'Agricultural specialisterne': rural employment revolution for those with Autism

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The subject of the 1991 book by Annabel Stehli, Sound of a Miracle: A Childs Triumph over Autism, is her daughter Georgiana (Georgie). Georgie, like many Autistics, likely suffered from Hyperacusis - she was so badly affected by some sounds that, as she told her mother, ‘The sound was the only thing that drove me crazy because I was so scared . . . and sound was going on all the time. It was hard to get away from it.’ (Stehli 1991, p.188).

…Hyperacusis is defined as a collapsed tolerance to normal environmental sounds. It is a rare hearing disorder whereby a person becomes highly sensitive to noise. Sometimes people think they have hyperacusis because they are bothered by loud sounds like music, heavy equipment or sirens. This is not hyperacusis because these sounds are loud to the normal ear. Individuals with hyperacusis have difficulty tolerating sounds which do not seem loud to others. The ears lose much of their normal dynamic range, and everyday noises sound unbearably or painfully loud. Simply stated, it is like the volume control on your hearing is stuck on HIGH! Hyperacusis can affect people of all ages and is almost always accompanied by tinnitus, an ailment that causes sufferers to hear constant ringing, buzzing or static. Unlike hyperacusis, tinnitus is very common and is associated with many hearing disorders. Hyperacusis and tinnitus can affect one or both ears. Recruitment is a similar hearing disorder which is often confused with hyperacusis. The difference is that an individual with hyperacusis is highly sensitive to sound but has ‘no hearing loss’ whereas a person with recruitment is highly sensitive to sound but also ‘has hearing loss’. This is an important difference…

(source: http://hyperreal.org/raves/health/tinnitus.FAQ)

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There is some controversy as to whether many people with Autism suffer from Hyperacusis or ‘Hypersensitive Hearing (of Unique Frequencies)’…

…Then there are individuals who are sound sensitive at birth but it is only specific to certain frequencies heard at loud levels (typically above 70 decibels). It may seem like we are splitting hairs here but remember–the key words with hypersensitive hearing are ? sound sensitive to specific frequencies heard at loud levels. These frequencies are typically labeled ‘problem’ frequencies. Autistic children are good examples of this. They can tolerate some sound at normal or even loud volumes but some frequencies are difficult to tolerable. Commonly autistic children, children who are marginally autistic, or non-autistic individuals who have hyperacute hearing are treated with auditory integration therapy (AIT). AIT takes regular music and filters out the problem frequencies through a special machine called an audiokinetron. Somehow this therapy seems to ‘retune’ their ears and normalizes their hearing tolerances. The music is listened to at decibel levels which can peak up to 90 decibels. This creates a problem for the hyperacusis patient. The therapy is too loud and only worsens the condition of the hyperacusis patient whose Loudness Discomfort Levels have been compromised…

(source: Hyperacusis Network > 4 Types of Sound Sensitivity)

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Whether the issue is called ‘Hyperacusis’ or ‘Hypersensitive Hearing (of Unique Frequencies)’, there is evidence of these types of issues in many people with Autism Spectrum Disorders. One of the treatments that is ment to be especially effective for these kinds of issues is the combination of Vitamin B6 with Magnesium. While studies in the past have not always been conclusive (as to the combination’s merits for treating Autism), they have virtually all utilised the non-active form of Vitamin B6, Pyridoxine Hydrochloride. This version, in addition to requiring conversion by the body to its active form, is toxic at high doses. I believe that combining Pyridoxal-5-Phosphate (P5P), the ‘active’ form of Vitamin B6, with Magnesium supplements would be more effective…

…The combination of magnesium and P5P seems to be especially effective in children with autism. Supplementation with these nutrients has been associated with improvements in social interactions, communication and overall functioning. In fact, some studies have indicated that children with autism are not good processors of plain vitamin B6, and should benefit from the active P5P form, as it does not require any conversion process…

…Magnesium and Vitamin B-6 has been researched for autism for decades, even before the autism epidemic started… A new study this month proved again the benefits of these two supplements.

