Conversations on Creativity with Darold Treffert, Part III:

Darold Treffert, M.D. is considered one of the foremost experts on savantism in the world. Dr. Treffert has published two books on savant syndrome: "Extraordinary People: Understanding Savant Syndrome" in 2006 and "Islands of Genius: The Bountiful Mind of the Autistic, Acquired and Sudden Savant" in 2010. He has been a contributor to numerous articles in professional journals and has participated in many broadcast and documentary television programs around the world. 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 technical consultant to the award-winning movie Rain Man that made "autistic savant" household terms and he maintains a very popular website at www.savantsyndrome.com hosted by the Wisconsin Medical Society.

Dr. Treffert was gracious enough to have a wide-ranging conversation with me. Over the course of a few days, we had a delightful time chatting about autism, savantism, genius, nature, nurture, intelligence, creativity, lessons learned, recent advances, and the future. This was one of the most satisfying and elucidating conversations I have ever had. I learned many things and it is my pleasure to share our in depth conversation with all of you. In my view, this interview demonstrates quite clearly the need for more compassion and research on all different kinds of minds and ways of achieving greatness.

In this third part, we discuss the mind of the savant.

SCOTT: How frequent is savant syndrome in the general population?

DAROLD: We know that about 1 out of 10 persons with autistic disorder has some savant characteristics, either at the splinter skill, the talented or prodigious level (See Part I, Defining Autism, Savantism, and Genius).

In the people who have other kinds of disabilities, such as, mental retardation, or Tourette's, or organic brain syndrome or dementia, the frequency is about 1 in 1400. So the best estimates one could have in terms of how many savants is about 1 out of 10 persons with autism and about 1 out of 1400 with other developmental disabilities.

I don't know what the arithmetic is in terms of how many autistic people there are in the world, or in the United States, but you take about 10% of that, and then for the other disabilities, it would be about 1 in 1400. The point is that savant syndrome is much more common in autism than it is in other kinds of central nervous system disabilities.

For a recent review, see "The Savant Syndrome: An Extraordinary Condition".

SCOTT: Why do you think the majority of savants are autistic? Why do you think there's a connection there?

DAROLD: Well, that's a good question, and an important question, and a question which really warrants further investigation. I think the reason is that savant syndrome, characteristically, consists of left hemisphere dysfunction coupled with right hemisphere emergence, and what you see in the savant are basically right brain skills.

Now I realize, and I acknowledge, that the right brain/left brain distinction is a tremendous oversimplification. We don't come neatly divided into right and left hemispheres, but the fact is that the two hemispheres of the brain do specialize in certain functions. The dominant hemisphere, generally the left hemisphere, does specialize in language, logical sequential thinking, and the right hemisphere is much more vivid, much more direct, much more concrete and associated with the kinds of skills that the savant shows which are music, art, and calendar calculating and the five typical skills of the savant.

It turns out that increasingly it's being demonstrated that in autism there is left hemisphere dysfunction. There are a number of studies that go way back to the days of the Pneumoencephalogram that show left hemisphere dysfunction in autism itself. And so it doesn't come as a surprise to me that if you have a condition which already shows left hemisphere dysfunction, that you would see more savant syndrome because, in my experience, the left hemisphere dysfunction is part of savant syndrome.

Up until this time, our ways of measuring left hemisphere/right hemisphere dysfunction have been rudimentary so I think over time we'll see if autism is more related to left hemisphere. One thing that points in that direction is that autism is four times more common in males than females. The same is true in savant syndrome, and there are reasons for that, which I think may bear on, not only in autism, but also in savant syndrome.

SCOTT: Does right brain dysfunction always accompany left brain dysfunction in savants? Have you seen any cases at all where that isn't the case?

DAROLD: That's a good question, and that's one that I think I'm anxious to find more about. Some of the early cases that I dealt with, Leslie Lemke being one example, if you look at his CT scan, there's no question about massive left hemisphere damage. And some other cases that I worked with early on, convinced me of that. But all we had in those days was structural imaging, that is, CT scan and MRI, and not all of those cases of structural imaging would show left brain damage. So savant syndrome and autism, I think, are not disorders of brain structure, but they're disorders of brain function.

And now that we have some ability to look at brain function instead of just the structure, I think we'll find out a great deal more about autism and about savant syndrome. And I'll be interested to see whether my observations about left brain/right brain, which were largely predicated on some of those early cases, as well as some new ones, holds true.

My guess is that there may be instances, and Asperger's may be one example, where one is actually seeing right-brain dysfunction with left-brain abilities because many people with Asperger's are really very facile with language. And some conditions, like Williams syndrome, particularly, where these people are known as little professors because of their ability to use, if not totally, to understand language. And so I'm open to see what we discover.

My guess is that autism, if you look at autism spectrum disorder, is probably not as left-brain oriented as I have believed it to be. But I haven't seen any evidence to the contrary, and I think with the imaging that we can do now, we'll find two things: one is that we'll find instances where there is right brain dysfunction, as opposed to left brain dysfunction, and we will find that the pathways, and the connectivity, is going to be much more than left brain/right brain; it's going to be unusual connectivities that transcend just right brain/left brain that we're talking about in cerebellum involvement.

