Current guidelines recommend that school-age children accumulate at least 60 minutes of moderate to vigorous physical activity (MVPA) on most days of the week. Research has established a valid methodology in measuring the intensity of physical activity levels in children without disabilities via heart rate (HR) monitoring. This case report describes whether this methodology can be applied to children with combined cerebral palsy (CP) and mild intellectual disability (ID). Physical activity (PA) patterns of two children with spastic CP and with mild ID were evaluated during 3 consecutive school settings: physical education, classroom, and recess. Amount and intensity of PA was successfully recorded in all three settings. Data indicated that the female child spent a total of 98.2 minutes (73% of allotted time) whereas the male child spent 21.1±8.8 minutes (16.2%) in MVPA, respectively. The results suggest that it is feasible to measure the intensity of physical activity in a school setting for children with combined spastic CP and ID. Further investigations with more participants at different function levels of CP will determine the extent to which this methodology can be used.