Autism and psychosis share overlapping clinical features and can occur comorbidly. Given growing recognition that early identification of psychosis risk symptoms may lead to better functional outcomes, the field needs valid tools for use in the assessment of psychosis risk symptoms within autism. This study employed a multi-method approach to evaluate the utility of a psychosis risk assessment tool, the Structured Interview for Psychosis-Risk Syndromes, for use with adolescents with autism. A total of 43 adolescents (N=21 with autism, N=22 typically developing) were interviewed using the positive symptom domain of the Structured Interview for Psychosis-Risk Syndromes. Study participant answers to interview questions were coded for verbal and behavioral responses, and error rates were compared between groups. Results indicate that adolescents with autism (all of whom had intact language skills) did not significantly differ from typically developing peers when answering questions about positive psychosis risk symptoms. A majority of verbal responses (93%) and behavioral responses (89%) to Structured Interview for Psychosis-Risk Syndrome items were rated as adequate for both groups, suggesting that the positive domain items from the Structured Interview for Psychosis-Risk Syndromes can be used with adolescents with autism. Regardless of diagnosis, higher rates of response errors were significantly correlated with greater difficulty understanding ambiguous language and increased interview times. Structured Interview for Psychosis-Risk Syndrome interviewers are cautioned to use follow-up probes to clarify items that might be confusing to participants and/or have higher response error rates for all adolescents, irrespective of autism status, to prevent false-positive responses for people with and without autism.