NAVY CYP INCLUSION SUPPORT PLAN
Basic InformationName of Child (Last, First, MI):Click here to enter text. / Date of Birth (MM/DD/YY):Click here to enter text.
Region:Click here to enter text. / Installation:Click here to enter text. / Program Type:☐CDC ☐SAC ☐Teen ☐CDH ☐Youth Sports
Program Name:Click here to enter text. / CYP Director:Click here to enter text.
Today’s Date (MM/DD/YY):Click here to enter text. / ☐Initial Support Plan / ☐Updated Support Plan
Plan Completed By (List family members and all CYP professionals involved in the process):
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Summary of Strengths and Needs
Strengths & Interests(Favorite activities, skills & talents)
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Summary of Needs(Brief summary of needs identified during information-gathering process)
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Recommendations from Family(What has worked for the child/youth in the past/in other settings)
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Individualized Supports
Accommodations and Support Strategies (Describe the individualized supports required to access the environment, activities & social connections, and the strategies that CYP Professionals will use to help the child/youth communicate, follow routines, and connect with others.)
Click here to enter text. / CYP Professional Responsibilities: (Assignroles and dates)
☐Teaching/modeling strategies:
☐Implementation: Click here to enter text.
☐Documentation:Click here to enter text.
CYP Professional Responses (Describe how CYP Professionals will respond to specific behaviors or needs)
Click here to enter text. / CYP Professional Responsibilities:(Assign roles and dates)
☐Teaching/modeling responses:
☐Implementation: Click here to enter text.
☐Documentation:Click here to enter text.
Implementation Supports
Collaboration & Training (Plan for how CYP professionals will work together and access relevant training)
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☐Coordinating Meetings:
☐Coordinating Training:
Resources Needed (Supports for the classroom, home, or group)
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☐Coordinating Resources:
Follow-Up Plan (When family and CYP professionals will meet to review progress and update plan)
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☐Coordinating Meetings:
CYP Director Signature / DateClick here to enter text.
Parent/Guardian Signature / DateClick here to enter text.
CNICCYP 1700/42A, MAY 2014 FOR OFFICIAL USE ONLY – PRIVACY SENSITIVE1|Page
NAVY CYP INCLUSION SUPPORT PLAN
Instructions for Completing the Inclusion Support Plan
Each child/youth with moderate or significant needs requires an Emergency Action Plan (EAP) and/or Inclusion Support Plan (ISP) on file – an EAP to address needs associated with an identified, diagnosed medical need, and an ISP to detail the accommodations and supports required to support a child’s developmental and/or behavioral needs. The CYP Director is responsible for coordinating the team efforts to develop and completing the ISP. The team will include the youth (whenever possible in SAC and Teen Programs), child/youth’s family, Training Specialist(s), and CYP Professionals working directly with the child/youth in the program setting. The team will use the following information to develop the ISP:
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NAVY CYP INCLUSION SUPPORT PLAN
Youth input/perspective (SAC and Teen Programs)
Family input/perspective
Needs identified through the information-gathering process
Recommendations from KIT
Recommendations/outcomes from IAT meeting
CYP Professionals’ input/perspective
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NAVY CYP INCLUSION SUPPORT PLAN
Each section of the plan includes valuable information for meeting the needs of the child/youth in Navy CYP and is described below:
Summary of Strengths and Needs
Strengths and Interests: Describe the child/youth’s favorite activities, skills and talents. This information will be useful to the team in developing supports.
Summary of Needs: Summarize the needs that were identified during the information-gathering process. For example, answer the question, “What does this child/youth need in order to participate in Navy CYP?” Answers may include things like, “help communicating wants and needs”/”individual attention to follow the routine”/”adaptations to the physical space and materials”. See Chapter 4, Section 4.2 of the Inclusion Operating Manual (OM) for additional examples of possible needs.
Recommendations from Family: Describe the things that work for the child in other settings such as at home or in the community (e.g. at Girl Scout meetings). If the child/youth has had experience in other Navy CYPs or community programs, a summary of what worked in those settings should be included in this section.
Individualized Supports
Accommodations and Support Strategies: Outline exactly which accommodations are required for the child/youth to access the program. Describe the adaptations and adjustments that will support the child’s participation and answer the question, “What do we need to add or change to accommodate the child/youth’s needs?” Also detail how CYP Professionals will teach adaptive skills or guide youth in using adaptive skills and promote independence. Adaptive skills are the age-appropriate and culturally relevant skills that children and youth use to meet the demands of the environment (e.g. listening, taking turns, waiting, understanding body language, etc.). Answer the question, “How can we help the child/youth develop the skills she needs to communicate with others, participate independently, and connect with her peers?” These strategies will be based on input from the family, CYP Professionals, KIT, and IAT. See Chapter 3, Section 2 of the OM for additional examples of accommodations.
- CYP Professional Roles and Responsibilities: Identify the CYP Professional(s) responsible for ensuring that: (a) direct care staff are fully trained to implement the plan effectively; (b) the plan is implemented fully and appropriately across all program settings; and, (c) documentation is collected on an established timeline detailing that the accommodations are in place, being used, and how the child/youth is responding to those accommodations.
CYP Professional Responses: Describe exactly what CYP Professionals will do or say in response to a child’s needs or behavior. Detail how CYP Professionals will be prepared to respond to the child/youth in a consistent, nurturing, and supportive way. Answer the question, “What do we do when the child/youth (has trouble communicating, withdraws, loses control, uses aggression, cries excessively, etc.)?” Answers include detailed descriptions of what CYP Professionals will say and do in specific situations. For example, if a child/youth tends to throw objects when upset, the section would include what CYP Professionals will say, “I see you are upset. Let’s take a break,” and do, “remain calm/position yourself between the child and the objects and point to the designated calming space/ if the child continues to throw objects, call for assistance”.
- CYP Professional Roles and Responsibilities:Identify the CYP Professional responsible for: (a) teaching the Direct Care Professionals how to respond to the child/youth in specific instances and the expected timeline; (b) implementing the responses with the child/youth in the program setting and the expected timeline; and, (c) documenting that the responses are being used consistently, how the child/youth is responding to them, and the expected timeline.
Implementation Supports
Collaboration & Training: Outlines how the CYP Professionals will work together and access training, with a focus on how CYP Professionals will communicate about progress between scheduled meetings and the training needed to implement the ISP. Answer the questions, “How are we going to make sure we work as a team? What does the team need to implement the ISP?” Many times the answers will include specific KIT training and support. For ISPs that include an additional adult support, programs must work with KIT to outline the specific training required for the Professional assigned to that role. Also detail the family’s roles and responsibilities for supporting implementation, including ongoing communication and any crossover activities that will reinforce strategies being implemented in the CYP.
Resources Needed: Highlight the supports needed to implement the ISP as written, focusing on any material or logistical things the team needs. Include any supports that the family will provide to support implementation. Answer the question, “What do we physically need to implement the ISP?” Answers may include, “pictures for the choice cards”/”written or picture instructions for our activities”/”yoga mat for the calming space”/”binoculars for the focus goggles at group time”.
Follow-Up Plan: State when and how often the team will meet to formally discuss and update the ISP.
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