This study reports findings from studies examining potential read-aloud accommodations on standardized reading comprehension assessments for students with decoding difficulties. Three types of accommodations were evaluated: question stems and answer options read aloud; question stems, answer options, and proper nouns read aloud; and full read-aloud. Drawing from a sample of 207 fourth-grade students with and without decoding difficulties, we used 3-level hierarchical linear modeling to assess whether there were significant differences between students with and without decoding difficulties in the effect of each accommodation relative to no accommodation. Analyses showed that, for the students with decoding difficulties, all 3 read-aloud accommodations had significant effects when compared with no accommodation at all, and these effects were significantly larger than for average readers (effect sizes: 0.49, 0.55, and 0.50, respectively). When non-individualized education program students were excluded from the group of students with decoding difficulties, the effect sizes became notably larger. [This is the online version of an article published in "Journal of Learning Disabilities."]