Using Technology to Engage Learners with Profound and Multiple Learning Difficulties (PMLD)


Students with PMLD have severe and complex learning difficulties. They can also have other significant difficulties, such as physical disabilities and auditory/visual impairments. PMLD students are often used to having little control over their environment and this is where technology can provide and promote independence. 

As all teachers know, the key to learning is engagement. These students may be engaged by a limited range of stimuli and may need a more personalised curriculum than other students. Children with PMLD may not be able intentionally communicate the likes and dislikes, so we often have to interpret their vocalisations, body language, facial expressions or behaviour to understand their preferences. Family members and those who know those students best will often know what they like instinctively. They may respond positively to tactile stimuli. Possibly massage – either soft or firm? Or the feeling of air blowing on their face? Sounds? Maybe a particular performer or kind of music? A particular person and their voice? High pitched sounds? Loud or quiet? Maybe lights, a particular colour or patterns? Or a taste? Once we have identified a student’s interests and preferences, we can develop engaging and enriching activities for them to participate in.

Initially we may simply be seeking for a student to show an awareness or respond positively to an activity. As a student becomes more proactive in their intentions we need to present them with a means of activating an activity. Traditionally this would be a switch. Many of our students have restricted movement, so the positioning of the switch is very important. We want to establish a position in which a student can press a switch to activate an activity with minimal physical strain. Sometimes this can be simply mounting the switch with Velcro on a tray or table. With other students we might use mounting arms attached to a wheelchair. They may prefer to activate a switch with their head. Eye tracking, used in the right way with the right student, presents a more technological approach which can be incredibly empowering for some PMLD students.  Whatever the means of activation we are seeking to find an optimal position for the equipment, so that triggering the desired result becomes second nature for the student. Initially, the student may need to be supported in the activation. With a switch, they may initially need physical prompting or hand-under-hand support. Once we have found the optimal position for the equipment, we want out students to become as independent as possible. Our students may have medical conditions, and different positions, so the position of the switch may change. However, we should try to keep the position as consistent as possible.

Once activating a device becomes second nature for a student we can start to use the technology to activate different choices in different environments. We might want to use our switch in a sensory room to activate a bubble tube, use the switch to turn the lights on in the classroom, activate a blender in a cooking lesson or simply to make a silly sound which will make other laugh. Google search will bring up a range of retailers selling switch operated toys. We can use adaptors to allow control over simple on/off mains or battery operated devices or toys. We have infa-red adaptors that allow control over remote controlled devices (TVs, air conditioners, CD players, interactive whiteboard screens). At the level of “cause and effect” we can use increasingly accessible and affordable technology alongside a healthy dose of imagination and creativity to give our PMLD students more control over their environment.

We now want our students to begin to make choices. Despite being written in 2011, Inclusive technology’s excellent Switch Progression Roadmap is freely downloadable and still provides an excellent framework within which we can begin to build up switch use beyond simple “make something happen” switch use. Ultimately we want our students to be making choices, using one switch, two switches or even by using Eye Gaze technology. And, of course, we want them to communicate. Once we have reached this stage, of course, our students are no longer PMLD. So, perhaps that is a subject for another day.

Cosmo switches

Specialist Resources


Pupils and students with severe learning difficulties are those of school age (Year 1 or above) who are working below the level of the National Curriculum. They will have lifelong developmental delay and may have additional impairments as well.
Those with profound and multiple learning difficulties have severe and complex learning needs in addition to other disabilities.




Below level 1

Assessing switch use PMLD pupils

101 ways with a Step by Step

101 ways with a BIGMack


Useful websites

Free downloadable one switch games:

A wealth of free online browser-based and downloadable switch-based resources from the author of The Switch Progression Roadmap:

Youtube videos switch accessible, either simple cause and effect or via scanning – for free:

Lots of very high quality posters and guides to help practitioners with accessibility technology, including switchessingle and multi-message devices and Eye GazeCall Scotland

A wealth of engaging games for switch and touchscreen:

Assess and teach early Eye Gaze skills: Insight

Create, edit and play personalised switch and touchscreen accessible learning materials that can be used in your classroom and with individual students securely online and then download them to your iPad or Android tablet: Choose IT Maker 3

Inclusive Technology software making it super-easy to create simple personalised switch accessible slideshows with custom images and sound: Slideshow Maker


PMLD student drumming
PMLD class during a sensory story session at Charlton Park Academy