TED | 关于学习障碍的思考

          

儿童的发育障碍通常是通过观察行为来诊断的，但是Aditi Shankardass建议，我们应该直接观察大脑。她在这场演讲中向我们展示一种改变了儿童成长轨迹的脑电图技术，甚至详细解释了这种技术又是如何揭示那些错误诊断的。

演讲者：Aditi Shankardass

演讲题目：A second opinion on developmental disorders

关于学习障碍的思考.mp3 来自英语七点半 00:00 07:36

  中英文对照翻译

When I was 10 years old, a cousin of mine took me on a tour of his medical school. And as a special treat, he took me to the pathology lab and took a real human brain out of the jar and placed it in my hands. And there it was, the seat of human consciousness, the powerhouse of the human body, sitting in my hands. And that day I knew that when I grew up, I was going to become a brain doctor, scientist, something or the other.

我十岁的时候，我的一个表兄带我参观了他上的医学院。作为一次特别优待，他带我去了病理学实验室，从一个罐子里拿出一个真正的人脑，把它放在了我手里。就是这 这里就是人们意识的载体，人们身体的司令部，它就在我手中。这一天我知道当我长大我会成为一名研究大脑的医生、科学家、或者是其他的什么。

Years later, when I finally grew up, my dream came true. And it was while I was doing my Ph.D. on the neurological causes of dyslexia in children that I encountered a startling fact that I'd like to share with you all today. It is estimated that one in six children, that's one in six children, suffer from some developmental disorder. This is a disorder that retards mental development in the child and causes permanent mental impairments. Which means that each and every one of you here today knows at least one child that is suffering from a developmental disorder.

几年之后当我真地长大了，我的梦想实现了。就在我做关于儿童阅读障碍的神经学起因的博士论文时，我发现了一个令人吃惊的现象。今天我想以此与你们分享。据估计有六分之一的儿童，六分之一呀，受发展障碍的影响。这是一种妨碍儿童智力发展，甚至导致智力永久损伤的疾病。这意味着今天在座的各位中每六个人中就有一个人知道至少一个孩子正在受发展障碍疾病的折磨。

But here's what really perplexed me. Despite the fact that each and every one of these disorders originates in the brain, most of these disorders are diagnosed solely on the basis of observable behavior. But diagnosing a brain disorder without actually looking at the brain is analogous to treating a patient with a heart problem based on their physical symptoms, without even doing an ECG or a chest X-ray to look at the heart. 

但是困扰我的还不是这个。尽管每一种疾病都可以在大脑中找到根源，但大部分只能通过可观察到的行为来确诊。诊断一种脑部疾病却不直接检查大脑，就像是治疗心脏病人根据他们的身体症状，而不做心电图或者胸部X-光片来检查心脏。 

It seemed so intuitive to me. To diagnose and treat a brain disorder accurately, it would be necessary to look at the brain directly. Looking at behavior alone can miss a vital piece of the puzzle and provide an incomplete, or even a misleading, picture of the child's problems. Yet, despite all the advances in medical technology, the diagnosis of brain disorders in one in six children still remained so limited.

我凭直觉感到要准确地诊断治疗脑部疾病，由此可见，直接检查大脑是很必要的。直接观察行为本身就可能错过至关重要的信息，而仅仅提供一种不完整，甚至能让人误解的构想。但是，尽管有先进的医疗技术，要诊断出六分之一患病儿童的病因依然不是件容易的事。

And then I came across a team at Harvard University that had taken one such advanced medical technology and finally applied it, instead of in brain research, towards diagnosing brain disorders in children. Their groundbreaking technology records the EEG, or the electrical activity of the brain, in real time, allowing us to watch the brain as it performs various functions and then detect even the slightest abnormality in any of these functions: vision, attention, language, audition. 

之后我便遇到了哈佛大学的一个小组，他们已经研发出了先进的医疗技术，并最终把这种技术应用到了诊断儿童脑部疾病中而不是应用到脑部研究。他们极具创造力的技术记录下了脑电图或实时的脑部电波活动，这可以让我们观察大脑，然后在它履行各种功能时我们就可以发现一些轻微的反常之处。比如下面的这些功能，视觉，注意力，语言，听觉等。 

A program called Brain Electrical Activity Mapping then triangulates the source of that abnormality in the brain. And another program called Statistical Probability Mapping then performs mathematical calculations to determine whether any of these abnormalities are clinically significant, allowing us to provide a much more accurate neurological diagnosis of the child's symptoms. 

有一项叫做大脑电波活动图谱的工程会找出大脑中的反常的地方，另一项叫做统计概率图谱的工程，用数学计算的办法来算出这些反常是否在临床上有用，如果有用就给我们提供了一种对儿童症状更准确的神经诊断方法。

And so I became the head of neurophysiology for the clinical arm of this team, and we're finally able to use this technology towards actually helping children with brain disorders. And I'm happy to say that I'm now in the process of setting up this technology here in India.

