It is hard to define ?severe and multiple disabilities? and the terms often cause confusion, because most states placed such children in segregated special classes often labeled ?severe and multiply handicapped? as if the two groups constituted one group. In the IDEA definition, ?multiple disabilities? means concomitant impairments (such as mental retardation and blindness; mental retardation and orthopedic impairment), the combination of which causes such severe educational problems that the child cannot be accommodated in special education programs solely for one of the impairments (Caldwell, 2005).
In order to keep a student?s interest in curriculum while meeting their academic level needs, the teacher should first determine ? in collaboration with other team members (e.g., OT, PT, speech therapist, parents, etc.) ? the student?s needs and then use differentiated instruction ? various teaching strategies, scaffolding, assistive technology – and allow learners to demonstrate learning in a variety of ways. The teacher should develop sensory-based activities which target auditory, visual, and kinesthetic learners. Strategies for math include: visual and graphic descriptions of problems, systematic and explicit instruction, student think-aloud (e.g., predicting, picturing, questioning, etc.), and group activities (heterogeneous ability groupings) (Coleman et al., 2015; Varsamis, & Agaliotis, 2011). For English language arts, the teacher should provide multiple soecially adapted books and texts (each appropriate for the student?s abilities), read interactively one-on-one and with small groups of children, and break assignments into smaller, manageable parts. Personally, I would also use toys, music and art to keep students interested in the curriculum.

Caldwell, P. (2005). Finding you finding me: Using intensive interaction to get in touch with people with severe learning disabilities combines with Autistic Spectrum Disorder. Jessica Kingsley, p. 7.
Coleman, M. B., Cramer, S. E., Yujeong, P., & Bell, S. M. (2015). Art educators? use of adaptations, assistive technology, and special education supports for students with physical, visual, severe and multiple disabilities. Journal of Developmental and Physical Disabilities, 27(5), 637-660.
Varsamis, P., & Agaliotis, I. (2011). Profiles of self-concept, goal orientation, and self-regulation in students with physical, intellectual, and multiple disabilities: Implications for instructional support. Research in Developmental Disabilities, 32(5), 1548-1555.