TEDIndia 2009
Aditi Shankardass: A second opinion on developmental disorders
Aditi Shankardass 對學習障礙的另類看法
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兒童發展障礙一般是以觀察患者的行為來診斷，但是 Aditi Shankardass 認為我們應該由直接觀察患者的大腦來診斷，在本演講中她說明了如何使用試驗室中那一台，卓越的 EEC (腦波圖) 設備發現過去的誤診，並因此而改變了這些孩子的一生。
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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我十歲的時候，
00:19
a cousin of mine took me on a tour of his medical school.
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我表哥帶我參觀他所就讀的醫學院。
00:22
And as a special treat,
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他特別
00:24
he took me to the pathology lab
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帶我到病理實驗室參觀，
00:26
and took a real human brain
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並從一個罐子裡
00:28
out of the jar
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拿出一個真實的人腦
00:30
and placed it in my hands.
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放在我的手上。
00:32
And there it was,
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就這樣
00:34
the seat of human consciousness,
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人類意識行為的所在地、
00:36
the powerhouse of the human body,
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人體的發電站
00:38
sitting in my hands.
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就放在我手中了。
00:40
And that day I knew that when I grew up,
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這樣的經驗讓我當下就決定，長大以後
00:42
I was going to become a brain doctor,
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一定要當一個腦科的醫生
00:44
scientist, something or the other.
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或科學家，或其他相關的職業。
00:47
Years later, when I finally grew up,
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幾年之後，我長大了，
00:50
my dream came true.
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我的夢想成真了。
00:52
And it was while I was doing my Ph.D.
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當我做有關
00:54
on the neurological causes
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造成兒童誦讀困難的神經
00:56
of dyslexia in children
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因素的博士研究時，
00:58
that I encountered a startling fact
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我遇到一個讓人驚心的狀況，
01:00
that I'd like to share with you all today.
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我希望在今天演講中和大家分享。
01:04
It is estimated that one in six children,
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據估計，每六個兒童就有一個
01:06
that's one in six children,
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也就是六分之一的兒童
01:09
suffer from some developmental disorder.
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都有某一類的發展障礙問題。
01:13
This is a disorder that
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這種發展障礙會
01:15
retards mental development in the child
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阻礙兒童的心智發展，
01:17
and causes permanent mental impairments.
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並造成永久性的心智減損。
01:21
Which means that each and every one of you here today
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這就是說今天在座的各位
01:24
knows at least one child that is suffering
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最少會認識一個
01:27
from a developmental disorder.
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有發展障礙的孩子。
01:30
But here's what really perplexed me.
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但有一件事情我一直覺得很困惑，
01:32
Despite the fact that each
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因為儘管每一個
01:34
and every one of these disorders
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發展障礙的個案
01:36
originates in the brain,
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都是起源於腦這個器官，
01:39
most of these disorders
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但是大部分的診斷
01:41
are diagnosed solely on the basis
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都只建立在
01:43
of observable behavior.
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可觀察的患者行為之上。
01:46
But diagnosing a brain disorder
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但是診斷腦部障礙
01:48
without actually looking at the brain
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卻沒有直接觀察腦部情況，
01:51
is analogous to treating a patient with a heart problem
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就好像治療心臟病患，
01:54
based on their physical symptoms,
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只根據病患的生理症狀來判斷，
01:56
without even doing an ECG or a chest X-ray
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而不看心電圖或是胸腔 X
01:59
to look at the heart.
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光片一樣。
02:01
It seemed so intuitive to me.
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我直覺的認為，
02:04
To diagnose and treat a brain disorder accurately,
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要精確的診斷和治療腦部障礙問題，
02:07
it would be necessary to look at the brain directly.
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直接觀察腦部信號是一定必要的，
02:10
Looking at behavior alone
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單只觀察患者的行為，
02:12
can miss a vital piece of the puzzle
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將會遺漏掉解讀這個拼圖相當重要的部分，
02:15
and provide an incomplete, or even a misleading,
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因而導致資訊不完整， 甚至錯誤解讀
02:18
picture of the child's problems.
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病童的問題，
02:21
Yet, despite all the advances in medical technology,
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然而， 儘管醫學技術已經很先進了，
02:24
the diagnosis of brain disorders
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但是對於有六分之一兒童
02:26
in one in six children
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可能罹患腦部障礙之診斷方法，
02:28
still remained so limited.
