. Successful inclusion is family-centered, and will require a family-CYP professional partnership. A child’s family is the CYP’s greatest resource for supporting a child. Establishing a strong rapport with a child’s family will make a successful experience much more likely for all involved. This chapter will focus on understanding the experience of parents of children with disabilities, how to effectively communicate with families, and tips for supporting families.

1. Understanding Families Parents of children with disabilities, just like parents of children without disabilities, have had a wide range of previous experiences, and bring with them individual beliefs and values. However, parents of children with disabilities often have the added burden of several negative experiences with how others have perceived their child or discriminated against them. Parents of children with disabilities and special needs have a long history with their children. They have been interviewed and assessed, probed and prodded for very personal information about their family and their child. Often times people ask personal questions that they should not ask like, “how did this happen?”, “does it run in your family?”, “did you drink alcohol while you were pregnant?”, or “did you have an amniocentesis?”

Families may have had more than one negative experience with a childcare center, family daycare or youth program. Many families have been told “no” automatically over the phone by several different types of programs. Some families have had their children kicked out of several programs in the past and are hesitant to disclose information about their child’s negative behavior for fear that the program will not accept their child. Some parents may believe their child will not be given the chance to succeed if they reveal the disability. They may also be worried about their child being given a label. Other parents may not want to divulge information because they need to keep their jobs. These are just a few of the possibilities and every family has different reasons for why they may not be forthcoming with information regarding their child’s disability.

Military families with children with disabilities have also experienced differences in the services available to their child from installation to installation.


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1.1 Concerns of Families with Children with Disabilities

One of the main concerns for families is whether the child will have appropriate supports in place. Parents are experts at supporting their children and will often worry whether a CYP can provide the same level of support. Communicating that all CYP professionals are committed to helping all children participate and enjoy the program will help ease parent concerns. Tell all parents that CYP professionals make accommodations to the materials, activities, and the environment to ensure that all children are able to meaningfully contribute to the program.

Field trips can be of particular concern for families as they involve transportation and physical settings that may be very different from the program environment. A field trip to the beach may be challenging to include a child who uses a wheelchair. Trips to amusement parks may involve noise and stimulation that is overwhelming for some children. It also may be more difficult to supervise children in a non-program setting, and parents may worry about this too. However, children with disabilities should be included in field trips as they are a natural part of the experience of childhood. It is important to think of all children when planning field trips so that CYP professionals can work together with families to come up with necessary accommodations.

Selecting an inclusive program for their child may be a big step for a family, especially if this is the first time they have enrolled their child in a child, youth or teen program. They may wonder if their child is ready for such an experience, if the other children in the program will be kind to their child and if the staff has the training and experience to ensure their safety and happiness.

1.2 The Role of Culture Many people are unaware of the role culture plays in influencing ideas about child development. All professionals act on their assumptions about children and child development even though they may not be consciously aware of them. Whenever a professional works with children, he or she is acting according to a group of cultural values and rules. This group of values influences what professionals perceive as right and wrong. It also affects what professionals think is “normal” and what will be “best” for a child. Things like table manners, proper behavior when interacting with adults, and the rules of acceptable emotional responses are rooted in culture.

Culture has an influence on the behaviors and beliefs learned at an early age, which persist into adulthood and become ultimate “truths”. For example, many professionals expect that children will both initiate interaction and respond to their questions and attempts at interaction while maintaining eye contact due to cultural influences on beliefs about proper behavior when interacting with an adult. Children from some cultures may have been taught that they are not allowed to initiate a conversation with an adult, children from other cultures may have been


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required to use titles of respect with adults, while others may have been taught to look directly at the adult when she is speaking or to look down while an adult is speaking (Lynch & Hanson, 2004).

Acting on what CYP professionals think will be best for a child may not be beneficial to a child if the actions conflict with his family’s set of cultural values and beliefs. There are some clues that there may be a significant cultural difference: a parent’s reaction to an interaction between a CYP professional and the child; a child’s response of discomfort, confusion or anxiety; or information gathered from the family about their child-rearing practices. CYP professionals must remain open with themselves and their feelings and be cautious of making a judgment about which way is right or wrong.

