Including children with disabilities in early childhood education programs: individualizing developmentally appropriate practices.

Early childhood educators are facing the challenge of creating quality educational programs for young children from an increasingly diverse mix of racial and cultural backgrounds. Programs that, in the past, have largely ignored the diversity of their participants must now re-examine approaches that emphasize the universality of linear lists of developmental milestones; they must pursue practices that reflect a pluralistic approach to both content and methods of instruction. Too many educators assume that children reach developmental milestones at similar points, leading to rather simplistic attempts to justify singular content and approach. Yet a multicultural, multi-ethnic, and multi-ability student population demands a unique and nontraditional approach, characterized by individualization and sensitivity to unique expressions of group identity.

The realities of diversity do not mitigate the fact that all children do seem to exhibit a finite set of accomplishments (milestones) that build, one upon the other, and proceed in an age-related fashion. We recognize the relevance of a developmental approach that is based upon the work of such theorists as Rousseau, Locke, Pestalozzi, Froebel, Piaget, and Vygotsky, exemplified by Itard's techniques, the Montessori approach, and the Head Start movement in the 1960s, as well as numerous other, more recent, examples of successful early childhood education programs. However, some children acquire skills at an earlier age than their age-mates, while others acquire those same skills much later than their peers or not at all. For example, not all children begin walking up stairs by placing both feet on each step before they move to the next step. Some alternate, placing only one foot on each step--a skill that Brigance (2004) claims one should expect to see exhibited 6 to 12 months after the two-feet per step approach. Some children seem to skip steps in a developmental sequence while others do not. Such variations are viewed as part of the "normal" range of individual differences, defined as falling less than one to two standard deviations above or below the theoretical mean for a given developmental area (such as cognitive, gross and fine motor, or social or language skills). Most of our attempts to adapt curriculum and strategies to diversity have been based upon either sociocultural differences or ability differences that fall within the range of what might be termed "normal variation."

Individually and Developmentally Appropriate Practices 

Developmentally appropriate practice (DAP) is considered the foundation of early childhood education and serves as a guideline for curriculum development. The National Association of Education for Young Children (NAEYC) defined DAP in three dimensions (Bredekamp & Copple, 1997, p. 9):

* What is known about child development and learning--knowledge of age-related human characteristics that permits general predictions within an age range about what activities, materials, interactions, or experiences will be safe, healthy, interesting, achievable, and also challenging to children

* What is known about the strength, interests, and needs of each individual child in the group to be able to adapt for and be responsive to inevitable individual variations

* Knowledge of the social and cultural contexts in which children live to ensure that learning experiences are meaningful, relevant, and respectful for the participating children and their families.

On the one hand, this NAEYC statement views children as members of an overall group who follow similar predictable developmental patterns. Yet it also emphasizes the importance of valuing young children as individuals, with different personalities or temperaments and learning styles. Furthermore, children are considered part of a cultural group, members of the community in which children and their families live and by which they are influenced in every aspect of living. Additionally, the NAEYC statement encourages early childhood professionals to move from "either-or thinking" to "both-and thinking" (Gonzalez-Mena, 2000). As is often the case, what is developmentally appropriate is not always individually or culturally appropriate. Instead of having to make a falsely dichotomous choice, educators often need to combine all dimensions and know the child as a whole person with individual needs and cultural differences.

The nature of DAP encourages the placement of children, with and without disabilities, in the same setting. In fact, most professional organizations support the concept of inclusive programs for all children, regardless of the nature or severity of the disability. For example, the Division for Early Childhood of the Council for Exceptional Children issued its "Position Statement on Inclusion," which was endorsed that same year by NAEYC: "DEC supports and advocates that young children and their families have full and successful access to health, social, educational, and other support services that promote full participation in family and community life" (Sandall, McLean, & Smith, 2000, p. 150). The statement also proposed that young children participating in group settings (such as preschool, play groups, child care, or kindergarten) be guided by developmentally and individually appropriate curriculum. The Association for Childhood Education International published a brochure that discusses the benefits of inclusion for the children with disabilities, the children without disabilities, and the parents, school, and community (Kostell, 1997). The Association for Persons With Severe Handicaps (TASH) endorses the inclusion of children with severe disabilities in regular education settings and argues that inclusion implies more than just physical presence; it includes access to the curriculum that is taught in the regular education classroom (TASH, 2000).

