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TEDIndia 2009

Aditi Shankardass: A second opinion on developmental disorders

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Views 961,301

Developmental disorders in children are typically diagnosed by observing behavior, but Aditi Shankardass suggests we should be looking directly at brains. She explains how one EEG technique has revealed mistaken diagnoses and transformed children's lives.

- Neuroscientist
Aditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis. Full bio

When I was 10 years old,
00:16
a cousin of mine took me on a tour of his medical school.
00:19
And as a special treat,
00:22
he took me to the pathology lab
00:24
and took a real human brain
00:26
out of the jar
00:28
and placed it in my hands.
00:30
And there it was,
00:32
the seat of human consciousness,
00:34
the powerhouse of the human body,
00:36
sitting in my hands.
00:38
And that day I knew that when I grew up,
00:40
I was going to become a brain doctor,
00:42
scientist, something or the other.
00:44
Years later, when I finally grew up,
00:47
my dream came true.
00:50
And it was while I was doing my Ph.D.
00:52
on the neurological causes
00:54
of dyslexia in children
00:56
that I encountered a startling fact
00:58
that I'd like to share with you all today.
01:00
It is estimated that one in six children,
01:04
that's one in six children,
01:06
suffer from some developmental disorder.
01:09
This is a disorder that
01:13
retards mental development in the child
01:15
and causes permanent mental impairments.
01:17
Which means that each and every one of you here today
01:21
knows at least one child that is suffering
01:24
from a developmental disorder.
01:27
But here's what really perplexed me.
01:30
Despite the fact that each
01:32
and every one of these disorders
01:34
originates in the brain,
01:36
most of these disorders
01:39
are diagnosed solely on the basis
01:41
of observable behavior.
01:43
But diagnosing a brain disorder
01:46
without actually looking at the brain
01:48
is analogous to treating a patient with a heart problem
01:51
based on their physical symptoms,
01:54
without even doing an ECG or a chest X-ray
01:56
to look at the heart.
01:59
It seemed so intuitive to me.
02:01
To diagnose and treat a brain disorder accurately,
02:04
it would be necessary to look at the brain directly.
02:07
Looking at behavior alone
02:10
can miss a vital piece of the puzzle
02:12
and provide an incomplete, or even a misleading,
02:15
picture of the child's problems.
02:18
Yet, despite all the advances in medical technology,
02:21
the diagnosis of brain disorders
02:24
in one in six children
02:26
still remained so limited.
02:28
And then I came across a team at Harvard University
02:32
that had taken one such advanced medical technology
02:35
and finally applied it,
02:38
instead of in brain research,
02:40
towards diagnosing brain disorders in children.
02:42
Their groundbreaking technology
02:46
records the EEG, or the electrical activity
02:48
of the brain, in real time,
02:51
allowing us to watch the brain
02:54
as it performs various functions
02:56
and then detect even the slightest abnormality
02:59
in any of these functions:
03:01
vision, attention, language, audition.
03:03
A program called Brain Electrical
03:06
Activity Mapping
03:08
then triangulates the source
03:10
of that abnormality in the brain.
03:12
And another program called
03:14
Statistical Probability Mapping
03:16
then performs mathematical calculations
03:18
to determine whether any of these abnormalities
03:21
are clinically significant,
03:23
allowing us to provide a much more accurate
03:25
neurological diagnosis
03:27
of the child's symptoms.
03:29
And so I became the head of neurophysiology
03:31
for the clinical arm of this team,
03:34
and we're finally able to use this technology
03:36
towards actually helping
03:38
children with brain disorders.
03:40
And I'm happy to say that I'm now in the process
03:42
of setting up this technology here in India.
03:44
I'd like to tell you about one such child,
03:48
whose story was also covered by ABC News.
03:51
Seven-year-old Justin Senigar
03:55
came to our clinic with this diagnosis
03:57
of very severe autism.
03:59
Like many autistic children,
04:01
his mind was locked inside his body.
04:03
There were moments when he would
04:06
actually space out for seconds at a time.
04:08
And the doctors told his parents
04:11
he was never going to be able
04:13
to communicate or interact socially,
04:15
and he would probably never have too much language.
04:17
When we used this groundbreaking EEG technology
04:21
to actually look at Justin's brain,
04:24
the results were startling.
04:27
It turned out that Justin was almost
04:30
certainly not autistic.
04:32
He was suffering from brain seizures
04:34
that were impossible to see with the naked eye,
04:37
but that were actually causing symptoms
04:40
that mimicked those of autism.
04:42
After Justin was given anti-seizure medication,
04:45
the change in him was amazing.
04:48
Within a period of 60 days,
04:51
his vocabulary went from two to three words
04:53
to 300 words.
04:56
And his communication and social interaction
04:58
were improved so dramatically
05:00
that he was enrolled into a regular school
05:02
and even became a karate super champ.
05:05
Research shows that 50 percent of children,
05:09
almost 50 percent of children
05:11
diagnosed with autism
05:13
are actually suffering from hidden brain seizures.
05:15
These are the faces of the children
05:20
that I have tested
05:22
with stories just like Justin.
05:24
All these children
05:27
came to our clinic with a diagnosis
05:29
of autism, attention deficit disorder,
05:31
mental retardation, language problems.
05:34
Instead, our EEG scans revealed
05:38
very specific problems hidden within their brains
05:41
that couldn't possibly have been detected
05:44
by their behavioral assessments.
05:46
So these EEG scans
05:49
enabled us to provide these children
05:51
with a much more accurate neurological diagnosis
05:53
and much more targeted treatment.
05:56
For too long now, children with developmental disorders
06:00
have suffered from misdiagnosis
06:03
while their real problems have gone undetected
06:05
and left to worsen.
06:07
And for too long, these children and their parents
06:09
have suffered undue frustration and desperation.
06:12
But we are now in a new era of neuroscience,
06:15
one in which we can finally look
06:18
directly at brain function in real time
06:21
with no risks and no side effects, non-invasively,
06:24
and find the true source
06:27
of so many disabilities in children.
06:29
So if I could inspire
06:32
even a fraction of you in the audience today
06:34
to share this pioneering diagnostic approach
06:37
with even one parent whose child
06:40
is suffering from a developmental disorder,
06:42
then perhaps one more puzzle
06:45
in one more brain will be solved.
06:47
One more mind will be unlocked.
06:49
And one more child who has been misdiagnosed
06:51
or even undiagnosed by the system
06:53
will finally realize his or her true potential
06:56
while there's still time
06:59
for his or her brain to recover.
07:01
And all this by simply watching the child's brainwaves.
07:03
Thank you.
07:06
(Applause)
07:08

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About the speaker:

Aditi Shankardass - Neuroscientist
Aditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis.

Why you should listen

Aditi Shankardass is a neuroscientist trained across three disciplines of the field: neurophysiology, neuroanatomy and neuropsychology. She has also worked across different levels of the field, from cellular to cognitive neuroscience, and been based in research labs as well as diagnostic clinics. Currently, she leads the Neurophysiology Lab of the Communicative Disorders Department at California State University.

Much of Shankardass' work has been devoted to the use of an advanced form of digital quantitative EEG (electroencephalography) technology that records the brain's activity in real time, and then analyzes it using complex display schematics and statistical comparisons to norms, enabling far more accurate diagnoses for children with developmental disorders. She is also actively involved in public outreach to increase understanding of brain disorders as a board member of the Global Neuroscience Initiative Foundation and a consultant for the BBC Science Line.

More profile about the speaker
Aditi Shankardass | Speaker | TED.com