Paravicini was born extremely prematurely, at 25 weeks. His blindness was caused by oxygen therapy given during his time in a neonatal intensive care unit. This also affected his developing brain, resulting in his severe learning disability. He also has autism.
He has absolute pitch and can play a piece of music after hearing it once. He began playing the piano by the age of two when his nanny gave him an old keyboard. His parents arranged for him to attend the Linden Lodge School for the Blind in London.
On his introductory visit to the school, in the music room he broke free from his parents, then headed straight for a piano being played, and then pushed the player, Adam Ockelford, aside to take over. Ockelford encouraged him and arranged first weekly and then daily lessons.Aged seven, he gave his first concert in Tooting Leisure Centre in South London.
In 1989, at the age of nine, Paravicini had his first major public concert at the Barbican Hall in London when he played with the Royal Philharmonic Pops Orchestra. In that year he appeared on Wogan and was the main subject of a documentary called Musical Savants. Aged ten he was presented with a Barnardo's Children's Champion Award by Diana, Princess of Wales. More opportunities followed, including playing at Ronnie Scott's Jazz Club.
Paravicini is a resident at the Royal National Institute of the Blind.
He was featured on an episode of Channel 5's Extraordinary People in an episode titled "The Musical Genius", which showed his journey to Las Vegas to play in a charity concert with another savant, Rex Lewis-Clack. He was interviewed twice by Lesley Stahl for 60 Minutes.
In 2009 he was one of the subjects of the NOVA series' episode, "Musical Minds", featuring neurologist Oliver Sacks, on PBS. He was featured a second time by 60 Minutes on 14 March 2010.In 2009 he performed for the former Chancellor Alistair Darling, when he unexpectedly played Big Spender.
On 13 May 2010 Paravicini made legal history when the United Kingdom's last remaining secret court was opened for the first time to discuss his future care. The Court of Protection, which controls the future of adults incapable of managing their own affairs, appointed Paravicini's family to look after his welfare and commercial future. Until that legal decision was made the Official Solicitor from the Ministry of Justice had been looking after his affairs, rather than his divorced parents, Nicolas Paravicini and Mary Ann Parker Bowles.
On August 26, 2010 Derek was featured on the History Channel's Stan Lee's Superhumans. On the show Derek was subjected to testing which verified his savantism and superhuman musical ability. After improvising at two pianos with the composer Matthew King, for a radio programme made for BBC Radio 4, Derek and Matthew collaborated on a new Piano Concerto entitled Blue which was first performed with the Orchestra of St John's in the Queen Elizabeth Hall, London in September 2011. This is believed to be the first concerto ever composed for someone with learning disabilities.