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Assessing learners with extensive support needs has traditionally been rooted in deficit perspectives, in which student incapacities are highlighted. We start this chapter with an overview of this historical view and identify its shortcomings. Next, we identify alternate assessment and progress monitoring as key efforts for shifting the lens from deficit-oriented assessment toward more grade-aligned, inclusive-, and strengths-based strategies. We also identify strategies for comprehensive assessment that can continue this shift in approach. Finally, we conclude with ideas for future directions in assessing learners with extensive support needs.