This study examines a large urban public school (UPS) district in the Midwest USA that has faced bankruptcy, state takeover of public education, and financial scams. As a result, UPS's capacity to integrate assistive technologies (AT) has been limited and is declining. This study investigates the UPS teachers' technological pedagogical content knowledge (TPACK) and how the UPS teachers integrate AT for students with speech and language impairments (SLI). This article details the UPS special education and general education teachers' TPACK across grade levels, content, and classroom settings. This article reports the UPS teachers' current integration of AT, instructional practices, implementation, and experiences integrating AT in the classroom for students with SLI. 94 UPS teachers participated in the online survey. The study found no significant differences in the UPS teachers' TPACK across classroom settings or grade levels. Results show no significant differences between the UPS teachers' TPACK in mathematics, social studies, science, or literacy content knowledge. The study revealed that UPS teachers utilize various AT tools, from basic tools like [calculators, audio/video recording devices, and voice amplifiers] to more advanced tools like [iPads, SmartBoards, and computers], for diagnostic, formative, and summative assessments. Results indicate that the UPS teachers utilize similar instructional methods across content and express mostly positive experiences integrating AT for SLI students.