This chapter sets out a neuroscientific model to explain the exceptional musicianship that characterizes some children on the autism spectrum who have learning difficulties. The model builds on Gaver’s “ecological” interpretation of auditory processing using Ockelford’s “zygonic” theory. This attributes the perception of musical structure to the recognition of intentional repetition, and establishes a hierarchy of music-structural forms of differing complexity that are reflected ontogenetically in children’s musical understanding. The cognition of music is far less neurologically demanding than the processing of language, and is a developmental precursor. In some children on the autism spectrum, auditory development focuses on the perceptual qualities of sounds that in some cases leads to acquisition of “absolute pitch,” and a fascination for the repetitive patterns in sound. The children can process both language and everyday sounds as though they were music. This drives exceptional musical development, but at the cost of language and an appreciation of everyday sounds.