Clearly, leading professional organizations endorse the concept of inclusive programming for children with disabilities; there also exists a strong legal basis for inclusion. The assumption of the universal relevance of the general education curriculum is readily apparent in the 2004 re-authorization of the Individuals With Disabilities Education Act (P.L. 108-446). This law requires that we reference the content of our curriculum for students with disabilities to that of their typically developing peers. For example, each student's individualized educational program (IEP), a written document that describes the needs of the child, must contain a statement of the child's present levels of educational performance, including how the child's disability affects his or her involvement and participation in appropriate activities. Furthermore, the IEP must include a statement of measurable annual goals, related to "meeting the child's needs that result from the child's disability to enable the child to be involved in and progress in the general curriculum" (Sec. 614; 20 USC 1414), and there must be a justification for non-participation in the regular class. Part C of P.L. 108-446 requires that children from birth to 3 years of age receive early intervention services in environments that are natural, or normal for children the same age who have no disabilities (IDEA Rules and Regulations, 1998). This stipulation extends the requirements of the Americans With Disabilities Act (Public Law 101-336) by requiring each state to not only ensure reasonable access by infants with disabilities to child care/educare programs, but also deliver early intervention services in such settings.

Planning for Inclusion: Adapting Developmentally Appropriate Practices

While examples of curricula for young children can be found that do provide substantive suggestions for adapting to meet the needs of children with sensory, cognitive, motor, emotional, and/or learning disabilities (e.g., Bricker & Waddell, 2002a, 2002b; Hauser-Cram, Bronson, & Upshur, 1993), most do little by way of providing meaningful, practical suggestions to the early childhood teacher. This means that the task of planning to include these children will fall upon the shoulders of those whose formal training and experience may not have prepared them for such diversity (Gelfer, Filler, & Perkins, 1999; Heller, 1992). To be successful at what can, at first, appear to be a very daunting task, teachers will have to plan for modifications in both content and strategy. Numerous authors have recognized the importance of instructional flexibility and the need for an approach that includes the individual modifications that are often necessary in order to meet the needs of diverse groups of learners (Allen & Cowdery, 2004; Friend & Bursuck, 2002; Giangreco, Broer, & Edelman, 2002; Pretti-Frontczak & Bricker, 2004). Inclusion is not accomplished by simply placing a child with disabilities in a setting with his typically developing peers. It is realized only when we have succeeded in designing a set of activities that ensure the full participation of all children, including the child with disabilities. Participation and not mere geographical proximity is the necessary pre-condition for achievement, and so meaningful participation requires systematic planning.

Table 1 contains a description of the steps involved in planning for the inclusion of a child with disabilities in a typical early childhood program. The planning process begins with the selection of a team of knowledgeable individuals who will be responsible for developing the plan. Team planning is essential, because the success of efforts to include students with disabilities, especially those with severe disabilities, is not the sole responsibility of any single individual. This planning team should include the parents and/or any other family members who share in daily caregiving activities; the general education early childhood teacher and the early interventionist or early childhood special education teacher; and the program administrator and any related service personnel, such as speech or occupational therapists who may provide services to the child and family.

The second step in the planning process is to construct a simple schedule of the daily activities for the setting in which the target child with disabilities will be included from start to finish. When listing the activities, it is important to note the average length of time devoted to each activity and to include all activities in which the child will likely be included throughout the week, since activities may vary from day to day.

Step 3 involves a careful specification of the instructional goals for the target child, which are taken directly from the IEP or the Individualized Family Service Plan (IFSP). Since these documents contain goals and/or objectives that may cover six months to a year, only those that are currently being addressed are listed. Here, it is important to indicate the family's priorities for instruction. The family and the educators may feel differently about the relative importance of goals and objectives. For example, the family may not believe that the child learning a particular social behavior is as important as the child acquiring gross motor skills, while the teacher might think that more emphasis should be placed upon sharing and cooperative play than upon learning to throw and run. Such differences present opportunities to jointly discuss how both priorities can be addressed simultaneously in one or more activities. An important additional consideration is whether or not the child has a behavior support plan, the presence of which indicates the need to carefully and systematically pay attention to a recurring, potentially serious, form of inappropriate behavior.

