What do teens with disabilities believe about their conditions, and what do they understand to be the causes, correlates, and consequences of disability? We elicited a cultural explanatory model (EM) of disability from longitudinal sample of 23 European American adolescents with varied cognitive disabilities and delay. We asked teens how they were similar to different from others; the name of this difference; its causes, severity, course, effects, associated problems and benefits; and need for treatment. IQ and type of disability strongly affected quality of responses only from the lowest functioning teens. A majority of teens had a reasonably rich and coherent EM, blending typical and disability themes of cultural knowledge and identity. The EM is a window into social context (schools, services, parents, and peers) as well as personal experience. Eliciting explanatory models from teens with disabilities is not only possible but also can enhance understanding of identity, family influence, and appropriate services.