Neither school reform nor the focus on developing accountability systems that measure and evaluate the success of schooling are new or innovative educational practices. Even before the No Child Left Behind (NCLB) Act of 2001, many states had changed or were changing their accountability and assessment systems. Similarly, individual school districts or local education authorities, often in the name of school reform, were using their own standards or benchmarks to assess progress for school improvement purposes and for fulfilling long-term district goals. While the Division on Developmental Disabilities (DDD) supports accountability systems to evaluate school and student achievement and progress, as well as the use of statewide assessments based on achievement and content standards, the author is concerned with how states determine accountability, and how they develop and implement assessments that affect students with disabilities. This article addresses a number of issues and concerns about statewide alternate assessments together with implications and recommendations by the DDD. (Contains 1 table.)