就这样我成为了这个团队中临床分支的领导者。最终我们可以用这种技术来帮助那些有大脑障碍的儿童。我很高兴现在我正将这项技术在印度建立起来。

I'd like to tell you about one such child, whose story was also covered by ABC News. Seven-year-old Justin Senigar came to our clinic with this diagnosis of very severe autism. Like many autistic children, his mind was locked inside his body. There were moments when he would actually space out for seconds at a time. And the doctors told his parents he was never going to be able to communicate or interact socially, and he would probably never have too much language.

我想告诉你，有这样一个孩子，他的故事也被ABC新闻报道过。七岁的查斯丁西尼加 来到我们诊所，他被诊断患有严重的自闭症。像许多自闭症儿童一样，他的思想被禁闭在身体中。就曾出现过他经常独自发呆几秒钟的情况。医生告诉他的父母，他再也不能与人交流了，他可能不太会说话了。

When we used this groundbreaking EEG technology to actually look at Justin's brain, the results were startling. It turned out that Justin was almost certainly not autistic. He was suffering from brain seizures that were impossible to see with the naked eye, but that were actually causing symptoms that mimicked those of autism. After Justin was given anti-seizure medication, the change in him was amazing. Within a period of 60 days, his vocabulary went from two to three words to 300 words. And his communication and social interaction were improved so dramatically that he was enrolled into a regular school and even became a karate super champ.

当我们用这种创造性的脑电图技术查看查斯丁的大脑时，结果令人吃惊。它显示查斯丁几乎没有自闭症。他正在受癫痫的折磨，而这几乎不可能用肉眼发现，却引起了像自闭症一样的症状。在治疗查斯丁的癫痫时，他的变化很惊人。60天之内，他的词汇量从两三个单词提高到300个单词。他的沟通和社交能力也得到了极大地提高，他上学之后还成为了空手道超级冠军。

Research shows that 50 percent of children, almost 50 percent of children diagnosed with autism are actually suffering from hidden brain seizures. These are the faces of the children that I have tested with stories just like Justin. All these children came to our clinic with a diagnosis of autism, attention deficit disorder, mental retardation, language problems. 

研究表明一半，几乎一半被诊断患有自闭症的儿童，实际上是受着隐秘的癫痫的折磨。这是一些我检测过的儿童的脸。有着像查斯丁一样故事的，这些孩子因为被诊断 患有自闭症，注意力缺失，智力障碍，语言问题来到我们的诊所。 

Instead, our EEG scans revealed very specific problems hidden within their brains that couldn't possibly have been detected by their behavioral assessments. So these EEG scans enabled us to provide these children with a much more accurate neurological diagnosis and much more targeted treatment.

而我们脑电图扫描显示他们的大脑中隐藏着一些问题，这些问题很可能不会通过对他们行为的估测来发现。因此这些脑电图扫描让我们对这些孩子做出了更为准确的精神诊断，我们也能更具针对性地治疗他们。

For too long now, children with developmental disorders have suffered from misdiagnosis while their real problems have gone undetected and left to worsen. And for too long, these children and their parents have suffered undue frustration and desperation. But we are now in a new era of neuroscience, one in which we can finally look directly at brain function in real time with no risks and no side effects, non-invasively, and find the true source of so many disabilities in children.

有发展障碍的儿童被误诊，而他们真正的问题却没有被发现，后来还变得更严重，这种情况持续太久了。这些孩子和他们的父母遭受挫折和绝望的折磨太久了。但现在我们处在一个神经科学的新时代，在这个时代我们可以实时地直接查看大脑的功能状态，这不会有危险或副作用，没有侵害性，并且可以找到这些儿童智力障碍的真正原因。

So if I could inspire even a fraction of you in the audience today to share this pioneering diagnostic approach with even one parent whose child is suffering from a developmental disorder, then perhaps one more puzzle in one more brain will be solved. One more mind will be unlocked. And one more child who has been misdiagnosed or even undiagnosed by the system will finally realize his or her true potential while there's still time for his or her brain to recover. And all this by simply watching the child's brainwaves.

如果今天我可以通过与一位孩子患有发展障碍的父母分享这种先进的诊断办法，让在座的各位中一小部分人感到备受鼓舞的话，那也许又可以消除了一个人的疑惑。又一个思想会被解放。又一个被误诊的、或是没有被该系统诊断的孩子会意识到他或她的潜力，并且还来得及让他或她的大脑恢复正常。而所有这些，只需通过观察这个孩子的脑电波。

Thank you.

谢谢。

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