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In this paper we discuss participatory approaches to designing interactive technologies for children with disabilities. While participatory design (PD) has been increasingly influential in the field of Human-Computer Interaction as a whole, applying its methods and theories to children with disabilities raises challenges specific to this target group and poses more fundamental questions about the limits of PD. We will first build the underlying argument of why we believe PD is particularly important when designing for children with disabilities, before discussing the challenges and opportunities that come with implementing PD in this context. We ground this discussion in our own experiences with developing a learning environment for children with autism spectrum conditions (ASC). We then consider future perspectives and develop research questions by reflecting on our experiences.