This article reports on a study that investigated the extent to which central ministry policy initiatives result in large-scale educational change in developing countries. Specifically, Lesotho's policy of inclusive special education was examined as a case study. The study employed a multi-method approach to yield a large data-set. Results indicate that policy implementation was limited in both depth (the approaches to inclusive education in some schools) and breadth (the number of schools that have received training in inclusive education). Where implementation was present, perceived teacher knowledge and skill was a strong predictor of success and teachers had positive attitudes toward children with disabilities.