It is valuable to ask questions about how the family views and feels about different situations and watch the way the child and family interact at the program. If there are siblings in the program, CYP professionals should pay attention to their interactions with one another. Remaining open with feelings about the family’s viewpoint, CYP professionals can try to find out whether they are comfortable with a difference in viewpoints. Using the information gathered about CYP professional cultural assumptions and those of the family, the professionals can find the best way to support the child in the program.

2. Communication with Families It is critical for CYP professionals to be sensitive to each family and approach them from a positive angle. Families need to hear that CYP professionals want their child to be successful in the program. Communicating this message clearly may encourage parents to share information. If families know CYP professionals want the child in the program and want to help him be successful, they will feel more comfortable sharing information and strategies for making accommodations. Once a program becomes more transparently inclusive, more parents will share more information prior to the child’s enrollment.

Inclusion is not conditional. It is not only for children who have disabilities that CYP professionals believe they can easily manage. When talking with parents of children with and without disabilities, communicating the message of inclusion is important. The message of inclusion is a belief that every child belongs and can have a great experience in CYPs, and that CYP professionals are willing and able to make that happen. Families can sense feelings of hesitance, fear, and resistance and will not want to leave their child with a hesitant, scared or unwilling professional. A CYP professional’s level of confidence in providing care to children with and without disabilities will be apparent to families. This does not require a professional to know everything about inclusion, disabilities or special education. A willingness to try, and


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confidence in the ability to work with all kinds of children, coupled with training and a solid partnership with families will allow the best chance for success.

2.1 What CYP Professionals Need to Know Families want you to think of their child as a child first, and would prefer CYP professionals just know him as Marcus or Sammy rather than as the child with a disability. Professionals should ask the family questions that will gather information on the following areas:

• Accommodations needed. • How to support the child’s behavior. • Child’s interests. • Child’s unique strengths and challenges.

For example, “Tell me about some accommodations that have worked for your child in the past.” It is a good idea to ask the family what helps calm the child down when he or she is upset and what types of environments work best for the child. Knowing the child’s special skills or interests and concentrating on including those interests into daily program activities can lay the foundation for success. CYP professionals do not need to know the child’s diagnosis: it will not tell them much and may reinforce stereotypes. No two individuals with the same disability will present in the same way. The diagnosis is just one of the many factors to consider when working with a child and CYP professionals are not allowed to ask a family to disclose their child’s diagnosis.

There are not two children with the same disability who present with the same abilities or needs. For example, some children with cerebral palsy may have minimal involvement, do not exhibit posturing or abnormal muscle tone, and do not require special equipment. Other children with cerebral palsy may have mild or moderate conditions that limit movement of some extremities and require the use of adaptive equipment such as orthoses (braces) or a walker. They may or may not have difficulty with speech. Some children have a more involved form of cerebral palsy that limits movement and requires assistive supports such as motorized wheelchairs and/or alternative and augmentative communication systems. Children with cerebral palsy may have average, or above average intelligence, or they may experience difficulty with learning.

The same range of examples can be used when we discuss children with autism, or other developmental disabilities. The individuals can be widely different in terms of their abilities and needs. Some children with autism will attend four-year colleges and be fully employed as adults. Others will have long and significant social-emotional or relational difficulties and need support throughout their lifetimes. Likewise, some persons with Downs syndrome may require support and assistance with all aspects of life planning, and others will live and work in the community with minimal support from others.


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If the family does share information about the child’s disability, it is okay to ask respectful questions to learn more about how the disability affects that child. Refrain from asking questions about the cause of the disability, whether it runs in the family, or other prying questions about family medical history or personal information. It is also not necessary to know a child’s developmental age to support her in a social, recreational setting.

