TEDIndia 2009
Aditi Shankardass: A second opinion on developmental disorders
Aditi Shankardass: Una segona opinió sobre els trastorns d'aprenentage.
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Els trastorns de desenvolupament en infants normalment són diagnosticats mitjançant l'observació de la conducta, però Aditi Shankardass sabia que havíem de mirar directament els seus cervells. Explica com l'extraordinari dispositiu EEG del seu laboratori ha posat de manifest diagnòstics erronis i ha transformat la vida d'aquests nens.
Aditi Shankardass - Neuroscientist
Aditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis. Full bio
Aditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis. Full bio
Double-click the English transcript below to play the video.
00:16
When I was 10 years old,
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Quan tenia 10 anys,
00:19
a cousin of mine took me on a tour of his medical school.
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un cosí em va portar a la seva facultat de Medicina.
00:22
And as a special treat,
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Com a colofó,
00:24
he took me to the pathology lab
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em va dur al laboratori de patologies
00:26
and took a real human brain
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i va treure un cervell humà de debò
00:28
out of the jar
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d'un recipient
00:30
and placed it in my hands.
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i me'l va posar a les mans.
00:32
And there it was,
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Allà hi era,
00:34
the seat of human consciousness,
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la seu de la consciència humana,
00:36
the powerhouse of the human body,
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el centre neuràlgic del cos humà,
00:38
sitting in my hands.
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plantat a les meves mans.
00:40
And that day I knew that when I grew up,
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Aquell dia vaig saber que, quan creixés,
00:42
I was going to become a brain doctor,
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em convertiria en neuròloga
00:44
scientist, something or the other.
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o científica, l'una o l'altra.
00:47
Years later, when I finally grew up,
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Anys després, quan vaig créixer finalment,
00:50
my dream came true.
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el meu somni es va fer realitat.
00:52
And it was while I was doing my Ph.D.
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I mentre feia el meu doctorat
00:54
on the neurological causes
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sobre les causes neurològiques
00:56
of dyslexia in children
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de la dislèxia en nens,
00:58
that I encountered a startling fact
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em vaig trobar davant d'un fet esbalaïdor
01:00
that I'd like to share with you all today.
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que m'agradaria compartir avui amb tots vosaltres.
01:04
It is estimated that one in six children,
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Es calcula que un de cada sis nens,
01:06
that's one in six children,
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un de cada sis nens,
01:09
suffer from some developmental disorder.
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pateix algun tipus de trastorn de desenvolupament.
01:13
This is a disorder that
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Es tracta d'un trastorn
01:15
retards mental development in the child
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que retarda el desenvolupament mental de l'infant
01:17
and causes permanent mental impairments.
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i provoca discapacitats mentals permanents.
01:21
Which means that each and every one of you here today
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Això significa que cadascun de vosaltres aquí i ara
01:24
knows at least one child that is suffering
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coneix com a mínim un nen que pateix
01:27
from a developmental disorder.
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un trastorn de desenvolupament.
01:30
But here's what really perplexed me.
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Però el que realment em va deixar sorpresa va ser el següent:
01:32
Despite the fact that each
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Malgrat que
01:34
and every one of these disorders
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cada un d'aquests trastorns
01:36
originates in the brain,
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s'origina al cervell,
01:39
most of these disorders
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la majoria d'ells
01:41
are diagnosed solely on the basis
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es diagnostiquen exclusivament basant-se
01:43
of observable behavior.
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en la conducta observable.
01:46
But diagnosing a brain disorder
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Però el diagnòstic d'un trastorn cerebral
01:48
without actually looking at the brain
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sense ni tan sols observar el cervell
01:51
is analogous to treating a patient with a heart problem
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és equivalent a tractar un pacient amb problemes cardíacs
01:54
based on their physical symptoms,
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basant-se en els símptomes físics que presenta,
01:56
without even doing an ECG or a chest X-ray
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sense fer ni tan sols un electrocardiograma (ECG) o una radiografia del tòrax
01:59
to look at the heart.
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per tal de mirar el cor.
02:01
It seemed so intuitive to me.
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Em va semblar tant intuitiu.
02:04
To diagnose and treat a brain disorder accurately,
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Per tal de diagnosticar i tractar amb precisió un trastorn cerebral,
02:07
it would be necessary to look at the brain directly.
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seria necessari mirar el cervell directament.
02:10
Looking at behavior alone
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Si només observem la conducta
02:12
can miss a vital piece of the puzzle
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podem passar per alt una peça vital del trencaclosques
02:15
and provide an incomplete, or even a misleading,
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i proporcionar una imatge incompleta,
02:18
picture of the child's problems.
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o fins i tot errònia, dels problemes de l'infant.
