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A story about a learner with PMLD and how multi-disciplinary working supports greater independence, UK

This is the story of Abigail, a learner with profound and multiple learning difficulties (PMLD), and how effective multi-disciplinary working has helped her to achieve greater independence at the National Star College. We will reflect on how a team of professionals hold Abigail at the centre of their work, sharing knowledge, information and experience to ensure she gets the best out of her learning experience, and feels valued, safe, supported and happy.


Abigail is on a two-year programme at the National Star College (NSC) where she is following a personalised programme to support her to realise her potential.  Abigail has profound and multiple learning disabilities alongside physical differences including being non-verbal, wheelchair-user and having Cerebral Palsy. Abigail needs full support to access education, the community and to participate in everyday life.

At NSC there are a range of therapy, health and educational services to support learners. This story will focus specifically on how we work effectively as a multi-disciplinary team (MDT) to meet Abigail’s needs.  

Abigail came to NSC in September 2015 having previously attended a specialist school.  This was her first residential placement, she now lives on-site at college with a group of peers supported by a team of residential staff.  During a pre-admission residential stay Abigail accessed sample education sessions where she was assessed by a range of therapists and education staff to consider her educational, therapeutic and care needs. Abigail’s first term at college comprised a baseline assessment period where the MDT worked closely together to inform an individualised plan to support her specific needs.

Throughout the college placement the MDT will meet regularly for progress reviews and planning, with flexibility to collaborate when specific action is needed, for example, to explore issues around fatigue and difficulties with maintaining attention.  In this case, the PLC (Personal Learning Co-ordinator) and residential team worked collaboratively to set in place a resting schedule for Abigail which had an immediate positive effect on levels of alertness. The PLC worked closely with the professional team to create a personalised timetable for Abigail which allows access to therapies, life skills and personalised learning with scope for multi-disciplinary working.

In Abigail’s case, the SLT (Speech and Language Therapist) worked individually with her to assess the appropriateness of using high- tech versus low-tech communication aids.  A low-tech communication approach was deemed most appropriate.  The SLT shared guidelines with the multi-disciplinary team and trained residential staff to ensure a collaborative approach to her communicative development. An example of this working positively is that Abigail was able to use choice cards and audio switches to indicate what colour she would like her bedroom painted and she has also used a similar approach to choose her meals – increasing her independence. In addition, an SLT assistant was timetabled into an educational session to model best practice.

The OT (Occupational therapist) worked alongside physiotherapists to co-ordinate postural and mobility management for Abigail. The Physiotherapist provided training and stretch guidelines for the residential staff to follow.  The OT has assessed the impact of her disability on her daily needs and has shared an OT handover report on how best to support Abigail. Professionals regularly share information on progress and programmes with the team to ensure consistency of approach. An example of information sharing has been the contribution to Abigail’s extension request report to help secure her an additional year at college.   

Written by
Maria Townley and Donna Fenley

Maria Townley
Personal Learning Co-ordinator
National Star College