Wisconsin Medical Society's Savant Syndrome
          Photo: Albert Einstein

 
 

Prodigious savants

A prodigious savant is someone with a skill level equivalent to or greater than that of a prodigy, regardless of any cognitive disability. The most common trait of prodigious savants is their seemingly limitless mnemonic skills, with many having eidetic or photographic memories. Prodigious savants are extremely rare, with fewer than one hundred noted in more than a century of literature on the subject. Dr. Darold A.Treffert M.D. estimates that fewer than fifty or so such individuals are alive today.

Here are a list of notable savants: See Albert Einstein University Source (bio on each savant listed below)
 
 
 
The following are well-known people with savant syndrome, noted for their talent in their identified fields:

Frequently Asked Questions

  • What is savant syndrome?
  • How common is savant syndrome?
  • What is the range of savant skills?
  • What are the typical savant skills?
  • What is Asperger's Disorder?
  • Why is savant syndrome seen more frequently in males than females?
  • When was savant syndrome first discovered?
  • What is the relationship of savant syndrome to IQ?
  • What is "autism"? What is the relationship of savant syndrome to autism?
  • What causes savant syndrome?
  • What is the 'treatment' for savant syndrome?
  • How often does the savant lose his or her special skills?
  • I have a son or daughter or other relative or acquaintance who has these special skills. What is the best approach to use in dealing with those?
  • Might there be a little Rain Man in each of us?



  • What is savant syndrome?

    Savant Syndrome is a rare, but spectacular, condition in which persons with various developmental disorders, including autistic disorder, have astonishing islands of ability, brilliance or talent that stand in stark, markedly incongruous contrast to overall limitations. The condition can be congenital (genetic or inborn), or can be acquired later in childhood, or even in adults. The savant skills co-exist with, or are superimposed upon, various developmental disabilities including autistic disorder, or other conditions such as mental retardation or brain injury or disease that occurs before (pre-natal) during (peri-natal) or after birth (post-natal), or even later in childhood or adult life. The extraordinary skills are always linked with prodigious memory of a special type — exceedingly deep but very, very narrow.


    back to top


    How common is savant syndrome?

    Approximately one in ten (10%) of persons with autistic disorder have some savant skills. In other forms of development disability, mental retardation or brain injury, savant skills occur in less than 1% of such persons (approximately 1:2000 in persons with mental retardation). Since these other forms of mental disability are much more common than autistic disorder however, it turns out that approximately 50% of persons with savant syndrome have autistic disorder, and the other 50% have some other form of developmental disability, mental retardation or brain injury or disease. Thus not all savants are autistic, and not all autistic persons are savants.


    back to top


    What is the range of savant skills?

    Savant skills exist over a spectrum of abilities. The most common savant abilities are called splinter skills. These include behaviors such as obsessive preoccupation with, and memorization of, music and sports trivia, license plate numbers, maps, historical facts, or obscure items such as vacuum cleaner motor sounds, for example. Talented savants are those persons in whom musical, artistic, mathematical or other special skills are more prominent and highly honed, usually within an area of single expertise, and are very conspicuous when viewed against their overall handicap. The term prodigious savant is reserved for those very rare persons in this already uncommon condition where the special skill or ability is so outstanding that it would be spectacular even if it were to occur in a non-handicapped person. There are probably fewer than 50 prodigious savants living worldwide at the present time who would meet this high threshold of special skill.


    back to top


    What are the typical savant skills?

    Particularly striking is the consistent observation also over this past century that savant skills typically, and curiously, are generally confined to only about five general areas of expertise — music, art, lightning calculating or other mathematical skills, calendar calculating and mechanical/spatial skills. This very limited, but spectacular, array of special skills is noteworthy considering the much wider palette of skills in the human repertoire, and the rarity of the obscure skill of calendar calculating in the general population, which seems an ability almost universal, innately so, among savants.

