The aim of this study, using a mixed methods research design, was to describe differences between elementary schools in their work with pupils described to be Pupils in Specific School Difficulties (PSSD). This group of pupils, consists of pupils who in many cases have had their education in a special school called a resource school. These special schools are administered at the central level, in the municipality where the study was done. An important finding in the beginning of this study, was that the distribution of placements from elementary schools to these special schools, were unequally distributed within the municipality. Placements in special schools during a period of ten years have been studied. Three elementary schools were selected having the same or almost the same socio-economic conditions in their vicinities. The number of placements as well as the relative frequency of placements (placements/school size) in special schools, differs to a large degree between these three schools. Two of the schools have every year, in average, had one of their pupils placed in a special school. The third school, however, have almost never had such a placement during the ten year period. This school distinguished itself by staff being in complete agreement on the positive value of inclusion. This particular school has succeeded in keeping almost all their pupils without any indication that, while attending to their special needs, this in any way deprived other pupils of their rightful learning. This study differs clearly from other research that reports differences between schools as a consequence of an intervention or a particular strategic application as derived from theoretical models. The results of this study are rather due to varying cultural patterns in the three participating schools even though they share the same values as expressed in the National Curriculum. This study contributes to an understanding of working with complex behavioural issues within school cultures; issues of a kind not easily examined by evidence-based research. It also clearly describes hindrances for inclusion.