Murza KA, Pavelko SL, Malani MD, et al.
Vitamin B 6-magnesium treatment for autism: the current status of the research.
Magnes Res.
2010 Jun;23(2):115-7…

(sources: http://www.europharmausa.com/DBFiles/Greensheet/138.pdf; http://naturopathicanswer.com/spectrum/wp-content/uploads/2010/11/6_10AutismNewsletter.pdf)

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Below are some extracted quotes as to why Magnesium and/or Vitamin B6 supplementation might help with ‘Hyperacusis’ or ‘Hypersensitive Hearing (of Unique Frequencies)’, problems often seen in individuals with Autism Spectrum Disorders…

…There have been some claims that vitamin B6 and magnesium could help to reduce oversensitivity to noise. These were largely based on the result of treatments for hyperacusis patients with learning disorders in the United States.

The use of vitamin B6 and magnesium for hearing oversensitivity has been largely restricted to those affected by hyperacusis alongside autism (or autistic-like symptoms). The use of vitamin B6 may help regulate the brain chemicals that control sensory information arriving at the brain whilst the magnesium could help the body to use the vitamin B6 effectively.

However, it is important to note that, since hyperacusis is a subjective phenomenon and therefore difficult to identify and study, its causes remain unknown. It is likely that there are a variety of different causes for the condition, and not all will be affected by the use of vitamin B6 and magnesium. There remains no conclusive proof to suggest that vitamin B6 and magnesium can help reduce oversensitivity to noise in the majority of people affected. Also, since side effects may occur if vitamin B6 and magnesium are taken at high doses, it is important to speak to a medical practitioner before considering any course of treatment…

…The researchers note that even mild deficiencies of magnesium are associated with irritability, sensitivity to noise, hyperexcitability, apprehension, and belligerence–all problems seen in autism. As parents also had reduced [intra-erythrocyte magnesium - Erc-Mg] values, the researchers suggest the possibility of a genetic vulnerability causing cellular magnesium depletion. They note, however, that not all of the children who improved showed elevations in Erc-Mg levels…

(sources: http://www.deafnessresearch.org.uk/factsheets/hyperacusis.pdf; http://naturopathicanswer.com/spectrum/wp-content/uploads/2010/11/6_10AutismNewsletter.pdf)

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I have already mentioned, in above posts, that Autistic individuals often have good visuo-spatial skills. Studies show that Autistics generally perform well in three-dimensional drawing, for example, and tasks such as assembling designs out of blocks printed with different patterns.

Similarly, in the auditory domain, the below study showed that individuals with High Functioning Autism have superior pitch discrimination and categorization abilities in comparison to controls…

J Cogn Neurosci. 2003 Feb 15;15(2):226-35.
Enhanced pitch sensitivity in individuals with autism: a signal detection analysis.
Bonnel A et al
University of Montreal; Riviere-des-Prairies Hospital, Montreal, Canada.

Abstract
Past research has shown a superiority of participants with high-functioning autism over comparison groups in memorizing picture-pitch associations and in detecting pitch changes in melodies. A subset of individuals with autism, known as “musical savants,” is also known to possess absolute pitch. This superiority might be due to an abnormally high sensitivity to fine-grained pitch differences in sounds. To test this hypothesis, psychoacoustic tasks were devised so as to use a signal detection methodology. Participants were all musically untrained and were divided into a group of 12 high-functioning individuals with autism and a group of 12 normally developing individuals. Their task was to judge the pitch of pure tones in a “same-different” discrimination task and in a “high-low” categorization task. In both tasks, the obtained psychometric functions revealed higher pitch sensitivity for subjects with autism, with a more pronounced advantage over control participants in the categorization task. These findings confirm that pitch processing is enhanced in “high-functioning” autism. Superior performance in pitch discrimination and categorization extends previous findings of enhanced visual performance to the auditory domain. Thus, and as predicted by the enhanced perceptual functioning model for peaks of ability in autism (Mottron & Burack, 2001), autistic individuals outperform typically developing population in a variety of low-level perceptual tasks.
PMID: 12676060 [PubMed - indexed for MEDLINE]

(source: Enhanced pitch sensitivity in individuals wi… [J Cogn Neurosci. 2003] - PubMed - NCBI)

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I have already mentioned, in above posts, that Autistic individuals often have good visuo-spatial skills. Studies show that Autistics generally perform well in three-dimensional drawing, for example, and tasks such as assembling designs out of blocks printed with different patterns.

