Accessible Summary People who get paid to support people with intellectual disabilities need to understand what is important to people with intellectual disabilities and how to help them get what they want. We asked people with intellectual disabilities and people paid to support them about what is important to people with disabilities and how people with disabilities can get what they want. We learned that: The people with intellectual disabilities whom we talked to knew what they wanted. The support people that we talked to had a hard time figuring out what people with intellectual disabilities wanted and how they could help them get what they wanted. The support people that we talked to said that some of the rules at their jobs made it hard to help people with intellectual disabilities to do what they wanted. Nearly everyone we talked to said that it was important to support people with intellectual disabilities in a caring way. Summary This study from the south‐western United States investigated the perceptions of persons with intellectual disability receiving support and of persons providing support regarding the autonomy of people with intellectual disability. The participants included 10 people with intellectual disability and 10 support workers. Through interviews, this qualitative investigation examined issues related to autonomy in support services. Analysis of participant interviews revealed that support workers and people with intellectual disability faced challenges that restricted the promotion of the autonomy of people with intellectual disability. Both groups of participants noted that support workers had to care about their work with individuals with intellectual disability to effectively promote their autonomy.