    Music is the generally the most common savant skill-usually playing piano by ear and almost always with perfect pitch. Other percussion instruments such as marimba or drums can be mastered as well, but much less frequently. Musical performance abilities predominate, but outstanding composing skills have been documented as well, most often linked to performance ability, but not necessarily so. The triad of mental disability, blindness and musical genius occurs with a curious, conspicuous frequency in reports over this past century, particularly when one considers the relative rarity of each of those circumstances individually.

    Artistic talent, usually painting or drawing, is seen next most frequently. Other forms of artistic talent can occur as well, such as sculpting. Lightning calculating or other mathematical skills, such as the ability to compute multi-digit prime numbers contrasted with the inability to perform even simple arithmetic, has often been reported. Mechanical ability, constructing or repairing intricate machines or motors for example, or spatial skills such as intricate map and route memorizing, or being able to compute distances with precise accuracy just from visualization, do occur, but are seen somewhat less frequently.

    Calendar calculating is curiously and conspicuously common among savants, particularly considering the rarity of that obscure skill in the general population. Beyond being able to name the day of the week that a date will occur on in any particular year, calendar calculating includes being able to name all the years in the next 100 in which Easter will fall on March 23rd, for example, or all the years in the next 20 when July 4 will fall on a Tuesday. The so-called 'calculating twins' reported extensively in the literature, have a calendar calculating span of over 40000 years backward or forward in time. They also remember the weather for every day of their adult life.

    Other skills are occasionally seen including multilingual acquisition ability or other unusual language (polyglot) skills, exquisite sensory discrimination in smell or touch, perfect appreciation of passing time without access to a clock face, or outstanding knowledge in specific fields such as neurophysiology, statistics, history or navigation, to name a few. While always controversial, there have been some reports of extra-sensory perception skills occurring in savants as well.

    Typically a particular one of these skills occurs singly in each person with savant syndrome. However in some instances multiple skills occur in the same person. Regardless of the type of skill, it is always combined with prodigious memory, and it is this special kind of memory-extraordinarily deep but very, very narrow — that cuts across all the various special skills and welds the condition of savant syndrome together.


    back to top


    What is Asperger's Disorder?

    Sometimes called "The little Professor" syndrome, most clinicians consider Asperger's disorder to be persons who are at the high functioning end of the Pervasive Developmental Disorders and Autistic Disorders spectrum. Within a year of each other, independently and a continent apart, Dr. Leo Kanner described in 1943 what he called "Early Infantile Autism" in 11 of his patients, and Dr. Hans Asperger, in 1944, described what he called "Autistic Psychopathy" in four of his patients. Eventually Dr. Asperger described 200 such patients in his group but it was not until 1981 that the term Asperger's Disorder was applied to such persons. Some of Asperger's observations are described in greater detail elsewhere on this site at this link.

    While Autistic Disorder and Asperger's share many characteristics in common, there are some signs and symptoms more unique to Asperger's such as often average to above average IQ although with scattered distribution; unusual interest and capability in natural sciences, complex calculations, computer programming or other areas of expertise which can be extensive and expansive; marked genetic roots with strong family histories of similar or related traits; early, rather than delayed, language and word recognition skills; poor motor coordination; and a generally higher level of social functioning than seen in Autistic persons but still with unusual, peculiar and naive social interactions. Characteristics shared between Asperger's and Autistic Disorder include a 6:1 male:female sex ratio, prodigious memory, social withdrawal or uneasiness, intense interest in collecting things with strong attachments to those objects and obsession with sameness to name several.

    Savant skills are very prominent in many Asperger's persons, certainly as high as in 10% of them, and it is often those highly specialized skills that bring Asperger's persons to prominence. A December, 2001 article in Wired magazine, explored the apparent "explosion" of Autism and Asperger's cases in the Silicon Valley of California, and raised questions about the continum of shared traits and strong family histories in persons with Asperger's disorder and what TIME magazine, in a May 3, 2002 article called "for lack of a better word, Aspergery." It is an interesting, continuing area of inquiry.


    back to top


    Why is savant syndrome seen more frequently in males than females?

