This study explored the characteristics of commonly used early literacy instruction designed by special education teachers for students with extensive support needs (ESN). The 15 special education teachers and 29 students were participants in a randomized controlled trial investigating the effectiveness of an early literacy intervention developed for students with ESN. The students in this study were members of the study's control group and received literacy instruction designed by their special education teachers. The study was conducted in 14 elementary schools across 10 school districts and three states. Literacy instruction was implemented in general education classrooms with peers participating in the lessons as "reading buddies." The results suggest that teachers in the control group placed the greatest instructional emphasis on vocabulary and comprehension development. However, there was wide variation among teachers both within and across states in their selection of other literacy instructional components to address. These findings are discussed in terms of their broader implications for special education teacher preparation, school district policy, and in-service training of teachers serving students with ESN.