Under the aegis of inclusion, greater numbers of learning support assistants (LSAs) in mainstream and special schools are increasingly required to assist teachers with pupils who have complex needs across the full age range. Because of the numerous and wide‐ranging learning difficulties and learning disabilities in addition to sensory impairment, behavioural difficulties and physical disability that they meet, their roles and responsibilities have dramatically changed. As a result, the professional needs of LSAs have grown and widened, and the question of whether these are being properly met arises. This paper reports on research carried out with a representative sample of learning support staff in Northern Ireland, and with special educational needs coordinators (SENCOs) and school nurses. The study examined through a questionnaire the perceptions of LSAs working in a range of schools as to their training needs and, through interviews, sought the views of the SENCOs on current and future training arrangements for LSAs, and the opinions of school nurses on how best children and young people with complex physical healthcare needs can be assisted by learning support staff. A process model was proposed to enable them fully to support inclusion and to tread a clear pathway towards their professional development. The results showed that the SENCOs and school nurses did not consider the qualifications most commonly held by support staff to be adequate for their jobs; the LSAs overwhelmingly wanted further training to undertake their roles, which often involved meeting pupils’ complex medical and health as well as learning needs, yet collaborative planning for this was largely confined to classroom level. Key challenges for LSAs included behaviour management and role reversal when substitute or class teachers were untrained in pupils’ complex needs. There was unanimity that they should be treated as professionals in their own right.