What the Research Says About TMS and Autism
If you are exploring TMS for your child, you are asking a good question, and the research is moving in an encouraging direction. This page sorts what we know into three groups: what is established, what looks promising, and what researchers are still learning, so you can decide with confidence.
At Brain Treatment Center Newport Beach, we offer MeRT®, an EEG-guided form of repetitive transcranial magnetic stimulation (rTMS), as an adjunctive option for families who want to consider it. It is not a cure for autism, and it does not replace the therapies and supports your child’s care team recommends. The research on TMS for autism is still early, and it is encouraging.
What we know
Proven supports come first, and TMS has been well tolerated in the studies so far.
Behavioral, developmental, and educational therapies have the strongest evidence for supporting children with autism. The CDC’s overview of autism treatment describes approaches such as applied behavior analysis (ABA), speech and language therapy, and occupational therapy. TMS is not a substitute for these. Many families who consider it use it alongside them.
Most side effects of TMS in autism studies were mild and short-lived. A meta-analysis of 11 studies found that about one in four participants experienced side effects, most often irritability, facial discomfort, or headache. One open-label study reported one seizure, and the authors attributed it to an instrument programming error. The studies were small, so these findings are preliminary.
Encouragingly, TMS has been well tolerated so far, and researchers are actively studying it for autism. It is not yet an established treatment for autism, which is why this research matters.
What looks promising
Several reviews and trials point in an encouraging direction, particularly for repetitive behaviors and some social skills. Together, they give researchers good reason to keep going, though no single study settles the question.
2018 meta-analysis
Systematic review · 23 reports, 371 patients
Researchers combined data on mostly children and adolescents and found a moderate improvement in repetitive and stereotyped behaviors. For social behavior, the controlled studies did not reach statistical significance. Most studies were at moderate to high risk of bias. The authors described the evidence as preliminary and called for larger, blinded, sham-controlled trials to build on these early signals.
2024 review
A review of seven randomized trials and ten open-label studies reported improvements in stereotyped and repetitive behavior and in verbal social domains. Only two of the 17 studies were double-blind, and the rest carried a moderate to high risk of bias. The authors describe TMS as showing potential, a hopeful finding but not a proven one.
Systematic review · 17 studies
Barahona-Corrêa and colleagues combined 23 reports covering 371 patients, mostly children and adolescents. They found a moderate improvement in repetitive and stereotyped behaviors. For social behavior, the controlled studies did not reach statistical significance. Most studies were at moderate to high risk of bias because raters or participants were not blinded, and only one controlled study was randomized, sham-controlled, and double-blind. The authors described the evidence as preliminary and called for larger, blinded, sham-controlled trials to build on these early signals.
2025 trial in autistic adults
Sham-controlled crossover · 50 started, 40 completed
This study used a different technique from MeRT: stimulation timed to the brain’s real-time activity state. Over 12 weeks, the researchers reported reduced cognitive inflexibility, perceptual overstability, and atypical nonverbal communication. The authors note a 20% dropout rate and possible placebo effects. Because this study was in adults, the next question is how children respond.
2022 alpha-frequency chart review
Retrospective chart review · 28 children
Children ages 3 to 9 in Queensland, Australia, received TMS set to each child’s own alpha-wave frequency. This is related to but separate from MeRT, and it’s a different study from our pilot below, even though it also involved 28 children. Caregivers reported improvements, and side effects were mostly brief. The study had no control group or blinding, so it shows where to look next, not what caused the changes.
Our pilot study: encouraging, and still early
The randomized, sham-controlled data we have on MeRT in children with autism comes from one small pilot study. Its early results were encouraging, and it suggests a direction worth testing further. A pilot does not prove that MeRT works.
What was reported
- 28 children with moderate to severe autism, randomly assigned in the first phase to MeRT or sham (placebo) stimulation for five weeks.
- 10 of 14 children who received MeRT improved by more than 5 points on the CARS2-ST rating scale, compared with 0 of 14 who received sham.
- After a second, open-label phase, 23 of all 28 children showed that level of improvement.
What it can't tell us yet
- It is small. Further studies are needed.
- The 23-of-28 figure includes the open-label phase, with no comparison group.
- It is presented as a poster, not a published trial.
- Many improvements were parent-reported, which expectations can influence.
- The lead author is affiliated with our clinic. Independent replication would strengthen confidence.
What researchers are still learning
These are the questions researchers are working to answer, and they are the ones families ask about most.
Whether benefits last. Few studies follow children for long.
Which children are most likely to respond. Studies have used different brain targets, frequencies, and schedules.
Whether EEG-guided personalization adds anything. We are not aware of a controlled head-to-head trial against standard TMS.
How much is placebo. Larger, independent, double-blind, sham-controlled trials are needed.
Long-term safety in children. Short-term tolerability looks acceptable, but the studies are small.
FDA status
The FDA has cleared the MeRT system for the treatment of PTSD. MeRT is not FDA-cleared for autism, so using it for autism is outside its cleared indication. That is why we describe the autism research as promising but early.
What this means for your family
If you are considering MeRT, talk it through with your child’s pediatrician or developmental specialist. We offer it as an adjunctive option alongside the supports your child already has, and results vary from child to child.
Talk with our team. We are happy to walk you through the research, how MeRT works, and what an evaluation involves, with no pressure to decide.
Sources and study details
| Source | Type | Who or how many | What to keep in mind |
|---|---|---|---|
| CDC, treatment and intervention for autism | Public health guidance | General | Describes behavioral, developmental, educational, and other approaches |
| Adverse effects of TMS for autism (systematic review and meta-analysis) | Meta-analysis | 11 studies, about 155 participants | Small, mixed-quality studies; findings preliminary |
| Barahona-Corrêa et al., 2018 | Systematic review and meta-analysis | 23 reports, 371 patients | Authors call the evidence preliminary and insufficient |
| Systematic review of TMS for autism, 2024 | Systematic review | 17 studies | Only 2 double-blind; moderate to high risk of bias |
| Watanabe and Yamasue, Nature Neuroscience, 2025 | Sham-controlled crossover trial | 50 autistic adults started, 40 completed | Different technique from MeRT; adults only |
| Kim et al., EEG-EKG guided TMS pilot study (poster) | Randomized pilot (poster) | 28 children | Small; 23 of 28 figure includes an uncontrolled phase |
| Alpha-frequency-guided rTMS chart review, 2022 | Retrospective chart review | 28 children (a different 28 than the pilot) | No control group or blinding; caregiver-rated; related but separate from MeRT |
| Wave Neuroscience press release, June 2026 | Company announcement | N/A | Names PTSD as the cleared indication |