A profound challenge


How to develop a curriculum for pupils with PMLD

In this article I am going to discuss the latest developments in curriculum design for pupils with profound and multiple learning difficulties (PMLD). I will consider what changes there have been in general and provide an introduction to the PMLD curriculum devised at one school in Coventry.

The developmental approach

Following a general relaxation in the prescriptions of the National Curriculum and the National Strategies, teachers working with pupils with PMLD have been writing new curriculum materials. The QCA (2001; 2009) learning difficulties booklets made it clear that teachers are free to develop whatever curriculum they feel is suitable for these pupils, but it has taken a little while for teachers to believe that this is really so. They seem to have been uneasy with major change and some schools still feel that they need to word their curriculum documents to fit in with the National Curriculum, although their actual teaching may not look very conventional.

According to a recent research study for Mencap (Lacey, in preparation), many schools including pupils with PMLD have a curriculum that is driven by a developmental perspective on learning. Some have been influenced by the assessment tool Routes for Learning (Welsh Assembly, 2006), which provides details of typical infant development applied to older children and young people who are functioning at this level. The Routemap contains early development behaviours in the areas of communication and early cognition, and these can guide teachers on the precise nature of what they should be teaching pupils. The assessment booklet clearly shows how and what to assess, what to look for during the assessment, and then gives teaching strategies for teaching to a particular behaviour.

The QCA guidelines have also encouraged teachers to look with fresh eyes at both curriculum content and teaching approaches suitable for pupils who are just beginning to take the first steps in learning. The result has been several sets of materials that are available freely online or for purchase from schools. One of the common elements of these materials is the movement away from a national curriculum perspective in favour of a developmental perspective. Schools are not driven by literacy, numeracy, science, geography and French but by early thinking, communication, self help skills, social interaction and mobility.

The curriculum presented below has been built on a range of ideas past and present. This curriculum was influenced by:

•    the importance of a developmental perspective (tempered by a consideration of the age, experience and specific understanding of individual pupils)
•    a focus on the basic skills of learning and living usually gained in the first year of life
•    interesting and challenging (subject) contexts within which to practice those basic skills.

Creating a curriculum for PMLD

I have been working with Castle Wood School in Coventry, a primary special school for pupils with moderate, severe and profound learning difficulties, to develop a draft curriculum. The school was formed a year ago by the merger of two nearby schools. Roughly a quarter of the school population has profound learning difficulties, with a mixture of wheelchair users and very ambulant children with autism. There are three curriculum levels:

•    P1 to 3: informal curriculum
•    P4 to 8:  semi-formal curriculum
•    NC Level 1 and above: formal curriculum.

The fundamental structure underpinning the informal, semi-formal and formal curricula are the twin pillars of communication and cognition. All pupils are learning to communicate and to think and learn. At the informal stage, “communication” and “cognition” form half of the curriculum. The other half consists of “physical”, “self care” and “independence”. There is no mention of National Curriculum subjects, although pupils use some subject areas, such as the arts, physical education and the humanities, to provide the contexts for their learning. These subjects are part of a thematic approach to the curriculum adopted by the whole school.

The content of the curriculum for pupils with PMLD was developed through studying the historical perspective on curriculum design, typical child development textbooks, published curriculum materials and curriculum documents from other schools.

The content of the curriculum is broken down into four areas: cognition, communication, physical, and self care and independence.

Children at a very early stage of development need people around them who can help them to explore and interpret the world. They have difficulty in making sense of that world and need many opportunities to handle and test out objects, look for patterns and sequences in experiences and generally extend their focus from the immediate to things further away.

The programme of learning for cognition is divided into a four areas:
•    awareness
•    exploration
•    control and early problem solving
•    sequence and pattern.

Children at a very early stage of developing communication require people around them to be responsive to any attempts at communication. Interpreting behaviour as potentially meaningful is one important adult response as this can encourage the child to repeat the behaviour.

The programme of learning is divided into three areas:
•    responding
•    interacting
•    communicating.

Children who are physically impaired or who are still learning to move need lots of opportunities to move around both supported and freely. Not only is it important that children learn to move so they can become more physically independent, but movement is vital for developing thinking and communicating skills. If children cannot manipulate toys or go and investigate objects and people, their learning is very restricted.

The programme of learning is divided into four main areas:

•    body awareness
•    fine motor
•    gross motor
•    mobility.

