Savant Syndrome: An Extraordinary Condition by Darold A. Treffert, MD

Darold A. Treffert, MD, Clinical Professor, University of Wisconsin Medical School-Madison, Behavioral Health Department, St. Agnes Hospital, 430 E Division St, Fond du Lac, WI 54935; phone 920.921.9381; www.daroldtreffert.com; www.savantsyndrome.com; e-mail [email protected]. Abstract Savant syndrome is a rare but extraordinary condition in which persons with serious mental disabilities, including autistic disorder, have some “island of genius” that stands in marked, incongruous contrast to overall handicap. In fact, as many as one in 10 autistic persons has such remarkable abilities in varying degrees, although savant syndrome occurs in other developmental disabilities or CNS injury or disease as well. While J. Landon Down included 10 such cases in his original description of this interesting circumstance in 1887, and Kanner included some such cases in his first accounts of early infantile autism in 1943, it was the 1989 movie Rain Man that made “autistic savant” a household term. While there is as yet no over-arching theory to explain all instances of savant syndrome, more progress has been made in better understanding this condition in the past 15 years than in the prior 100. This article summarizes past and present world literature on this topic, describes more recent cases, reviews current research findings, provides intervention strategies to channel such skills, and outlines future directions of inquiry to better explain this extraordinary condition. Recent case reports increasingly implicate left hemisphere dysfunction with right hemisphere compensatory processes as an important causal component in many cases of savant syndrome, including those occurring in persons with autistic disorder. Especially intriguing are reports of newly emerging art, music and other savant-like skills in previously nondisabled persons following CNS injury or disease. These cases of “acquired” savant syndrome raise the possibility of hidden potential, perhaps, within us all, and add to findings that implicate left hemisphere dysfunction as a causal factor in savant syndrome overall. Savant skills in autistic persons, rather than being irrelevant and frivolous, can in fact, by “training the talent,” serve as a “conduit toward normalization,” with an increase in language, social, and daily living skills, providing more independence for the savant overall. Examples of such useful intervention and channeling are provided. New imaging techniques and other novel research approaches, described herein, provide additional tools to better explore the unique window into the brain that this remarkable condition provides with its vast implications for not only better understanding savant syndrome, but perhaps shedding light as well on the hidden within us all. No model of brain function, including memory, will be complete until it can fully incorporate and explain this jarring juxtaposition of severe mental handicap and prodigious mental ability. The journey toward such an explanation is underway.