There is a great need to help test designers determine how to make tests that are accessible to individuals with disabilities. This report takes "design patterns", which were developed at SRI for assessment design, and uses them to clarify issues related to accessibility features for individuals with disabilities--such as low-vision and blindness--taking a test of reading. Design patterns appear useful in clarifying how variable features of a test design need to be matched to disability-related characteristics of test takers in order to ensure accessibility. Giving consideration to accessibility issues during the development and use of design patterns may help improve the validity and fairness of tests, as well as their accessibility for individuals with disabilities.