    Savant syndrome does occur four to six times more frequently in males than females. Partly that is due to the fact that savant syndrome occurs in as high as 10% of persons with autistic disorder where that same disproportionate male:female ratio is seen. Even beyond that, however, research by Geschwind and Galaburda, explained in greater detail elsewhere on this site, demonstrated in the developing human fetus the left hemisphere of the brain always completes its development later than the right hemisphere. Therefore the left hemisphere of the brain is exposed for a longer period of time than the right to brain insult or injury of any kind. One such type of neuronal damage can be produced by circulating testosterone, which in the male fetus, reaches very high levels and can be, in some instances, neurotoxic. This same testosterone mediated developmental injury, causing left hemisphere brain damage before birth in males may account for the same highly disproportionate male:female ratio seen in some other forms of CNS injury such as stuttering, dyslexia, hyperactivity, other learning disabilities and autistic disorder itself.


    back to top


    When was savant syndrome first discovered?

    No doubt savants have been present throughout history. Although the term 'savant' was not applied to these special people until 1887 by Dr. J. Langdon Down, as described below, a report describing Jedediah Buxton, a prodigious lightning calculator who performed the most complicated multiplications and divisions swiftly in his head, appeared in a German Psychology Journal, Gnothi Sauton, as early as 1751.

    Then in 1789, Dr. Benjamin Rush, often referred to as the father of American Psychiatry, described in detail the lightning calculating skills of Thomas Fuller "who could comprehend scarcely anything, either theoretical or practical, more complex than counting." When Fuller was asked how many seconds a man had lived who was 70 years, 17 days and 12 hours old he gave the correct answer of 2,210,500,800 in 90 seconds even correcting for the 17 leap years included.

    But it was in 1887 that Dr. J. Langdon Down gave a series of lectures before the Medical Society of London based on his 30-year experience as Superintendent of the Earlswood Asylum. In those lectures he described 10 cases in careful detail of instances in which there was a striking contrast of superiority and disability in the same person. The special abilities included extraordinary musical, artistic, mathematical and mechanical skills always coupled with phenomenal memory in each and every case. One individual built exquisite model ships from hand-fashioned parts and could recite complex texts verbatim. Another boy, after attending opera, would come away with a perfect recollection of all the arias. Another lad had memorized The Rise and Fall of the Roman Empire in its entirety and could recite it forward or backward. Still another young man could multiply multi-digit figures in his head as quickly as they could be written down on paper.

    Dr. Down is best known for having named Down's Syndrome. But the cases of special abilities in otherwise severely disabled persons caught his attention as well and he coined the term idiot savant for these extraordinary individuals, linking those two words together because at that time the term idiot was an accepted scientific term for IQ below 25, and savant, or "knowledgeable person", was derived from the French word savoir meaning "to know". Dr. Down meant no harm by the term "idiot", and in fact he apologized for having to apply it — "I have no liking for the term. It is so frequently a term of reproach" he cautioned — but it was the accepted scientific term for a level of mental retardation at that time. While descriptive perhaps, the term idiot savant was actually a misnomer since almost all reported cases since that time occur in persons with IQ above 40. In the interest of accuracy and dignity the term Savant Syndrome has been substituted and widely accepted. That term is preferable to autistic savant because only about one-half of persons with savant syndrome are autistic, and the other half have developmental disabilities or other forms of central nervous system injury or disease.


    back to top


    What is the relationship of savant syndrome to IQ?

    When Dr. Down originally named the condition idiot savant, he linked its name with a classification of IQ of less than 25, but almost all reported cases have occurred in persons with an IQ above 40. However a low measured IQ score, or 'mental retardation' either as a symptom or separate disorder, is not what determines whether a person is or is not a savant. Instead the term savant syndrome encompasses a number of different mental disabilities including, but not limited to, the separate disorder of mental retardation itself. When applied to savant syndrome, the term 'mental disability' can include disorders as Autism, Asperger's, Hyperlexia or Williams Syndrome, for example. In some of these persons measured IQ can be normal or even superior, although when that is the case, usually the IQ sub-scores show a wide scatter among the various sub-tests that make up the overall IQ test battery with some sub-tests showing severe limitations and other showing extremely high scores. Thus a low IQ score, while often present in savant syndrome, is not necessarily the case in all instances, and it is not a finding essential or requisite to savant syndrome. Some savants do score in the normal or superior range on commonly used IQ tests, or at least on some of the sub-tests that make up the overall IQ test battery.

