General education students often receive instruction from multiple school staff, such as reading specialists and English Speakers of Other Languages (ESOL) teachers. This study's purpose was to explore how instructional support teachers and general education teachers collaborate in order to align instruction, and employed grounded theory methodology to code and analyze teacher interviews in a public school system. Research questions included perceptions of how these two types of school professionals work together, along with perceptions about school level collaboration and administrative support. Results show that factors from the district to the intrapersonal level, along with different modes of communication, cumulatively affect the interactions between these two types of school professionals. Subsequently, the nature of these interactions has an effect on both teachers and students. This study has implications for school interventions, professional development, and future research on collaboration in schools.