Background: Improving behavioral and social problems in children with autism requires extensive training programs even with parents at home. The main goal of this study is to design a virtual reality (VR) intervention based on the TEACCH method in combination with risperidone to evaluate its effectiveness on social and behavioral problems. Methods: Forty-three children with autism (6-12 years old) randomly were divided into three groups: risperidone (n = 15), risperidone + VR (n = 15), and control (n = 13). The interventions lasted for 3 months (90 sessions) and post-test assessments were done immediately after intervention. Follow up tests were done 3 months after that. Results: Risperidone + VR group showed significant differences in social skills (MD = 36.59; 95% CI: 30.74 to 38.42, P < 0.001, ŋ2 = 1.51 in post-test; MD = 19.63; 95% CI: 17.27 to 21.63, P < 0.001, ŋ2 = 0.86 in follow up); and behavioral symptoms (MD = -36.12 ; 95% CI: -39.72 to -36.91, P < 0.001, ŋ2 = 1.99 in post-test; MD = -28.82 ; 95% CI: -29.43 to -25.32, P < 0.001, ŋ2 = 1.58 in follow up) compared to the control group. However, the risperidone group showed significant differences in social skills (MD = 2.03; 95% CI: 0.82 to 3.67, P < 0.001, ŋ2 = 0.12) and behavioral symptoms (MD = -36.66; 95% CI: -38.96 to -34.27, P < 0.001, ŋ2 = 1.96) only in post-test. Thus, the experimental groups did not have any significant difference in post-test.
Conclusion:Combined interventions such as VR can enhance the effectiveness of risperidone response and boost children's preparedness to practice and learn social interaction.