**5. Cognitive and psychological theories and explanations underlying special gifts and talents and savant skills in ASD**

The development of special gifts and talents in ASD has been associated in general with the ability to process local information. These abilities include detail-focused cognitive style (weak coherence) [52], enhanced perceptual functioning [53], an accentuated capacity for systemizing [54], privileged access to low-level perceptual processes [55] and various other psychological and physiological states.

#### **5.1. Weak central coherence**

The main current interpretation of special gifts and savant skills associated with autism in‐

According to Treffert [36]: "Savant syndrome is a rare, but extraordinary condition in which persons with serious mental disabilities, including autistic disorder, have some 'island of genius' which stands in marked, incongruous contrast to overall handicap" (p.1351). Savant skills are found more commonly in ASD than in any other group [37] and are generally at‐ tributed to low-functioning autism but can also occur in individuals with normal and very

Theories put forward to explain savant skills strongly suggest a relationship with repetitive, obsessional and restricted behaviour [38]. Savants generally exhibit circumscribed interests usually within their skill area [39], which leads to considerable rehearsal, practice and train‐ ing. Savant skills are also strongly associated with rote memory [40]. Pring [41] in her analy‐ sis of memory characteristics in savants argued against the rote memory explanation and instead proposed the existence of complex long-term memory structures in savants. In gen‐ eral, memory is considered an essential cognitive component of savant skills. In addition, re‐ searchers have suggested a role for 'implicit' or unintentional, learning in savant skill development [42,43]. Results of neuropsychological examinations of a calendar-calculating savant indicated that good memory, superior mental calculation and knowledge of calendar are the underlying elements for this specific talent [44]. Taken together, the classical portrait of the autistic savant is largely imitative and not very creative and some writers [e.g. 45] ar‐ gued that true creativity is missing in savants "there are no savant geniuses about…. Their mental limitations disallow and preclude an awareness of innovative developments" (p. 177). In contrast, other theorists [46,47] believe that savants, particularly those with Asperg‐ er syndrome with above average intelligence levels [48] can be extremely creative. Mottron et al [49] write that "Savant performance cannot be reduced to uniquely efficient rote memo‐ ry skills …. and encompasses not only the ability for strict recall, requiring pattern comple‐ tion, but also the ability to produce creative, new material within the constraints of a

Various pathological conditions such as frontotemporal dementia, dominant-hemisphere strokes, head injuries and infections may also result in the emergence of savant like abilities [e.g. 50]. Of particular interest is the fact that individuals with these diverse types of disor‐ ders and emerging savant skills also develop cognitive features and behavioural traits,

clude cognitive and psychological theories as well as various other models.

**4. Savant syndrome and creativity**

774 Recent Advances in Autism Spectrum Disorders - Volume I

previously integrated structure" (p.1388).

which are characteristic of autism [51].

high intelligence.

A different cognitive style, the weak central coherence theory (WCC) proposed by Uta Frith [56] and Frith and Happé [57] has been suggested as an explanation for certain special abili‐ ties found in ASD. This exceptional part-based processing style is demonstrated in the supe‐ rior ability individuals with ASD show on tasks such as block design and embedded figures resulting from deficits in integration processes that serve to draw information together as a meaningful whole [see 58]. According to Frith [59], the WCC particularly addresses the spe‐ cial gifts and talents and acute perceptual abilities in autism (e.g. hypersensitivity, visual and auditory abilities) and can explain the achievements of individuals with ASD syndrome in art, science, music, and many other areas. Local coherence, which is defined by close at‐ tention to mechanical or physical patterns, is exemplified in the work of Temple Grandin [60]. Atypical attentional mechanisms and abnormal neural connectivity have been suggest‐ ed as possible cognitive and neural mechanisms underlying WCC.

#### **5.2. Enhanced perceptual functioning**

Also located at the level of perception is the model proposed by Mottron and Burack [61] and Mottron et al [62] which are based on enhanced perceptual functioning (EPF) suggesting that people with autism have an overdevelopment of low-level perceptual abilities at the expense of high-level processing mechanisms. This theory provides a con‐ vincing account of special abilities in ASD such as peaks of ability in visual and audito‐ ry modalities and also indicates that a variety of cognitive processes are required for the development of savant abilities. For example, Mottron et al [63] propose that enhanced detection of patterns, including similarity within and among patterns is contributing to creativity evident in savants. As far as neural correlates for their theory is concerned the authors suggest the notion of brain plasticity and an overfunctioning of brain regions in‐ volved in perception in autism [64].

EPF and WCC are similar in emphasizing detail focused processing bias and superior local processing. Superiority in local coherence may be specific to autistic creativity and as argued by Mills [65] "produces an imaginative faculty defined by close attention to mechanical or physical patterns not psychological or social rules" (p.126).

