The active involvement of secondary school students with high-incidence disabilities (HI) in instructional accommodations is essential to both enacting the accommodations and to the accommodations effectiveness. Very little is known about students with HI's knowledge about instructional accommodations, experiences with them, or opinions on effective practices. A focus group study was conducted with 10 high school students with HI. A content analysis (Fraenkel & Wallen, 2009) revealed they are unaware of how their accommodations are identified, and that they typically are not directly taught to use them. The students explained how accommodations are usually provided in the classroom, including the ways they signal need, and offered their suggestions for more effective practices, which included responding to fairness and potential embarrassment. Their comments also revealed their beliefs and practices for self-advocating for accommodations.