The purpose of this qualitative descriptive study was to explore what elementary teachers recommend and understand in identifying appropriate referral and classroom support placement procedures of English language learners with a suspected disability in the southeastern United States. Incorporating the conceptual frameworks of Bandura (1977) and Vygotsky (1986), the study investigated what elementary teachers recommend for identifying appropriate placement for English language learners and what elementary teachers understand in pre-referral and referral procedures before referring English language learners for special education testing for a suspected disability. Data was collected from 12 semi-structured one-on-one interviews and 40 qualitative questionnaire participants. Once the data was manually organized and analyzed using Braun and Clarke's (2006) thematic analysis procedure, the use of NVivo software supported further organization. Communication was repeatedly described as the most important and difficult challenge teachers face in determining proper educational placements. Teachers described strategies helpful for determining proper placement before and during pre-referral processes and mentioned interventions such as chunking assignments, translating curriculum, and using wait time. Teachers described their knowledge level in this pre-referral and referral process as lacking in many ways. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]