Determining whether an English learner with significant cognitive disabilities should participate in an alternate English language proficiency (alt-ELP) assessment is a challenge for Individualized Education Program teams. Although some states provide guidelines for making the decision, many do not. The purpose of this resource is to provide information on how to identify which English learners who may have a most significant cognitive disability are eligible to take an alt-ELP assessment. It does this in several ways. First, it summarizes the federal assessment requirements for English learners with the most significant cognitive disabilities. Second, it provides an overview of what is known about the characteristics of students with the most significant cognitive disabilities, English learners, and English learners with the most significant cognitive disabilities. Third, it offers a framework for identifying English learners with the most significant cognitive disabilities who are eligible to participate in the alt-ELP assessment. The framework includes guiding questions and vignettes of example decisions. Fourth, the resource lists additional considerations for ensuring that students are accurately identified and supported. Last, it incorporates a list of publications and key organizations with information on identifying English learners with the most significant cognitive disabilities.