    IQ is a measure of so-called 'general intelligence'. While some scatter is common in most persons on the sub-tests of the IQ test battery, sub-test scores do tend to cluster in certain ranges for a given individual producing, when averaged, an overall 'general' intelligence score, or IQ. That IQ score does tend to be correlated with a general level of overall intellectual functioning. But the very wide scatter of abilities seen in some savants on the IQ sub-scores, which is much more pronounced than in most persons, has raised the question of whether it would be more accurate to view all persons as a series of multiple intelligences, rather than having what has been designated general intelligence, or IQ. Indeed some investigators view savants as refuting the notion of 'general intelligence' and argue, instead, that each of us have multiple intelligences and testing & measurement of "IQ" in all persons should be revised to reflect that reality.

    Further, in viewing 'mental retardation' one needs to differentiate between 'actual' retardation (measured IQ below 70) and 'functional' retardation. The latter can occur in someone with seemingly normal or even superior intellectual capacity whose mental disability, from whatever etiology, causes them to function at a much lower level over all than one might expect from estimated or even measured IQ. It is not uncommon to see some autistic persons, for example, function at a superior level in some areas such as mathematics, verbal skills or memory, but be so severely disabled in other areas so as to 'function' at much lower level overall. The present IQ sub-tests, such as digit span, for example, are not sufficiently tailored to realistically assess certain areas of superior function in savants, and do need to be revised and tailored accordingly to be able to get a true measure of savant capabilities for comparative studies in the area of 'intelligence'.

    In summary, measured IQ levels in savant syndrome most often are below 70. However while savant syndrome can occur in persons where Mental Retardation is the basic CNS disorder, savant syndrome can also be seen in persons with IO's below 70 as a finding or symptom where the basic developmental disorder is instead Autism, Asperger's, Hyperlexia, PDD or Williams Syndrome, for example, or a number of other conditions following CNS injury or disease. While it is true that in most persons with savant syndrome measured IQ is below 70, savant syndrome includes a number of mental disorders in which IQ function, in scattered areas of functioning at least, can be normal or even superior. In short, savant syndrome is not synonymous with, nor limited to mental retardation, and in some persons with savant syndrome IQ can be in the normal, or even superior range.


    back to top


    What is "autism"? What is the relationship of savant syndrome to autism?

    The word 'autism' has lost its specificity. With respect to children the term 'autism' referred originally to a group of youngsters first described by Dr. Leo Kanner in 1943 to whom he attached the diagnosis of Early Infantile Autism. These were children who from a very early age showed "autistic" aloneness, mutism or language that failed to convey meaning to others, suspected deafness, a tendency to stare through but not at people, obsessive desire for sameness, use of the third person rather than personal pronouns, echolalia, literalness, fascination with spinning objects and rhythm, over-all serious-mindedness, phenomenal rote memory, and many repetitive and stereotypical behaviors, to name some of their characteristics and behaviors. They were children often described as being "in a world of their own".

    Over the years, however, the term "autism" has been expanded to include what now is generally referred to as Autistic Disorder. This official diagnostic category includes, but is not now limited to, Kanner's original Early Infantile Autism group. In a state-wide survey in Wisconsin only about 25% of children with Autistic Disorder actually had Early Infantile Autism. The remainder had many of the same signs and symptoms of Early Infantile Autism, but with an onset either later in childhood, at about age 2 or 3, after a period of normal growth and development, or else they presented a clinical picture of autistic symptoms mixed with signs of other organic brain dysfunction.

