There has been an increased interest in developing computer-adaptive testing (CAT) and multistage assessments for K-12 accountability assessments. The move to adaptive testing has been met with some resistance by those in the field of special education who express concern about routing of students with divergent profiles (e.g., some students with math-based learning disabilities may have difficulty with basic computation but not high level problem solving) and poor performance on early test questions. This paper consists of a literature review focusing on adaptive testing issues for students with disabilities in the K-12 sector. While it is clear that there are issues that will present obstacles to administering accountability tests adaptively to students with disabilities, this synthesis of research and policy developments with respect to this topic will be useful both for development of research agendas and to inform states that are currently using or are considering moving to CAT.