The Arts in Psychotherapy, Vol. 17 pp. 177-178. 0 Pergamon Press plc, 1990. Printed in the U.S.A. 0197.4556/90 $3.00 + .OO

BOOK REVIEW

Extraordinary People

Darold A. Treffert

(New York: Harper & Row, 1989, 291~~. $17.45)

This is an extraordinary book that very success- fully brings together most of the known case histories and research related to the Savant Syndrome. Treffert defines the Savant Syndrome as “an exceedingly rare condition in which persons with serious mental hand- icaps, either from developmental disability (mental retardation) or major mental illness (Early Infantile Autism or schizophrenia), have spectacular islands of ability or brilliance which stand in stark, markedly incongruous contrast to the handicap” (p.XXV). He makes further distinctions between those savants whose skills would be remarkable simply in contrast to the handicap (talented savants or savant I), and “others with a much rarer form of the condition in which the brilliance is not only spectacular in contrast to the handicap, but would be spectacular even if viewed in a normal person (prodigious savants or savant II)” (p.XXV).

The original term idiot savant was created by Dr. Langdon Down in 19th century England, the same Down who is now best remembered for his descrip- tion of the form of mental retardation named after him-Down’s Syndrome. Because the term idiot now has a negative connotation not existent at that time, Treffert has suggested the more positive descriptive term Savant Syndrome.

Because so many savants have been musical sa- vants, this book should be of special interest to the music therapist. In fact, as the author points out, musical skill is the most frequently occurring skill that is encountered in this unusual condition. Savants in art are rare, whereas those with special counting and math abilities are more frequent. Savant Syndrome occurs in males more frequently than females in a

ratio of 6:1, and the typical IQ is in the range of 40-70.

Prodigious savants (musical or other) are very rare with “less than 100 cases reported in all world literature on the topic during the past 100 years” (p.XXVI). There seems to be a special correlation between the conditions of blindness, mental retarda- tion, and exceptional musical ability. When blindness exists it is typically caused by retrolental fibroplasia, a form of blindness caused by excess oxygen admin- istered to prematurely born children.

The remarkable musical skills found in prodigious musical savants are typically characterized by “insis- tence on sameness, perfect pitch and prodigious memory with ability to repeat exactly, mistakes and all, pieces of extraordinary length and complexity” (p.34), performance that is “mechanical, stereotyped and devoid of emotion or passion” (p.32), and “the musical skill is almost always with the piano” (p.34). Musical creativity “is most often limited to improvi- sation and producing variations on a theme rather than producing new themes and new pieces” (p.34). However, in one study, Hermelin, O’Connor and Lee (1986), ’ five musical savant children were superior to a control group of normal musically talented children in such creativity variables as “the ability to continue appropriately a theretofore unknown tune when it was begun and then stopped” or “the ability to improvise over a twelve-bar blues sequence played to the subject” (p.31).

Treffert presents many fascinating case histories of prodigious musical savants past and present. Thomas Greene Bethune (Blind Tom) was born as a slave in Georgia in 1850. “Incapable of learning in areas

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other than music” (p. 17), he early displayed remark- able abilities for imitative performance at the piano. His master, Colonel Bethune, began Tom on the concert circuit at the age of seven; he earned over $100,000 in his first year of performing. With a spoken vocabulary of less than 100 words, he had a piano performance repertoire of over 5000 pieces. He performed in the White House for President Buchanan at the age of 11, and continued to give concerts until the age of 53 coinciding with the death of Colonel Bethune.

A contemporary prodigious musical savant who receives a great deal of attention in this book is Leslie Len&e, whom the author cites as “the most remark- able savant I have ever met, or read about or studied” (p.104). Leslie is blind, severely mentally handi- capped, and has cerebral palsy. He has never had any formal musical training, yet “upon hearing Tchaikowsky ‘s Piano Concerto No. 1 on the piano for the first time in his ten years, he played it back flawlessly and without hesitation. He can do the same with any other piece of music, no matter how long or complex. Yet he can not hold a utensil to eat and merely repeats in monotone fashion that which is spoken to him” (p.XI). Leslie has appeared on several nationally broadcast television programs, such as “Sixty Min- utes,” and has given concerts internationally. Many other remarkable muscial savants and their abilities are described in detail.

In attempting to understand the musical savant phenomenon, Treffert looks at a variety of contribu- tory factors. In examining the association between blindness caused by retrolental fibroplasia, retarda- tion, and musical brillance, it is suggested that the excess oxygen that leads to retinal damage and retrolental fibroplasia may also have caused brain damage. A “pathology of superiority may be created wherein compensatory growth occurs in some por- tions of the brain (right brain) as a result of poorer development of or actual pre-natal injury to other brain areas (left brain)” (p. 196). Most savant skills, in fact, appear to be associated with abilities (like music) that are right hemisphere functions-with the typical savant displaying (simultaneously) intact right brain function and left brain damage. Other factors that may play into the development of the musical savant syndrome include phenomenal memory, the effects of sensory deprivation, and/or social isolation and social reinforcement.

Memory is often of the eidetic type, a form of photographic memory in which the exact image can be retained in the mind well after seeing an object. Sensory deprivation and isolation may lead to an intense preoccupation with trivial or bizarre endeav-

ors, such as memorizing obscure facts, counting, and mental arithmetic. It has been postulated that the savant’s remarkable memory may be, in fact, an inability to forget, rather than an enhanced ability to retain. Lack of attention to external stimulation (many savants also show autistic tendencies) combined with a one-sided preoccupation with a single endeavor can lead to remarkable results. Finally, the social rein- forcement that prodigious performance can bring to an individual also contributes to the development of these propensities.

Again, savants do occur in other than musical areas, and particularly in areas related to math and counting. As memory, math, and music abilities are so closely related in the savant condition, Treffert suggests that they must also be closely linked in the brain itself. He postulates that music performance may be a form of “unconscious counting” (p.35), which would partially explain how a musical savant can perform without any conscious understanding of musical principles.

Treffert advocates the support and development of the savant’s skills, and most of the savants described seem to have enjoyed their special abilities, were frustrated when deprived of an outlet for their talents, and in general seemed to be relatively content and well adjusted people. In short, their musical and other talents seemed to serve a therapeutic function for them, providing outlets and recognition that enriched their lives.

Finally, as Treffert suggests, “We can learn a great deal about human potential from the jarring contradiction, the magnificent coexistence of defi- ciency and superiority, that is Savant Syndrome” (p.270).

For the music therapist, the musical savant raises many pertinent questions pertaining to the nature of musical abilities, cerebral functioning, and the mean- ing of music in the human experience. For all therapists in the creative arts a greater understanding of Savant Syndrome is significant through providing insights into the deepest meaning of artistic expres- sion and the creative and expressive potential of every human being.

Joseph Moreno, RMT Director of Music Therapy

Maryville College-Saint Louis St. Louis, MO 63141

Notes

‘Hermelin, B., O’Connor, N., & Lee, S. (1987). Musical inven- tiveness of five ildiot savants. Psychological Medicine, 17, 685- 694.