Of individuals with an intellectual disability, 1% are recognized as having a profound intellectual disability and commonly present at a mental age of roughly three years or below. While inclusive music education models and therapeutic models have received considerable attention, there is a scarcity of literature on music education for students with profound intellectual and/or multiple disabilities (PIMD) in adaptive, substantially separate music classes that provide access to music curricula, pedagogies, and supports specifically designed for students with PIMD. This article includes a philosophical discussion of adaptive music education for students with PIMD--particularly nonspeaking students--and provides suggestions and pedagogies for working with these individuals. Implementing these strategies will position music educators to provide equitable access to music education and more effectively serve this vulnerable population of individuals.