    Thus at the present time Autistic Disorder is a spectrum condition ranging in severity of disability from mild to profound. It is classified as a Developmental Disability, meaning it is in fact an organic or biological, not psychological, disorder that involves dysfunction of some portion of the central nervous system. In reality Autistic Disorder should probably more accurately be called "the Group of Autistic Disorders" because it appears those disorders stem from a variety of causes, and not from a single etiology. Also, those various disorders or sub-groups present with a variety of differing clinical symptoms and onsets, and have varying clinical courses and outcomes. No single cause has been identified for either Autistic Disorder, or the sub-group of Early Infantile Autism, but it appears that some cases are genetic or in-born, and others involve, perhaps, some environmental, nutritional, metabolic, or other causes. The search for those causes is underway, as is the search for specific treatments for specific sub-groups of this over-all spectrum condition of Autistic Disorder.

    Finally "autism" as a disorder needs to be separated from "autism" as a symptom. A number of CNS disorders such as Mental Retardation or other forms of CNS injury or disease, can have "autistic" symptoms or "autistic" behaviors as a part of the over-all clinical picture. But those autistic symptoms are not synonymous with, or the same as, Autistic Disorder as such.

    Within the broad classification of Autistic Disorder, as pointed out above, approximately one in ten such persons has savant syndrome at a splinter skill, talented or prodigious level, with splinter skills being by far the most common presentation. Most clinicians include Asperger's Disorder in the spectrum of Autistic Disorders, and in persons with Asperger's Disorder savant skills are likewise quite common, at least at that 10% level. Interestingly Dr. Hans Asperger, in Austria in 1944, when he first described the disorder that now bears his name, entirely unaware of Dr. Kanner's work in America, also applied the term "autistic" to his group of newly described patients, just as Dr. Kanner had applied that term to his group of youngsters only a year earlier in the United States. Asperger's Disorder is described in more detail here on this Web site.

    In summary, Autistic Disorder appears in fact to be a group of disorders, one sub-group of which is Early Infantile Autism as originally described by Dr. Kanner. Onset can be from birth, or symptoms can occur after a period of normal development. The etiology is organic, not psychologic, and the causes are apparently several, rather than a single one. Within Autistic Disorder as many as 10% of such individuals have savant syndrome. However savant syndrome can also occur in conditions other than Autistic Disorder, although not as frequently. Therefore not all autistic persons are savants, and not all savants are autistic.

    Update: The May 6, 2002 issue of TIME magazine has a special section entitled "The Secrets of Autism" providing in-depth articles on the apparent "explosion" in cases of Autism and Asperger's being reported by some observers, in the United States generally and in the Silicon Valley particularly, and provides as well some detailed recent research findings regarding the several proposed causes of those disorders. It is a very informative and comprehensive update. By way of perspective, with respect to the sudden "explosion" of Autism and Asperger's, however, this sentence is particularly important: "While many experts believe the increase is a by-product of a recent broadening of diagnostic criteria, others are convinced that the surge is at least in part real and of grave concern." That dispute between a real increase in cases, or an apparent increase because of broadened criteria and better case finding, continues. With respect to the many causes explored in the article, this sentence provides a crucial perspective: "In the end, it is not merely possible, but likely, that scientists will discover multiple routes—some rare, some common; some purely genetic, some not—that lead to similar end points."

    As pointed out in the FAQ answer above, Autistic Disorder is best described as a GROUP of disorders, rather than a single condition, where the final common symptom and behavioral pathways result in a shared symptom complex with multiple etiologies. It is unlikely that "Autistic Disorder" springs from a single cause, just as "Mental Retardation," as a disorder, for example, does not spring from one cause alone. Mental Retardation, while a condition different from Autistic Disorder, does provide another example of a circumstance in which shared traits and behaviors fuse into a final common symptom path, producing an overall symptom complex which stems from a variety of different causes (e.g. Down Syndrome; phenylketonuria(PKU); perinatal hypoxia; post-natal brain trauma etc.)


    back to top


    What causes savant syndrome?

