The purpose of this qualitative study was to examine the influences on special education teachers' decisions about literacy for their students with severe disabilities. With the use of multiple case study and grounded theory methodologies, four middle and high school special education teachers were purposefully selected to participate in interviews and videotaped observations. Transcripts and videos were analyzed in concert with documents, such as individualized education programs and teaching materials, using constant comparative analysis. Four key influences were identified that guided literacy decisions: (a) contexts; (b) beliefs about students, teaching, and learning; (c) expectations; and (d) self-efficacy. These four components form the basis for a preliminary theoretical framework of teacher decision making about literacy for students with severe disabilities.