Policy, mandating early screening for dyslexia and use of specific interventions, is increasing throughout the United States. The authors designed a descriptive case study to learn what impact policies have on practice and how literacy specialists, trained in both comprehensive and structured literacy approaches, provide support for students. Data collected from focus groups, interviews and observations were analyzed. We found that (1) literacy specialists selected specific instructional practices to address individual reader's profiles, (2) literacy specialists believed that reading intervention support fits best within a balanced, comprehensive, literacy framework, (3) literacy specialists approached their readers with a holistic, humanizing view, (4) literacy specialists capacity for providing reading support has grown over the past fifteen years to meet the varied needs of the students they serve, and (5) literacy specialists deal with misinformation and confusion in their schools about dyslexia that has resulted in lost instructional time with their students. These results highlight the importance of hearing from literacy specialists to understand the complexity of their work and the range of reading behaviors and instructional needs seen in their schools.