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Most states require literacy screening of all K–3 students to identify students at risk of reading difficulty. States often allow districts to use different commercial literacy screening assessments to meet this requirement. Using a mixed-methods procedure, we compared assessments used in two states (Colorado and Massachusetts) to each other and to state-level assessments. Results show that the meaning of reading risk varies significantly across assessments due to differences in content, administration/scoring methods, and/or risk level definitions. Additionally, scores used to identify students at risk differ in their rigor and alignment with state-level assessments across and even within assessments, complicating their use to show growth. Findings provide important factors for users to consider when choosing and using screening assessments.