In the post just above this one, I mentioned a study which showed that, in the auditory domain, individuals with High Functioning Autism have superior pitch discrimination and categorization abilities in comparison to controls.

So what might account for these rather surprising findings, in a population known to be ‘weaker’ in so many areas?

…In an effort to reconcile these findings showing both impaired and enhanced sensory function in [Autism Spectrum Disorders], it has been suggested that perceptual abilities may depend on the nature and complexity of the sensory stimuli, with impairments characterizing responses to more complex stimuli and enhancements seen more often with simple stimuli (Samson et al., 2006; Mongillo et al., 2008). For instance, in the same study, adolescents and adults with autism were found to show superior orientation discrimination of luminance-defined gratings but inferior discrimination of texture-defined gratings that are believed to be processed further along the visual pathway (Bertone et al., 2005). Given that multisensory function depends on stimulus integration, it may be an inherently complex process even when the component stimuli are exceedingly low level. Such a view is supported by the tendency for multisensory processing to occur both within and beyond primary sensory cortices (Ghazanfar and Schroeder, 2006)…

(source: Altered Auditory and Multisensory Temporal Processing in Autism Spectrum Disorders)

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In addition to my above post, which showed that the ability to detect fine-grained pitch changes is superior in individuals with High Functioning Autism, there are many other studies which have similar findings (I have included some below for reference purposes). So there is definitely relatively intact or enhanced musical pitch processing in Autism Spectrum Disorders…

What is the relationship then between this strength in ‘featural processing’ and the potential development of savant musical abilities in some people with Autism Spectrum Disorders? Savant Syndrome is where people with ‘developmental delays’ of the brain, demonstrate profound and prodigious capacities and/or abilities far in excess of those considered normal.

…In line with these predictions, Heaton, Hermelin, and Pring (1998), Heavey et al. (1999) and Hermelin (2001) have argued that a tendency towards featural processing can be advantageous to savants at the early stages of knowledge acquisition as it facilitates accurate memory for the individual elements upon which increasingly highly structured information is based…

Heaton, P., Hermelin, B., & Pring, L. (1998).
Autism and pitch processing: a precursor for savant musical ability?
Music Perception, 15, 291-305.

Heaton, P., Pring, L., & Hermelin, B. (1999).
A pseudo-savant: a case of exceptional musical splinter skills.
Neurocase, 5, 503-509.

Heaton, P. (2003).
Pitch memory, labelling and disembedding in autism.
Journal of Child Psychology and Psychiatry, 44, 1-9.

Heaton, P. (2005).
Interval and contour processing in autism.
Journal of Autism and Developmental Disorders, 8, 1-7.

Mottron, L., Peretz, I., & Menard, E. (2000).
Local and global processing of music in high-functioning persons with autism: beyond central coherence?
Journal of Child Psychology and Psychiatry, 41, 1057-1065.
(source: http://www.sedsu.org/Pdf/Heaton_04.pdf)

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I have already mentioned splinter skills in another post. Individuals with Autism Spectrum Disorders can often have ‘Islets of ability’, for example with regards to pitch perception. Indeed some individuals with Autism may have exceptional musical abilities without reaching the incredible level of someone with Savant Syndrome…

Philos Trans R Soc Lond B Biol Sci. 2009 May 27;364(1522):1443-7.
Assessing musical skills in autistic children who are not savants.
Heaton P.

