These guidelines are intended to provide a resource to use in assessing, planning, providing, evaluating, and improving the quality of programs for California pupils with severe orthopedic impairments. The first three chapters present characteristic elements of a well-designed program in the areas of: (1) identification and assessment, (2) the Individualized Education Program, and (3) unique program needs. Chapter 4 emphasizes that decisions for placing pupils with severe orthopedic impairments in an educational program should be based on the educational needs of pupils rather than on their handicapping condition. The supporting role of the special education teacher is stressed. Chapter 5 specifies staff competencies of the site administrator, special education staff, related services staff, and support service staff. Chapter 6 examines other special considerations such as monitoring medications, implementing emergency procedures, coordinating services among agencies, and making facilities accessible. Seven appendixes include program evaluation guidelines, forms related to least restrictive environment requirements, examples for modifying regular education programs, selected legal requirements, procedures and guidelines for health care, resources for technical assistance, and a directive to special educators concerning intelligence testingn of black pupils. A glossary completes the guide. (DB)