When Disability-Specific Information is Helpful

There are times when it is helpful to know specific information about a child’s diagnosis. One of the best examples of this might be a child with Prader-Willi syndrome (PWS). Children with this diagnosis have a biologically driven tendency for seeking food and typical behavior modification programs do not work. If CYP professionals know this is a dominant characteristic of Prader-Willi syndrome, they will not blame the child or the parents for the behavior, nor will they attempt to “teach” the child not to seek food. Best inclusion practices would suggest that the respectful accommodation for this child might include storing food away from the child and sitting next to the child during family style dining to help him or her with the appropriate serving sizes. Another respectful accommodation might include passing out measured snacks individually to children rather than leaving them on a table or setting up food buffet style.

Knowing that a child has Tourette’s syndrome will help a CYP professional understand behavioral characteristics of this disorder such as excessive movement, vocal tics or swearing. A child should not be punished for behaviors that are beyond his control, even if there are “rules” about swearing in the facility. CYP professionals can and should make a respectful accommodation for the child. That might include being vigilant enough to notice when the child is starting to exhibit certain behaviors and allowing the child to remove himself from the room or activity.

Some children may have developmental disabilities associated with a diagnosis such as William’s syndrome or pervasive developmental disorder that would exhibit as a lack of social inhibitions or unrestrained emotions. A CYP professional who is respectful might view these characteristics as a positive and subsequently view that child as an outgoing and enthusiastic member of the group who might be the first to share each day.

Many examples have been given for situations when it was helpful to know some specifics about a diagnosis. It is equally important to remember that a diagnosis should never limit expectations or goals for a child. There are many children in every diagnostic category who far exceed all expectations. There are also children who will exhibit only minimal signs of the disability because of previous experiences or environmental influences.

Diagnosis is only one of many factors contributing to who the child is as a person. The child is a reflection of his biologic and genetic makeup as well as a reflection of his experiences with his


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family, school, friends or peers. The information that a CYP professional receives about a diagnosis should not be a license to allow that child to engage in unacceptable behavior. Good child development and youth programs have clear-cut ground rules and while they need to be applied as universally as possible, they frequently need to be modified for a child with a disability. With training, consistency and good observation skills, most providers will be able to anticipate and respond to the child in a positive manner.

2.2 Sharing Concerns CYP professionals working in CDCs or CDHs are often the first people in a child’s life to notice differences in the way the child learns, communicates, moves or processes information through the senses. As professionals working with young children, CYP staff members have experience with hundreds of infants, toddlers, and preschoolers and can recognize when a child may be developing differently. Parents may or may not have knowledge of typical child development or older children in the home. Meeting with a family to share concerns about a child’s development and CYP efforts to work effectively with the child can help identify resources and information for promoting the child’s belonging and successful participation.

Prepare for the Meeting

Spend time gathering information and documenting objective observations prior to meeting with the family. CYP professionals should focus observations on times or activities that are difficult for the child, documenting the ABCs of behavior. Focusing on observable behavior and the types of environments or approaches that work for the child will help to clarify concerns. It is important to document the strategies that CYP professionals have used to support the child and the child’s reaction to the supports.

When scheduling a meeting with the family, consider the relationship that has been established with the family and whether the family has expressed similar concerns with the child’s behavior at home. If the child is not already identified as a child with a disability or special needs, it may be difficult to know how the family will react to CYP concerns. Parents of school-age children and teens (who may or may not have diagnosed disabilities) will also react differently to concerns about their children’s behavior. In addition to gathering information and documentation, compile a list of programs, services, and resources for referral. Include information about CYP and military support services, local early intervention services (on and off base), behavioral support services, and school district special education services.

Create a Comfortable Environment

Parents may be hesitant to meet with CYP professionals and may experience stress or anxiety prior to or during the meeting. They may have had previous experiences where professionals


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have questioned their parenting style or resisted their child’s participation in a childcare setting. It is important to create a welcoming and calming environment, as emotions play a large role in how adults receive information.

• Schedule adequate time to discuss concerns so parents feel their child and needs are important to CYP professionals.