Self care and independence
In this area of the curriculum, children with PMLD need to learn the skills that typical children learn at home before starting school. Learning to use the toilet, clean your teeth, get dressed and undressed, and eat with a spoon are all vitally important areas and should not be considered as activities to be completed as quickly as possible between lessons. Children should be given sufficient time to learn to become as independent as possible in all these personal care areas.

The programme of learning is divided into six areas:

•    eating and drinking
•    dressing and undressing
•    using the toilet
•    cleaning teeth
•    brushing hair
•    washing and showering.

Programmes of learning

Each of the four curriculum areas have a list of the opportunities children need in order to learn.  It was decided to present the curriculum with an emphasis on learning rather than on assessment, so that the pupils can demonstrate what they can do and understand, rather than being taken step by step through a list of pre-decided behaviours. In this way, the curriculum is flexible and can meet the range of needs presented by pupils with PMLD. For example, in the cognition programme, the area of “awareness” contains the following: awareness (of stimuli – people, objects and activities). All functional senses should be used and children should have opportunities to:

•    recognise an obvious change happening very close to self (for example, stills when hand is massaged or when sees a bright flashing light)
•    recognise when a stimulus starts and stops (for example, stills, moves limbs, turns after the stimuli start or stop)
•    accept stimuli for an increasing amount of time (for example, will hold objects or allow feet to be in the foot spa)
•    respond to a widening range of stimuli (for example, turns to a range of flashing objects)
•    anticipate stimuli that occur over and over again (for example, smile before being pushed on the swing after several pushes)
•    respond to a range of stimuli that are quieter or less obvious (for example, smile at quiet singing)
•    attend to stimuli further away (for example, hears music a few feet away or smells lunch as the trolley comes in)
•    transfer attention from one stimulus to another (for example, look at jumping dog and when it finishes look at moving car)
•    attend to stimuli in a busy classroom (for example, watch another child moving around)
•    locate a specific stimulus against a busy background (for example, find favourite toy in a box of several toys or turn to name in a noisy room).


The basic content of the curriculum at this school is not new.  Elements come from the 1970s and 80s, when the emphasis was on developmental checklists and behaviour modification. Other elements come from the National Curriculum years, when the emphasis moved to giving access to school subjects. It seems to be a natural progression to bring these elements together and take a developmental perspective on basic learning and life skills embedded in interesting contexts which are influenced by relevant school subjects. The decision at the school to move away from National Curriculum subjects was made so that teachers can concentrate on individual pupils’ needs rather than how to make a particular subject accessible. If the emphasis is on early developmental skills, then these are likely to be taught, as the following example demonstrates:

Mandeep is learning to explore a reactive environment.  He is practising this by touching the hanging bells and scratching at the drum. This is not a music lesson but music is providing an interesting context for him to develop his basic cognitive skills.  After a while, the adult joins in and encourages Mandeep to interact with her in a turn-taking game. At this point, he is clearly learning about early communication.  As the game continues, the instruments are abandoned for a favourite game of “boo”.  This leads on to another favourite game that involves pulling off a brightly coloured wig. The two do return to making sounds later in the session and Mandeep touches the computer screen to activate his favourite song. As this is not a music lesson, the adult is free to pursue exploring a reactive environment in whatever way is motivating for Mandeep. She does not have to provide a balanced music lesson, nor consider how to make music accessible at KS3.

The current academic year (2011-12) will be the first year for trialling and evaluating the new curriculum for pupils with PMLD at Castle Wood School. We are hopeful that children will show good rates of progress, especially as staff will be starting from each child’s current understanding and gently encouraging them to move forwards, concentrating on the fundamentals of learning and living.

Further information

Dr Penny Lacey is a Senior Lecturer in Education at the University of Birmingham and has published widely on the subjects of PMLD and learning difficulties. She also teaches one day a week at Castle Wood School, Coventry:


Lacey, P. (2010) SMART and SCRUFFY Targets, in SLD Experience, 57, 16-21.
Lacey, P. (in preparation) Educational Provision for Pupils with Severe and Profound and Multiple Learning Difficulties (Research Report for Mencap).
QCA (2001; 2009) Teaching and Assessing the Curriculum for Pupils with Learning Difficulties (London: QCA).
Welsh Assembly Government (2006) Routes for Learning (Cardiff: WAG).

Penny Lacey
Author: Penny Lacey

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