Step 4 is, perhaps, the most important aspect of the planning process; it is the determination of exactly how many opportunities exist in the typical schedule to address the individual needs of the child with a disability and what program supports are needed to make an opportunity a successful reality. Each skill targeted in the IEP/IFSP must be referenced to the activities of the typical early childhood program. The team must ask (and answer) the question, "Does this activity provide an opportunity to address any of the skills in the IEP or IFSP?" and "If so, which ones?" In answering the questions, it becomes important to examine what the focus of the activity is for typically developing children. If it seems reasonable to the team that the activity may provide a context in which the needs of the child with disabilities can be addressed, without completely altering the meaningfulness of the activity for typically developing children, then the team can examine what adaptations may be needed. The effort to ensure that activities provide opportunities to address the needs of all children is central to what has been termed activity-based instruction (Pretti-Frontczak & Bricker, 2004).

As indicated in Table 1, adaptations may consist of two types. One involves individualizing the content of the activity by changing its focus or fundamental purpose for the target child. A modified content, or even a different content entirely, may be taught to the child with disabilities while the other children receive content appropriate for their needs. A second kind of adaptation involves changing the physical layout, modifying materials for the child, or even changing the way that staff conduct the activity. For example, while children with sensory disabilities, like blindness or low vision, may still function at age level and require no modification of content, they will require large print or Braille reading material. A child with cerebral palsy and an associated motor disability may require special equipment, such as a cut-out table and chairs with supports, wedges to facilitate upper body movement while in a prone play position, or a prone board to provide support in an upright position (Campbell, 2006). In some situations, it may even be necessary to add staff during the activity to ensure adequate instructional support without sacrificing instructional time for the other children. This might be the case with a child who presents a significant challenging behavior that requires an involved support plan, the focus of which is to teach a positive incompatible replacement behavior (see Figure 2).

[FIGURE 2 OMITTED]

Step 5 involves determining what related services are required and how often and how long each related service session should be. Children with significant disabilities often require such services as occupational therapy and speech therapy, and may need to receive one-on-one instruction from an early childhood special educator. While the preference is to provide these services in the natural setting of the early childhood classroom, it may be necessary to remove the child to a different setting for the service. If that is the case, then the team must decide what classroom activity (or activities) is (are) least important and thus could be missed by the child. This is usually accomplished by viewing each activity in terms of the opportunities it provides for addressing skills from the IEP or IFSP, and then selecting times for the child to leave the classroom when activities are occurring that provide the fewest number of individually relevant instructional opportunities. Sometimes, however, the schedule of those professionals who are delivering the service may need to be taken into account when making the choice.

The final step, Step 6, is also an extremely important aspect of team planning. Parents and other family members have their own perspective on what, among all of the skills that may be included in the IEP or IFSP, is most important. It is critical that staff respect those priorities by making sure that, first, they are aware of parental priorities and, second, adequate opportunities exist to address high-priority skills during daily program activities. In addition, families may have concerns regarding skills or behaviors that are best addressed outside of the formal confines of the program setting. It is extremely important that the skills learned at the center also are taught and practiced in natural settings--those settings in which the skill or behavior is most likely to be demanded or exhibited. Natural settings are the environments where children with disabilities would participate or function if they did not have a disability. These environments may include the child's home, the neighborhood playground, community activity or child care centers, restaurants, Head Start programs, or other settings designed for children without disabilities (Cook, Klein, Tessier, & Daley, 2004). While it is unlikely that program staff will be able to provide continuous, direct instructional support at home or in the community, it still would be possible to make visits and provide occasional community-based instruction. Making suggestions to the family as to how to generalize procedures employed at the center is another important aspect of the child's program. These procedures need to be planned for as carefully as you would the daily activities.

The Activity Matrix

A good way to summarize and represent the results of this six-step planning process is to construct what has been referred to as an "Activity Matrix" (Fox & Williams, 1991). Figures 1 and 2 contain an example format for an activity matrix. Figure 1 is an Activity Matrix for Chu Chu, a Chinese American boy with moderate mental retardation. Figure 2 was developed for Nikki, an African American girl with autism spectrum disorder and moderate cognitive delay. Each of the daily activities of the typical early childhood program is written in one of the columns to the right of the box labeled "Activities" across the top of the form (planning Step 2). Directly below is a space for the "Length of Time," where the duration, in minutes, of each activity is entered. Since some children, particularly those with disabilities, may need to be involved in an alternative activity (e.g., speech therapy), space is provided to list those activities that could be substituted at an appropriate time for one of the regularly scheduled activities (planning Step 5). We have found it helpful to number each of these alternative activities directly above the activity name and then refer to the activity by that number. Writing the number above one of the scheduled activities indicates that the alternative activity will occur instead of the scheduled activity. Down the left side of the matrix, room is provided for the individual instructional goals or objectives from the child's IEP or IFS (planning Step 3).

