TEDIndia 2009
Aditi Shankardass: A second opinion on developmental disorders
Aditi Shankardass: En fornyet vurdering af indlæringsvanskligheder
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Udviklingsforstyrrelser hos børn er typisk diagnosticeret ved at observere adfærd, men Aditi Shankardass ved, at vi bør se direkte på deres hjerner. Hun forklarer, hvordan hendes laboratoriums bemærkelsesværdige EEG enhed har afsløret fejldiagnoser og forandret børns liv.
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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Da jeg var 10 år gammel,
00:19
a cousin of mine took me on a tour of his medical school.
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viste min fætter mig rundt på sit medicinstudie.
00:22
And as a special treat,
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Og som noget helt særligt
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he took me to the pathology lab
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viste han mig patologilaboratoriet
00:26
and took a real human brain
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og tog en rigtig menneskehjerne
00:28
out of the jar
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ud af glasset
00:30
and placed it in my hands.
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og lagde den i mine hænder.
00:32
And there it was,
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Og der lå den,
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the seat of human consciousness,
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sædet af den menneskelige bevidsthed,
00:36
the powerhouse of the human body,
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kraftens hus i det menneskelige legeme,
00:38
sitting in my hands.
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liggende i mine hænder.
00:40
And that day I knew that when I grew up,
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Og den dag vidste jeg, at når jeg blev voksen,
00:42
I was going to become a brain doctor,
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så ville jeg være hjernelæge,
00:44
scientist, something or the other.
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videnskabsmand eller noget i den retning.
00:47
Years later, when I finally grew up,
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Flere år senere, da jeg endelig blev voksen,
00:50
my dream came true.
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blev min drøm til virkelighed.
00:52
And it was while I was doing my Ph.D.
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Og det var imens jeg var i gang med min Ph.D.
00:54
on the neurological causes
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om de neurologiske årsager
00:56
of dyslexia in children
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til ordblindhed i børn,
00:58
that I encountered a startling fact
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at jeg stødte på en overraskende kendsgerning,
01:00
that I'd like to share with you all today.
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som jeg gerne vil dele med jer i dag.
01:04
It is estimated that one in six children,
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Det anslås, at 1 ud af 6 børn,
01:06
that's one in six children,
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det er et ud af seks børn,
01:09
suffer from some developmental disorder.
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lider af en slags udviklingsforstyrrelse.
01:13
This is a disorder that
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Det er en lidelse, der
01:15
retards mental development in the child
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forsinker den mentale udvikling i barnet,
01:17
and causes permanent mental impairments.
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og forårsager permanente psykiske handicaps.
01:21
Which means that each and every one of you here today
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Og det betyder at hver og en af jer her i dag
01:24
knows at least one child that is suffering
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kender mindst ét barn, der lider
01:27
from a developmental disorder.
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af en udviklingsforstyrrelse.
01:30
But here's what really perplexed me.
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Men det der virkelig forvirrede mig var,
01:32
Despite the fact that each
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at til trods for kendsgerningen, at hver
01:34
and every one of these disorders
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og en af disse lidelser
01:36
originates in the brain,
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har oprindelse i hjernen,
01:39
most of these disorders
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så bliver de fleste af disse lidelser
01:41
are diagnosed solely on the basis
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kun diagnosticeret på basis
01:43
of observable behavior.
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af observerbar adfærd.
01:46
But diagnosing a brain disorder
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Men at diagnosticere en hjernesygdom
01:48
without actually looking at the brain
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uden rent faktisk at kigge på hjernen,
01:51
is analogous to treating a patient with a heart problem
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svarer til at behandle en patient med et hjerteproblem
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based on their physical symptoms,
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baseret på deres fysiske symptomer,
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without even doing an ECG or a chest X-ray
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uden overhovedet at foretage en EKG eller røntgenfotografering
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to look at the heart.
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for at se på hjertet.
02:01
It seemed so intuitive to me.
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Det virkede så intuitivt for mig.
02:04
To diagnose and treat a brain disorder accurately,
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For at diagnosticere og behandle en hjernesygdom præcist,
02:07
it would be necessary to look at the brain directly.
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måtte det være nødvendigt at kigge direkte på hjernen.
02:10
Looking at behavior alone
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At kigge på adfærden alene kan betyde,
02:12
can miss a vital piece of the puzzle
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at man går glip af en vigtig brik i puslespillet
02:15
and provide an incomplete, or even a misleading,
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og det giver et ufuldstændigt, eller ligefrem vildledende
02:18
picture of the child's problems.
