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Savant skills included more fully developed talents, such as being able to name the elevation of both the sun and the moon at any time of day, on any specified date; being able to name the day of the week for any date in the distant past or future (a talent known as calendrical calculation) and perfect pitch. Importantly, the abilities and the skills had to be exceptional by the standards of the general population, but also well above the individual's overall level of ability. In total, roughly 30 per cent had some kind of special ability (Philosophical Transactions of the Royal Society B, vol 364, p 1359).

For musical savants like Paravicini, Happé suggests that a bias towards small details might have led their developing brains to focus more on the exact notes than the overall melody, leading to perfect pitch and an exceptional musical memory. In art, a focus on small regions of a picture could lead to accurate perspective drawing.

Most people find this harder when they are shown an unsegmented version of the pattern versus a segmented one, but people with autism don't have this preference, demonstrating their skill at seeing a whole in terms of its parts even if there are no obvious dividing lines (see diagram). "It shows they are able to do the segmentation in their minds," says Winner. The precocious realists did not have this preference either, indicating a talent for realistic drawing may arise from this isolated trait commonly found in autism (Philosophical Transactions of the Royal Society B, vol 364, p 1449).

Although these results help to pinpoint exactly what it is about autism that predisposes people to talent, it's still not clear why an eye for detail is more common in autistic people in the first place. Clues might lie in the work of Simon Baron-Cohen from the University of Cambridge, which suggests that people with autism are "hypersensitive" to sensory information

Daniel Tammet, a prodigious savant who has memorised pi to 22,514 digits, believes his own talents have arisen from a special ability to connect different pieces of information together. "Savant abilities are linked to a highly associative type of thinking, an extreme form of a kind that everyone does - examples would include daydreaming, puns and the use of metaphors," he says.

The few studies of savant brains certainly suggest they are physically different from the average brain. For example, when Happé and Wallace studied the brain of a savant gifted at art, calendrical calculation and memory, they found his cortex was thicker in the areas associated with visuospatial processing and calculation and thinner in other regions associated with social cognition, compared with people who were neither savants nor autistic. But whether these differences were innate or grew with lifelong practice was still unclear.

The answer to that question may come from an unlikely source - a study of London taxi drivers who have acquired an encyclopedic memory of the streets of London known as "the Knowledge". Given that taxi drivers must remember the layout of 25,000 streets and the location of thousands of places of interest, and retrieve the information instantaneously, some researchers like Happé believe the Knowledge qualifies as a savant-like skill.

Eleanor Maguire and colleagues at the Institute of Neurology at University College London and colleagues found that drivers with the Knowledge have a bigger rear hippocampus than bus drivers and adults who do not drive taxis. In addition, the hippocampus appears to be larger the longer a taxi driver has been working, and shrinks once they retire (Philosophical Transactions of the Royal Society B, DOI: 10.1098/rstb.2008.0288).

In fact, it seems the remaining mystery is not so much how savants achieve their talents, but what drives them in the first place. "Motivation is a big unknown," says Wallace. "It's an enormous driving force in giftedness and in savants, but we don't know a lot about it."

One person who has something of an inside view on what contributes to savant ability is Paravicini's mentor, Adam Ockelford, a professor of music at Roehampton University in London who has watched Paravicini's talent blossom since the age of 4. When they first met, Paravicini was entirely self-taught and bashed at his plastic keyboard with his fists and elbows to reproduce the sounds he was hearing. It was only after years of practice that his technical skills developed.

But as researchers like Wallace have suggested, Paravicini seemed motivated way beyond the average music student. In fact, he seemed to be playing as if his life depended on it, and Ockelford thinks it's this that truly sets savants apart from their peers. "The survival instinct gets turned with extraordinary force into something else - in Derek's case music," says Ockelford. "When people see Derek, they think it is amazing, almost religious. But to me, it's mainly just hard work."

It is time to merge High Functioning autism disorders with Aspergers Disorder and separate them from Autistic Disorder.

It is time for the DSM to recognize the importance of levels of ability to function in and understand the world and to reflect those levels in their classification of development disorders.

In theory, this finding could lead to educational techniques that could help very young children with autism build their social referencing skills. This could be hugely important for children with autism, since their challenges with "reading" social cues create so many problems as they enter school, interact with peers, and begin to navigate social relationships.

Thompson (1993) describes facilitated communication as a classic example of the self-fulfilling prophecy. The facilitator wants to believe that the person with a severe cognitive and language disability is actually of normal to superior intellectual ability. Parents especially want to believe that a way has been found to finally unlock the door to their real son or daughter.

