This chapter considers the challenge posed to professionals by a group of children who have a range of disabilities and are also deaf. While this group have been recognised as a significant minority amongst the population of children with permanent childhood deafness, our understanding of the nature of this group is anything but complete. Issues concerning this group include clear identification of the children involved, an understanding of the diversity of specific needs presented and the wide range of professionals who attempt to meet the learning needs of these children and their families. The numbers alone demand that services have a proactive approach to these children but there are challenges which threaten such an approach. These include lack of agreement over the nature of such groups, difficulty with the ranking of hearing loss within a range of special learning needs, lack of specialised training opportunities and pressures on services to have clearly identifiable outcome measures related to positive intervention. The further challenges of working within a multidisciplinary team are considered together with the wider issues regarding training and advocacy.