The purpose of this year-long, collective case study was to investigate what influences contributed to alternate assessment outcomes for students with significant disabilities. This study of seven students and teachers in two school districts revealed seven main factors that contributed to students' scores on the state's alternate assessment, including resources, curriculum, instructional effectiveness, teacher and student characteristics, data collection and compilation, and features of the state's assessment and accountability system. Implications of this study are discussed in light of current educational reform efforts and related legislation. (Contains 1 table.)