Twenty middle school special education teachers from five states were interviewed in order to gain insight into their understanding of accommodation practices. Interview questions solicited information about teachers' understanding of test accommodations, the decision-making process they employed when choosing accommodations, and their reasons for assignment of specific accommodations to individual students. Interviews revealed a general lack of knowledge about the theoretical and empirical basis for making accommodation assignment decisions. Drawing on information gained from these interviews as well as previous research on teachers' and test accommodations, a list of professional development considerations is shared. Considerations are intended to provide a partial solution toward reducing the gap between research and practice in the appropriate assignment of test accommodations. (Contains 2 tables.)