Medical procedures for persons with ASDs such as routine physicals and bloodwork are often associated with nonadherence and problem behavior in individuals with developmental disabilities. Although differential reinforcement of alternative behavior (DRA) is often effective in increasing adherence, it typically includes an extinction component, which can be difficult to implement with integrity. The purpose of this study was to evaluate DRA alone and in combination with fading for increasing adherence and decreasing problem behavior during routine medical exams in two individuals with an autism spectrum disorder. An indirect assessment was conducted to identify exam steps and those that seemed problematic. Next, a functional analysis (FA) was conducted to determine if problem behavior was maintained by escape from medical demands. Treatment resulted in increases in adherence with medical procedures and decreases in problem behavior for both participants. Treatment gains were maintained over 2 months.