Future Directions

It’s no secret that people with autism can have difficulty with both projecting conventional demeanor and understanding the nuances of communication with others. This brings a whole host of what autistic adult John Elder Robison has termed “social disabilities.” Other people don’t understand the richness and depth of feeling of an autistic person and the autistic person can miss the true import of another person’s words or actions. Isolation, depression and limited employment options can follow.

In addition to social relatedness, there can be issues with cognition and process such as slow brain processing speed, sadness, rigidity and inflexibility.  Some people with autism may also have slow brain processing speeds. A medical hypothesis for this is that while brains form new neural connections and then in turn prune most of them, the brains of autistic people don’t eliminate unnecessary connections as effectively, leading to a neural ‘thicket’ that the electrical impulse that carries information must navigate. The electrical activity of the brain can’t find the main neural pathway because the autistic brain has too many connections. It’s like a car that can only take the back roads on a trip instead of finding the main neural superhighway

No Current “Solutions”

There has been little an autistic person or their family could do to improve the autistic person’s actual social functioning. Most current interventions address the symptoms and effects of autism – drugs for anxiety or depression, classes that teach daily living skills, adaptive coping, problem solving and social skills. Family members spend a great deal of time helping, teaching, coaching, and learning and seeking anything that might help the autistic person navigate the social world and master activities of daily living. “We could have gotten him social skills classes for the rest of his life and he wouldn’t have been able to do what he could do after 40 seconds of TMS.”

Autism still has no scientifically validated treatment for core functional deficits, despite increasing prevalence across our country. Individuals, families and communities bear the daily costs of disability, from social isolation to unemployment to assisted living. However there are clues from early published clinical studies that show the potential for high-impact remediation from repeated treatments of specific areas of the brain with non-invasive brain stimulation such as Transcranial Magnetic Stimulation (TMS).  

While the FDA has approved TMS treatments for depression, and diagnostic research studies using TMS and investigations on the benefit of TMS for conditions such as Alzheimer’s disease continue apace, research on TMS as a treatment for autism has been sparse.

A number of individuals in pilot studies have experienced remarkable improvement in social skills and other executive functioning after TMS. They became more clearly present to themselves, and more able to manage the unspoken expectations of human interactions. There needs to be a happy medium between the slow acceptance of science and clinical treatment and jumping into treatment before we have the scientific data to support safety, tolerability, and efficacy. With input from medical experts to establish research objectives and clinical protocols, the Clearly Present Foundation promotes this leading-edge, scientifically validated research to clarify its medical validity and speed its availability to make a difference for those with autism and their families.

Limited Current Research on TMS

In the United States there have been only two reputable research universities, Harvard University/Beth Israel Deaconess Medical Center, and the University of Louisville, that have published research on the therapeutic use of TMS in Autism.  TMS also holds promise in the treatment of Alzheimer’s and in certain military applications. Research grants tend to focus on these applications of TMS.  Consequently, TMS researchers can lack financial support to pursue autism as an area of inquiry.Just because a preventative measure, a technique or a treatment is shown to be medically beneficial, it does not automatically follow that that measure, technique or treatment will be adopted by doctors and made available to help the general population. In between the first scientific “ah ha” and common usage come many hurdles.The acclaimed surgeon and author Atul Gawande noted2 recently that we expect valid medical breakthroughs to spread virally but this is often not the case. For example, a surgeon named James Lind first published the connection between increased consumption of citrus and reduction in scurvy during ocean voyages in 1753.3  However, the British navy did not adopt the preventative measure until 1795 — more than 40 years later!