    While a number of theories have been put forth to date, no single theory can explain all savants. Some of those theories have included eidetic imagery or the related but separate phenomenon generally called photographic memory; inherited skills; sensory deprivation and sensory isolation with overcompensation in isolated skills, compensation, ritualistic practice and reinforcement of very narrow skills to offset and compensate for lack of more general capacity or intelligence; and phenomenal memorizing ability. There are problems with each of those theories. For example formal testing shows the presence of eidetic imagery in some, but not all, savants. Two studies, one of 25 savants and another of 51 savants showed relatives with special skills or abilities in some, but not all cases; another study of 23 savants found only one family member with special skills. A number of studies, especially those looking at calendar calculating and prodigious musical ability, have demonstrated that savant abilities extend well beyond memorization alone as accounting for the special abilities, and have documented that literal, rote memory alone cannot provide a basis for the presence of extensive savant skills.

    One theory, which quite consistently provides an increasingly plausible explanation for savant abilities in many cases, is left brain injury with right brain compensation. While left hemisphere/right hemisphere separation in the brain is an over-simplification, the fact is that the two brain hemispheres do tend to have specialized functions. The skills most often seen in savants are those associated with the right hemisphere, and those most lacking are those associated with the left hemisphere. A number of cases studied thus far do document left hemisphere damage on CT and MRI scans, and those imaging studies are also correlated with corresponding left-sided deficits on detailed neuropsychological testing. Further, recent PET scan studies, in previously normal, non-disabled older persons where savant skills have emerged as a fronto-temporal dementia proceeds (see below), have shown defects in the left anterior temporal lobe. When those same PET scan studies were carried out on an 11 year old autistic, artistic savant, the same left anterior temporal lobe dysfunction was present. PET studies have also shown particular defects in left hemisphere function in autistic persons, with confirming left-sided findings on neuropsychological tests. Even before CT and PET imaging were available, pneumoencephalograms demonstrated left hemisphere abnormalities, particular in the left temporal lobe areas, in 15 of 17 autistic patients, four of whom had savant skills in music or mechanical interest areas.

    In addition to left brain injury and right brain compensation, in the savant, it is postulated that there is corresponding damage to the higher level cognitive or semantic memory circuitry, with enhanced compensatory function in the lower level, more primitive, habit or procedural memory circuitry. This results in reliance on the characteristic automatic memory — exceedingly deep but very, very narrow — habit memory seen in all savants. Such left brain damage/right brain compensation, coupled with semantic memory damage and procedural memory compensation, produces, then, the emergence of right brain skills coupled with automatic memory typically and characteristically seen in savant syndrome.


    back to top


    What is the 'treatment' for savant syndrome?

    Savant Syndrome is not a disorder or disease by itself. It is, instead, a condition in which extraordinary skills and prodigious memory are grafted onto, or superimposed upon, a more basic brain dysfunction that rises from a developmental disability, or some other form of central nervous system disease or disorder. Therefore the 'treatment' for savant syndrome is the same treatment as that directed toward the more basic central nervous system disorder, such as Autism or Asperger's disorder, for example. Or in the case of persons with some other form of CNS injury, for example, it would be those treatment and rehabilitation efforts as directed toward overcoming the residual symptoms from such injury.

    The special skills and abilities the savant demonstrates, however, can be used as a useful tool in the overall treatment and rehabilitation efforts directed toward overcoming or lessening the handicaps from the more basic developmental disorder, injury or disease. In many cases those extraordinary abilities can be used as a way of engaging the handicapped person in improved communication capacity, improved social interaction, and improved mastery of even daily living skills with movement, than, toward greater independence overall. In that manner the savant skills can serve as a 'conduit toward normalization' for the savant and there are many individual examples of that posted on this web site and recorded in numerous other case reports and individual stories.
     

    The 1988 fictional film Rain Man was loosely based on the savant Kim Peek, among others.[11]

    back to top


    How often does the savant lose his or her special skills?

