The purpose of this literature review is to examine what makes reading for understanding especially challenging for children on the autism spectrum, most of whom are skilled at decoding and less skilled at comprehension. This paper first summarizes the research on reading comprehension with a focus on the cognitive skills and processes that are involved in gaining meaning from text and then reviews studies of reading comprehension deficits in children on the spectrum. The paper concludes with a review of reading comprehension interventions for children on the spectrum. These children can especially benefit from interventions addressing particular cognitive processes, such as locating antecedent events, generating and answering questions, locating referents, and rereading to repair understanding.