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Special Education Information: Disability Definitions: Definition of Severe: Multiple Disabilities

Definition of Severe and/or Multiple Disabilities

Fact Sheet Number 10 (FS10), January 2001
National Information Center for Children and Youth with Disabilities


People with severe disabilities are those who traditionally have been labelled as having severe to profound mental retardation. These people require ongoing, extensive support in more than one major life activity in order to participate in integrated community settings and enjoy the quality of life available to people with fewer or no disabilities. They frequently have additional disabilities, including movement difficulties, sensory losses, and behavior problems.


In the 1998-99 school year, the states reported to the U.S. Department of Education that they were providing services to 107,591 students with multiple disabilities (Twenty-Second Annual Report to Congress, 2000).


Children and youth with severe or multiple disabilities may exhibit a wide range of characteristics, depending on the combination and severity of disabilities and the person's age. Some of these characteristics may include:

  • Limited speech or communication;
  • Difficulty in basic physical mobility;
  • Tendency to forget skills through disuse;
  • Trouble generalizing skills from one situation to another; and/or
  • A need for support in major life activities (e.g., domestic, leisure, community use, vocational).


A variety of medical problems may accompany severe disabilities. Examples include seizures, sensory loss, hydrocephalus, and scoliosis. These conditions should be considered when establishing school services. A multi-disciplinary team consisting of the student's parents, educational specialists and medical specialists in the areas in which the individual demonstrates problems should work together to plan and coordinate necessary services.


Early intervention programs, preschool and educational programs with the appropriate support services are important to children with severe disabilities. Educators, physical therapists, occupational therapists, and speech-language pathologists are all members of the team that may provide services, along with others, as needed for each individual. Assistive technology, such as computers and augmentative/alternative communication devices and techniques, may provide valuable instructional assistance in the educational programs for students with severe/multiple disabilities.

In order to effectively address the considerable needs of individuals with severe and/or multiple disabilities, educational programs need to incorporate a variety of components, including language development, social skill development, functional skill development (i.e., self-help skills), and vocational skill development. Related services are of great importance, and the appropriate therapists (such as speech and language, occupational, physical, behavioral and recreational therapists) need to work closely with classroom teachers and parents. Best practices indicate that related services are best offered during the natural routine of the school and community, rather than by removing the student from class for isolated therapy.

Classroom arrangements must take into consideration students' needs for medications, special diets, or special equipment. Adaptive aids and equipment enable students to increase their range of functioning. The use of computers, augmentative/alternative communication systems, communication boards, head sticks, and adaptive switches are some of the technological advances which enable students with severe disabilities to participate more fully in integrated settings.

Integration/inclusion with nondisabled peers is another important component of the educational setting. Research is showing that attending the same school and participating in the same activities as their nondisabled peers is crucial to the development of social skills and friendships for children and youth with severe disabilities. Traditionally, children with severe disabilities have been educated in center-based, segregated schools. However, recently many schools are effectively and successfully educating children with severe disabilities in their neighborhood school within the regular classroom, making sure that appropriate support services and curriculum modifications are available. The benefits to inclusion are being seen to benefit not only those with disabilities but also their nondisabled peers and the professionals who work with them.

Schools are addressing the needs of students in several ways, generally involving a team approach. Modifications to the regular curriculum require collaboration on the part of the special educator, the regular educator, and other specialists involved in the student's program. Community-based instruction is also an important characteristic of educational programming, particularly as students grow older and where increasing time is spent in the community. School to work transition planning and working toward job placement in integrated, competitive settings are important to a student's success and the long-range quality of his or her life.

In light of the current Vocational Rehabilitation Act and the practice of supported employment, schools are now using school-to-work transition planning and working toward job placement in integrated, competitive settings rather than sheltered employment and day activity centers.


Downing, J.E. (1996). Including students with severe and multiple disabilities in typical classrooms: Practical strategies for teachers. Baltimore, MD: Paul H. Brookes. (Telephone: 1-800-638-3775.)

Klein, M.D., Chen, D., & Haney, M. (in press). PLAI (Promoting learning through active interaction): A guide to early communication with young children who have multiple disabilities. Baltimore, Paul H. Brookes. (Telephone: 1-800-638-3775.)

Orelove, F., & Sobsey, D. (1996). Educating children with multiple disabilities: A transdisciplinary approach (3rd ed.). Baltimore, MD: Paul H. Brookes. (Telephone: 1-800-638-3775.)

Rainforth, B., York, J., & Macdonald, C. (1997). Collaborative teams for students with severe disabilities: Integrating therapy and educational services (2nd ed.). Baltimore, MD: Paul H. Brookes. (Telephone: 1-800-638-3775.)

Update January 2001

This fact sheet is made possible through Cooperative Agreement #H326N980002 between the Academy for Educational Development and the Office of Special Education Programs. The contents of this publication do not necessarily reflect the views or policies of the Department of Education, nor does mention of trade names, commercial products or organizations imply endorsement by the U. S. Government.

This information is in the public domain unless otherwise indicated. Readers are encouraged to copy and share it, but please credit the National Information Center for Children and Youth with Disabilities (NICHCY).

National Information Center for Children and Youth with Disabilities
P.O. Box 1492
Washington, DC 20013
1-800-695-0285 (Voice/TT)
E-mail: nichcy@aed.org
Web site: http://www.nichcy.org/

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