    In my experience, not very often. Indeed, quite to the contrary, continued practice and use of the special skills generally leads to greater ability, more facility and increased expertise. For many years there was a debate, in trying to help the savant, whether to work toward "eliminating the defect" or "training the talent". As it turns out, "training the talent" can be a useful technique in making some progress toward "eliminating the defect". Fortunately, story after story and case after case have demonstrated that highlighting and using savant skills in treatment efforts does not come at the high price of a dreaded trade-off of the special skills for such progress overall. The case of Nadia, who lost her very advanced artistic skills when she began schooling and training directed toward better language and learning skills, was thought to represent, perhaps, that dreaded trade-off of extraordinary abilities in one sphere for gains and advancements in another. Overwhelmingly, however, that is not the experience with most savants. Indeed quite the opposite has been true-the special skills provide a unique conduit toward normalization that can enhance progress, and the savant skills are not lost in the process.


    back to top


    I have a son or daughter or other relative or acquaintance who has these special skills. What is the best approach to use in dealing with those?

    As elsewhere in medicine and psychiatry, the first step in treatment is to make a diagnosis. Savant syndrome is not a stand-alone condition as such, and the special skills of the savant can be seen in a number of similar, yet different, separate conditions as explained above. So the first step in helping the child who shows special savant skills, is to have a complete evaluation to determine what the basic disability or disorder is that underlies those special abilities.

    With children, such evaluations often begin with a family physician or pediatrician familiar to the family through the regular well-baby check-ups. Characteristic signs and symptoms of autism or other developmental disabilities may be the presenting signs and symptoms, or there may be developmental delays and neurologic difficulties. With autism, for example, deafness is often suspected. Typically those signs and symptoms result in a referral to a child psychiatrist, psychologist, or neuropsychologist in some private or public clinic or agency. Ordinarily, then, a multi-disciplinary evaluation results with input from language and speech therapists, and educational specialists as well, along to supplement whatever medical findings that might exist. In many cases certain blood and/or urine laboratory studies, including chromosome analysis, may be ordered. In some cases imaging studies such as CT or MRI brain scans may be indicated as well. Eventually a working diagnosis for the basic disability is made and specific treatments, that are such targeted toward specific disabilities, are begun. An overall treatment plan, including individualized speech and educational strategies, is then outlined and implemented. These strategies can be incorporated as a part of Individual Educational Plan (IEP) required by schools through special education programming.

    With an over-all treatment and educational plan directed toward the basic disability underway, taking into account strengths and abilities as well, the savant skills themselves can be used as tools or a conduit toward better engaging the child in increased language interchange and increased socialization, using recognition and praise of the special skills as reinforcing tools. To counteract excessive preoccupation, one can channel repetitive behaviors toward more purposeful activities. Parents are really very innovative in that regard, and they need to trust some of their own ideas and intuitions as to how to exactly accomplish that in each individual circumstance. So there is no uniform prescription in that regard. The best source of advice for dealing with problem behaviors, as well as channeling unique skills, in fact often comes from other parents who have found, by trial and error, such useful techniques. Thus local parent/support groups can be a rich resource of such ideas and inspiration for new families struggling with the particularly disabilities in their youngster, and they can also be a rich source of understanding, encouragement and support. Such groups exist in almost every community nowadays, and many similar information and support groups exist on the internet through Autism or Asperger's or Hyperlexia site and links, for example, as well as some sites directed toward even less common conditions such as Williams Syndrome or Rett's Disorder.

    For some youngsters, the less specific and somewhat confusing diagnosis of PDD-NOS (Pervasive Developmental Disorder Not Otherwise Specified) is used as a working diagnosis. A very valuable web site to understand PDD better, and to help identify specific resources or practitioners in particular communities that might be of help, is the site maintained by the Yale Child Study Center Developmental Disabilities Clinic at
    http://www.med.yale.edu/chldstdy/autism/index.html.

