Small group instruction in classrooms provides children opportunities to collaborate on academic tasks, as well as opportunities for social interactions. Although such arrangements are common for children with typical development, children with moderate to severe disabilities (MSD) may receive few or no opportunities to participate meaningfully in small group instruction with same-age peers with typical development. The purpose of this study was to evaluate the use of a progressive time delay procedure for teaching children with MSD (autism spectrum disorder and/or intellectual disability) and those with typical social development, but at-risk for academic failure, to name sight words during small group instruction. In addition, children had multiple opportunities per session to provide tokens to peers, praise peers for correct responses, and initiate conversations and respond to a peer's conversation initiations. Results indicated that children with and without disabilities can learn to name sight words, as well as learn to initiate conversation when tokens include pictures or photographs of each child's preferred items or activities. Implications for teachers and future studies are provided.