[FIGURE 1 OMITTED]

As suggested in Table 1, Step 4, the process continues by reading the first objective for the child and then looking at the first activity (arrival). You then ask yourself, "Does 'arrival' present an opportunity to address this objective?" Let's say, for the purpose of discussion, that the first objective for Chu Chu is from the "social skills/self-help" domain and it is "Chu Chu will greet his friends." Does "arrival" (i.e., coming into the room, hanging up his coat, putting his backpack away, and going to the table) present any opportunities for Chu Chu to acknowledge the presence of the other children by saying "hello"? Of course, that is a natural sub-activity involved in "arrival," so an "X" is placed in the box out from it and under "arrival" to indicate that a naturally occurring opportunity exists to practice the skills involved in "greeting friends" during this activity. What of the next activity? Does free choice time provide an opportunity to work on "greeting friends"? Probably not, so leave that box blank and look across the page, still on the row for the first objective, to the next activity, which is "outdoor play." Does it present any natural opportunities to practice greeting friends? Do the same thing for the next objective, and the next, until you have examined each activity in terms of its potential for each of Chu Chu's current IEP objectives. Those with high potential will have more Xs in the boxes under them; those with less potential will have fewer Xs. Skills that are of high priority to parents are indicated by a [square root] instead of an X. The last row in the matrix is left blank so that additions can be made if, upon reflection, the team feels a certain skill or behavior not included in the IEP or IFSP would benefit from focused attention.

It is important to remember that while an activity presents an opportunity to address the needs of a student with disabilities, it does not necessarily require adaptations. As indicated in Table 1, Step 4.3, an adaptation refers to the need to either change the content or substantive purpose of an activity, or change the way in which the activity is conducted by changing the setting arrangements, staffing patterns and responsibilities, or materials. Again, to use Chu Chu as the example, we have suggested in Figure 1 that arrival provides an opportunity to address his need to learn to greet his friends, a social skill goal taken from his IEP. Since this is not typically a skill that is the focus of instruction during arrival time, an adaptation of the first type (change in focus or content) is indicated by placement of an "X" to indicate Adaptation: Modified content/focus. But in order to accomplish this goal, the teacher will have to change how she behaves during the arrival of all of her students by focusing her attention specifically upon Chu Chu, prompting him to say "hello" and acknowledge others' greetings. Since this focused structure is not a typical part of the teacher's behavior during arrival, it would constitute an adaptation of the second type (Adaptation: Modified arrangement/staffing) and may require additional staff to help out with the other children while the teacher concentrates her attention on Chu Chu. Or, perhaps a "special friend" can be designated to help.

As is evident from Figure 1, arrival also provides an opportunity to address three other goals from Chu Chu's IEP: expressive vocabulary, pincer grasp, and signaling to use the bathroom should he need to do so. Because teaching these skills is not a part of the arrival activity for the other children, it needs further adaptation. Later, while outside, Chu Chu can practice greeting friends and using his expressive language and fine motor pincer grasp, but the signs indicating the need for an adaptation suggest that Chu Chu's caregivers will need to more carefully structure his activities so that he has sufficient opportunities to practice these skills each time he goes outside.

As required by his IEP, Chu Chu also will receive two types of related services, outside of the classroom (planning Step 5). Looking at Figure 1, it is evident that his team believed that the best time for him to miss a class activity to receive these services was during free choice time and part of the time devoted to learning centers. Additionally, Chu Chu's Activity Matrix indicates two family priority skills (planning Step 3.2): the social skill of greeting friends and the self-help skill of signaling his need to use the bathroom. The family also had indicated that they very much want Chu Chu to exhibit age-appropriate skills at restaurants, since they enjoy eating out as a family (planning Step 6). Staff plan to help identify non-obtrusive strategies that the family may use to reinforce Chu Chu's use of appropriate social and communication skills in this community environment. Those that involve signaling his need to use the bathroom are of particular concern.

