Children with multiple disabilities, often experience challenges in communication, mobility, and learning. Despite these challenges, substantial research exists that documents successful educational methods and strategies for these students. Specifically, students with multiple disabilities have successfully been taught to use a voice output communication aid (VOCA) to initiate play with peers in inclusive classrooms. Unfortunately in many of today's schools, students with multiple disabilities face learning challenges that, combined with teachers' lack of training and experience, too often result in a lack of quality literacy programs for these students. A call for increased access to the general education curriculum, advances in instructional and assistive technology, and improved methods for literacy instruction should encourage the development of quality literacy programs for learners with multiple disabilities. This article describes literacy routines developed and implemented with three elementary students with multiple disabilities. A literacy framework, literacy lesson plans, instructional materials, and technology applications are highlighted. (Contains 1 table, 3 figures and 5 online resources.)