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卻依然非常有限。
02:32
And then I came across a team at Harvard University
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後來我遇到哈佛大學的一個團隊，
02:35
that had taken one such advanced medical technology
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他們不用過去的研究腦部的方式，
02:38
and finally applied it,
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而改使用一種先進的醫療技術，
02:40
instead of in brain research,
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並將之應用
02:42
towards diagnosing brain disorders in children.
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在診斷兒童的腦部障礙方面，
02:46
Their groundbreaking technology
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這個突破性的技術
02:48
records the EEG, or the electrical activity
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能夠即時的紀錄腦部的腦波圖，
02:51
of the brain, in real time,
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或其他腦部活動的電子信號，
02:54
allowing us to watch the brain
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由此我們可以觀察到腦部
02:56
as it performs various functions
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在進行各種不同功能活動，
02:59
and then detect even the slightest abnormality
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並偵測到在進行這些功能時，
03:01
in any of these functions:
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非常細微的異常狀態，
03:03
vision, attention, language, audition.
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如視覺、注意力、語言及聽覺等功能中的異常現象。
03:06
A program called Brain Electrical
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(方法是) 先以一個名為｢腦部電子
03:08
Activity Mapping
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活動對映計｣，
03:10
then triangulates the source
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用三角定位的方式找出。
03:12
of that abnormality in the brain.
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腦部不正常信號的來源
03:14
And another program called
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然後用一個
03:16
Statistical Probability Mapping
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名為｢統計可能性對映計劃｣
03:18
then performs mathematical calculations
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作數學計算，
03:21
to determine whether any of these abnormalities
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以決定這些不正常點
03:23
are clinically significant,
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是否有臨床診斷上的意義，
03:25
allowing us to provide a much more accurate
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藉此可以對病童症狀
03:27
neurological diagnosis
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提供更精確的
03:29
of the child's symptoms.
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神經學診斷結果。
03:31
And so I became the head of neurophysiology
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因此我擔任了這個團隊
03:34
for the clinical arm of this team,
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臨床部門的神經生理學領導人，
03:36
and we're finally able to use this technology
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我們終於能夠應用這項技術，
03:38
towards actually helping
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實際幫助
03:40
children with brain disorders.
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有腦部障礙的兒童
03:42
And I'm happy to say that I'm now in the process
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我也很高興的告訴大家，現在
03:44
of setting up this technology here in India.
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我正在將這項技術應用在印度這裡。
03:48
I'd like to tell you about one such child,
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我想與各位談一位美國廣播公司(ABC)
03:51
whose story was also covered by ABC News.
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曾經報導過的那個孩子，
03:55
Seven-year-old Justin Senigar
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這位七歲的小孩名叫賈斯丁 (Justin Senigar) ，
03:57
came to our clinic with this diagnosis
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來到我們診所時是被診斷為
03:59
of very severe autism.
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有嚴重自閉症。
04:01
Like many autistic children,
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就像一般的自閉症的小孩，
04:03
his mind was locked inside his body.
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他的心智是被限鎖在他自己的身體範圍內。
04:06
There were moments when he would
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這是他每次發作時
04:08
actually space out for seconds at a time.
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昏昏沉沉的情形。
04:11
And the doctors told his parents
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醫生對他的父母說
04:13
he was never going to be able
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他將永遠無法
04:15
to communicate or interact socially,
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和這個社會溝通及互動，
04:17
and he would probably never have too much language.
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很有可能他不會有多少語言能力 。
04:21
When we used this groundbreaking EEG technology
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當我們使用這項破天荒的腦波圖(EEC)技術
04:24
to actually look at Justin's brain,
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去觀察賈斯丁的腦部，
04:27
the results were startling.
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結果讓人吃驚，
04:30
It turned out that Justin was almost
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我們幾乎可以確定賈斯丁
04:32
certainly not autistic.
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不是自閉症兒，
04:34
He was suffering from brain seizures
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他是因為被其他腦部毛病所擾
04:37
that were impossible to see with the naked eye,
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而肉眼看不到這個毛病。
04:40
but that were actually causing symptoms
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這樣產生的症狀，
04:42
that mimicked those of autism.
