This study investigated the perspectives of 23 first-generation Asian American mothers of children with developmental disabilities. The intent was to explore the working relationships between the mothers and professionals in health care and special education in the United States. The participants in this study were from China, Taiwan, Vietnam, Korea, Japan, and India. Data were drawn from semi-structured interviews conducted over 16 months of fieldwork. The study revealed that mothers endured significant hardships because of communication and cultural barriers. Levels of English proficiency and acculturation as well as a variety of cultural factors were found to be the primary determinants of their perceptions of interactions with the professionals. Implications for professional practice and support for Asian American mothers are discussed. (Contains 2 tables.)