• Choose a collaborative seating arrangement (chairs side-by-side or in a circle). • Designate a private area for the meeting where concerns cannot be overheard by CYP

operations clerks, other families or children. In a CDH, the meeting may need to be scheduled outside of typical hours of care.

• Open the meeting by asking the family to share how they see their child, sharing positive observations from the CYP where appropriate.

• Be open to the family’s perspective on their child’s development, ask questions and let the parents know their input is valuable.

• Ask the family what they would like to see their child accomplish at the CYP. In a CDC or CDH, this might include asking how they would like to see their child playing or interacting with others. In a SAC or CYP it may involve asking how they would like to see their child participating in games and activities.

• Communicate concerns clearly, using concrete examples. • Accept parents’ feelings and empathize with their situation. Some families may be upset,

angry, or shocked. Avoid becoming defensive or angry at the parents’ reaction to concerns. • Avoid suggesting or insinuating that a child has a specific diagnosis or disability. Most CYP

professionals are not qualified to make a diagnosis and doing so can delay or hinder the family’s access to services and resources.

Support Parents Through the Process

Parents will experience information differently according to whether they understood and processed the information, whether they have similar concerns about their child’s development, whether they agree with CYP professionals’ observations, and cultural and language differences. Many families fear that the CYP will reject their child if extra support and resources are needed. If a family does not understand the concerns or disagrees with the observations of the child, they may be upset when CYP professionals suggest resources or services. Some families may choose to not follow CYP recommendations for resources or follow through on referrals. Understand that parents need time to process information that may be upsetting and scary. There may be an adjustment period for families as they learn to accept differences in their child’s development. Recognize that a parent may move continuously through the phases described below and that most families do not follow a linear path to acceptance:

• Shock – a parent may appear sad, cry, or have no emotional response.


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• Denial – a parent may avoid evidence to support CYP observations or search for a “cure”. • Anger – a parent may outwardly express anger, withdraw with guilt or blame the CYP

professionals. • Shame, guilt, hopelessness and anxiety – a parent may experience any number of emotions in

response to feeling overwhelmed with the responsibility of caring for a child with special needs.

• Acceptance – a parent may become neutral to a child’s needs or begin to understand and appreciate the child.

• Planning for the future – a parent may begin to imagine a future for the child and support CYP professionals in designing supports and accommodations.

2.3 Establishing Open Communication Open communication is one of the most important elements of supporting a child and his or her family’s participation in CYP. CYP professionals should establish a method for keeping the communication lines open when a family enrolls their child in CYP. After meeting about concerns, it becomes necessary to check in with the family about preferred communication methods. A continuous exchange of information will support the family as they learn more about their child’s development and behavior and how to support the child at home, school and the CYP. Every family will have a different idea of the amount and type of communication they find helpful. Some families prefer a weekly exchange, while other families request a daily exchange of information.

In communicating with parents, remember that anger and blame are natural reactions for parents as they adjust to their child’s needs in CYP. Keeping this in mind will help CYP professionals to accept the parents’ feelings without becoming defensive or angry. Periodically asking questions that may provide insight into how a parent is feeling and how he or she perceives the situation will be helpful in developing an understanding relationship. Methods for ongoing communication include the following:

• Communication journal: A small journal that is designed to travel between the child’s home and CYP. The journal is a living record of the child’s experience in the program and includes information about the child’s progress and questions, comments, and ideas. CYP professionals should designate a secure place to keep the journal while it is at the CYP to protect the child’s confidentiality. Information written in the journal should be concrete (focus on observable behavior) and objective (focus on what can be seen or heard). Communication journals are available through Navy CYP Training & Curriculum Specialists and KIT.


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• Weekly meetings: Scheduling a weekly meeting may work best for a family that prefers verbal communication. The meeting may be scheduled in person or over the phone. It is a good idea to include more than one CYP professional on the call or in the meeting.

• Email or text messages: Some families prefer electronic communication via email or text. Families with time constraints may benefit from short pieces of information or one question or comment at a time.

