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Abstract Autism is a neurodevelopmental condition with varied trajectories through the lifespan, leading to individualized patterns of strengths and challenges. Longitudinal autism cohort studies show the importance of developmental and adaptive skills starting in the early years, followed by emerging co-occurring conditions, and opportunities for autonomy and community participation when approaching adulthood. Studies of interventions to support developmental outcomes in autistic children have shown benefits; however, adverse events from therapies and outcomes prioritized by autistic people must be incorporated. Programs for autistic children and youth are making some progress by including members of diverse communities, developing and adapting interventions to meet their needs. Most importantly, autistic people have highlighted the many contributors to a ‘good life’, prominent among which are acceptance and meaningful inclusion. This review summarizes the latest evidence about developmental trajectories and outcomes among autistic children and youth, and how this translates into clinical practice and policy.