Figure 2 is similar to Figure 1. Activities of the early childhood (EC) program are listed in which Nikki, a 3-year-old with autism and moderate cognitive delay, is included. Skills that are the focus of instruction are taken directly from her IEP and are recorded down the left side of the matrix; an "X" is entered for each activity for each skill that may be addressed during that activity, and the need for adaptations is noted where necessary. As is the case with Chu Chu, Nikki's family's priorities are included. Attending church services is one of their top priorities. Therefore, their desire to have Nikki develop non-disruptive ways of occupying herself during the main service (so that they can all sit together as a family) is recorded in the matrix.

One major difference between Chu Chu's matrix and Nikki's is the indicated need for a behavior support plan for Nikki. She will often scream and hit when blocked from engaging in a behavior or if she is otherwise frustrated in an attempt to gain attention or access to a desired object. The support plan is the primary responsibility of those who are also responsible for the IEP, typically the ECSE teacher, behavior specialists with the public school district, and the family. However, since it will have to be implemented throughout the day in the regular early childhood setting, as well as in the community, it becomes essential that the EC program staff are involved in a determination of the adaptations that may be necessary to ensure success in the inclusive setting. Children with severe behavior problems often provide the greatest challenge to successful inclusion. We have found, however, that careful team planning with an eye toward modifications and supports, along with a willingness to try alternatives, will greatly reduce potential disruptions and go a long way toward creating an atmosphere of acceptance.

Conclusion

Developmentally appropriate practices in early childhood education programs must be implemented with a clear understanding of and appreciation for the extremes of individual variation that are likely to be encountered. Cultural, ethnic, and racial diversities are important and valued characteristics of the population of young children currently served by early childhood education programs. We now recognize the importance of curricula that celebrate different values and associated expressions of those values in both the content and strategy of instruction. As Noonan and McCormick (1993) noted, it is important to reference the early childhood curriculum to the child's social environment. However, recent social and legal imperatives have given additional meaning to "diversity." Children with a range of disabilities, including those with severe cognitive, motor, emotional, and behavioral disabilities, are a valuable aspect of the differences that we celebrate in our early childhood education programs. Their presence should cause us to pause and take a closer look at what we believe about how all children grow and learn and how we teach them. If children are to benefit from the participation that inclusion brings, then educators, administrators, related service professionals, and parents must be ever-mindful that participation and achievement require that we emphasize the uniqueness of each child.

References

Allen, K. E., & Cowdery, G. E. (2004). The exceptional child: Inclusion in early childhood education. (5th ed.). Albany, NY: Thomson/Delmar Publishers.

Association for Persons with Severe Handicaps, The. (2000). TASH Resolution on Quality Inclusive Education. Baltimore: Author.

Bredekamp, S., & Copple, C. (Eds.). (1997). Developmentally appropriate practice in early childhood programs (Rev. ed.). Washington DC: National Association for the Education of Young Children.

Bricker, D., & Waddell, M. (2002a). Assessment, evaluation and programming system (2nd ed.): Curriculum for birth to three years: Volume 3. Baltimore: Paul H. Brookes.

Bricker, D., & Waddell, M. (2002b). Assessment, evaluation and programming system (2nd ed.): Curriculum for three to six years: Volume 4. Baltimore: Paul H. Brookes.

Brigance, A.H. (2004). Brigance Diagnostic Inventory of Early Development (2nd ed.). North Billerica, MA: Curriculum Associates.

Campbell, P. H. (2006). Addressing motor disabilities. In M. E. Snell & F. Brown (Eds.), Instruction of students with severe disabilities (6th ed., pp. 291-327). Upper Saddle River, NJ: Merrill.

Cook, R. E, Klein, M. D, Tessier, A., & Daley, S. (2004). Adapting early childhood curricula for children in inclusive settings (6th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

Fox, T. J., & Williams, W. (1991). Implementing best practices for all students in their local school. Burlington, VT: Center for Developmental Disabilities, The University of Vermont.

Friend, M., & Bursuck, W. D. (2002). Including students with special needs: A practical guide for classroom teachers (3rd ed.). Boston: Allyn and Bacon.

Gelfer, J., Filler, J., & Perkins, P. (1999). The development of a bachelor's degree in early childhood education: Preparation for teaching inclusive education. Early Child Development and Care, 154, 41-48.

Giangreco, M. F., Broer, S. M., & Edelman, W. (2002). "That was then, this is now!" Paraprofessional support for students with disabilities in general education classrooms. Exceptionality, 10(1), 47-64.

Gonzalez-Mena, J. (2000). Foundations: Early childhood education in a diverse society. Mountain View, CA: Mayfield.

