This manual was developed in conjunction with the implementation of the Colorado Effective Education Model, a systems change project designed to develop best educational practices for students with severe disabilities in inclusive settings. The manual presents adaptations to better meet elementary level students' goals and objectives and describes processes for identifying student outcomes within the context of regular education curriculum/activities. Introductory sections offer general guidelines for designing curricular adaptations to enhance learners' participation and level of mastery, and offer guidelines for designing noncurricular adaptations in the environment, materials, assistance, and presentation. A decision-making framework for using adaptations is provided, followed by a case study applying the framework. A chart then lists basic skills and adaptive/alternate activities in the areas of: typical routines, math, science, language arts, reading, social studies, physical education, and music. (JDD)