The method chosen for ongoing communication must be convenient for both the family and the CYP professionals. Scheduling a weekly meeting that causes the CYP to be understaffed during a difficult time of the day (i.e. transition into the after-school program) will not be convenient for CYP professionals. Similarly, scheduling a weekly meeting that requires the parent to leave work early will be a burden for the family. The method chosen must also be feasible, for example, if email is the preferred method and the CYP does not have access to a computer, it will be difficult to keep the communication lines open. Whichever method or combination of methods is agreed upon should remain consistent until either the parent or CYP requests a change or modification.

3. Additional Resources • Parents Helping Parents has three main service areas: Education, Community & Family

Services, and Health-related Services, www.php.com. • The Technical Assistance Alliance (TAA) for Parent Centers provides resources for parents

throughout the country, www.taalliance.org. • www.mothersfromhell2.org is an advocacy and humorous support site for mothers of

children with disabilities. • www.militaryonesource.com is a valuable resource for military families.

http://www.php.com/

http://www.taalliance.org/

http://www.mothersfromhell2.org/

http://www.militaryonesource.com/

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Appendix A: Sample Emergency Action Plan

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Appendix B: Inclusion Support Referral Form

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NAVY CHILD AND YOUTH PROGRAMS INCLUSION SUPPORT INFORMATION AND REFERRAL FORM

SECTION 1: INTAKE INFORMATION To be completed by CYP Professionals NAME OF CHILD

AGE SEX TODAY’S DATE

CYP PROFESSIONAL

EMAIL PHONE

INSTALLATION

REGION

TYPE OF PROGRAM

� CDC � CDH � BEFORE SCHOOL � AFTER SCHOOL � VACATION CAMP � TEENS � YOUTH SPORTS � OPEN REC � KINDERGARTEN CARE � INSTRUCTIONAL CLASSES CHECK ALL THAT APPLY � DIAGNOSED DISABILITY � MEDICAL NEED � CHALLENGING BEHAVIOR � OTHER: SECTION 2: REFERRAL INFORMATION CYP professionals answer the following four questions to determine whether a child should be referred to KIT: Does the child have a life threatening condition?

YES Please specify:

�NO

Is the program missing any necessary information or documentation for children with medical needs that require the administration of medication?

YES Please specify:

�NO

Does the child require accommodations to participate in the CYP?

YES Please specify:

�NO

Does the child have a challenging behavior that interferes with the child’s participation or relationships?

YES Please specify:

�NO

SECTION 3: REFERRAL DECISION If you answered NO to all four questions above, this form does not need to be submitted to KIT. Place this form in the child’s file and ensure the following information is included in the file (if applicable): medication authorization form, emergency action plan (i.e. allergy response plan), behavior plan and/or Individualized Education Plan (IEP). If you answered YES to any of the four questions above, email this form to KIT via email at [email protected]. RECOMMENDATIONS To be completed by a KIT Inclusion Specialist DATE OF HELPLINE CALL

DATE CUSTOMIZED RECOMMENDATIONS EMAILED TO CYP PROFESSIONAL:

CASE RECOMMENDED FOR INCLUSION ACTION TEAM

YES

�NO

OTHER INFORMATION INCLUSION SPECIALIST SIGNATURE

DATE


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Appendix C: Sample IAT Support Plan

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Sample IAT Support Plan: Emailed List of Recommendations

• Establish a consistent routine for Sammy throughout the day and prepare him for upcoming activities. For example, use a consistent entrance activity so Sammy knows what to expect every day when he arrives. Depending on his interests, an entrance activity might be reading a book, doing yoga poses, or feeding the fish. Preparing Sammy for activities may involve reviewing the schedule each day, providing individual cues when a transition is about to begin, and using “First, then” statements – “First art, then snack”.

• Create a quiet area where all children can take a break. Spend time teaching Sammy about the quiet area – what it is for, when you might use it, and what you might do while you are in the quiet area (i.e. close your eyes and take a deep breath, stretch your body, sit and look at a book).

• Observe how Sammy reacts to different types of stimulation in the environment (lights, sounds, smells, touch, movement, etc.) and offer calming activities when he seems overwhelmed.

