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Think-alouds can support students in developing metacognition and thinking skills, often improving problem solving skills and academic achievement. Yet, it is seldom used in mathematics. This study investigated elementary teachers’ perceptions of the implementation of think-alouds in mathematics, particularly for students who struggle. Using a practical action research approach, researchers worked with elementary teachers over six-months to use think-alouds in mathematics. Teachers noted using think-alouds improved students’ growth mindset in mathematics, helped teachers develop a greater awareness of their own, and their students’ mathematical thinking, and offered access points for learners who struggle to engage with rich mathematical tasks. This study offers insight into ways teachers can support all learners to deepen their thinking in mathematics.