Hauser-Cram, P., Bronson, M. B., & Upshur, C. C. (1993). The effects of the classroom environment on the social and mastery behavior of preshcool children with disabilities. Early Childhood Research Quarterly, 8, 479-497.

Heller, H.W. (1992). A rationale for departmentalization of special education. In W. Stainback & S. Stainback (Eds.), Contoversial issues confronting special education (pp. 271-281). Needham Heights, MA: Allyn and Bacon.

Individuals with Disabilities Education Act (IDEA), [section]303.18 of Rules and Regulations (1998).

Individuals with Disabilities Education Improvement Act, 20 U.S.C. 1414, [section]614 (2004).

Kostell, P. H. (1997). Inclusion. (ACEI Speaks brochure.) Olney, MD: Association for Childhood Education International.

Noonan, M. J., & McCormick, L. (1993). Early intervention in natural environments: Methods and procedures. Belmont, CA: Brookes/Cole Publishing.

Pretti-Frontczak, K., & Bricker, D. (2004). An activity-based approach to early intervention (3rd ed.). Baltimore: Paul H. Brookes.

Sandall, S., McLean, M. E., & Smith, B.J. (2000). DEC recommended practices in early intervention/early childhood special education. Longmont, CO: Sopris West.

John Filler is Professor, Department of Education, University of Nevada, Las Vegas. Yaoying Xu is Assistant Professor, Department of Special Education and Disability Policy, Virginia Commonwealth University, Richmond.

Table 1: Steps in Planning for Inclusion

STEP ONE:                 1.1 Invite the target child's parents
Form the inclusion            and/or other significant caregivers to
planning team.                participate in planning for inclusion.
                          1.2 Invite the EC program administrator to
                              participate, along with the general
                              early childhood education (EC) teacher
                              and the special education (ECSE) teacher
                              or early interventionist (EI).
                          1.3 Determine if there are others who should
                              be invited to participate on the
                              planning team (e.g., speech or
                              occupational or physical therapists who
                              may be delivering related services).

STEP TWO: List each       2.1 One member of the team (typically, the
daily activity of the         EC teacher) lists each activity from
typical EC program.           arrival to departure.
                          2.2 If the daily activities vary from day to
                              day, then care must be taken to include
                              all activities.
                          2.3 Note the typical length of time devoted
                              to each daily activity.

STEP THREE:               3.1 From the child's IEP or IFSP, list each
Determine the areas           current instructional target (these
of instructional              may be taken directly from the IEP
emphasis for the              objectives or child outcome statements
target child.                 that have not yet been met).
                          3.2 Determine which of these objectives is
                              a priority for the family.
                          3.3 Note whether the child exhibits any
                              particular behavior problems for which
                              a support plan may have been developed.
                          3.4 Inquire as to whether the family has any
                              additional instructional concerns that
                              may not have been noted in the IEP or
                              IFSP List these as well.

STEP FOUR:                4.1 The team determines which of the
Determine what                activities in the typical program
opportunities to              setting provide a reasonable opportunity
address the needs of          to address the instructional needs of
the target child may          the target child.
be provided by the        4.2 The team discusses and determines if an
daily EC program              adaptation is required to address the
activities.                   instructional target.
                          4.3 If an adaptation to the activity, as it
                              is typically conducted, is needed to
                              make a determination as to the nature of
                              the adaptation; modification of content
                              (changes in focus, rules, and/or
                              materials); and/or modification in the
                              way the activity is conducted (changes
                              in physical setting, materials, and/or
                              staffing).

STEP FIVE:                5.1 From the IEP or IFSP, note the target
Determine what                child's need for a related service, the
modifications are             weekly schedule for each service, and
necessary to meet the         the beginning date and length of time
target child's possible       for each service visit.
need for related          5.2 Discuss and determine whether the
services.                     service can reasonably be delivered in
                              the typical program setting by modifying
                              an activity.
                          5.3 If the service cannot reasonably be
                              delivered in the natural setting of
                              the classroom, then determine which
                              activities the child will miss in order
                              to receive the service in a different
                              room or program setting.

STEP SIX: Determine       6.1 Note any concerns of the family that are
what needs the                more appropriately addressed at home or
family may see for            in the community.
addressing skills/        6.2 Indicate which skills from the IEP/IFSP
behavior at home or           also can be addressed in these "other,"
in the community.             more natural environments.