The use of paraprofessional services is an established and crucial aspect in the pursuit of a free and appropriate public education for students with disabilities (Etscheidt, 2005). Paraprofessionals are often the primary providers of instruction for students with severe disabilities yet are the least trained instructional personnel in schools (Giangreco, Broer, & Edelman, 2001; Giangreco, Smith, & Pinckney, 2006). Identified competencies and necessary training content for paraprofessionals who serve students with severe disabilities are nearly absent in the professional literature. This study extended the current literature regarding paraprofessionals who serve students with disabilities in public schools by focusing specifically on those paraprofessionals who serve students with severe disabilities in inclusive general education elementary school settings and support the need for these paraprofessionals to be adequately trained for their specialized instructional duties. This multiple-case study offers a cross-case analysis of three Oregon school districts related to paraprofessionals who serve elementary students with severe disabilities in included settings. Through one-to-one interviews, focus groups and document review, the daily responsibilities, orientation, ongoing training practices and the training needs of these paraprofessionals are explored. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]