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A significant math performance gap persists between general education and special education middle school students despite increased access to curriculum. Specially Designed Instruction (SDI) is the component of special education services intended to address students’ unique academic challenges. SDI includes advance planning, alignment to the student’s needs, and instructional delivery. This case study examined special education middle school math teachers’ implementation of SDI to meet the needs of students with Specific Learning Disability (SLD). The study collected data over a six-week period from five middle school math teachers who provided instruction to students with SLD who received special education services. This study revealed implications for teacher practice and teacher preparation by identifying obstacles to effective implementation of SDI.