This study was conducted to determine whether the symbolic form of achievement test items influences student performance and whether teachers' use of different symbolic forms during instruction influences estimates of student achievement. The analyses conducted to examine these issues used student achievement test data and teacher responses to questions about their instructional methods from the Second International Mathematics Study (SIMS) of eighth-graders. Most items used traditional symbolic forms, but some used alternative forms such as diagrams, graphs, or verbal expressions. To investigate the effects of symbolic form, it would be necessary to hold other features of the test item constant (numerical complexity, for example); this was not possible with SIMS data. There were significant relationships between teachers' use of symbolic forms and student achievement. Results suggest that the use of alternative symbolic forms may be important for student learning of mathematics. A 14-item list of references is included. An appendix contains 29 tables of data from the analyses, and 16 figures illustrating symbolic forms. (SLD)