Against a background of increasing student eligibility for "access arrangements" in examinations for the General Certificate of Secondary Education (GCSE), this article examines the processes within schools that structure a student's access to the provision of reading support, including staff and student viewpoints. Dominic Griffiths, who is a Senior Advisory Teacher with Tameside Local Authority Education Psychology and Learning Support Team, and Kevin Woods, who is a Senior Lecturer in Educational and Child Psychology at the University of Manchester, report upon a series of four case studies, each based within an urban secondary school offering some form of reading support to students in GCSE examinations. Each case study incorporates student interviews, observations of reading support in action, and interviews with staff who manage and provide reading support in examinations. Quantitative findings show an association between students' preferred mode of reading support and the location in which it is provided. Qualitative analyses revealed key themes relating to the dynamics of provision and use of reading support, including "student worthiness", "relationships" and "unfair advantage". Recommendations are made for a more central role for student consultation within processes for providing reader support to GCSE examination candidates.