This report takes an in-depth look at how classroom practices in Rhode Island, Illinois, and Washington State have been influenced by state accountability policies and the No Child Left Behind Act (NCLB). It examines how teachers and administrators have responded to increased accountability and pressure to meet state standards. Drawing from case studies of 18 schools in the three states, Center on Education Policy highlights the national implications for how accountability is impacting curriculum and instruction and provides recommendations to help mitigate some of the harmful effects of standards-based accountability systems. (Contains 2 footnotes.)