Reauthorization of the Individuals with Disabilities Education Act (IDEA) in 2004 established procedural mandates and accountability requirements ensuring all students with disabilities participate and progress in general education curriculum. Broadly speaking, improvements toward greater access have been found for many students with disabilities; however, the extent to which this holds true for students with extensive and pervasive support needs is not evident. Past research associated with least restrictive environment (LRE) for students with extensive and pervasive support needs was considered when replicating previous research using the cumulative placement rate to analyze LRE data for students with extensive and pervasive support needs (autism, intellectual disability, deaf blindness, and multiple disabilities). Results indicate that student with extensive and pervasive support needs have substantially less positive LRE placement trends over the past 15 years with most placed in separate classrooms and settings. Recommendations for transforming federal and state policies and procedures are shared.