#### **5.3. Systemizing theory**

This above interpretation appears to be in line with the "systemizing theory" put forward by Baron-Cohen et al. [66] which emphasises the superior ability in recognizing repeating patterns in stimuli (e.g. numerical, spatial, mechanical, auditory systemizing). The "system‐ izing theory", in contrast to the WCC model, predicts that individuals with ASD have a strong central coherence as indicated by their excellent skills in integrating information in areas such as astronomy and physics. This ability, however, does not apply to non-systemiz‐ able fields such as fiction. Similar to the WCC the systemizing model also posits excellent attention to detail in perception and memory. Baron-Cohen et al [67] further suggest that this excellent attention to detail is a consequence of sensory hypersensitivity found in indi‐ viduals with ASD. Belmonte et al [68] posited that local overconnectivity in the posterior sensory parts of the cortex is responsible for the sensory 'magnification' in ASD.

maticians are intuitive thinkers and rely on the unconscious mind to a large extent, like for example the genius mathematician Poincarė [78]. Freudian theory holds that primary proc‐ esses or primitive thinking which creative persons have more access to are based on their weak defence mechanisms of repression. Individuals with Asperger syndrome have very weak defence mechanisms thus allowing them access to early childhood memories [79].

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Low levels of repression or inhibition are associated with creativity and a number of theo‐ rists [80, 81] have suggested that creativity is "a disinhibition syndrome", i.e. highly creative individuals lack cognitive inhibition. Neural correlates of cognitive disinhibition are the frontal lobes and research indicates that creative individuals show less frontal-lobe activity during verbal association tasks [82]. Deficits in inhibition have been documented in autism [83] as well as in Attention Deficit Hyperactivity Disorder (ADHD) [84] a neurodevelop‐

Also relevant in this context maybe the concept of "flow" proposed by the psychologist Csíkszentmihályi [85]. The notion of "flow" indicates a familiar state of reduced self-aware‐ ness where temporal concerns (time, food, ego-self, etc) are ignored during periods where the individual is fully immersed in a task or process. According to Csíkszentmihályi "flow" is characterised by a feeling of great absorption, engagement and fulfilment and thought to be inherently reinforcing and rewarding [86]. As alerted to in the chapter "Atypical Sense of Self in Autism Spectrum Disorders: A Neuro-cognitive Perspective" (this book) [87] dimin‐ ished self-awareness which is a characteristic of individuals with ASD and associated with right hemisphere dysfunction might be advantageous in the development of special talents

To conclude, although no single theory can explain the cognitive mechanisms underlying savant skill development, prodigious memory, atypical perception and excellent attention to

The study of the neural basis of creativity is an area greatly neglected by scientific research and despite methodological difficulties associated with investigating creativity any account

Neuroscientific approaches aiming to determine the physiological basis of creative thought, are assuming that creativity is a measurable trait. Creativity can be interpreted as physiolog‐ ical changes that are required for creative problem solving focussing on EEG measures of cortical activation [90]. Theories of creativity in general postulate that low levels of cortical activation contribute to creative inspiration. Imaging data [91] suggest that great creativity not only requires a high level of specialized knowledge (stored in temporal and parietal lobes) and divergent thinking (mediated by the frontal lobes) but also co-activation and communication between areas of the brain that normally do not show strong connections. Highly creative individuals also possess the ability to modulate neurotransmitters [92, 93] such as the norepinephrine system (located in the frontal lobes), indicated by a reduction of cerebral levels of norepinephrine during creative periods. Support for the role of frontal

detail are fundamentally associated with savant like talents in individual with ASD.

of creativity must include explanations about the neural correlates of creativity [89].

mental disorder that is associated with increased creativity.

in ASD as quoted by Happé and Vital [88] (p.1373).

**6. Neural basis of creativity in non-clinical populations**

#### **5.4. Low level information processing**

The work of Synder et al. [69] also provides an understanding of certain forms of creativity. According to Snyder and Mitchell [70] outstanding savant skills might be accomplished by accessing early stages of information processing. Their controversial model predicts the pos‐ sibility of accessing non-conscious information by artificially disinhibiting the inhibiting net‐ works associated with concept formation, using transcranial magnetic brain stimulation (TMS). By means of this method Snyder et al. [71] propose that this process will open "the door for restoration of perfect pitch, for recalling detail... and even enhancing creativity". A recent EEG study [72] attributing increased visual detail perception in autism to neural ab‐ normalities related to low-level visual processing potentially supports this theory.

Snyders's theory [73] furthermore suggests the possibility that savant skills may be latent in everyone, but a "form of cortical disinhibition or atypical hemispheric imbalance" is re‐ quired in order to access them (p. 1399). In support for his theory Snyder quotes the emer‐ gence of savant skills in individuals without any previous history for talents due to a variety of illnesses.

