This report addresses issues on the use of accommodations, modifications, or alternatives for students with disabilities in large-scale educational assessment programs. First, a set of definitions from current literature and the 1997 Individuals with Disabilities Education Act are offered. The importance of agreement between instructional and assessment staff at the state, district, and school levels on the meaning and use of accommodations is stressed. A table presents Maryland's accommodations for scheduling, setting, equipment/technology, presentation, and responses. Another table summarizes possible modifications by the skill areas of mathematics, reading, written expression, scheduling and organization, and handwriting. A distinction is then made between "alternate assessment" and "alternative assessment." The following sections address the duration of uses of, limitations of, and procedure and process of accommodations, modifications, and alternates. Discussion of the importance of matching purposes of assessment and assessment decisions and decisions about students "in a gray area" with respect to curriculum and testing follows. (Contains 16 references.) (DB)