Children with autism spectrum disorders (ASD) present an exceptional need for varied instruction within the physical education environment. Adapted physical educators need to be prepared to make a significant amount of choices in regards to adaptations and modifications given the situations they may encounter with their students. However, many pre-service adapted physical education (APE) specialists may be unprepared to address the unique challenges faced with children with ASD's ever increasing presence in the classroom. This study involved interviews and observations of four pre-service APE specialists who were working one-on-one with a child with ASD during a practicum. In this analysis four factors: (1) physical environment; (2) instructional strategies; (3) behavioral issues; and (4) personal discernment, surfaced as major influences in the decision making of the pre-service teacher. This analysis looks to build a foundational understanding of how this relationship exists in the APE setting with children with ASD. This study reveals that pre-service teacher have limited knowledge which leads to an inability to make important instructional decisions and overcome barriers that arise with children with ASD. Teacher-training programs should address these concerns in order to build confident and successful teachers.