The purpose of this qualitative descriptive study was to explore how teachers described the integrative interactions, practices, and supports implemented as aligning with the IEPs when supporting students with significant and profound cognitive and physical disabilities in the general education environment. This study connected to the social constructivist theory by Vygotsky. The sample for this study included fifteen participants with data collected through interviews and artifacts. The collected artifacts were present levels of performance, specially designed instruction, and extent of participation with the general education from the IEP for two students. Descriptive data was collected and analyzed with thematic analysis. The themes identified were: technology is an integrative practice for students with complex needs to provide communication applications and lesson materials, paraprofessionals are used to provide individualized support and modified materials to students in the general education environment, collaboration and grouping strategies are used to enhance interactions between classmates in the general education setting, teachers document material support as ways for teachers to provide tangible ways for teachers to present materials, and teachers document non-material support to provide assistance with increasing participation. In the future, teachers should be provided professional development opportunities regarding how to include students in the general education setting. It is also important for teachers to understand each individual students needs, along with strategies to properly scaffold instruction for students. [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.]