Background: The aim of this study was to analyse the impact of medical conditions of children with profound intellectual and multiple disabilities on the professional support they receive in centres for special education. Method: The medical files, the daily records and daily communication records between parents and professionals were reviewed for 48 children with profound intellectual and multiple disabilities in three centres for special education in the Netherlands. In addition, interviews were held with direct service professionals and medical doctors to complete the data collection. Results: Not only do major medical conditions, such as hospital admissions, but also minor medical conditions, such as an increase in body temperature or the drowsy state a child is in as a result of a seizure, have an impact on performing activities and therapies in a child's educational centre. Conclusions: As a result of the prevalence of the medical conditions, professionals may decide not to carry on actions that were planned or do not offer an alternative programme. The risk of many "empty" hours despite the presence of highly specialized professional support is high.