02:21
Yet, despite all the advances in medical technology,
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Tot i els avenços en tecnologia mèdica,
02:24
the diagnosis of brain disorders
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el diagnòstic dels trastorns cerebrals
02:26
in one in six children
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en un de cada sis nens
02:28
still remained so limited.
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era encara molt limitat.
02:32
And then I came across a team at Harvard University
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Aleshores vaig topar amb un equip a la Universitat de Harvard
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that had taken one such advanced medical technology
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que havia agafat una tecnologia mèdica molt avançada
02:38
and finally applied it,
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i finalment l'havia aplicada
02:40
instead of in brain research,
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en comptes de cap a la investigació del cervell,
02:42
towards diagnosing brain disorders in children.
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cap al diagnòstic de trastorns cerebrals en infants.
02:46
Their groundbreaking technology
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La seva tecnologia innovadora
02:48
records the EEG, or the electrical activity
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enregistra l'EEG o l'activitat elèctrica
02:51
of the brain, in real time,
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del cervell en temps real,
02:54
allowing us to watch the brain
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de forma que ens permet observar el cervell
02:56
as it performs various functions
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mentre duu a terme diverses funcions
02:59
and then detect even the slightest abnormality
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i detectar fins i tot la més petita anomalia
03:01
in any of these functions:
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en qualsevol d'aquestes funcions,
03:03
vision, attention, language, audition.
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visió, atenció, llenguatge, audició.
03:06
A program called Brain Electrical
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Un programa que s'anomena Mapa d'Activitat
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Activity Mapping
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Elèctrica Cerebral
03:10
then triangulates the source
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triangula aleshores la font
03:12
of that abnormality in the brain.
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de l'anomalia en el cervell.
03:14
And another program called
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I un altre programa anomenat
03:16
Statistical Probability Mapping
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Mapa de Probabilitat Estadística
03:18
then performs mathematical calculations
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realitza uns càlculs matemàtics
03:21
to determine whether any of these abnormalities
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per tal de determinar si qualsevol d'aquestes anomalies
03:23
are clinically significant,
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és significant des del punt de vista clínic,
03:25
allowing us to provide a much more accurate
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la qual cosa ens permet de proveir un diagnòstic
03:27
neurological diagnosis
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neurològic molt més precís
03:29
of the child's symptoms.
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dels símptomes del nen.
03:31
And so I became the head of neurophysiology
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I així em vaig convertir en la cap de neurofisiologia
03:34
for the clinical arm of this team,
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de la branca clínica d'aquest equip.
03:36
and we're finally able to use this technology
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I per fi, som capaços de fer servir aquesta tecnologia
03:38
towards actually helping
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per tal de veritablement ajudar
03:40
children with brain disorders.
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els nens amb trastorns cerebrals.
03:42
And I'm happy to say that I'm now in the process
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Em fa feliç anunciar que estic en camí
03:44
of setting up this technology here in India.
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d'instal·lar aquesta tecnologia aquí, a l'Índia.
03:48
I'd like to tell you about one such child,
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M'agradaria parlar-vos d'un nen,
03:51
whose story was also covered by ABC News.
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la història del qual va publicar la cadena ABC News.
03:55
Seven-year-old Justin Senigar
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En Justin Senigar, de set anys,
03:57
came to our clinic with this diagnosis
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va venir a la clínica amb un diagnòstic
03:59
of very severe autism.
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d'autisme greu.
04:01
Like many autistic children,
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Com molts altres nens autistes,
04:03
his mind was locked inside his body.
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la seva ment estava tancada dins del seu cos.
04:06
There were moments when he would
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Hi havia moments en els quals
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actually space out for seconds at a time.
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estava absent durant segons sencers.
04:11
And the doctors told his parents
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Els metges van dir als pares
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he was never going to be able
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que en Justin mai no seria capaç
04:15
to communicate or interact socially,
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de comunicar-se o interactuar en un entorn social
04:17
and he would probably never have too much language.
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i que, amb probabilitat, mai no tindria un llenguatge gaire desenvolupat.
04:21
When we used this groundbreaking EEG technology
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Quan vam fer servir aquesta innovadora tecnologia de l'EEG
04:24
to actually look at Justin's brain,
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per tal de d'observar el cervell d'en Justin,
04:27
the results were startling.
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els resultats van ser sorprenents.
04:30
It turned out that Justin was almost
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Va resultar que, gairebé segur,
04:32
certainly not autistic.
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en Justin no era autista.
04:34
He was suffering from brain seizures
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Patia de convulsions cerebrals
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that were impossible to see with the naked eye,
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impossibles de detectar a simple vista,
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but that were actually causing symptoms
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però que causaven uns símptomes
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that mimicked those of autism.
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molt semblants als de l'autisme.