…Abstract
Descriptions of autistic musical savants suggest that they possess extraordinary skills within the domain. However, until recently little was known about the musical skills and potential of individuals with autism who are not savants. The results from these more recent studies investigating music perception, cognition and learning in musically untrained children with autism have revealed a pattern of abilities that are either enhanced or spared. For example, increased sensitivity to musical pitch and timbre is frequently observed, and studies investigating perception of musical structure and emotions have consistently failed to reveal deficits in autism. While the phenomenon of the savant syndrome is of considerable theoretical interest, it may have led to an under-consideration of the potential talents and skills of that vast majority of autistic individuals, who do not meet savant criteria. Data from empirical studies show that many autistic children possess musical potential that can and should be developed.
PMID: 19528029 [PubMed - indexed for MEDLINE]

(source: Assessing musical skills … [Philos Trans R Soc Lond B Biol Sci. 2009] - PubMed - NCBI)

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The thing regarding writing about savants is that you are writing about a very small segment of the population. Prodigous savants are very rare (see quote below) - prodigous savants are those individuals whose abilities are spectacular in contrast with their disability and would be spectacular even if they occurred in normal persons. In contrast, ‘talented savants’ are far more common as you might expect -where the skills are remarkable simply in contrast with the disability…

…Savants are rare.
This ‘myth’] is true. Indeed, prodigious savants are extremely rare, with fewer than one hundred noted in more than a century of literature on the subject. (A prodigious savant is someone whose skill level would qualify him or her as a ‘prodigy,’ or exceptional talent, even in the absence of a cognitive disability.) Fewer than fifty or so such individuals are believed to be alive in the world today. About half of them are prodigious musical savants.

However, savant skills are best understood as part of a broad spectrum. Some 10% of autistic people are known to have some area of competence which is in contrast to their overall disability; this is termed a ‘splinter’ savant skill. When these ‘splinter’ skills are more organized and coherent, it is appropriate to call the people who possess them ‘talented savants,’ according to a definition proposed by Darold Treffert M.D. and which is now gaining wide acceptance. Thousands of ‘talented savants’ are alive in the world today…

(source: The Savant Academy)

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The Savant Academy does a good job at trying to dispel the myths out there about Savant Syndrome. The common stereotype of a Savant is probably someone like the person depicted in the movie Rain Man, but the truth is far more complicated of course…

…Musical savants play back what they hear, note for note.
Prodigious musical savants are not ‘tape recorders,’ ‘player pianos,’ or ‘computer punch card readers.’ Though most non-musicians simply can’t recognize the subtleties, after hearing a piece for the first time, it is unusual for a savant to play it back in a literal note-for-note manner.

Savants grasp and retain the underlying fabric of a piece of music, and are quite adept at filling in the pieces and chords in ways that fit their hands, physical technique, and skill level. This is, in fact, one of their greatest strengths. Unless a savant has been specifically asked to replicate a piece exactly, perhaps as an exercise, savants are generally content to do their own thing. In fact, it’s what most of them prefer to do!

Savants are not creative.
Many savants love to improvise, and in fact prefer the stimulation of improvising to playing ‘set’ pieces.

The best savant jazz musician in the USA is Tony … who plays 18 instruments in addition to the piano. Now 29 years old, Tony’s story inspired the 1999 television movie, ‘Journey of the Heart.’ Unfortunately, ‘Journey of the Heart’ introduced a number of myths about savants, including the notion that creativity is a struggle for those with Savant Syndrome. In fact, many savants show a high level of creative ability from an early age.

For a period of time, Tony was regarded as the only savant in the world who was proficient at jazz; today, thanks to specialized training, there are several savants who are regarded as first-rate jazz improvisers… Tony’s mother, fought from an early age for teaching and funding for her son’s gift. She tells people that her son has a triple handicap: he is blind, autistic, and has Savant Syndrome. “Having Savant Syndrome is like having a whole other special need,” she explains. After attending Perkins School for the Blind, Tony DeBlois graduated … from the Berklee School of Music. He performs frequently … and is in demand for appearances all over the world…

(source: The Savant Academy)

