Profound and Multiple Learning Difficulties (PMLD)

Local Providers for Profound and Multiple Learning Difficulties

What PMLD is

Profound and Multiple Learning Difficulties (PMLD) describe children and young people with severe learning disabilities combined with significant physical or sensory needs.
They require a high level of support with learning, communication, and daily activities.

With consistent care, therapy and specialist education, pupils with PMLD can enjoy meaningful experiences and develop communication and independence skills.

Related guidance

  • Severe Learning Difficulties (SLD)
  • Medical Technology Users
  • Wheelchair Users
  • SEN Wellbeing
  • Sensory Processing Disorder (SPD)

    Signs and characteristics

    Individuals with PMLD may:

    • have very limited understanding and communication

    • rely on facial expressions, sounds, or gestures to interact

    • need help with all aspects of daily living and self-care

    • experience mobility, vision or hearing impairments

    • respond strongly to sensory experiences (light, sound, touch)

    Check signs of PMLD
    Learn how profound and multiple needs affect learning and interaction.

    Common health and sensory needs

    Children with PMLD may also have:

    • epilepsy or other medical conditions

    • feeding or respiratory needs requiring medical technology

    • vision or hearing impairments

    • difficulties with muscle tone, posture, and movement

    Care is often coordinated between families, therapists, medical staff and education providers.

    Learn about sensory and physical needs in PMLD
    Understand how multi-sensory learning can support engagement.

    Getting assessed and supported

    Assessment is multidisciplinary and usually includes:

    • educational psychology

    • physiotherapy, occupational therapy and speech therapy

    • medical evaluations and sensory assessments

    Support plans focus on comfort, engagement and quality of life, not academic attainment.

    Children with PMLD will always require an EHCP and access to specialist education settings.

    Support in education

    Education for pupils with PMLD focuses on:

    • sensory and experiential learning

    • communication and emotional expression

    • physical development and positioning

    • personalised routines with therapy integration

    • close collaboration with families and healthcare professionals

    Learning is delivered through individualised programmes rather than national curriculum outcomes.

    Therapies and approaches

    Effective support may include:

    • Physiotherapy and hydrotherapy for movement

    • Speech and language therapy for communication and swallowing

    • Music, sensory and art therapies for engagement

    • Assistive technology such as eye-gaze or switches

    • Palliative care support where complex health needs exist

    Get support for PMLD

    Search for special schools, therapists and carers experienced in supporting children with profound and multiple learning difficulties.