A review of the research and a case study of current practice in one large urban school district evaluate the decision-making process of including students with disabilities in systems of educational accountability and the identification and provision of suitable accommodations for such students. Issues in the inclusion of students with disabilities in such programs as the National Assessment of Educational Progress are raised. The accountability system incorporated in the Maryland School Performance Program and the accommodations identified to facilitate the participation of students with disabilities are briefly described. A multi-site embedded case study was used to evaluate six schools (five elementary and one middle) committed to a reform initiative in an urban Maryland school district. Interviews, observations, and document analysis were used. Results indicated that decision-making factors are critically linked to the commitment of the district and schools to create inclusive environments which result in shared responsibility and ownership of students with disabilities by both regular and special educators. Capacity building within schools appeared to be the essential component, with implications for professional development, curriculum development, school improvement plans, and utilizing accommodations that facilitate achievement of standards. (Contains 18 references.) (DB)