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The Autistic Savant

By Darold A. Treffert, MD

This website generates many inquiries about the “autistic savant,” particularly because the Academy Award winning movie Rain Man made “autistic savant” a household word. But savant skills are not limited to autistic persons, nor are all autistic persons savants. Therefore Savant Syndrome is a more accurate and inclusive term for this remarkable condition and Savant Syndrome includes some persons (about 50%) who are autistic with superimposed savant abilities, but also includes persons with other Developmental Disabilities (the other 50%) who have savant abilities as well. With that caveat, since autistic savants are a distinct subgroup in Savant Syndrome, and often of special interest, this section focuses separately on what we do know about the “autistic savant” as one important part of Savant Syndrome overall.

Raymond Babbitt, as portrayed so accurately and sensitively by Dustin Hoffman in Rain Man, certainly is the world’s best known autistic savant. While a composite character, and not based on the story of one individual, Raymond Babbitt is an accurate portrayal of a high functioning person who is autistic, with superimposed extraordinary special skills coupled with a prodigious memory. That combination of Autistic Disorder + extraordinary special abilities + remarkable memory is the “autistic savant.”

But not all autistic persons are savants. Approximately one in 10(10%) do have some special skills over a spectrum ranging from what are called “splinter skills” to “prodigious’ savants.” The latter have special skills so spectacular that they would be remarkable even if they were present in a non-handicapped persons. Savant skills also occur in other forms of Developmental Disability, such as Mental Retardation, but with much less frequency, as low as 1:2000 in a residential population. But since Mental Retardation is much more common than Autistic Disorder, and since the frequency of savant skills in that group is much lower than in persons with autism, as is it turns out, approximately 50% of persons with savant syndrome have Autistic Disorder, and 50% have some other form of Developmental Disability including Mental Retardation.

Among the 10% of persons who are autistic, there is a wide spectrum of savant abilities. Most common are what are called “splinter skills” such as obsessive preoccupation with and memorization of sports trivia, license plates, maps or things as obscure as vacuum cleaner motor sounds, for example. “Talented” savants are those persons whose special skills and abilities are more specialized and highly honed making those skills obviously conspicuous when viewed over against overall handicap. Finally there is a group of “prodigious” savants whose skills are so spectacular they would be conspicuous even if they were to occur in a non-handicapped person. There are probably fewer than 50 persons living worldwide who would meet the high-threshold definition of prodigious savants, and approximately one-half of that group would be autistic savants.

This startling juxtaposition of superiority and handicap was originally given the unfortunate name “idiot savant” by Dr. J. Langdon Down (better known for having described Down’s Syndrome) in 1887. In a series of lectures in London that year, Dr. Down described his 30-year experience as Superintendent of Earlswood Asylum during which time he was fascinated by the extraordinary paradox of superiority and handicap in the same person. He described 10 such cases including one boy who would come away from an opera with perfect recollection of all of the arias; another could multiply many-digit figures in his head as quickly as they could be written down; another lad had memorized and could recite — backward or forward — albeit with little comprehension — “The Rise and Fall of the Roman Empire,” in its entirety. There is no description in these cases that would permit a diagnosis of Autistic Disorder as opposed to some other form of Developmental Disability, but surely some were autistic.

Down made a number of observations that are still valid a century later, and are applicable to the autistic savant today. First, the skills are almost always limited to a very narrow range of special abilities: music, art, mathematics including lightning calculating & calendar calculating; and mechanical or spatial skills. This narrow range of abilities is particularly intriguing when considering the wide range of abilities in the human repertoire. Second, Down noted that these spectacular special bailees are always linked to a phenomenal memory of a unique type — very narrow but exceedingly deep — often with little understanding or comprehension of that which is so massively stored, a characteristic he called “verbal adhesion” and others have called “memory without reckoning”. Third, Down noted that his cases were limited entirely to males. While not that stringent, over time the actual male:female ratio has turned out to be approximately six males for every female savant.

The term “idiot savant” has largely been discarded now, appropriately, and has been replaced by Savant Syndrome. Actually that original term as used by Down was a misnomer since almost all reported cases occur in persons with IQ of 40 or over. In Down’s time the word “idiot” was an accepted scientific classification for mental retardation with IQ below 25 and he combined that term with the word “savant” derived from the French word “savoir” which means “to know” or “knowledgeable person.”

The condition of Early Infantile Autism, however, was not described as a separate entity until 56 years after Down’s original description of savant syndrome. In 1943 Dr. Leo Kanner carefully and accurately described, and named, a condition he called Early Infantile Autism now generally referred to as Autistic Disorder, and sometimes just as autism. Autistic Disorder is not a single entity and is more appropriately described as a group of disorders, with a variety of etiologies all with the final common path, cluster and constellation of symptoms we now call Autistic Disorder or autism. Among that group of persons with Autistic Disorder, approximately one in 10 have some savant abilities on the spectrum from splinter skills to prodigious savant. These special skills are superimposed, or grafted on to, the Autistic Disorder. along with phenomenal memory, as described below.

