Beyond the biological traits that differentiate ancient species of hominins from extant humans, differences in social organization remain an important yet difficult issue to assess. Psychological features and interindividual relations, in particular, are among the least accessible aspects of past behaviors. Although the fossil and archaeological records do not easily allow us to tackle these kinds of issues, contrasting views on the cognitive capabilities and behavioral sophistication of fossil human species have often been expressed. In this issue of PNAS, Gracia et al. (1) provide new evidence on the survival of an abnormal individual with possible cognitive deficits from a group of pre-Neandertal Pleistocene hunter-gatherers, currently assigned to a geological age of >500 ka. The cranium SH14 from the Sima de los Huesos (Sierra de Atapuerca, Spain) is the earliest documented case of human neurocranial and brain deformity in the fossil record to date. Despite her/his pathological condition, this individual was not rejected at birth and survived until at least 5 years of age, apparently receiving the same attention as other children from the group.