rTMS to Improve Motor Function in Autism

Inclusion Criteria:

ASD or control participants must meet all of the inclusion criteria to eligible for this study:

1. Aged between 18 and 40 years old. 40 years is chosen as the cut-off because of thereport of high rates of Parkinsonism in autistic adults > 39years;

2. Have IQ>70;

3. Are able to read, write and communicate effectively in English;

4. Are able to provide informed consent. We will recruit only intellectually-ableautistic adults. The intellectual ability will be determined using WASI-II. Theability to provide consent will be determined using clinical assessment.

5. Have no prior history of seizure;

6. Must sign and date the informed consent form;

7. Stated willingness to comply with all study procedures;

8. Agreement to adhere to Lifestyle Considerations, that is: refrain from consumptionof alcohol, tobacco, marijuana, or caffeine on the day of study visits.

All ASD participants:

1. Will have DSM-5 diagnosis of ASD without intellectual disability, confirmed byclinical assessment and the Autism Diagnostic Observation Schedule - 2 (ADOS-2);

2. Will have significant motor function difficulties defined as a standard compositescore <40 (i.e., >1 standard deviation below the mean) on either fine or gross motorcomposite scores of the Bruininks-Oseretsky Test of Motor Proficiency, SecondEdition or BOT-2;

3. Are clinically stable as determined by clinical assessment, with no medicationchanges over the past 4 weeks. Given the high variability of handedness in ASD, wewill include participants with left, right or mixed handedness.

Exclusion Criteria:

ASD or control participants will be excluded if they experience/have:

1. Current pregnancy;

2. Current or past history of co-morbid medical condition that may require urgentmedical intervention;

3. DSM-5 substance use disorder (other than tobacco) within the past 6 months; however,all participants will be asked to refrain from smoking or taking caffeine four hoursprior to the iTBS session;

4. Significant hearing or visual impairment interfering with the ability to read orhear instructions;

5. Significantly debilitating medical or neurologic illness (e.g., encephalitis,aneurysms, tumors, central nervous system infections), or acute or unstable medicalillnesses as determined by project physician (e.g., uncontrolled diabetes);

6. Metal implants or a pace-maker;

7. Prior rTMS treatment;

In addition, ASD participants will be excluded if they report taking benzodiazepines or anticonvulsants currently.

NT controls will be excluded if they have:

1. Presence of psychopathology other than specific phobia, as screened by PersonalityAssessment Inventory and;

2. A known diagnosis of Pervasive Developmental Disorder or ASD among any biologicallyrelated family members.