The skills in the autistic savant continue to be seen within a curiously narrow but remarkable constant range of human abilities: music, usually piano and almost always with perfect pitch; art, typically drawing, painting or sculpting; lightning calculating, calendar calculating or other facility with numbers such as computing prime numbers; and mechanical abilities or spatial skills. Unusual language talent — polyglot savant — skills have been reported but are very rare. Other less frequently reported special skills include map memorizing, remarkable sense of direction, unusual sensory discrimination such as enhanced sense of smell or touch, and prefect appreciation of passing time without knowledge of a clock face. A conspicuously disproportionate number of musical savants through this past century, and at the present time, are blind and autistic, demonstrating a curiously recurrent triad of blindness, autism and musical genius.

In most autistic savants a single special skill exists; in others multiple skills occur. The skills tend to be right hemisphere in type — nonsymbolic, concrete, directly perceived — in contrast to left hemisphere type that tend to be more sequential, logical and symbolic including language specialization. To the extent imaging studies such as CT, MRI or PET have been carried out, savants, and particularly autistic savants, do demonstrate left hemisphere damage, with presumably, right hemisphere compensatory function. This left hemisphere damage can be from a variety of prenatal, perinatal and postnatal causes described in detail elsewhere on this Web site. It is postulated that this left hemisphere damage is coupled with corresponding damage to the higher level cognitive (cortico-limbic) memory circuitry with compensatory take over of lower level (cortico-striatal) so-called “habit” or procedural memory. This accounts for the linking of predominantly right brain skills with habit memory so characteristic of autistic savants and savant syndrome more generally. In addition to this idiosyncratic brain circuitry, intense concentration, practice, compensatory drives and reinforcement by family, teachers and others play a major role in developing and polishing the savant skills and memory linked so characteristically and regularly in the autistic savant.

CT and MRI scans, impressive as they are, only document brain structure. The real future in unlocking the dynamics and circuitry of savants, and indeed Autistic Disorder itself, will come from PET and SPECT imaging which map brain function, not just it’s architecture. Increasingly in Autistic Disorder, more and more evidence of left hemisphere dysfunction emerges, and in savant syndrome such left hemisphere dysfunction in likewise increasingly evident, and implicated as an important explanation of savant abilities. There has been only one SPECT functional imaging study reported thus far on an autistic savant, in this case an 11-year-old autistic artist, D.B. That study showed a distinct abnormality in the left anterior temporal area of the brain. What is so striking about that finding is that it mirrors exactly another recent, far-reaching discovery about savant abilities. Dr. Bruce Miller, a San Francisco neurologist, has described 12 cases now of new savant abilities emerging in elderly, previously non-disabled persons as a particular type of dementia (fronto-temporal dementia) proceeded. The SPECT abnormality in these patients was identical to that of the childhood autistic savant. This finding of new savant abilities emerging as a dementia proceeds raises profound questions about hidden potential v a little Raymond Babbitt — perhaps within us all. All of these findings and their significance are described in much more detail in other sections of this Web site.

There have been a number of autistic savants who are quite well known and, because of their extraordinary talent, have had considerable international recognition. Some of these such as Richard Wawro, and Tony DeBlois have special sections on this web site. Several others such as Ellen are described in detail in my book, Extraordinary People. Stephen Wiltshire has three books of his own published, one of them a national best seller in England, about him, and his remarkable drawing ability. Nadia was described in detail in a book by Dr. Lorna Selfe. “The Twins”, the calendar calculators, have been the subject of a number of scientific articles and book chapters. In addition to calendar calculating, they remember the weather every day of their adult life, and are able to compute prime numbers still in the absence of even simple arithmetic skills. And then, of course, there is Raymond Babbitt who all the world now seems to know.

But there is more to autistic savants than the scientific interests of brain circuits, neurons and hemispheres. Embedded in the lives of these remarkable people as well are the human interest stories about the power of love, belief, and caring in the families, caretakers, therapists and teachers that surround the savant, in first discovering, then appreciating, then helping to actualize and realize the savant’s full potential beyond deficits. Rather than fearing some dreaded tradeoff of these special gifts as the price of training and teaching the savant broader communication, social and daily living skills, these remarkable abilities can themselves serve as what I call a “conduit toward normalization” without loss of those unique talents. The century old debate of whether to “train the talent” or “eliminate the defect” can be convincingly answered now. Training the talent can in fact help ameliorate or lessen the defect. There are now compelling and inspiring examples of such useful application of special skills toward normalization in the classroom, in the workplace, and the home in a number of well known autistic savants, some of whom are mentioned above.

Until we can understand and explain the savant, we cannot fully understand and explain ourselves. For no model of brain function, including memory, will be complete until it can fully incorporate and account for this amazing condition and its remarkable manifestations. And no conclusions about human potential can be finalized either until we fully explore the ramifications of what is seen in the savant. Serious study of savant syndrome, including the autistic savant, can propel us along further than we have ever been in understanding, and maximizing, both brain function and human potential.

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For more information, please contact:
Darold A. Treffert, MD
St. Agnes Hospital, Fond du Lac, Wisconsin
Clinical Professor, Department of Psychiatry
University of Wisconsin Medical School, Madison
Personal website: http://www.daroldtreffert.com
E-mail: savants@charter.net