Students with emotional disturbance (ED) represent the fourth most prevalent category of disability in the United States. Although the IDEA definition states that the educational performance of students with ED is adversely influenced by inappropriate behavior and feelings, the literature focuses mainly on the problem behaviors and not on the educational needs of this population. Recently, however, interest in the academic achievement of students with ED has increased. Coleman and Vaughn (2000), for example, in their review of reading instruction identified only eight studies that addressed reading outcomes for students with ED. Other than the positive effect of a peer tutoring program noted in three of the reviewed studies, the research literature provides limited information on reading interventions for students with ED. Nelson, Benner, Lane, and Smith (2004) have suggested that reading instruction for students with ED may need instructional approaches that differ from those generally employed by classroom teachers. The purpose of the presented case study was to identify and document the extent of accommodations required to support a validated expository reading comprehension intervention, self-regulated strategy development (SRSD) instruction, for TWA (Think Before Reading, Think While Reading, Think After Reading) (Mason, 2004). This study provides evidence that for students with ED, specialized instruction, beyond what has been developed for most struggling learners, is often required to accommodate problem behavior. (Contains 2 figures and 1 table.)