Transcranial Magnetic Stimulation for Restricted and Repetitive Behavior in ASD

Prior treatment

• Any contraindications for TMS e.g. history of seizures other than clear substance-induced/fever-induced seizures with neurologist note or normal clean EEG and no seizure in at least 12 months prior to enrollment.
• Currently taking Clozapine or another medication that the PI determines increases the risk of TMS or may disrupt the efficacy.

Other illness

• Any current or past history of any physical condition which in the investigator's opinion might put the subject at risk or interfere with study results interpretation.
• DSM-5 diagnosis of bipolar disorder or a psychotic disorder e.g. schizophrenia.
• Conditions that increase the risk for COVID-19 (in accordance with university guidelines).

Other

• Pregnancy.
• Active substance use (\<1 week) or intoxication verified by toxicology screen--of cocaine, amphetamines, benzodiazepines.
• Showing symptoms of withdrawal from alcohol or benzodiazepines.
• Significant sensory impairments such as blindness or deafness.
• Current severe insomnia (must sleep a minimum of 4 hours the night before stimulation).
• Not willing to cooperate with the TMS procedures.
• A motor threshold that is too high to allow safe/tolerable treatment.

• Diagnosis of Autism Spectrum Disorder (ASD)
• Meet criteria for Autism Spectrum Disorder (ASD) on clinical assessments (ADOS-2 or CARS if conducted remotely \& ADI-R)
• Aged between 12-45 years old
• Have a reliable informant who can complete relevant questionnaires
• Have DARB scores which indicate high levels (50% or above) of RRB on one of the following domains: Insistence on Sameness, Obsessive Compulsive Behaviors, and Unusual Interests