Virtual Reality (VR) has been an active area of research in the development of interactive interventions for individuals with autism spectrum disorder (ASD) for over two decades. These immersive environments create a safe platform in which therapy can address the core symptoms associated with this condition. Recent advancements in spatial audio rendering techniques for VR now allow for the creation of realistic audio environments that accurately match their visual counterparts. However, reported auditory processing impairments associated with autism may affect how an individual interacts with their virtual therapy application. This study aims to investigate if these difficulties in processing audio information would directly impact how individuals with autism interact with a presented virtual spatial audio environment. Two experiments were conducted with participants diagnosed with ASD (n = 29) that compared: (1) behavioral reaction between spatialized and non-spatialized audio; and (2) the effect of background noise on participant interaction. Participants listening to binaural-based spatial audio showed higher spatial attention towards target auditory events. In addition, the amount of competing background audio was reported to influence spatial attention and interaction. These findings suggest that despite associated sensory processing difficulties, those with ASD can correctly decode the auditory cues simulated in current spatial audio rendering techniques.