Due to the numerous interventions available for children with autism, parents are faced with challenging decisions regarding treatments from the time of diagnosis and throughout their child’s life. This exploratory qualitative study investigated the reasons behind parents’ decisions about interventions for their child with autism. In-depth interviews were conducted with 23 parents from 18 families making decisions for 19 young children to understand their perspectives on deciding a philosophical approach, choosing a preschool program, and/or deciding on alternative treatments. Children had a diagnosis of pervasive developmental disorder not otherwise specified or autistic disorder and were below the age of 7 years. Parents’ considerations were categorized into the themes of parental, child, and program attributes. Recommendations were made regarding areas to explore with families to provide support as they weigh the numerous options available. Recommendations for policy changes that could improve diagnostic and treatment services for children with autism and their families were discussed.