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billede af barnets problemer.
02:21
Yet, despite all the advances in medical technology,
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Og til trods for alle fremskridt inden for den medicinske tekonologi,
02:24
the diagnosis of brain disorders
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forblev diagnosticeringen af hjernesygdomme
02:26
in one in six children
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i et ud af seks børn
02:28
still remained so limited.
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stadig så begrænset.
02:32
And then I came across a team at Harvard University
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Og så stødte jeg på et team på Harvard Universitet,
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that had taken one such advanced medical technology
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der havde taget den avancerede medicinske teknologi
02:38
and finally applied it,
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og endeligt anvendt den
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instead of in brain research,
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i stedet for hjerneforskning,
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towards diagnosing brain disorders in children.
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for at diagnosticere hjernesygdomme i børn.
02:46
Their groundbreaking technology
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Deres banebrydende teknologi
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records the EEG, or the electrical activity
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registrerer EEG eller den elektriske aktivitet
02:51
of the brain, in real time,
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i hjernen i realtid,
02:54
allowing us to watch the brain
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hvilket lader os se på hjernen,
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as it performs various functions
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mens den udfører forskellige funtioner
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and then detect even the slightest abnormality
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og vi kan se selv de mindste abnormaliteter
03:01
in any of these functions:
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i hver af disse funktioner:
03:03
vision, attention, language, audition.
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syn, opmærskomhed, sprog, hørelse.
03:06
A program called Brain Electrical
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Et program kaldet Hjernens Elektriske
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Activity Mapping
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Aktivitetskortlægning
03:10
then triangulates the source
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triangulerer så kilden
03:12
of that abnormality in the brain.
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til denne abnormalitet i hjernen.
03:14
And another program called
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Og et andet program, der hedder
03:16
Statistical Probability Mapping
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Statistisk Sandsynlighedskortlægning,
03:18
then performs mathematical calculations
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udfører så matematiske udregninger
03:21
to determine whether any of these abnormalities
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for at bestemme om disse abnormaliteter
03:23
are clinically significant,
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er klinisk signifikante,
03:25
allowing us to provide a much more accurate
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hvilket giver os en meget mere nøjagtig
03:27
neurological diagnosis
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neurologisk diagnose
03:29
of the child's symptoms.
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af barnets symptomer.
03:31
And so I became the head of neurophysiology
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Og så blev jeg leder af neurofysiologi
03:34
for the clinical arm of this team,
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for den kliniske del af dette team.
03:36
and we're finally able to use this technology
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Nu kan vi endelig bruge denne teknologi
03:38
towards actually helping
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til rent faktisk at hjælpe
03:40
children with brain disorders.
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børn med hjernesygdomme.
03:42
And I'm happy to say that I'm now in the process
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Og jeg kan med glæde sige, at jeg nu er i gang med at
03:44
of setting up this technology here in India.
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etablere denne teknologi her i Indien.
03:48
I'd like to tell you about one such child,
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Jeg vil gerne fortælle Jer om et sådant barn,
03:51
whose story was also covered by ABC News.
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hvis historie også blev fortalt på ABC News.
03:55
Seven-year-old Justin Senigar
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Syv-årige Justin Senigar
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came to our clinic with this diagnosis
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kom til vores klinik, diagnosticeret
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of very severe autism.
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med svær autisme.
04:01
Like many autistic children,
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Ligesom hos mange andre autistiske børn
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his mind was locked inside his body.
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var hans sind indelåst i hans krop.
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There were moments when he would
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Der var øjeblikke, hvor han
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actually space out for seconds at a time.
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blev helt tom i blikket i flere sekunder ad gangen.
04:11
And the doctors told his parents
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Og lægerne sagde til hans forældre,
04:13
he was never going to be able
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at han aldrig ville kunne
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to communicate or interact socially,
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kommunikere eller fungere socialt,
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and he would probably never have too much language.
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og at han sikkert aldrig ville have meget sprog.
04:21
When we used this groundbreaking EEG technology
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Da vi brugte den banebrydende EEG teknologi
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to actually look at Justin's brain,
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for faktisk at se på Justins hjerne,
04:27
the results were startling.
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var resultatet overraskende.
04:30
It turned out that Justin was almost
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Det viste sig at Justin næsten helt
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certainly not autistic.
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sikkert ikke var autistisk.
