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The Common Core State Standards in Mathematics require that students learn math through real world situations. To meet these requirements, math test items have become lengthy word problems. As a result, it is unclear that we are always measuring math ability without the conflation of literacy. Through linguistic analyses and cognitive interviews with third-grade students, we illustrate item-level construct-irrelevant factors that are not being attended to with current item development practices. We found that math items had reading levels above third-grade level and exhibited multiple features of linguistic complexity which led to participant confusion.