An important part of test development is ensuring alignment between test forms and content standards. One common way of measuring alignment is the Webb (1997, 2007) alignment procedure. This article investigates (a) how well item writers understand components of the definition of Depth of Knowledge (DOK) from the Webb alignment procedure and (b) how consistent their DOK ratings are with ratings provided by other committees of educators across grade levels, content areas, and alternate assessment levels in a Midwestern state alternate assessment system. Results indicate that many item writers understand key features of DOK. However, some item writers struggled to articulate what DOK means and had some misconceptions. Additional analyses suggested some lack of consistency between the item writer DOK ratings and the committee DOK ratings. Some notable differences were found across alternate assessment levels and content areas. Implications for future item writing training and alignment studies are provided. (Contains 6 tables.)