Educational Access for students with PMLD

What is PMLD?

When a child has more than one learning disability, it is referred to as profound and multiple learning disabilities (PMLD). These children may have major communication difficulties, and their capacity to understand and express themselves might be limited. In addition, sensory or physical disabilities, complex health needs, and mental health difficulties are all aspects to consider when dealing with PMLD. If the child with PMLD does not receive adequate support, he or she will develop behavioural issues as a result of the combination of these demands. Children with PMLD might require a high level of personal care and support in their everyday activities (e.g: help to eat, to wash hands), to ensure for them high quality of life. PMLD can affect children with autism and Down syndrome. PMLDcan be caused by a hereditary condition, or it can develop prior to, during, or after birth as a result of a serious brain illness or damage.

These types of complex learning difficulties will require adjustments to learning activities. There are many ways to increase access to the curriculum and create active learning environments where everyone can thrive. Education staff in special schools have found inventive ways to address both severe learning difficulties and moderate learning difficultiesin classroom environments. This type of inclusive education requires a lot of skill and knowledge and teachers don't always get the credit they deserve. In this article, we will explore some of the implications of PMLD and look at some of the learning activities schools can consider when designing an active learning environment. As our knowledge of complex learning disabilities has grown and our thinking evolved around neurodiversity so have the effective learning activities.

What are Profound and Multiple Learning Disabilities (PMLD)?

PMLD occurs when a child has more than one learning disability combined with major communication difficulties, sensory or physical disabilities, complex health needs, and mental health challenges. These children typically require high levels of personal care and support in daily activities like eating and washing hands. PMLD can be caused by hereditary conditions or develop before, during, or after birth due to serious brain illness or damage.

Complex learning disabilities can be very different and the individual needs of each child will always have to be taken into account. A school would usually have to get multiple viewpoints from different education staff including SENDCo's and educational psychologists. What teachers might initially see is the behaviour at school of the pupil, utilise all the professional school services available in order to fully understand the issues. Severe learning difficulties and moderate learning difficulties might include an interplay of the following:

• Poor recall, trouble taking turns, and difficulties with taught subjects are all examples of severe learning problems.
• Physical limitations include a lack of muscle coordination, which makes it harder to carry out daily duties, and restricted mobility, which limits muscle flexibility.
• Sensory impairments include things like eyesight and hearing loss.
• Complex health needs, such as epilepsy or respiratory issues, as well as eating and drinking issues
• Acting out, having trouble interacting socially, and not following directions are all examples of challenging behaviour.
• Restricted communication: limited speech, difficulty comprehending what others are saying, and difficulties interacting socially with others.

The Education Endowment have created a great tool for schools to plot out the needs of their SEND pupils. This tool might be a useful way of framing the needs of your PMLD students.

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How can teachers address the educational needs of students with PMLD?

Teachers can address PMLD students' needs by moving beyond traditional teaching approaches and implementing effective sensory strategies that engage multiple senses. This includes creating active learning environments with adjusted activities that accommodate severe and moderate learning difficulties. Success requires recognising that challenging behaviours like pushing, biting, or running are often communication attempts that need to be decoded and addressed appropriately.

People with profound learning disabilities, like people with any other disability, will continue to improve and learn throughout their lives if they are given the proper support and care. This necessitates offering early intervention to help the student build their early development skills. Learning the concept of cause and effect, for example, putting your hand on a hot cup can burn you, or taking turns rolling a ball between us. Also, keep in mind that the child will learn at a slower pace because he or she is still absorbing the concept. Some pupils, for example, may have very short-term memories, so they will need more time and may need to repeat the concept multiple times before they get it. In order to teach new concepts, it is necessary to repeat it. Furthermore, be able to set appropriate aims while taking into account any other extra needs, such as physical or sensory needs and improving student engagement.

