The fastest-growing developmental disability is Autism Spectrum Disorder (ASD). There is an interesting debate about whether this growth is a product of increased autism incidence or what has been dubbed “diagnostic substitution” (i.e., moving people from one diagnostic category, such as “language impairment,” to the autism category). Regardless, the number of students arriving on college campuses with an ASD diagnosis is substantially higher now than it has ever been and will undoubtedly continue to grow over time. The disability accommodations process triggered by such a diagnosis is unique and will continue to present challenges to professors and administrators.