Snyder's model explains many of the talents and characteristics associated with Asperger geniuses including their childlike view of the world and lack of preconceptions, which is beneficial for developing new and original theories and perspectives. For example, Ludwig Wittgenstein, who had Asperger syndrome did spend little time reading other philosophers and felt most of them were wrong anyhow. He didn't want to "cloud his mind with false theories" [74].

#### **5.5. Primary process thought and disinhibition syndrome, reduced self-awareness – 'Flow'**

Theories of creativity [75, 76] also highlight the importance of primary process thought as found in dreaming, free association and psychosis in creative processes. Einstein suggested that creative scientists are the ones with "access to their dreams. Occasionally, a dream will actually provide the solution to a problem", as cited by Gregory [77] (p.226). Many mathe‐ maticians are intuitive thinkers and rely on the unconscious mind to a large extent, like for example the genius mathematician Poincarė [78]. Freudian theory holds that primary proc‐ esses or primitive thinking which creative persons have more access to are based on their weak defence mechanisms of repression. Individuals with Asperger syndrome have very weak defence mechanisms thus allowing them access to early childhood memories [79].

Low levels of repression or inhibition are associated with creativity and a number of theo‐ rists [80, 81] have suggested that creativity is "a disinhibition syndrome", i.e. highly creative individuals lack cognitive inhibition. Neural correlates of cognitive disinhibition are the frontal lobes and research indicates that creative individuals show less frontal-lobe activity during verbal association tasks [82]. Deficits in inhibition have been documented in autism [83] as well as in Attention Deficit Hyperactivity Disorder (ADHD) [84] a neurodevelop‐ mental disorder that is associated with increased creativity.

Also relevant in this context maybe the concept of "flow" proposed by the psychologist Csíkszentmihályi [85]. The notion of "flow" indicates a familiar state of reduced self-aware‐ ness where temporal concerns (time, food, ego-self, etc) are ignored during periods where the individual is fully immersed in a task or process. According to Csíkszentmihályi "flow" is characterised by a feeling of great absorption, engagement and fulfilment and thought to be inherently reinforcing and rewarding [86]. As alerted to in the chapter "Atypical Sense of Self in Autism Spectrum Disorders: A Neuro-cognitive Perspective" (this book) [87] dimin‐ ished self-awareness which is a characteristic of individuals with ASD and associated with right hemisphere dysfunction might be advantageous in the development of special talents in ASD as quoted by Happé and Vital [88] (p.1373).

To conclude, although no single theory can explain the cognitive mechanisms underlying savant skill development, prodigious memory, atypical perception and excellent attention to detail are fundamentally associated with savant like talents in individual with ASD.

#### **6. Neural basis of creativity in non-clinical populations**

**5.3. Systemizing theory**

776 Recent Advances in Autism Spectrum Disorders - Volume I

**5.4. Low level information processing**

of illnesses.

theories" [74].

**'Flow'**

This above interpretation appears to be in line with the "systemizing theory" put forward by Baron-Cohen et al. [66] which emphasises the superior ability in recognizing repeating patterns in stimuli (e.g. numerical, spatial, mechanical, auditory systemizing). The "system‐ izing theory", in contrast to the WCC model, predicts that individuals with ASD have a strong central coherence as indicated by their excellent skills in integrating information in areas such as astronomy and physics. This ability, however, does not apply to non-systemiz‐ able fields such as fiction. Similar to the WCC the systemizing model also posits excellent attention to detail in perception and memory. Baron-Cohen et al [67] further suggest that this excellent attention to detail is a consequence of sensory hypersensitivity found in indi‐ viduals with ASD. Belmonte et al [68] posited that local overconnectivity in the posterior

The work of Synder et al. [69] also provides an understanding of certain forms of creativity. According to Snyder and Mitchell [70] outstanding savant skills might be accomplished by accessing early stages of information processing. Their controversial model predicts the pos‐ sibility of accessing non-conscious information by artificially disinhibiting the inhibiting net‐ works associated with concept formation, using transcranial magnetic brain stimulation (TMS). By means of this method Snyder et al. [71] propose that this process will open "the door for restoration of perfect pitch, for recalling detail... and even enhancing creativity". A recent EEG study [72] attributing increased visual detail perception in autism to neural ab‐

Snyders's theory [73] furthermore suggests the possibility that savant skills may be latent in everyone, but a "form of cortical disinhibition or atypical hemispheric imbalance" is re‐ quired in order to access them (p. 1399). In support for his theory Snyder quotes the emer‐ gence of savant skills in individuals without any previous history for talents due to a variety

Snyder's model explains many of the talents and characteristics associated with Asperger geniuses including their childlike view of the world and lack of preconceptions, which is beneficial for developing new and original theories and perspectives. For example, Ludwig Wittgenstein, who had Asperger syndrome did spend little time reading other philosophers and felt most of them were wrong anyhow. He didn't want to "cloud his mind with false

**5.5. Primary process thought and disinhibition syndrome, reduced self-awareness –**

Theories of creativity [75, 76] also highlight the importance of primary process thought as found in dreaming, free association and psychosis in creative processes. Einstein suggested that creative scientists are the ones with "access to their dreams. Occasionally, a dream will actually provide the solution to a problem", as cited by Gregory [77] (p.226). Many mathe‐

sensory parts of the cortex is responsible for the sensory 'magnification' in ASD.

normalities related to low-level visual processing potentially supports this theory.

