As states begin to highlight the system supports used to include English language learners with disabilities in standards-based assessments and accountability programs, implementation of those supports will be closely examined by school districts. This case study investigates the classroom culture in an early childhood preschool program for four-year-old children with disabilities. Classroom observations were used to determine how two young children with disabilities were acquiring English as a second language. Specific focus was given to activities that allowed for second language acquisition, native language development, the attainment of developmental skills, and alternative communication skills such as sign language and a communication board. An investigation took place into current theories to create a knowledge base for understanding how young children acquire linguistic skills in English and how classroom culture was created.