Skip to main content

Children with profound and multiple learning disability (PMLD) have difficulties in more than one area, including severe learning disability, combined with other significant problems and complex needs. Many are lifelong wheelchair users.

The problems and complex needs experienced by children with PMLD may include physical disabilities, sensory impairment (sight and hearing), autism, social-emotional and mental health needs and severe medical issues such as epilepsy. These children have considerable difficulty communicating, very limited understanding, and many show challenging behaviours. They require a high level of adult support for both learning needs and personal care throughout their lifetime.

But it’s important to remember that people with PMLD are a diverse group of individuals with their own personalities, preferences and ways of communicating. The abilities of these children vary considerably.

Finding a school

Children with PMLD are educated in special schools. They are likely to need sensory stimulation and a curriculum broken down into very small steps. Some pupils communicate by gesture, eye pointing or symbols, or assistive technology. Their attainments are likely to remain low and as they are working below the standard of the National Curriculum assessments, and not able to engage in subject-specific study; their progress is measured differently. P scales 1-4 are currently used as descriptors of the emergence of skills, knowledge and understanding appropriate to the nature of the child’s special need. From late 2021 these will be replaced by an Engagement Model covering five areas:

  • exploration
  • realisation
  • anticipation
  • persistence
  • initiation.

A child with PMLD is unlikely to continue to further education and may need supported living arrangements at 25.

Social isolation

People with PMLD remain one of the most marginalised groups in society. Due to the multiplicity of their disabilities and because our communities have not historically been inclusive, they are often excluded from playing a full role in society.

But things are changing, largely thanks to organisations such as Mencap. Their Involve Me project, for example, aims to increase the involvement of people with PMLD in decision making and consultation. The Involve Me summary booklet and practical guide is a result of this three-year project supported by the Renton Foundation and run by Mencap in partnership with the British Institute of Learning Disability (BILD). People with PMLD and staff took part by learning about using different approaches to communication: sharing stories, creative communication, peer advocacy and multimedia advocacy.

How we can help

The Good Schools Guide website features reviews of recommended schools for PMLD or consult our SEN team for one-to-one help.

Further information

Find out more about how to get the right support and communication for a child with PMLD by visiting

Most popular Good Schools Guide articles

  • Special educational needs introduction

    Need help? Perhaps you suspect your child has some learning difficulty and you would like advice on what you should do. Or perhaps it is becoming clear that your child's current school is not working for him or her, and you need help to find a mainstream school which has better SEN provision, or to find a special school which will best cater for your child's area of need. Our SEN consultancy team advises on both special schools, and the mainstream schools with good SEN support, from reception through to the specialist colleges for 19+. Special Educational Needs Index

  • The Good Schools Guide International

    Coronavirus As a result of the coronavirus outbreak, The Good Schools Guide International offers the following guidance:  Determine the global situation and that of individual countries on government mandated school closures by accessing the UNESCO information on this link:   For updates on the medical situation, go to  the World Health Organisation website at  If you wish to contact one of our GSGI listed schools to discover their current status or any plans for alternate learning strategies, please go to our database to find email and phone numbers for each school If your company makes you brexit, The GSGI should be your first stop.…

  • Uni in the USA... and beyond

    The British guide to great universities from Harvard to Hong Kong. We tell you how to choose, how to apply, how to pay.

  • Grammar schools best value added

    We examined the value-added from KS2 to GCSE for 2017 to see which state selective grammar schools added the most value to their offspring. A note of caution - the more highly selective a grammar school, the less scope there will be to add value. Read more

  • Performing arts schools

    At specialist music, dance or performing arts schools, the arts aren't optional extras. They’re intrinsic to the school curriculum. Students are expected to fit in high level training and hours of practice alongside a full academic provision. It's a lot to ask any child to take on, but for those with exceptional performing ability this kind of education can be transformative.

Subscribe for instant access to in-depth reviews:

☑ 30,000 Independent, state and special schools in our parent-friendly interactive directory
☑ Instant access to in-depth UK school reviews
☑ Honest, opinionated and fearless independent reviews of over 1,200 schools
☑ Independent tutor company reviews

Try before you buy - The Charter School Southwark

Buy Now

GSG Blog >

The Good Schools Guide newsletter

The Good Schools Guide Newsletter

Educational insight in your inbox. Sign up for our popular newsletters.