04:34
He was suffering from brain seizures
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Hen led af slagtilfælde i hjernen,
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that were impossible to see with the naked eye,
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som man umuligt kunne se med det blotte øje,
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but that were actually causing symptoms
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men som faktisk forårsagede de symptomer,
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that mimicked those of autism.
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der lignede autisme.
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After Justin was given anti-seizure medication,
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Efter Justin fik anti-slagtilfældemedicin,
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the change in him was amazing.
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var forandringen i ham utrolig.
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Within a period of 60 days,
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Inden for en periode på 60 dage
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his vocabulary went from two to three words
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voksede hans ordforråd fra to-tre ord
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to 300 words.
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til 300 ord.
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And his communication and social interaction
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Og hans kommunikation og sociale adfærd
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were improved so dramatically
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blev så meget bedre,
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that he was enrolled into a regular school
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at han blev indskrevet i en almidelig skole,
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and even became a karate super champ.
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og han blev endda karatemester.
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Research shows that 50 percent of children,
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Forskning viser at 50% af børn,
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almost 50 percent of children
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næsten 50% af børn
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diagnosed with autism
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diagnosticeret med autisme,
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are actually suffering from hidden brain seizures.
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rent faktisk lider af gemte slagtilfælde i hjernen.
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These are the faces of the children
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Disse er ansigterne på børnene,
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that I have tested
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som jeg har testet,
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with stories just like Justin.
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med historier ligesom Justins.
05:27
All these children
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Alle disse børn
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came to our clinic with a diagnosis
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kom til vores klinik diagnosticeret
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of autism, attention deficit disorder,
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med autisme, opmærksomhedsunderskud,
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mental retardation, language problems.
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mental retardering, sprogproblemer.
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Instead, our EEG scans revealed
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I stedet viste vores EEG-scanniger
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very specific problems hidden within their brains
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meget specifikke problemer gemt i deres hjerner,
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that couldn't possibly have been detected
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som umuligt kunne have været opdaget
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by their behavioral assessments.
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via adfærdsmæssige vurderinger.
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So these EEG scans
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Derfor hjalp disse EEG-scanniger
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enabled us to provide these children
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os med at give disse børn
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with a much more accurate neurological diagnosis
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en meget mere nøjagtig neurologisk diagnose
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and much more targeted treatment.
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og en meget mere målrettet behandling.
06:00
For too long now, children with developmental disorders
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I alt for lang tid nu har børn med udviklingsforstyrrelser
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have suffered from misdiagnosis
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lidt af fejldiagnoser,
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while their real problems have gone undetected
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mens deres rigtige problemer forbliver uopdagede
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and left to worsen.
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og forværres.
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And for too long, these children and their parents
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Og i for lang tid har disse børn og deres forældre
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have suffered undue frustration and desperation.
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lidt unødig frustration og desperation.
06:15
But we are now in a new era of neuroscience,
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Men nu er vi i en ny æra af neurovidenskab,
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one in which we can finally look
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i hvilken vi endelig kan se
06:21
directly at brain function in real time
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direkte på hjernens funktioner i realtid,
06:24
with no risks and no side effects, non-invasively,
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uden risici eller bivirkninger, ikke-invasivt,
06:27
and find the true source
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og finde den sande kilde
06:29
of so many disabilities in children.
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til så mange handicaps i børn.
06:32
So if I could inspire
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Så hvis jeg kan inspirere
06:34
even a fraction of you in the audience today
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selv kun en brøkdel af jer i publikum i dag
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to share this pioneering diagnostic approach
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til at dele denne banebrydende diagnostiske metode
06:40
with even one parent whose child
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med blot én forælder hvis barn
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is suffering from a developmental disorder,
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lider af en udviklingsforstyrrelse,
06:45
then perhaps one more puzzle
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så bliver måske endnu et puslespil
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in one more brain will be solved.
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i en hjerne løst.
06:49
One more mind will be unlocked.
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Endnu et sind kan blive befriet.
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And one more child who has been misdiagnosed
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Og endnu et barn som er blevet fejldiagnosticeret,
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or even undiagnosed by the system
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eller helt udiagnosticeret af systemet,
06:56
will finally realize his or her true potential
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kan endeligt realisere sit sande potentiale,
06:59
while there's still time
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mens der stadig er tid
07:01
for his or her brain to recover.
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til at hans eller hendes hjerne kan komme sig.
07:03
And all this by simply watching the child's brainwaves.
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Og alt dette blot ved at kigge på barnets hjernebølger.
07:06
Thank you.
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Tak.
07:08
(Applause)
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Bifald.
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