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After Justin was given anti-seizure medication,
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Després de donar en Justin un medicament contra aquestes convulsions,
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the change in him was amazing.
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el canvi va ser impactant.
04:51
Within a period of 60 days,
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Al cap de 60 dies,
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his vocabulary went from two to three words
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el seu vocabulari va passar de dues o tres paraules
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to 300 words.
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a 300.
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And his communication and social interaction
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A més, la seva comunicació i interacció social
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were improved so dramatically
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van millorar de forma tan espectacular
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that he was enrolled into a regular school
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que va ser matriculat en una escola normal
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and even became a karate super champ.
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i, fins i tot, va arribar a ser un supercampió de karate.
05:09
Research shows that 50 percent of children,
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Les investigacions mostren que el 50% del nens,
05:11
almost 50 percent of children
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gairebé el 50% dels nens,
05:13
diagnosed with autism
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diagnosticats amb autisme
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are actually suffering from hidden brain seizures.
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en realitat pateixen convulsions cerebrals ocultes.
05:20
These are the faces of the children
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Aquestes són les cares dels infants
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that I have tested
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que he examinat
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with stories just like Justin.
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i que tenen històries com la d'en Justin.
05:27
All these children
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Tots aquests nens
05:29
came to our clinic with a diagnosis
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van venir a la nostra clínica amb un diagnòstic
05:31
of autism, attention deficit disorder,
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d'autisme, de trastorn de dèficit d'atenció,
05:34
mental retardation, language problems.
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retard mental, problemes de llenguatge.
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Instead, our EEG scans revealed
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En canvi, els nostres escàners d'EEG van posar al descobert
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very specific problems hidden within their brains
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problemes molt específics amagats dins el cervell
05:44
that couldn't possibly have been detected
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que no haurien pogut ser detectats
05:46
by their behavioral assessments.
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per mitjà de les avaluacions de conducta.
05:49
So these EEG scans
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Així doncs, aquests escàners d'EEG
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enabled us to provide these children
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ens van permetre de proporcionar els infants
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with a much more accurate neurological diagnosis
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un diagnòstic neurològic molt més exacte
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and much more targeted treatment.
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i un tractament molt més acurat.
06:00
For too long now, children with developmental disorders
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Durant massa temps, els infants amb trastorns de desenvolupament
06:03
have suffered from misdiagnosis
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han patit de diagnòstics erronis
06:05
while their real problems have gone undetected
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mentre que els veritables problemes han passat desapercebuts
06:07
and left to worsen.
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i s'ha deixat que empitjoressin.
06:09
And for too long, these children and their parents
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I durant massa temps, aquests nens i els seus pares
06:12
have suffered undue frustration and desperation.
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han patit desesperació i frustració indegudes.
06:15
But we are now in a new era of neuroscience,
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Ara ens trobem en una nova era de la neurociència,
06:18
one in which we can finally look
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una era en la qual podem per fi observar
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directly at brain function in real time
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directament el funcionament del cervell en temps real
06:24
with no risks and no side effects, non-invasively,
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sense córrer riscos ni patir efectes secundaris, de forma no invasiva,
06:27
and find the true source
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i trobar l'origen real
06:29
of so many disabilities in children.
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de tantes discapacitats en els infants.
06:32
So if I could inspire
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Així doncs, si pogués promoure
06:34
even a fraction of you in the audience today
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ni que fos una petita part de tots vosaltres
06:37
to share this pioneering diagnostic approach
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que compartissiu aquesta visió pionera del diagnòstic
06:40
with even one parent whose child
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amb tan sols un pare el fill del qual
06:42
is suffering from a developmental disorder,
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pateixi un trastorn de desenvolupament,
06:45
then perhaps one more puzzle
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aleshores, potser, es podria resoldre
06:47
in one more brain will be solved.
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un misteri més d'un altre cervell.
06:49
One more mind will be unlocked.
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Una altra ment seria alliberada.
06:51
And one more child who has been misdiagnosed
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I un altre nen que el sistema ha diagnosticat de forma errònia
06:53
or even undiagnosed by the system
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o que ni tan sols ha diagnosticat
06:56
will finally realize his or her true potential
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podria finalment desenvolupar el seu veritable potencial
06:59
while there's still time
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mentre encara hi hagi temps
07:01
for his or her brain to recover.
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perquè el seu cervell es recuperi.
07:03
And all this by simply watching the child's brainwaves.
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I tot això es pot aconseguir només observant les ones cerebrals de l'infant.
07:06
Thank you.
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Gràcies.
07:08
(Applause)
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(Aplaudiments)
ABOUT THE SPEAKER
Aditi Shankardass - NeuroscientistAditi 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.
Aditi Shankardass | Speaker | TED.com