• Use Sammy’s interests to help facilitate interactions with peers. For example, if Sammy loves the Boston Red Sox, bring in newspaper clippings of baseball stories for the children to create a giant baseball collage of their favorite teams. Sammy may still need support in responding to questions or comments from peers but he may feel more confident talking about a personal interest.

Outline of strategies and accommodations

• CYP professionals have implemented a written schedule to help Sammy prepare for activities throughout the day. A staff person reviews the schedule with him at the start of the program day and helps him cross off activities as they are completed.

• CYP professionals will offer Sammy opportunities for movement when he seems upset – he will be offered a choice of jumping on the trampoline or bouncing on the exercise ball.

• An occupational therapist from Sammy’s school is available for consultations with CYP professionals as needed.

• CYP professionals will provide additional time to transition from one activity to another. • CYP professionals will take photographs of the children in the program to create books on

how to make a friend to help Sammy connect with others.

Plans

There is not an emergency action plan, health management plan, or behavior plan needed at this time.

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Collaboration and Training

• All CYP professionals working at the after-school will be allowed to review a copy of the IAT support plan during work hours. The plan will be kept in the director’s office in a locked file cabinet and staff will review it one at a time in the office.

• After each CYP professional has reviewed the support plan, a brief staff meeting will be held to discuss how they will implement the accommodations and who will be responsible for each one (i.e. who will contact the occupational therapist, who will take the photographs, etc)

• The SAC Director will contact Sammy’s occupational therapist to request a training for the CYP professionals on using movement activities to help Sammy reorganize and focus.

Resources Recommended by IAT

• Autism Society of Northern Virginia offers the most extensive and comprehensive resource list and guide in the Northern Virginia area specific to the autism spectrum, 703-495-8444.

• The Arlington County Community Services Board (ACCSB) as an advocate, educator, community organizer, and community planner for services. The Child and Youth Committee meets on the first Monday of the month at 7:00 p.m. at DHS Headquarters, 3033 Wilson Blvd., www.arlingtonva.us

• The Arlington Partnership for Children, Youth, and Families is working with the community and specifically with County agencies and youth service providers to promote Developmental Assets. Developmental Assets are essential relationships, experiences, skills and values ALL kids need and that ALL adults can help develop. CYP professionals can visit www.arlingtonva.us for more information about how to build Developmental Assets in children and youth.

Follow-up

CYP professionals and the family will use a communication journal as a method for ongoing communication. The next IAT meeting is scheduled thirty days from today. CYP professionals will call the KIT helpline for recommendations as needed.

http://www.arlingtonva.us/

http://www.arlingtonva.us/

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Appendix D: Environment Checklists

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Physical Environment Needs work

Some-what Achieved Notes

Materials are accessible to all children (account for children of different sizes, children with limited mobility).

Activity areas are well defined and labeled.

Room set-up is consistent for children with low vision.

Room set-up is accessible for children, staff, and families using a walker, wheelchair or stroller.

The overall environment is calming (the space is not overwhelming or over stimulating).

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Sensory Environment Needs Work


White noise coming from lights, fans, and equipment is minimal.

Non-latex gloves are available for children who avoid art materials.

Lighting can be adjusted (and/or there are areas with lower light).

There is a quiet corner or area where children can take a break from program activity.

Sound devices are used to get children’s attention and signal transitions (drum, bell, etc).

There are several opportunities for children to explore different tactile experiences.

Deep pressure activities are offered to children who need them (example: child is allowed to hold weighted object on her lap to refocus).

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Emotional Environment Needs work


Caregivers for each group of children are consistent (day to day).

Children are prepared for changes in staffing or staff transitions (i.e. one staff goes on break and another staff enters).

There is an activity schedule posted at eye level for children.

Caregivers refer to the schedule several times per day to prepare children for transitions and what will happen next.

Alternative small group activities are offered for children who have a difficult time participating in large group activities.

Navy CYP Inclusion Guidebook

Education

Transcript of Navy CYP Inclusion Guidebook