In short, people want facilitated communication to work.

Advocates of facilitated communication often respond to naysayers, "It can't hurt to try it." Biklen agrees, "It is not harmful to teach people to communicate through pointing." However, he qualifies his claim with the caveat that "it can be harmful if the facilitator over interprets, does not monitor the person's eyes, facilitates when the person is looking away, is not sensitive to the possibility of guiding the person, and asks leading rather than clarifying questions."

Some argue that "false communication" may distort beliefs, understanding, and rehabilitative approaches to persons with autism and other developmental disabilities.

There are at least 50 legal cases in the U.S. involving allegations of sexual abuse produced through facilitated communication (Berger, 1994). Several such cases have already occurred in Australia, and some have arisen in Europe (Green, 1992).

Additionally, facilitated communication in the past few years has been the source of many contested abuse allegations, usually allegedly reported by an individual with very limited unassisted communication skills against a family caregiver or caregivers.

With the exception of three empirical studies (Intellectual Disability Review Panel, 1989; Calculator and Singer, 1992; and Velazquez (in press)) which provide preliminary validation of facilitated communication, most of the support for the validity of facilitated communication is based on anecdotal reports.

Unfortunately, validity questions surround anecdotal reports of facilitated communication. In general, these reports lack the controls necessary to rule out experimenter biases, reliability concerns, and threats to validity (Cummins and Prior, 1992; Jacobsen, Eberlin, Mulick, Schwartz, Szempruch, and Wheeler, 1994).

Although Biklen (1990) admits that facilitator influence is a real possibility, facilitated communications are typically reported as though they are the words of the person with a disability.

Without exception, these empirical studies have questioned the authenticity of the communication as truly coming from the individual versus the facilitator.

Interdisciplinary Party Report (1988) and the Intellectual Disability Review Panel (1989) both of which examined the source of facilitated communications produced by persons in Australia, and found strong evidence that responses obtained through facilitation were influenced by the facilitator.

Gina Green, Director of Research for the New England Center for Autism and Associate Scientist for the E.K. Shriver Center for Mental Retardation, Inc., has reviewed over 150 cases where empirical testing was performed and cites 15 independent conduct evaluations involving 136 individuals with autism and/or mental retardatiion who were alleged to have been taught to communicate via facilitated communication. In none of the cases were investigators able to confirm facilitated communication by the 136 individuals.

An initial retrospective study is comparing two groups of 20 children initially diagnosed with autism who were functioning well after two or more years of treatment, either with a discrete trial training approach or the DIR approach. The study aims to determine if treatment differences lead to subtle differences in outcome, for example, in terms of flexibility, emotional range, creativity and richness of the child's inner life. Investigators are planning to follow this research with a prospective, randomized, more rigorous study of the two approaches.

"In our previous studies we found out that it looks like you can't just deliver a standard treatment to autistic kids, that there's so much variability among the children that what works for one child doesn't work for another child," he says. "Our hypothesis is that...unless you individualize treatment, you're not going to get the best effect."

Researchers at the University of Maryland are testing an intervention to trigger children's "social engagement system," which includes behaviors such as listening, looking, facial expressions and vocalizations that support social interaction, says psychologist Stephen Porges, PhD. The treatment is designed to improve autistic children's ability to interact with others, thereby making them more receptive to traditional therapies.

The intervention is based on the theory that tensing the middle ear muscles enables people to pick out the human voice from lower frequency sounds in the environment, Porges says. Treatment involves exercising middle ear muscles by playing music that has been altered to include only frequencies associated with the human voice, which improves one's ability to listen to human voices. This, in turn, stimulates the entire social engagement system, Porges says. About 80 percent of 50 children with autism or other behavioral problems receiving this treatment via five 45-minute sessions in a double blind, randomized controlled study showed marked improvements in listening, language and other communication skills.

In a report last year in the Journal of Autism and Developmental Disorders (Vol. 28, No. 1, p. 15-23) evaluating an intensive home-based discrete trial training intervention, Stephen Sheinkopf, PhD, of the University of Miami and Bryna Siegel, PhD, of the University of California, San Francisco, noted that children receiving an average of only 21 hours per week of treatment showed gains in IQ comparable to those achieved by children receiving 32 hours per week. The intensity question remains an issue of importance for the autism community. "If we need 40 hours a week, fine," says psychologist Geraldine Dawson, PhD, of the University of Washington. "But if you only need 25, you have to realize that 40 hours is a tremendous burden not only financially, but on families and on the child."