Inside a childs brain

Written by Pragati Verma | Updated: Dec 1 2009, 04:22am hrs
Figuring out if a kid has autism can be tricky. Most clinicians rely on behavioural characteristics to make a diagnosis. A brain imaging technology developed by Harvard University Childrens Hospital and being used at Bright Minds Institute has shown that many of these children diagnosed with autism could actually be suffering from brain seizures that are treatable. Indian hospitals including Max and Apollo are considering this brain imaging technology for diagnosing autism and other mental disorders.

Despite the fact that these developmental disorders originate in the brain, most of the children are diagnosed solely on the basis of the childs observable behaviour. For instance, a child is usually diagnosed with autism after a single psychological assessment, often lasting just one hour, laments Aditi Shankardass, head of neurophysiology at Bright Minds Institute, and head of EEG Laboratory at the department for communicative disorders at California State University Long Beach. Typically, children with impairments in social interaction; impairments in communication; and restricted interests and repetitive behaviour are diagnosed autistic.

According to her, almost half the 200 children who arrived at her clinic, previously diagnosed with autism, were in fact suffering from brain seizures, causing symptoms identical to autism. They used EEG (electroencephalography) technology to record the electric currents developed in the brain by means of electrodes applied to the scalp to look at brains. They found that many children who had been diagnosed autistic were not autistic at all. Many of them had brain seizures which are impossible to see with the naked eye but cause symptoms identical to autism. What the parents thought were moments of spacing out turned out to be moments of seizure activity.

I do not suggest that this neurophysiological test (EEG scan) be used as a replacement for neuropsychological tests (behavioural assessments), but that they be used in conjunction with such tests, to better triangulate the true source of the childs symptoms, Shankardass clarifies.

The brain contains over 100 billion nerve cells called neurons. Each neuron may have hundreds or thousands of connections that carry messages to other nerve cells in the brain and body. The connections and the chemical messengers they send (called neurotransmitters) let the neurons that help you see, feel, move, remember, and work together as they should. Some of the cells and connections in the brain of a kid with autismespecially those that affect communication, emotions and sensesdont develop properly or get damaged. An EEG can help confirm the seizures presence.

On a visit to India, Shankardass is currently in talks with Indian hospitals including Apollo and Max to install these at their premises. This technology records the EEG or electrical activity of the brain in real time, allowing them to watch the brain as it performs various functions, and detect the slightest abnormality in any of these functions.

A program called brain electrical activity mapping (BEAM) then triangulates the source of abnormal activity in the brain. Another program called statistical probability mapping (SPM) then applies various mathematical calculations to determine whether these abnormalities are clinically significant, allowing them to provide a more accurate neurological diagnosis of the childs symptoms.

About 74 million children are estimated to suffer from developmental disorders in India. Globally, one in six children suffer from such brain disorders. The rising numbers of autistic children, she says, are actually due to inaccurate diagnoses rather than a boom in autism. These EEG scans, she says, are revealing specific problems hidden within these childrens brains that would never have been detected by behavioural assessments, enabling more accurate diagnosis and more targeted treatments.

To prove her point, she explains the case of Justin Senigar, who came to her clinic after being diagnosed with autism. There were moments when he would actually space out for a few seconds at a time. The doctors told his parents he would never be able to communicate or interact normally, she recalls. EEG testing showed that he was suffering from seizures. After being given anti-seizure medication, his vocabulary went from two to three words to 200 to 300 words within a period of 60 days. His communication and social interaction improved so dramatically that he was able to enroll in a regular school, and learn karate. As many as 50% of children diagnosed with autism may be suffering from hidden brain seizures, she claims.