Why do idiot-savants belong disproportionately to the male sex ?

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  We saw in chapter 3 that there are more male geniuses than female geniuses.   Is it a coincidence that we see this phenomenon in isolated form more frequently among males,  and even disproportionately so,  in pervasive developmental disorders such as autism and psychosis (particularly manic-depressive psychosis) ?   First of all,  what does the term "idiot-savant"  mean ?    It is a generic term referring to isolated extreme cognitive talent or ability in people otherwise extremely intellectually handicapped.   The most typical forms of its expression are calendar counting,  drawing of photographic quality,  musical ability,  extraordinary addition or subtraction ability, hyperlexia.  One example of the idiot savant   phenomenon was portrayed in the film Rain Man  in which Dustin Hoffman played the role of an autist who was an extraordinary gambler.   Now,  one study,  carried out by one of the great early specialists of autism,  Rimland,  investigated the incredibly large number of 5,400 autistic children.   Among these children,  the ratio of boys to girls was 3.16:1.    However,  the ratio of boys to girls in the idiot-savant sample (531 cases altogether)  was 3.54:1.      The statistics are similar in reports of manic-depressive children.  Unlike the situation in the conduct disorder, hyperactivity, and unipolar depression disorders,  outstanding special ability is quite common in juvenile manic depressives (as high as 40% according to one study) and in pervasive developmental disorders like autism (as high as 35% according to one study).   The proportion of boys among idiot-savant  children is always very high.

I am tempted to advance a speculative interpretation of the male-prevalence of special abilities in the "pervasive" developmental disorders (autism, psychosis,  mental retardation).   Solitary play of a visuospatial nature may be a more tempting activity for boys,  normal or deficient.  Isn't it true that normal boys will more often take apart toys,  get heavily into drawing,  like to play with puzzles such as Rubic's cube ?  It seems to me that most special abilities noted in the pervasive disorders involve some sort of visuospatial processing.   Calendar games involve spatial mnemonics (memory aides).  Does not musical genius involve a special ability to "see" melodies in one's mind's eye ?  Idiot-savant  drawing is a sort of exercise in photocopying.   In short,  the point I want to make is that the male prevalence of special talent may be the result of preferred activities which become over-practiced,  and there may not truly exist a localized and distinct brain superiority underlying them,   but rather a general sex difference which gets blown out of proportion in socially isolated children.  

A vignette on a case of prodigeal musical ability in a pervasively impaired child

In a book entitled The exceptional brain   Lola Bogyo and Ronald Ellis describe the case of musical prodigy JL.    This “mono-savant” case was born prematurely with brain damage rendering him blind, mentally deficient and epileptic,  and requiring institutionalization.   He was paralyzed on the right side of his body.  His speech was severely impaired.  Even in adulthood, he still had no concept of time, of size, form,  and could not wash, feed or relieve himself autonomously.  He had the overall developmental level of a two year old,  and was intellectually untestable (profoundly deficient).    He started playing the piano at home around 3 years of age.  Several family members were musically active.  He spontaneously spent whole days and nights on the piano,  and this pursuit was not discouraged by the family.  He then mastered the organ, melodica,  harmonica and guitar.  He also sings quite well.   He  has absolute pitch,  and can replicate just about any melody.  He has a repertoire of hundreds of musical pieces including jazz, opera and classical music.  He can join into a group improvising jazz.   He plays with his left (unparalyzed body side) and invents effective solutions to compensate the unavailability of his right body side.   Bogyo and Ellis propose that this case simply manifested an area of mental preservation,  a normal learning rate within that particular domain,  and exceptional motivation bolstered by a supportive family environment.

Why are male and female alcoholism so different ?  A few  researchers specialized in alcoholism have been so impressed by gender differences in the alcoholic career that some have gone out on a limb and actually argued that the heredity of the two forms is not the same. Women alcoholics typically drink at home and are depressed and have tendencies toward somatization.  Onset is typically in adulthood. Alcoholic men typically drink anywhere but home and have a conduct disorder.  Onset is often pubertal or adolescent.   I propose that alcohol researchers who have argued for hereditary sex segregation of alcoholism have simply gotten mixed up in a chicken and egg problem.  My explanation of the phenomenon is simply this:  Alcoholism in women is going to be more likely to occur when the woman is in the grips of a female-typical mental disturbance.   This disturbance is likely to be depression.   Likewise,  alcoholism is more likely to develop in a man with a male-typical mental disturbance,  like character disorder.   The depression and character disorder are primary and the alcoholism is secondary in a sufficient proportion of men and women for the alcoholic trajectory to simply piggyback the primary disorder.