OBJECTIVES: To examine the difficulty using services reported by caregivers of children aged 3-17 years with ASD as compared to caregivers of children with other developmental disorders (DD) and mental health conditions (MHC).  METHODS: A cross sectional study was conducted using the 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) (N = 18,702). Difficulty using services was assessed as issues with: eligibility, availability, getting appointments, cost, and obtaining information. Chi-square analyses and separate binomial logistic regressions were conducted to compare likelihood of difficulty with all five measures across ASD, DD only, MHC only, and DD & MHC groups, after adjusting for socio-demographics, number of special children in the household, child’s functional ability, and presence of a physical condition.  RESULTS: Majority of the sample were older children (6-17 years), Whites, caregivers with ≥200% FPL income and greater than high school education. Sixteen percent (n = 3,025) of the caregivers had a child with an ASD diagnosis. As compared to caregivers of children with MHC only, caregivers of children with ASD were significantly more likely to report issues with availability (AOR = 2.16, 95% CI = 1.66-2.82), information (AOR = 1.89, 95% CI = 1.46-2.45), eligibility (AOR = 1.80, 95% CI = 1.38-2.37), cost (AOR = 1.67, 95% CI = 1.31-2.14), and appointments (AOR = 1.35, 95% CI = 1.09-1.68). When compared to the DD & MHC group, the ASD group was found to be significantly more likely to report issues with availability, obtaining information, and cost of services. CONCLUSIONS: ASD caregivers reported greater difficulty with all five service difficulty measures as compared to caregivers of children with MHC only. However, ASD group reported greater problems only in availability, obtaining information, and cost of services, when compared to DD & MHC group.