As we now have functional imaging, and we now have fiber tracking, in which you can actually see the connections as they exist, rather than implying that they are there from functional imaging, I think we'll find that there may be some disorders. We know, for example, that there is a condition called nonverbal learning disorder, and that is clearly a right brain dysfunction, as opposed to left brain, so at least clinically we see that condition, and it may well be that it's going to be more than left brain/right brain. It's going to be other more complex connectivities or lack of connectivities that will provide insight into autism, and to savant syndrome itself.

SCOTT: Yeah, I think that's very sensible, and hopefully will provide insight into how ordinary folk can, through experience, rewire their brain in unusual ways.

DAROLD: Right.

SCOTT: What ways are autistic savants locked into a particular mode of thought?

DAROLD: As a group they tend to think quite concretely as opposed to abstractly. They tend to be focused in their thinking, rather than versatile in their thinking, and have a certain obsessiveness, or rigidity, about their thinking and thought, which they sometimes find it hard to deviate. Although, as I said earlier, this shows up in some savants as the original replication and then they begin to improvise and finally are able to actually create something new. But there's an obsessive rigidity, a single-focus kind of element to their thinking which tends to be concrete.

Many of them do think in pictures, like Temple Grandin describes, but others, like this gentleman I met with yesterday, describes that he thinks almost entirely in pictures and as a form of concrete thinking. The concrete, obsessive, narrowly focused-- that sort of obsessive force behind the thinking is what one sees characteristically.

SCOTT: As you know, Daniel Tammet is quite unique in that he can switch between both concrete and abstract modes of thought. Do you have any ideas, maybe neurologically, what is enabling him to do that, whereas others savants don't have that ability?

DAROLD: Yeah, he is able to do that. Of course, Daniel is, you know, exceedingly bright and versatile, although he does have his things that he obsesses about or certain ritualistic kinds of behaviors.

I think the best example of that that I can think of is Jill Bolte Taylor. She was a neuroanatomist at Harvard and had a stroke, which left her very impaired initially and yet now she's emerged from that in a really spectacular way and has written a book called "My Stroke of Insight". She describes how when she was actually having her stroke, she was on the telephone trying to get help, but there was another part of her that was not wanting help. She describes her stroke in terms of left-brain/right-brain switching as she was having her stroke.

She's recovered remarkably from that and now is a gifted lecturer. In fact, I'm not sure if you're familiar with the TED lectures or not, but they are people that are gifted lecturers and she gave an 18-minute speech on her stroke and her recovery, which is just marvelous, and has propelled her on to the national scene now as an international lecturer.

Anyway, she talks in her book about being able to literally "shift to the right", as she calls it. I mean, she's a neuroanatomist, who does very left-brain kinds of things, but with the insight that she got from her stroke, was her ability to reach into the right hemisphere, so to speak, and a different kind of experience, a different kind of feeling, a different kind of equanimity almost that's associated with that.

She says she's able to shift to the right on command or at will. And, I think she gives the best description of what that is. Now, she's also obviously a very bright individual, as Daniel is, but I think there are some people who, in terms of neurotypicals, who are better at making that shift than others.

I mean, there are left-brain executives who run their companies with accounting, and budgets, and analyses, and do a remarkable job with logical, sequential kind of thinking, but they don't really have the vision that some other kind of leaders might have, who may not be as successful left-brain-wise with their business, but have the vision of where they ought to go and maybe strike it rich in that regard and are able to shift to the right in terms of their vision, and also shift to the right in terms of being able to balance what they do with what they are.

And, I guess my left brain, to some degree, is what I do, and that serves me well, but to some extent I think, there's more of who I am in the right side of my brain-- recognizing again, Scott, that we're not neatly divided down the middle but the fact that the hemispheres do specialize in certain functions. So Daniel was able to do that, and I think, as I said, the best description of that that I've seen is Jill Bolte Taylor, where she talks about this shift to the right, and what that means and what is associated with that, compared to kind of a left brain existence.

© 2011 by Scott Barry Kaufman

Other parts of the series:

Part I, Defining Autism, Savantism, and Genius

Part II, Dispelling Myths about Autism

Part IV, The Origins of Extraordinary Savant Skills

Part V, The Acquired and Sudden Savant

Part VI, What Savants Reveal about Greatness

Part VII, The Inner Savant in All of Us

Part VIII, Lessons Learned and Recent Advances

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BIO:

Dr. Treffert completed both medical school and a psychiatric residency at the University of Wisconsin where he is presently 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. He then was Superintendent of WMHI until 1979 when he became Director of Community Mental Health services in Fond du Lac, Wisconsin where he now lives. Dr. Treffert has received honorary awards from the Wisconsin Mental Health Association, the Office of Alcoholism and Drug Abuse of Wisconsin and the Wisconsin Association for Marriage and Family Therapy. He has been listed in The Best Doctors in America, by peer selection, beginning in 1979. He resides in Fond du Lac, Wisconsin and is on the staff of St. Agnes Hospital in that community. His web site can be accessed at www.daroldtreffert.com.