Trends in the supplementary aids and services (SAS) written in individualized education programs (IEPs) for students with significant disabilities (a) in different educational placements, (b) with and without behavior support plans (BSP), and (c) with and without complex communication needs (CCN) are examined using multivariate analysis of variance. Results show no significant differences in SAS for students across separate, resource, and inclusive placements. Students with BSPs had significantly more collaborative and behavior SAS than those without BSPs. Students with CCN had significantly more social-communication SAS than those whose IEPs indicated little to no communication support needs; however, 51.1% of students with CCN had no social-communication SAS. Findings raise concern around the extent to which SAS are considered before placement decisions, the high frequency of paraprofessional support for students with BSPs, and the low frequency of social-communication SAS written for students with CCN. Implications for policy, practice, and future research are provided.