Students who are deaf or hard of hearing (Deaf/HH) and communicate using American Sign Language (ASL) may benefit from sign accommodations on state assessments. However, there have been challenges in standardizing assessment content including how items should be signed. Technology enhanced assessment offers the opportunity to provide standardized sign support delivered through the test platform. One goal of the Guidelines for Accessible Assessment Project (GAAP) was to develop research-based sign guidelines that can be used across states, consortia, and assessment vendors to produce reliable and valid signed representations of assessment items and tasks for students who communicate using sign language. This report highlights the findings from cognitive labs conducted with students to gain their input and feedback on the proposed guidelines. A total of 46 elementary-, middle-, and high-school-aged students who were Deaf/HH and communicated using ASL participated in cognitive labs. The research findings point to the students' preferences for the provision of the sign support in general and for this support being grounded in ASL rather than representations aligned with other languages. Generally, students also voiced their preferences for graphics to be described in detailed ASL. However, overall research results were mixed. These findings support the approach of making individualized decisions informed by students' unique needs and preferences. Additionally, the study results suggest that in the process of developing sign supports for computer-based assessments, it is important to consider the individual needs of the diverse community of Deaf/HH students. The appendix contains "Study Instruments." [The contents of this document were developed at the National Center on Educational Outcomes (NCEO) under a subcontract from the Maryland Department of Education for an Enhanced Assessment Grant (#S368A120006) from the U.S. Department of Education.]