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Dr. Darold A. Treffert is an internationally recognised expert on Savant Syndrome. He is also a psychiatrist who specializes in the epidemiology of Autism Spectrum Disorders and a Clinical Professor at the University of Wisconsin Medical School. Below is what this very experienced expert has to say about behavioral approaches to treating Autism. Note similarities to my post above where I mention the importance of early detection and intensive intervention…

…With respect to behavioral approaches one rule applies: ‘the earlier the better’. There is research evidence, and certainly day-to-day practice examples, of children who have improved, sometimes dramatically, with early behavioral interventions however defined. For some this is formal, structured ABA or TEACCH approaches in the home and classroom. For others it is less formal, but equally as intensive, behavioral interventions in the classroom–sometimes mainstreamed, sometimes special classrooms and sometimes home schooled–and in the homes. …The key words in these approaches are early and intense.…

(source: Autistic Disorder: 52 Years Later: Some Common Sense Conclusions | Wisconsin Medical Society)

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Dr. Darold A. Treffert is an internationally recognised expert on Savant Syndrome - indeed he has written a number of books on the subject. He is also a psychiatrist who specializes in the epidemiology of Autism Spectrum Disorders and a Clinical Professor at the University of Wisconsin Medical School. In the extracted quote below, he makes the point of attempting to harness the abilities of an Autistic individual as much as possible rather than trying to focus on his/her disability. This is in line with the ideas expressed to help people of all ages with Autism Spectrum Disorders by the Neurodiversity guru, Dr. Thomas Armstrong…

…In these [early and intensive behavioural interventions for Autism], one tries to reach and engage what I call ‘the island of intactness’ in whatever form that exists, and gradually expand that island of intactness further and further out. …For that one in 10 autistic child that has some savant skills, even at a ‘splinter skill’ level, art, music or math may be the island of intactness that one can engage and build upon for what I call the ‘conduit toward normalization’ which is explored in greater depth on the savant syndrome Web site…

(source: Autistic Disorder: 52 Years Later: Some Common Sense Conclusions | Wisconsin Medical Society)

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I mentioned in an earlier post that DSM V proposes to create one category of Autism Spectrum Disorder, thereby removing Asperger’s Syndrome and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) from the DSM.
*DSM V is the planned fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, due to be published in May 2013.

Dr. Darold A. Treffert, an internationally recognised expert on Savant Syndrome and the epidemiology of Autism Spectrum Disorders, believes that this may not be such a good thing…

…SCOTT: What do you think of the proposed DSM-V changes in regards to autism?

DAROLD: Well, there’s concern that Asperger’s will disappear and it’ll be inculcated into autism. I’m concerned that the DSM in general tends to lose its specificity for conditions, and they become more spectrum disorders, or disease-like disorders. We have medicalized a lot of things that I think are not really medical conditions.

For example, there is such a thing as adolescent shyness-- adolescents who are shy-- and they don’t all have social avoidance disorder. We continually are diluting what are conditions that we need to maintain the specificity along the lines in regards to autism. As we dilute it more, that may be useful for public education and early intervention, but from a research point of view, we’re losing the specificity that ought to remain.

…DAROLD: Yeah. We have to be careful that we don’t keep multiplying disorders and diluting them. I think there is a difference. People talk about Asperger’s as high-functioning autism, which I think it is. But it does have some of its own characteristics, like the preservation of language, particularly, which may be right brain dysfunction instead of left brain dysfunction, and we lose something in that, as things lose their specificity, and we keep diluting things. I’m not sure that’s helpful…

(source: Conversations on Creativity with Darold Treffert, Part I: Defining Autism, Savantism, and Genius | Psychology Today)

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An interesting point to mention are the empathetic qualities of some of the people that research Autism and Savant Syndrome. This is important to truly respecting the minds of those with special needs. And it may be an important prerequisite to being a great researcher in this area…

…[Dr. Darold A. Treffert] initially became interested in savants in medical school when Leo Kanner, the psychiatrist who first described autism in 1943, spent a semester as a visiting professor…

Kanner, Treffert recalls, was “a very gentle soul with a pleasant bedside manner. He wasn’t just describing these people, but he cared about them as well.” Treffert, who has an appointment as a UW-Madison clinical psychiatry professor, could easily be describing himself. He is universally respected and liked in the campus medical community, no doubt due to a kindly and unassuming civility that seems more typical of a bygone era.

