This chapter looks at inclusion specifically with respect to young people with severe learning difficulties (SLD) and profound and multiple learning difficulties (PMLD). It draws on research and on the views of practitioners to ask if practice, attitudes, and policy have in fact included this group of learners at all or whether what Hodkinson acknowledges as 'the clash between ideality and practicality' has meant that they have been overlooked. Lesson time can simply consist of keeping a learner with SLD or PMLD visibly busy with no real connection to the rest of the class. Understandings amongst teachers were often confusing or potentially detrimental, and in one instance it was difficult to get across the message that equality and inclusion is not about treating everyone the same but about identifying and mitigating individual learning barriers. Sometimes the exclusion clauses are tacit, but they almost refer to young people with highly complex needs, such as those on the SLD and PMLD spectrums.