Brief Report: social disability in autism spectrum disorder: results from Research Units on Pediatric Psychopharmacology (RUPP) Autism Network trials.

Scahill et al. (2013) looked at two big drug trials for kids with autism. They wanted to know if the ABC Social Withdrawal subscale could spot real changes in social disability.

Each trial compared risperidone (with or without parent training) against placebo. The scale tracked social withdrawal before and after treatment.

The scale picked up medium-sized gains in both trials. Kids on active drug scored better on social withdrawal than kids on placebo.

The same measure worked across two separate studies, giving clinicians confidence it can detect medication-related social improvement.

Hudson et al. (2012) had already pooled 33 autism drug trials. Their review includes the same risperidone studies Lawrence re-examines, but adds other medications. Only a handful show solid evidence, so risperidone remains a top pick for irritability and social withdrawal.

McGonigle et al. (2014) took a different path. Their recess-based CBT doubled positive peer interactions without any medication. Medium drug effects and large behavioral effects both show social skills can move, giving you two validated routes—biological or behavioral—to target the same core problem.

Zhang et al. (2022) adds a third angle. Peer-mediated PRT in classrooms also lifted social responses in an RCT. Together these papers form a triangle: pills, CBT, or peer coaching can each improve social functioning; your choice depends on client values, side-effect tolerance, and setting constraints.

If you need a quick, sensitive gauge for social withdrawal, the ABC subscale has now passed two large RCT tests. Use it to track change whether you prescribe, teach social skills, or run peer networks. One measure works across interventions, keeping data collection simple for your team and easy to explain to families.