    Whatever diagnosis eventually is applied to the basic disability, it is important to remember that just as there is considerable overlap in symptoms with the various disabilities and diagnostic groups, so there is a great deal of overlap in treatment and education approaches as well. A specific diagnosis of the basic disability, while helpful is some respects, risks sometimes over-categorizing, over-classifying and stereotyping individual persons. Whatever the diagnosis, with respect to treatment, one uses whatever works. With respect to savant skills themselves, as mentioned above, those special talents and skills, rather than being interfering or limiting, if properly channeled, can serve as a conduit toward normalization and greater growth and independence. In real life with the savant, that is done in a highly individualized manner with each person using whatever ideas and intuitions spring from daily contact with that person by parents, teachers, therapists or others. Parents, I find, are extraordinarily inventive in that regard, and parents 'who have been there' can often provide some very useful hints, tips and pearls to other parents just beginning complicated treatment and therapy odyssey.

    At the present time some savants are in full-inclusion school classrooms while other are in special education classrooms (DD or ED). Still others, in some areas of the country, are side by side with the non-disabled children in the 'normal' gifted and talented classrooms. In each of those settings a mentoring program has been helpful for the special abilities, and disabilities, of each particular person with savant skills.


    back to top


    Might there be a little Rain Man in each of us?

    The idea that some savant capabilities — a little Rain Man — might reside in each of us rises from several observations. First, there have been instances reported of previously non-disabled, "normal" persons in whom some previously latent savant skills emerged following a head injury, a phenomenon called "acquired" savant syndrome. Second, Dr. Bruce Miller's work, as described in detail elsewhere on this site, documents 12 cases of elderly persons, previously non-disabled, with no extraordinary savant skills, whose savant abilities newly emerged, sometimes at a prodigious level, after a particular type of dementia-fronto-temporal dementia-began and progressed. Thirdly, some procedures such as hypnosis or sodium amytal interviews in non-disabled persons, and brain surface electrode exploration during certain types of neurosurgical procedures, provide evidence that a huge reservoir of memories lies dormant, and non-accessed, in each of us. Fourth, the images and memories that surface, often to our surprise, during some dreams , also tap that huge store of buried memories beyond that available in our everyday waking state. Finally, often as we relax or 'tune out' other distractions, sometime after 'retirement' for example, some previously hidden, latent interests, talents or abilities quite suddenly, and surprisingly, emerge. Sometimes that emergence is actually a re-kindling of some earlier childhood abilities, such as art, for whatever reason set aside with maturation and 'growing up'.

    There are several theories as to why that might be the case. My own view, described in much greater detail here on this site under this same question, is that while each of us still has the same lower level memory circuitry the savant uses (non-cognitive, habit or procedural memory) we have come generally to rely on our higher level, broader and more versatile cognitive or semantic memory circuits because that particular memory function serves us well, and better. Correspondingly, while each of us have as well many right brain capabilities (non-symbolic, artistic, concrete, directly perceived) we live in a world that rewards left brain strengths (sequential, logical, and symbolic including language specialization). Thus we have generally come to rely on the well-worn circuits of left brain function + semantic memory, to the exclusion or relative disuse of right brain function + habit memory. But when those well worn circuits are disturbed by head injury or CNS disease, for example, the more primitive, lower level circuits of right brain/habit memory do come to the fore. Some refer to that in brain injury and disease as a compensatory phenomenon called "paradoxical facilitation". But is actual brain injury or disease necessary in order to tap some of that buried potential, or might there be other methods short of injury or disease itself to bring us in touch with more buried skills and memory function? Could specific cognitive techniques or other procedures facilitate such a process in all of us? Some investigators are using large magnetic circuits (rTMS) to temporarily disable brain function in certain areas in non-disabled persons to see if these more primitive, buried circuits can emerge in 'normal' persons. That work is described as well in much more detail elsewhere on this Web site.

    The search for hidden potential that lies, perhaps, within each of us is an intriguing area of research and savant research may provide some clues to that interesting possibility, as well as providing some useful insights to the interface between savant functioning and genius overall.

    back to top


    These are some of the frequently asked questions about savant syndrome. If you have other questions as well, please contact:
    Darold A. Treffert, MD
    St. Agnes Hospital, Fond du Lac, Wisconsin
    Clinical Professor, Department of Psychiatry
    University of Wisconsin Medical School, Madison

© Wisconsin Medical Society | All rights reserved | 2011