Most changes require only flexibility and are commonsense changes that we may even see in effect already for younger age groups. These types of changes are tried and true. They have worked in special recreation programs since the 1970s. Depending on the sport and the player and, yes, the level of competition they can be effective in a league. It must absorb the cost, or spread it through the league by including it as a cost when calculating fees paid by all registrants.
Some decisions watch the balance between safety and competition.
In Virginia, a boy who uses a wheelchair was denied the opportunity to play basketball because of safety and competition issues, but was still given some options for basketball participation. However, a boy in Ohio who can stand but has a physical disability is suing to have the right to play in boy's baseball. A boy in Arizona who uses crutches is suing to play age-group soccer. The most important case in this area is Anderson v. Little League, a 1992 case from Arizona. Anderson was a boy's baseball third-base coach.