For students with autism, recess is often a missed opportunity to develop social competence and relationships. Although interventions have been developed to promote interactions and social skills for students with average or above-average intellectual functioning, there has been less focus on students with autism who have below-average intellectual functioning or who meet the criteria for intellectual disability. In this single-case design study, we tested the efficacy of a combined peer-mediated and social skills instruction intervention on the interactions, play, and social skills of three students with autism who met their state's criteria for alternate assessment for students with significant cognitive disabilities. Social skills instruction featured video models that portrayed same-aged peers demonstrating individualized social skills on the playground. For all three students, there were substantial increases in interactions, play and social skills, and students and their peers provided positive feedback about the intervention.