Mr. Yasser Hashmi
M. Omer Sheikh: 2003-02-0129 Wednesday 4 th July, 2001
Autistic Savant Syndrome
Autism is a little-understood biological disorder of the brain which begins in infancy. Autistic individuals are severely impaired in their understanding of the world around them. We never doubt the gifts that go with able brains but we are far less willing to credit disabled brains with the power to astound us with extraordinary talents of sometimes phenomenal dimensions which the unimpaired brains cannot easily match. This is the phenomenon of the Autistic Savant, genius of a different kind. People who have seen the movie Rain Man (1988) or more recently Mercury Rising (1998) will agree.
The startling concurrence 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.
The term "idiot savant" has largely been discarded now, because of its colloquial, pejorative connotation and has been replaced by Savant Syndrome. In reality 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". In a 1978 article in Psychology Today, Dr. Bernard Rimland introduced a more appropriate term 'Autistic Savant,' which is the current label.
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.
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 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. Savant prevalence in the non-autistic population, including those with mental retardation, is less than 1%.
Whatever special skills the autistic patients might have, they are always linked with phenomenal memory which is very specialized. Therefore the combination of Autistic Disorder + extraordinary special abilities + remarkable memory is the "autistic savant".
There is a wide gamut 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 over-all 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 fewer than 100 reported cases of prodigious savants in the world literature.
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. Secondly, Down noted that these spectacular special abilities are always linked to an extraordinary memory of a unique type - very narrow but exceedingly deep - often with little understanding or comprehension of that which is so massively stored. He called this characteristic "verbal adhesion" and others have called it "memory without reckoning". Thirdly, 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.
In most autistic savants a single special skill exists; in others multiple skills occur. The skills tend to be right hemisphere in type - non-symbolic, concrete, and directly perceived in contrast to left hemisphere type that tend to be more sequential, logical and symbolic including language specialization. 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 regularly re-occurring triad of musical genius, blindness and autism is particularly striking in the world literature on this topic.
A distinct subgroup of autistic children are labeled Hyperlexic because of their developmentally advanced early reading abilities. Children with the syndrome of Hyperlexia often read without instruction as early as age two, sometimes before they learn to talk (Kupperman, Bligh, & Barouski, 1991), but have deficits in comprehension and social skills. Literature also reports instances of exceptional spelling ability. In one case, a girl could type multiple pages of complex dictated text error-free. Another autistic but brilliant child could write rapidly and beautifully in several languages including such diverse scripts as Japanese, Russian, and Hebrew (Rimland & Fein, 1988). Of other savant abilities probably associated with vision is the unusual sense of location, a sometimes extraordinary ability to construct exact mental maps of places often seen and visited only once. Although coordination is a problem for a considerable number of children with autism (Blake, 1988), there are some persons with autism whose coordination and balance are exceptional. Rimland and Fein (1988) tell of a baby who could balance on the rails of his crib. These same authors report that sensory sensitivity can also be extreme in persons with autism. Excessive auditory sensitivity can result in the child learning to block out sound and sometimes result in the misdiagnosis of deafness. In some cases crossmodal sensitivity, such as the ability to identify color by touch, has been reported (Rimland & Fein, 1988; Rimland, 1989).
Although the gifts and talents associated with children who are autistic are fascinating, these individuals are not necessarily capable of natural application of those skills for practical purposes. The early prodigies in reading (Hyperlexics) often have difficulty comprehending what they read. Savants may tend to interpret speech literally and miss unspoken messages. These difficulties with linguistic and paralinguistic interpretation often lead to problems in establishing friendships.
George, the calendar calculator, can tell you all the years in which your birthday fell on a Thursday. He can also tell which years in the next 100 Easter will fall on March 23. His calendar calculating abilities span 40,000 years backward or forward. He also remembers the weather for every day of his adult life.
The reason why some autistic individuals have savant abilities is not known. There are many theories, but there is no evidence to support any of them. One of the world's prominent authorities on the savant, Dr Darrold Treffert, said in 1989: "The significance of the savant syndrome lies in our inability to explain it. The savants stand as a clear reminder of our ignorance about ourselves, especially how our brains function."