…Lewis Leavitt, a pediatrician who works at the UW’s Waisman Center, concurs. Treffert, he says, "should be recognized for not forgetting the humanness charged with helping to start a children’s unit, and most of the patients were autistic…

(source: http://www.uwalumni.com/media/documents/pdf/onwisconsin/2007summer/Savants.pdf)

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Also, as I have mentioned before a number of times, that success for people with special needs is often greatly aided by the support and love of those around them, from trainers to parents to doctors…

…“There’s a tendency to look at the savant with sort of a gee-whiz type of mentality,” says [Dr. Darold A. Treffert], “but there’s really much more to it than that. Scientific advances are important, but the other side of it is the incredible input and love and support and belief of the families of these youngsters and what that can do for them.” Treffert is fond of saying that on his quest to understand savants, "I’ve learned as much about matters of the heart as I have about circuits in the brain…

(source: http://www.uwalumni.com/media/documents/pdf/onwisconsin/2007summer/Savants.pdf)

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One interesting aspect of prodigous savants is what studying them can teach us about ourselves…

…“One of the most pressing questions for me,” [Dr. Darold A. Treffert] says, “is how do people know things they’ve never learned?” He believes these individuals may be accessing knowledge that was already there but lying dormant. “I think we all come with much more software installed than we formerly believed,” he says. “Many times, people think of us being born with this marvelous piece of equipment called the brain with a blank disk, and we become what we put on the disk.” But the prodigious savant, he says, “tells us that there’s much more on that disk when we’re born. That gets at this whole idea of the potential within us all.”

Treffert uses the term genetic memory to refer to things that we may be born knowing, but later lose as more complex mental development supersedes this knowledge. “We hear that we only use ten percent of our brain or less,” he says, and he posits that genetic memory could account for some of that underutilized 90 percent. In the animal kingdom, he continues, we see genetic memory all the time–for instance, when birds migrate…

(source: http://www.uwalumni.com/media/documents/pdf/onwisconsin/2007summer/Savants.pdf)

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I have mentioned in a post above that Dr. Darold A. Treffert, an internationally recognised expert on Savant Syndrome and the epidemiology of Autism Spectrum Disorders, likes specificity in terms of making an accurate diagnosis. For example there is Hyperlexia - defined as the precocious ability to read words without prior training in learning to read typically before the age of 5. With regards to Hyperlexia, Treffert is keen to distinguishing autistic-like behaviors from an actual Autism Spectrum Disorder…

…A second group of children who read early are some with autistic disorder where the hyperlexia is in fact sometimes viewed as a savant-like ‘splinter skill’ associated with the autism. These children have other signs and symptoms of Autistic Disorder and the early reading is but one facet of that more pervasive disorder. Intervention and treatment in this group is directed at the underlying Autistic Disorder. However the precocious reading ability can itself be a valuable treatment tool for teaching language and social skills and should not be marginalized or disregarded as unimportant or frivolous. I refer to this group as Hyperlexia II…

…there is a third group of children… This third group of children who read early present with a startling precocious ability to read, well beyond that expected at the child’s chronological age. The hyperlexia is coupled with an intense fascination with letters or numbers. Yet in spite of the intense preoccupation and ability with words, there are, correspondingly, significant problems in understanding verbal language. Comprehension of that which is masterfully read is often poor, and thinking is concrete and literal. There is difficulty with, and paucity of, abstract thinking. There may be some behaviors and symptoms commonly associated with autism spectrum disorders as well including echolalia (repeating rather than initiating conversation), pronoun reversals, intense need to keep routines (obsession with sameness), auditory or other sensory hypersensitivity, specific intense fears, strong auditory & visual memory, and selective listening with the appearance of suspected deafness. In this group of children these latter ‘autistic’ traits and behaviors are only ‘autistic-like’ however, mirroring those seen in autistic disorder itself. However, in contrast to those in Autistic Disorder, these ‘autistic-like’ symptoms fade over time as the child ‘outgrows’ his or her ‘autism’ as some parents have described that transition. I call this group Hyperlexia III…

