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This study examined the treatment rates and patterns in children and adolescents with autism spectrum disorders (ASDs). Data were collected on 353 nonreferred children and adolescents (mean age 9.5 +/- 3.9 years; range 3-21 years) with ASDs from public schools across Ohio. Parents provided information on the use of psychotropic medicines, vitamins, supplements, and modified diets. They also completed measures of social competence, problem behavior, and adaptive behavior. Results indicated that 46.7% of subjects had taken at least one psychotropic medication in the past year. In addition, 17.3% of subjects had taken some type of specially formulated vitamin or supplement, 15.5% were on a modified diet, 11.9% had some combination of psychotropic medication and an alternative treatment, and 4.8% had taken an anticonvulsant. Logistic regressions indicated that greater age, lower adaptive skills and social competence, and higher levels of problem behavior were associated with greater medication use. This was the first study to focus exclusively on a younger population, to survey patterns of modified diets, and to obtain standardized ratings of social competence, problem behaviors, and adaptive behavior in relation to medication use. The results of this study highlight the need for more research on psychotropic medication in children and adolescents with ASDs.