This paper describes approaches to care and associated service use by families with a child with autism. A combined telephone and self-administered survey was completed by 301 families with a child, 8 years old or younger, in North Carolina, during the winter of 2003-2004. Findings indicate that 66% of families used one or more approach to care and there was a significant (p < 0.05) association between approach and the pattern of service use. There appears to be a distinctive set of services associated with each approach to care, but with overlap between them. Speech/language therapy at school was the most frequently used service and also identified as the best service. The majority (81%) of families reported they were satisfied with services.