This grounded theory study described the perspectives of school-based occupational therapists working in inclusive early childhood classrooms emphasizing interactions with teaching staff. Six therapists were interviewed multiple times over several months. The participants viewed their interactions with teaching staff as challenging but potentially rewarding experiences. Viewing collaboration as valuable, their descriptions nonetheless generally omitted many collaborative features, with therapists often assigned the role of “expert.” Data analysis revealed four major themes: (1) “It’s Not Like I Don’t Value Collaboration” (the benefits of collaboration); (2) “Collaboration—I Can’t Do It Alone” (the challenges of interactions); (3) “My Opinion, Please Ask for It” (attachment to the expert status), and (4) “Is This Collaboration?” (interactions in practice). The results of this study suggest that current recommendations for collaboration for inclusion in school-based occupational therapy are not optimally implemented in all practice settings.