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Piano Man theory

June 17, 2005

The case for diagnosing the "Piano Man" as an autistic savant is compelling ("Autism experts offer to help in Piano Man case", June 10).

If this unfortunate man is to receive the best care, he surely needs to be assessed by experts in this condition.

His circumstances are consistent with the following hypothesis. Teenage autistic males can be impossible to handle in a family environment. They need skilled institutional care. Suppose this man is from a country where the state provision for mental illness is in wards where the emphasis is on sedation. A caring family might want to avoid that fate, but to do so they would need to operate a system of strict house arrest, possibly by keeping the person locked up in a secure room cut off from public gaze and therefore recognition.

After a decade of this, the family might have reached a breakdown point.

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They may have used a people trafficker to deposit him in the UK on an established route from Amsterdam to the north Kent coast. Labels were removed from his clothes to hinder identification. They dressed him smartly so that the police would not presume him to be an asylum-seeker.

If this hypothesis has merit, then the man deserves care in a unit specialising in autism, which is a neurological condition not an illness.

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Simon Mitton
Fellow, St Edmund's College Cambridge University

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