The study of the neural basis of creativity is an area greatly neglected by scientific research and despite methodological difficulties associated with investigating creativity any account of creativity must include explanations about the neural correlates of creativity [89].

Neuroscientific approaches aiming to determine the physiological basis of creative thought, are assuming that creativity is a measurable trait. Creativity can be interpreted as physiolog‐ ical changes that are required for creative problem solving focussing on EEG measures of cortical activation [90]. Theories of creativity in general postulate that low levels of cortical activation contribute to creative inspiration. Imaging data [91] suggest that great creativity not only requires a high level of specialized knowledge (stored in temporal and parietal lobes) and divergent thinking (mediated by the frontal lobes) but also co-activation and communication between areas of the brain that normally do not show strong connections. Highly creative individuals also possess the ability to modulate neurotransmitters [92, 93] such as the norepinephrine system (located in the frontal lobes), indicated by a reduction of cerebral levels of norepinephrine during creative periods. Support for the role of frontal areas in a fluid analogy-making task comes from an fMRI study [94] indicating bilateral neu‐ ral activations. A study measuring differences in cerebral blood flow between highly crea‐ tive individuals and controls during a verbal task of creative thinking [95] implicated a neural network consisting of right and left fronto-temporal, parietal, and cerebellar regions in highly creative performances. These areas are involved in cognition, emotion, working memory and response to novelty.

**7.2. Right hemisphere processing and creativity**

Treffert is "central to explaining savant syndrome" (p.1356).

detecting even the smallest changes in the environment.

ences have been reported in the literature on creativity [122].

**7.3. Neuroanatomical abnormalities in autism**

artistic, visual or spatial abilities (mathematics) are primarily RH skills.

Savant skills are linked to the RH [113], which is dominant for attention, visuospatial and emotional function. Various authors [114-115] have suggested that autistic savants have atypical LH dysfunction with RH compensation. Based on research evidence including imaging studies Treffert [116] speculated that "one mechanism in some savants, whether congenital or acquired is left brain dysfunction with right brain compensation." The notion of "paradoxical functional facilitation" as described by Kapur [117] denotes loss of function in one damaged brain area and enhanced function of another area, which as emphasized by

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RH skills can be characterized as non-symbolic, artistic, concrete and directly perceived in contrast to LH skills that are more sequential, logical, and symbolic. For example musical,

The association between RH and creativity is based on research evidence demonstrating that the RH is more involved in production of mental images than the LH, perception and pro‐ duction of music, e.g. the right inferior frontal gyrus is known to be involved in musical pitch encoding and melodic pitch memory [118]. EEG studies show that highly creative indi‐ viduals show more right than left-hemisphere activation during experimental studies [119], indicating that during the creative process creative individuals rely more on the RH. Lesion studies as well as unimpaired population studies have demonstrated that the RH is superior to the LH at noticing anomalies in objects [120]. Individuals with autism are well known for

In sum, several lines of evidence suggest that atypical cerebral asymmetry which is a highly heritable trait [121] is associated with autism and linked to certain aspects of creativity. It is also likely that some of the structural brain abnormalities evidenced in autism are related to the special cognitive functioning that encourages great creativity. Neurological brain differ‐

Converging neuroscientific evidence has suggested that the neuropathology of ASD is wide‐ ly distributed, involving impaired connectivity throughout the brain. Neuroanatomical ab‐ normalities in autism include increase in cortical thickness [123], and increase in head and brain size [124]. Accelerated growth in brain size in early childhood in autism has been documented by a range of studies [125], which may be consistent with the asymmetric cere‐ bral lateralization in autism as discussed above. The increased brain volumes in autism are believed to be the result of insufficient or abnormal prenatal pruning, which together with genetic factors are most likely to underlie these growth abnormalities [126]. In addition, there is evidence of higher birth weight [127] and faster body growth [128] as well as in‐ creased levels of growth hormones [129] in autism. These altered brain growth rates are con‐ sidered to have a strong influence on patterns of brain connectivity and cerebral lateralization [130, 131] and differential cognitive functioning. For example, the increased hippocampus size in autism [132] may be associated with enhanced visual-spatial, mathe‐
