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This resource book provides teachers and therapists with a user-friendly bank of practical ideas and suggestions to use in MSE for pupils with profound and multiple learning difficulties. These include: equipment and resources that can be used to engineer the environment to promote particular outcomes; a set of photocopiable, fast, easy-to-complete, observation and assessment forms; a selection of practical strategies and methods that can be used in the MSE; and ideas to help teachers integrate environment, assessment and instruction to maximize individual programmes.