Communication Needs:

Face expressions, voice noises (whispering, shouting), body language, and behaviour are the primary means of communication for children with PMLD. They may be able to communicate using a limited set of formal tools such as speech, symbols, or signs. They have trouble understanding and using verbal communication in situations and with people. As a result, individuals feel safe sticking to their daily pattern and avoiding unexpected incidents. Teachers can use modelling techniques to help students understand communication patterns, while also considering how motivation plays a crucial role. Supporting these students requires understanding attention difficulties and implementing strategies that address social-emotional learning needs.s.

Here are a few ideas for supporting interactions:

• Maintaining eye contact, using facial expressions, and paying attention to body language will ensure the child understands he or she is being listened to.
• Pay close attention to the child's reactions. They may become uneasy or joyful, and they may turn their heads to indicate their preferences.
• Give children time to respond; they may be slower to absorb what has been said or shown to them.
• When communicating with a youngster, try to use a calm and collected tone of voice.

Sensory Needs:

Children with PMLD may have significant sensory impairments such as vision or hearing loss. It is critical to ensure that the learning environment takes these into account. If a youngster struggles to see or hear, it may be worthwhile to investigate the utilisation of visual or auditory aids. When instructing a child with PMLD, it is critical to consider their sensory sensitivities. Some youngsters may be hypersensitive to particular sounds, textures, or lights, which can cause pain and suffering. Creating a pleasant and accepting learning environment that is adapted to the child's sensory requirements is critical.

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Practical Strategies for Inclusive Education

Inclusive education for students with PMLD involves practical strategies such as creating multi-sensory environments, using assistive technology, and ensuring consistent routines. Individualized Education Plans (IEPs) should be regularly reviewed and adapted in collaboration with a multi-professional team to meet the evolving needs of the student. It's also essential to provide ongoing training and support for staff to enhance their understanding of PMLD and effective teaching methods.

Here are some practical strategies for inclusive education:

• Multi-Sensory Environments: Provide opportunities for students to engage with different sensory experiences such as tactile, visual, auditory, and olfactory stimuli. This can help to stimulate their senses and promote learning.
• Assistive Technology: Utilize assistive technology such as communication aids, adaptive switches, and specialised software to support students' communication, mobility, and participation in learning activities.
• Consistent Routines: Establish consistent routines and schedules to provide students with a sense of predictability and security. This can help to reduce anxiety and promote engagement in learning activities.
• Individualized Education Plans (IEPs): Develop individualized education plans that are tailored to meet the unique needs and goals of each student. Regularly review and adapt IEPs in collaboration with a multi-professional team.
• Collaboration with Multi-Professional Team: Work collaboratively with a multi-professional team including therapists, psychologists, and other specialists to provide comprehensive support for students with PMLD.
• Ongoing Training and Support for Staff: Provide ongoing training and support for staff to enhance their understanding of PMLD and effective teaching methods.

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Conclusion

Supporting students with PMLD requires a complete and individualised approach. It's about understanding their unique needs, strengths, and challenges and creating an environment where they can thrive. By focusing on communication, sensory integration, and practical strategies, educators can make a significant difference in the lives of these students.

Remember that progress may be slow and incremental, but every small step is a victory. Celebrate these achievements, and always maintain a positive and encouraging attitude. The journey of educating students with PMLD is a collaborative one, requiring dedication, patience, and a willingness to learn and adapt.

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Further Reading

1. Ware, J., & Coupe O’Kane, J. (2000). *Reflecting on values: promoting inclusion for pupils with profound and multiple learning difficulties*. Support for Learning, 15(3), 118-124.
2. Nind, M., & Hewett, D. (2001). *A curriculum for pupils with profound and multiple learning difficulties*. Curriculum Journal, 12(1), 5-23.
3. Bigby, C., & Beadle-Brown, J. (2011). *Active support: enabling and helping people with intellectual disabilities*. Jessica Kingsley Publishers.
4. Arthur, M., et al. (2017). *The impact of intensive interaction on the communication skills of adults with profound and multiple learning disabilities*. Journal of Applied Research in Intellectual Disabilities, 30(1), 59-71.