Theories to explain Savant Syndrome include eidetic imagery, inherited skills, concrete thinking and inability to think abstractly, compensation & reinforcement, and left brain injury with right brain compensation. Newer findings on cerebral lateralization, and some imaging and other studies that do show left hemisphere damage in savants, suggest that the most plausible explanation for Savant Syndrome to be left brain damage from pre-natal, peri-natal or post-natal CNS damage with migratory, right brain compensation, coupled with corresponding damage to higher level, cognitive memory circuitry with compensatory take over of lower level, habit memory. The condition can also be congenital or acquired in an otherwise normal individual following CNS injury or disease.
One of the pre-natal CNS injury mechanisms, which has implications not only for Savant Syndrome but other disorders as well in which male sex in over-represented, is the neurotoxic effect of circulating testosterone on the left hemisphere in the male fetus. Since the left brain completes its development later than the right brain, it is at risk for CNS damage for a longer period of time to circulating-testosterone (which can be neurotoxic).
Gifted children with autism are most often identified by the particularly unusual nature of their talents. Researchers Donnelly and Altman (1992) have suggested that the social and communication deficits characteristic of autistic children may be the cause of the maladaptive manifestations in their cognitive and/or esthetic capabilities which lead to the eccentric skill are associated with the savant syndrome. In other words, the failure to comprehend the broader range of normal and functional life skills creates a limited but intensive focus that produces the remarkable area(s) of talent in savants. Dr. Rimland speculates that these individuals have incredible concentration abilities and can focus their complete attention to a specific area of interest. Recently it is become apparent that the giant intellectual leaps of the savant, while still retaining their sense of mystery for science, are now seen to originate in the right hemisphere of the brain.
Gardner (1987) uses the savant skills of individuals with autism to illustrate the exceptional capacities of the brain. However, studies show that these individuals lose their extreme savant skills as they become more habilitated (Rimland & Fein, 1988). Grandin (1992) suggests that savants lose their unusual talents as they become less fixated on their specialized interests. While the autistic savants are then less able to do "tricks", their intelligence is freed for a wider variety of tasks. A child named Nadia drew beautiful pictures of horses, and her drawings have been compared to those of Rembrandt. Interestingly, she lost her drawing abilities when she started to learn to speak.
Etiologic considerations aside, what is the best approach to the savant, and his or her special skills? Phillips framed the controversy in 1930 when he stated: "The problem of treatment comes next. The question that arises is one of method, whether is it better to eliminate the defects or train the talent". While questions of etiology remain, the results, especially in recent years, answer Phillip's question. It states that the talent should be trained and with it some of the 'defect' subsides. The special talent, in fact, becomes a means to normalization, using the unique savant skills to help toward more socialization, language acquisition and independence without any tradeoff or loss of special abilities for those valuable gains in other areas, the case of Nadia notwithstanding.
Interests of the savant are best served by a balanced educational approach that includes social skills, training, counseling and opportunities for interactions with others, together with encouraging savant skills but not letting them dominate the individual's life. The goal of dealing with the special skills in the savant is not to eradicate them, however monotonous, impractical and frivolous they might sometimes seem. The goal is rather to put them to good use, creatively and patiently, without the fear that they will either take over the savant's life or disappear from it. The skills instead can remain as modes of expression through which others can reach and relate to the savant as was in the case of Kim Peek, who was one of the persons on whom the savant in the movie Rain Man was modeled.
The challenge for the educator of gifted and talented students is to recognize the gifted among the autistic population, to identify their idiosyncratic skills, and to channel these into productive areas, promoting social integration.
Until we can understand and explain the Savant, we cannot fully understand and explain ourselves. No model of brain function, including memory, will be complete until it can fully incorporate and account for this paradoxical condition and its remarkable manifestations. Is the savant a "landmark to our ignorance" about how the brain works, or have we made some progress in better understanding this marvelous mystery?
Admittedly, researchers in psychology feel that they will never truly understand memory and cognition until they understand the Autistic Savant.
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