Students with autism spectrum disorder (ASD) who have extensive support needs (ESN) may require support to develop appropriate social behavior. School-wide Positive Behavioral Interventions and Supports (SWPBIS) is an evidence-based framework to support the social and behavioral needs of all students. As an evidence-based practice commonly used as a Tier 2 support within SWPBIS, check-in/check-out (CICO) has improved social behavior among students with and without disabilities. However, the literature on the efficacy of CICO does not include students with ASD who have ESN. The purpose of this study was to examine the effects of traditional and adapted CICO as a Tier 2 support within the SWPBIS framework on the adherence to school-wide expectations and challenging behavior of four elementary students with ASD who have ESN. Results of this multiple baseline across participants design study were inconclusive regarding challenging behavior and adherence to school-wide expectations across participants. Further, social validity data collected from all participants indicated the intervention was feasible and an overall positive experience.