This research investigates teachers' perceptions of testing accommodations to the Ontario Secondary School Literacy Test (OSSLT) for students with special needs. The study reports findings from 98 Northeastern Ontario grade 9 and 10 English teachers who were involved in providing accommodations to the OSSLT. Teachers who responded to the Teacher Opinion Survey on the Effects of Testing Accommodations did not appear to be supportive of standards testing with accommodations for students with special needs. Issues relating to the comparability of test results were concerned with alternate test formats. Most of the respondents did not favour the use of provincial standards tests as appropriate measures of learning outcomes with students with or without special needs and did not perceive provincial standards tests as being fair measures of learning outcomes for students with special needs. Beginning teachers and teachers with the most years of experience tended to express perceptions that differentiated from the pool of respondents on the questions regarding the comparability of test results and fairness. Discussion focuses on the appropriateness of the use of provincial standards tests with students with special needs, the effects of testing accommodations, and suggestions regarding best practices in assessment with learners with special needs. Traditionally, measurement specialists have provided testing accommodations for examinees with physical disabilities such as blindness or impaired mobility. Following passage of the Americans with Disabilities Act of 1990, advocates for the disabled have argued that federal law also requires testing accommodations for students with learning disabilities. These accommodations may affect test validity, requiring measurement specialists to weigh the social goal of inclusive education for the disabled against the measurement goal of accurate test score interpretation.