Using an evidence-based perspective and key concepts from the Occupational Therapy Practice Framework, this guideline provides an overview of the occupational therapy process for individuals with autism spectrum disorder (ASD), the prevalence of which is increasing rapidly in the United States. It defines the occupational therapy domain, process, and interventions—including sensory integration and sensory-based interventions, relationship-based interventions, school-based programs, social skills interventions, and comprehensive behavioral interventions—that occur within the boundaries of acceptable practice. This publication is designed to help occupational therapists and occupational therapy assistants, as well as individuals who manage, reimburse, or set policy for occupational therapy services, understand the contribution of occupational therapy in treating children and adolescents with ASD. This guideline also can serve as a reference for parents, school administrators, educators, and other school staff; health care facility managers; education and health care regulators; third-party payers; and managed care organizations.