Autistic children comprise a large group of young people who are looked-after by their local authority and for whom educational outcomes are amongst the poorest of all children in care. Virtual School Heads (VSHs) in England have a statutory responsibility to improve the educational outcomes of children in care following the implementation of the Children and Families Act 2014. However, very little is known about the experiences of VSHs in supporting autistic children in care, including whether and how knowledge about autism diagnosis is shared within interprofessional teams. This qualitative study reports the findings from nine semi-structured interviews with eight VSHs and one occupational therapist from eight local authorities in England. VSHs worked within multiple and diverse teams locally and nationally to co-ordinate and manage effective provision but reported that knowledge about autism was often uncertain and conflated with attachment difficulties. They could not state with confidence that individuals around the child were sufficiently enabled to provide appropriate support and educational provision. The VSH, and the children they support, occupy liminal roles which create challenges for effective communication and support. Crucially, young people's views need to be authentically gathered and holistically understood to inform and improve provision.