This paper describes the processes under taken by a student music therapist to improve her clinical practice and enhance the quality of service provided to children with profound and multiple disabilities. Using an Action Research model it aims to show how rigorous investigation of one's own practice can improve understanding of the clients and enhance students' abilities and confidence when carrying out placement work. An interview process with three registered music therapists preceded a 12 week action research process. Three cycles were undertaken with each lasting 4 weeks and the interview material informed the initial cycle. Clinical notes, a research journal and video recordings of sessions were three data gathering tools used to evaluate the success of techniques employed. This intensive critical analysis led to a greater awareness of in session communications and an improvement in techniques such as active waiting and repetition of activities. This in turn created increased opportunities for response to musical offerings by this client group.