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看起來和自閉症呈現的現象很像。
04:45
After Justin was given anti-seizure medication,
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在給賈斯丁作抗發作的治療之後，
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the change in him was amazing.
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他的改變非常驚人。
04:51
Within a period of 60 days,
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在六十天之內，
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his vocabulary went from two to three words
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他所認識的字彙由三兩個字，
04:56
to 300 words.
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進步到三百個字，
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And his communication and social interaction
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他的溝通以及和社會互動的能力，
05:00
were improved so dramatically
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更是有戲劇性的發展，
05:02
that he was enrolled into a regular school
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他可以到一般的學校就讀，
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and even became a karate super champ.
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，甚至變成空手道優勝者
05:09
Research shows that 50 percent of children,
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研究顯示百分之五十,
05:11
almost 50 percent of children
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接近百分之五十,
05:13
diagnosed with autism
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被診斷為自閉症兒童，
05:15
are actually suffering from hidden brain seizures.
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其實是被其他潛在的腦部疾病所苦，
05:20
These are the faces of the children
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這些
05:22
that I have tested
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是我診斷過
05:24
with stories just like Justin.
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有和賈斯丁一樣情況的小孩，
05:27
All these children
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當他們到
05:29
came to our clinic with a diagnosis
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我們的診所來時是被誤診
05:31
of autism, attention deficit disorder,
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為自閉症、有注意力缺陷、
05:34
mental retardation, language problems.
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精神障礙 及語言障礙等
05:38
Instead, our EEG scans revealed
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但當我們用我們的EEC作掃描後，
05:41
very specific problems hidden within their brains
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潛藏在他們腦部特定地方的問題就顯現出來了，
05:44
that couldn't possibly have been detected
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而這些問題是不可能用
05:46
by their behavioral assessments.
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過去行為評估法可以發現的，
05:49
So these EEG scans
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所以EEC掃描
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enabled us to provide these children
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讓我們能過對這些孩童，
05:53
with a much more accurate neurological diagnosis
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提供更精確的診斷
05:56
and much more targeted treatment.
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及對症下藥的治療，
06:00
For too long now, children with developmental disorders
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長久以來，有行為發展障礙的小孩
06:03
have suffered from misdiagnosis
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一直苦於真正的問題
06:05
while their real problems have gone undetected
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沒有被檢測出來的誤診中，
06:07
and left to worsen.
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因而情況更加惡化。
06:09
And for too long, these children and their parents
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這些小孩的父母也長久以來
06:12
have suffered undue frustration and desperation.
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一直處在無窮盡的挫折及絕望之中。
06:15
But we are now in a new era of neuroscience,
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但是現在神經科學的新世紀來臨了，
06:18
one in which we can finally look
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用這個新科技，我們終於
06:21
directly at brain function in real time
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可以用非侵入性、
06:24
with no risks and no side effects, non-invasively,
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沒有風險及副作用、直接且及時的
06:27
and find the true source
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發現許多失能兒童
06:29
of so many disabilities in children.
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真正的病源。
06:32
So if I could inspire
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所以如果我能激發
06:34
even a fraction of you in the audience today
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今天聽眾中一部分人，
06:37
to share this pioneering diagnostic approach
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將這一項先進的診斷方式
06:40
with even one parent whose child
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與患有發展障礙兒童的
06:42
is suffering from a developmental disorder,
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一對父母溝通分享，
06:45
then perhaps one more puzzle
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也許就又有一個腦
06:47
in one more brain will be solved.
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的困惑會被解決，
06:49
One more mind will be unlocked.
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又有一個被鎖住的心智也將被解開，
06:51
And one more child who has been misdiagnosed
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又有一個被現在診斷系統誤診
06:53
or even undiagnosed by the system
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或是不曾診斷病因的兒童
06:56
will finally realize his or her true potential
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能夠在還能補救的時限之前救回來，
06:59
while there's still time
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而得以將他們的潛力
07:01
for his or her brain to recover.
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實際展現出來。
07:03
And all this by simply watching the child's brainwaves.
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而這一切，只要由觀察小孩的腦波圖就可以做得到。
07:06
Thank you.
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謝謝
07:08
(Applause)
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掌聲
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