Savant syndrome is estimated to affect around one in a million people. The condition affects more males than females, at a ratio of 6:1. The first medical account of the condition was in 1783. Among those with autism, 1 in 10 to 1 in 200 have savant syndrome to some degree. It is estimated that there are fewer than a hundred prodigious savants, with skills so extraordinary that they would be considered spectacular even for a non-impaired person, currently living.
While Down is best known for having described Down's syndrome (trisomy 21) and savant syndrome in his 1887 lecture, he made an additional very astute observation about what he called ‘developmental retardation’. Today, that condition is known as autistic disorder. Reflecting on his 30 years of experience, he divided mental retardation into ‘congenital’ and ‘accidental’ categories. However, he mentioned, there was a third kind of mental retardation that occurred in children who did not have the usual ‘physical aspects’ of retardation. Some of these children had developed normally and then suddenly regressed and ‘lost wonted brightness’ and ‘lost speech’. There was the suspension of ‘normal intellectual growth’. These children lived ‘in a world of their own’, spoke ‘in the third person’, had ‘rhythmical and automatic movements’ and ‘lessened responsiveness to all endearments of friends’. As many as one in 10 persons with autistic disorder have such remarkable abilities in varying degrees, although savant syndrome occurs in other developmental disabilities or in other types of central nervous system injury or disease as well. Whatever the particular savant skill, it is always linked to massive memory.
For better understanding we have an example/condition:
Without doubt, the best-known autistic savant is a fictional one, Raymond Babbitt, as portrayed by Dustin Hoffman in the 1988 movie Rain man. However, the original inspiration for the savant portrayed in Rain man was a now 57-year-old male who has memorized over 6000 books and has encyclopedic knowledge of geography, music, literature, history, sports and nine other areas of expertise (Peek & Hanson 2008). He can name all the US area codes and major city zip codes. He has also memorized the maps in the front of telephone books and can tell you precisely how to get from one US city to another, and then how to get around in that city street by street. He also has calendar-calculating abilities and, more recently, rather advanced musical talent has surfaced. Of unique interest is his ability to read extremely rapidly, simultaneously scanning one page with the left eye and the other page with the right eye. Magnetic resonance imaging (MRI) shows the absence of the corpus callosum along with other substantial central nervous system (CNS) damage.
Savant syndrome can be congenital or acquired, and it is not a stand-alone condition. Rather, the special savant skills are always grafted on to some underlying disability that can include, but is not limited to, autism spectrum disorder.
Congenital savant syndrome means savant skills present from birth or emerging in early childhood with conditions such as early onset and late onset autism spectrum disorder, other developmental disorders, intellectual disability, Williams syndrome, agenesis of the corpus callosum, tuberous sclerosis, hypopituitarism, or other brain disorders as the underlying disability.
Acquired savant syndrome refers to savant abilities that emerge, sometimes at a prodigious level, in a previously neurotypical child or adult following head injury, stroke, dementia or other central nervous system (CNS) incident. Recent reports of savant-type abilities emerging in previously healthy elderly persons with fronto-temporal dementia have been particularly intriguing. The prospect of dormant potential triggered, or released, by CNS injury existing within each person has far-reaching implications.
Savants are classified into three categories based on the spectrum of their abilities.
•Splinter savants are individuals with some skills and interest in a specific area, that stand out in contrast to their overall level of functioning. For example, they may be obsessively preoccupied with memorizing maps, historical facts, and sports trivia.
•Talented savants are those with impressive skills that stand out among individuals with similar level of functioning. Talented savants show musical, artistic, or mathematical skills that seem very conspicuous compared to their overall disability.
•Prodigious savants are individuals that display extraordinary skills not only in contrast to their general level of functioning, but that are also remarkable compared to the general population.
Savant skills do not fade or disappear; rather a pattern of replication to improvisation to creation is often seen. Example, the case of Nadia, who lost her special art skills when exposed to traditional schooling, raised the prospect of a ‘dreaded trade-off’ of savant skills for acquisition of better language, communication and daily living skills (Selfe 1978). But experience has shown that such loss of special skills is the exception rather than the rule in savant syndrome. Instead, with continued use, the special abilities either persist at the same level or actually increase. There is a pattern of progression of savant abilities in a number of prodigious savants particularly that ends in the capacity to be creative.
Since Down's first description of savant syndrome, numerous theories have been put forth to explain this astonishing juxtaposition of ability and disability in the same person. One mechanism in some savants, whether congenital or acquired, is left brain dysfunction with right brain compensation, a form of ‘paradoxical functional facilitation’ as described by Kapur (1996). Brink (1980) raised that possibility with a case in which left brain injury in a child gave rise to some mechanical and other savant skills. Miller's recent work with persons with fronto-temporal dementia (FTD) in whom savant skills surfaced, sometimes at a prodigious level, adds impetus to that speculation. Those studies led him to conclude that ‘loss of function in the left anterior lobe may lead to facilitation of artistic or musical skills’. Hou et al. (2000) stated it this way: ‘The anatomic substrate for the savant syndrome may involve loss of function in the left temporal lobe with enhanced function of the posterior neocortex’.
How Is Savant Syndrome Diagnosed and Treated?When a child has an extensive ability in one or more areas when compared to other children of the same age or IQ level, it can be diagnosed as savant syndrome.
Savant syndrome is not a disease or disorder to get treated, and it is just a condition where the child has extraordinary skills and memory in addition to a basic dysfunction of the brain. This dysfunction might be due to a developmental disability or a disorder associated with the central nervous system.
Aetiologic 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…is it better to eliminate the defects or train the talent?’ Experience has provided a clear answer—‘train the talent’! And as one does so, some of the ‘defect’ subsides. The special talent, in fact, becomes a conduit towards normalization, using the unique savant skills to achieve better socialization, language acquisition and independence, all without the trade-off or loss of special abilities for those valuable gains in other areas of functioning.
The special skills can be used as a way of engaging attention of the savant, and rather than seeing the special abilities as frivolous, they can be used as a form of expression with the goal of channelling those abilities more usefully.
Savant syndrome is not a disorder. Instead, it is a condition in which the savants have extensive abilities in one or more areas when compared to normal people of the same age or IQ level. It is rare but considered an extraordinary condition as people with serious mental disabilities has some “islands of genius,” which stands remarkable.
