This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link:http://openaccess.city.ac.uk/3571/ Link to published version: http://dx.doi.org/10.1111/j. 1471-3802.2010.01184.x Copyright and reuse: City Research Online aims to make research outputs of City, University of London available to a wider audience. Copyright and Moral Rights remain with the author(s) and/or copyright holders. URLs from City Research Online may be freely distributed and linked to. City Research Online: http://openaccess.city.ac.uk/ publications@city.ac.uk City Research OnlineImplementing AAC with children with profound and multiple learning disabilities: A study in rationale underpinning intervention. Implementing AAC with children with profound and multiple learning disabilities: A study in rationale underpinning intervention.2 Abstract:There is a developing research base to support the rationale underpinning words. Key words: profound and multiple learning disabilities; functional communication; augmentative supports; communication opportunities.Implementing AAC with children with profound and multiple learning disabilities: A study in rationale underpinning intervention. 3 1.Introduction.This paper seeks to explore the processes involved in planning the development of augmentative and alternative (AAC) systems for two children who are described as having profound and multiple disabilities (PMLD). Aside from the processes involved, it will consider the evidence base underpinning the selection of AAC materials, and it will attempt to consider the strategies that are necessary when developing appropriate supports for these children.AAC is described as an area of clinical practice that attempts to compensate (temporarily or permanently) for the impairment and disability patterns of individuals with severe disorders of communication. (Beukelman & Mirenda, 1992 Light, Collier & Parnes, 1985). However, the evidence and methodology underpinning the process of implementing AAC support for people with profound and multiple disabilities is unclear.The term "profound and multiple disabilities" or PMLD is used to describe individuals who have a profound cognitive impairment alongside multiple disabilities including physical, sensory and /or health related difficulties, (WHO, 1992;Cartwright & Wind-Cowie, 2005). Consequently, those with PMLD are likely to be pre-verbal communicators and may require carers and significant others to interpret their non-verbal communication signals as well as using touch, natural gesture and objects with them to support their language and communication opportunities within the environment, (Guess et al., 1993;Green et al., 1996;Bloom, 1993;Brooks, 2005;Franco, 1997;Locke, 1997).Implementing AAC with children with profound and multiple learning disabilities: A study in rationale underpinning intervention. 4Difficulties with communication place children who have PMLD at risk of becoming excluded and may often lead to "social and edu...