Caregiver Experiences of Children with Autism Receiving Outpatient Transcranial Magnetic Stimulation (TMS) Treatment: A Qualitative Phenomenological Study

Autism Spectrum Disorder (ASD) affects more than 1% of Australian children and is associated with complex, long term caregiving demands. Outpatient Transcranial Magnetic Stimulation (TMS) is an emerging, non-invasive neuromodulation therapy that shows potential for improving behavioural, emotional, and cognitive functioning in autistic children. However, little is known about how this intensive, multi-session therapy is experienced by caregivers within real-world outpatient settings. This qualitative study used an interpretative phenomenological approach to explore how caregivers made sense of their child’s outpatient TMS treatment. Twelve caregivers from two clinics in Queensland participated in semi‑structured interviews. Analysis identified four superordinate themes: decision making and preparation, emotional and relational transformation, perceived child development and external validation, and challenges and resilience. Caregivers approached TMS with a combination of hope and caution, engaging in extensive information-seeking and preparation. Over the course of therapy, many reported perceived changes in their children’s emotional regulation, communication, and engagement, which were interpreted as meaningful shifts within the family dynamic. These perceptions were often reinforced by feedback from teachers, clinicians, and extended networks. Despite significant financial, logistical, and emotional demands, caregivers framed their commitment as a purposeful investment in their child’s future, sustained by small yet significant signs of progress. The findings suggest that outpatient TMS extends beyond a single clinical intervention, unfolding over time as a relational experience shaped within family routines. Therapeutic value was most often understood through changes in connection and engagement rather than measurable clinical outcomes alone. The project provides support for the importance of autism-affirming environments, consistent routines, and strong caregiver–clinician partnerships, in addition to the need for equitable and accessible service models as paediatric neuromodulation becomes more widely adopted.