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Getting to Know Savant Syndrome: Part VII

autismHow 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.

I have a son or daughter or other relative or acquaintance that 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 overall 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 others 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.

About Darold Treffert MD

Dr. Treffert completed both medical school and a psychiatric residency at the University of Wisconsin where he has been a Clinical Professor of Psychiatry. Following his training he developed the Child-Adolescent Unit at Winnebago Mental Health Institute. It was there he met his first autistic savant in 1962 and has been engaged in research on savant syndrome since that time, exploring the unique window into the brain, memory and creativity that this remarkable condition provides. Dr. Treffert has published two books on savant syndrome. Extraordinary People: Understanding Savant Syndrome has been published in ten languages. His most recent book Islands of Genius: The Bountiful Mind of the Autistic, Acquired and Sudden Savant was published in April, 2010. He has been a contributor to numerous articles in professional journals and has participated in many broadcast and documentary television programs including those in the U.S., Japan, Sweden, Korea, South Africa, Germany, England and many other countries. In his efforts to raise public understanding about autism and savant syndrome he has regularly appeared on programs such as 60 Minutes, Oprah, Today, CBS Evening News and many others. Dr. Treffert was a consultant to the award-winning movie Rain Man which made “autistic savant” household terms and he maintains a very internationally respected website at www.savantsyndrome.com hosted by the Wisconsin Medical Society which has kept him in touch with many persons around the world with savant syndrome and their families. Dr. Treffert has been a member of the medical staff of St. Agnes Hospital since 1963. He currently is a research consultant to Doll and Associates and the AABCC program working with Dr. Matt Doll and staff on some autism research projects.

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