(source: Hyperlexia: Reading Precociousness or Savant Skill? | Wisconsin Medical Society)

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Indeed Dr. Darold A. Treffert has recently had a journal article published which includes a Continuing Medical Education (CME) quiz on Separating ‘Autistic-like’ Behaviors from an actual Autistic Spectrum Disorder: http://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/110/6/287.pdf

Treffert identifies several categories where it is important to distinguish between Autistic and non-Autistic Spectrum children who may present with Hyperlexia and/or other symptoms:

To be able to provide examples of hyperlexia types I, II, and III for children who read early; Einstein syndrome for children who speak late; and ‘blindisms’ for children who are severely visually impaired…

(source: http://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/110/6/287.pdf)

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The recently-published journal article that the above Continuing Medical Education (CME) page comes from is called Hyperlexia III: Separating ‘Autistic-like’ Behaviors from Autistic Disorder; Assessing Children who Read Early or Speak Late.

One of the reasons, Dr. Darold A. Treffert likes to specificy diagnoses is to prevent unnecessary worry and other issues from arising for parents and others. For example, an Autism Diagnosis is considered hard to take for many parents, and it is probably best that such a diagnosis is not made prematurely…

…He also found, based on correspondence with parents, that some children who speak late have transient autistic-like symptoms that faded over time in children in whom a diagnosis of autism had been prematurely and mistakenly applied. With that error came the same worry, concern, and pessimism in those families that some of the parents of hyperlexic III children were experiencing as expressed in correspondence with me.
…Exceedingly careful history, observation, and examination is critical; it may be necessary to let the natural history of the disorder emerge before applying a definitive diagnosis or label that can have important, lasting consequences. Treatment can still be applied to target symptoms, but parents or others may be spared the unnecessary worry and fear that can accompany certain diagnoses.
…The abundance of caution works in the other direction as well. Just as there is risk in making ‘false positive’ diagnoses of [Autism Spectrum Disorders] in children who read early, speak late, or are visually impaired, there is also the risk of giving ‘false hope’ in those instances where certain symptoms are a part of autistic spectrum disorder. My answer to both those risks: careful, comprehensive evaluation by skilled clinicians knowledgeable about [Autism Spectrum Disorders] as well as hyperlexia III, Einstein syndrome, and blindisms. From such an informed consultation, equally informed intervention strategies will emerge, whatever the proper diagnosis…

(source: http://www.wisconsinmedicalsociety.org/_SAVANT/_RES/_files/pdf/hyperlexiaforweb.pdf)

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Einstein Syndrome is a term used to describe exceptionally bright people who experience a delay in development of speech. It is named after the famous physicist Albert Einstein, because his speech was delayed till age five. Thomas Sowell, author of the 2001 book, The Einstein Syndrome: Bright Children Who Talk Late, is the originator of the term:

The Einstein Syndrome is a follow-up to Late-Talking Children, which established Thomas Sowell as a leading spokesman on the subject of late-talking children. While many children who talk late suffer from developmental disorders or autism, there is a certain well-defined group who are developmentally normal or even quite bright, yet who may go past their fourth birthday before beginning to talk. These children are often misdiagnosed as autistic or retarded, a mistake that is doubly hard on parents who must first worry about their apparently handicapped children and then see them lumped into special classes and therapy groups where all the other children are clearly very different… Sowell can now identify a particular syndrome, a cluster of common symptoms and family characteristics, that differentiates these late-talking children from others; relate this syndrome to other syndromes; speculate about its causes; and describe how children with this syndrome are likely to develop.

source: Amazon.com: The Einstein Syndrome: Bright Children Who Talk Late (9780465081400): Thomas Sowell: Books