Background Children with profound intellectual and multiple disabilities (PIMD) meet other children with PIMD in day care centres or schools. This study explores the peer‐directed behaviours of children with PIMD, the peer interaction‐influencing behaviour of the direct support workers and the children's positioning. Method Group activities for children with PIMD initiated by a direct support worker were video‐recorded. The behaviour and positioning of the children and the behaviour of the direct support workers were coded. Results Limited peer‐directed behaviour of the children with PIMD and peer interaction‐influencing behaviour of the direct support workers are observed. Weak associations were found between the positioning or peer interaction‐influencing behaviours and the behaviour of children with PIMD. Conclusions Children with PIMD show social interest in each other during group activities. More knowledge is needed to create an environment which facilitates peer‐directed behaviours of persons with PIMD.