Physical activity in preschool children contributes to the development of motor skills and it is important to know how to choose the right exercise, which is in accordance with the child's abilities and abilities. When performing certain tasks, it is very important to devote a lot of effort to children with special needs and carefully plan carefully how we will include them in group work. Unfortunately, children with special needs spend a lot of time in health facilities, where they are in contact with professional staff, adults, and they are not given as many opportunities to spend time with their peers. It is necessary to include such children in the work as much as possible, in order to strengthen their self-confidence and motivation. By including children with disabilities, in the concept of physical and health culture, it also encourages children to physical work and activity. This final paper deals with the topic of working with children with special needs in the physical education class. The paper will present different concepts related to the types of developmental difficulties. Inclusion and inclusive education will be explained, followed by the role of physical and health education. The most prominent part of the paper presents organizational forms of work, methods of work and adaptation of physical activities to children with special needs, and lists several different activities for children. Furthermore, aids will be explained and researched. In working with children who require special programs, educators and professional personality, it is precisely these aids that facilitate. The support of educators, adults and even peers of children is important because it motivates them for successful development and progress. In order for children to develop better, to provide them with a sense of belonging and ensure that all needs are met, including physical, it is necessary to ensure continuous education and also create quality, mutual cooperation of educators, parents, children and associates.