Social skills are important treatment targets for individuals with autism spectrum disorders (ASD) across the lifespan. However, few treatments are available for adolescents and adults with ASD who also have severe to profound intellectual disability (S/PID). Several social skill interventions have been described that may improve social skills in this population, including video modeling, developmental, peer-mediated, behavioral, and structured teaching interventions. However, significant challenges in research design and methodology exist across these studies. This paper reviews research examining social skill interventions for youth and adults with ASD and S/PID and points out weaknesses and challenges in this literature. We propose a developmental framework of adapting early childhood interventions for use with youth and adults with ASD and S/PID as one starting point for intervention development.