This descriptive study sought to determine the attitudes of middle school teachers in Indiana, Kentucky, and Ohio toward the current implementation of key components of the middle school concept within their schools. Researchers were asked to assess the relationship of state accountability programs to the implementation levels of such components. Random cluster sampling was used to select participants from a population list of districts. One hundred four teachers of 201 (52%) completed the questionnaires. Results revealed that many essential components of effective middle school programs are currently present in the schools, but often less so than in prior years. Other tenets were perceived to be disappearing or absent completely. A lack of fit with state testing/accountability was the primary reason for the current lack of fully implemented middle school components, although a clear majority of teachers did not select this option. Some reported that high-stakes testing/state testing and accountability had some positive effects in the classroom. Teachers, however, believed they have less autonomy. Most perceived a decrease for enrichment, elective, or exploratory courses and activities. In sum, the results from this tri-state study suggested that teachers still consider the middle school concept to be quite relevant and applicable. The real issue would appear to be the intensity, integrity, and strength with which the components are implemented. (Contains 7 tables.)