As a developmental pediatrician, I have spent many years researching and diagnosing learning disorders. During my time as director of the Division of Child Development at the University of South Florida’s College of Medicine, in the 1980s and 1990s, I conducted research on Brain Electrical Activity Mapping (BEAM) and published a number of papers around the topic. Our research was driven by the belief that detecting and diagnosing learning disorders through brain activity would be much more accurate and successful than the current method of relying upon observable behavior.
Unfortunately, although we were able to identify key areas of brain abnormality, and even developed diagnostic tests to evaluate the data, I began to question the clinical diagnostic utility of BEAM. In fact, the topic remains under much debate due to the overlap and inconsistency of findings over the years.
I was interested to come across the TEDTalk from Aditi Shankardass, A Second Opinion on Learning Disorders. Her team is utilizing EEG technology in an attempt to more accurately diagnose learning disorders. She speaks specifically about the ability of this technology to detect seizures in a child that was previously thought to have autism. However, neurologists have been able to use traditional EEG for this purpose for over 90 years and there is little evidence that BEAM enhances our diagnostic ability in any significant way. Multiple studies have shown that seizures masking as autism is a very rare occurrence.
Significant differences have been detected between children with ADHD and children without, and between children with LD and children without; however, the findings are not consistent and there is considerable overlap. For instance, if you look at the BEAM maps of ADHD children compared to children without ADHD, the primary differences will be in the frontal lobe. But when you look at the BEAM maps of schizophrenic adults compared to non-schizophrenic adults, they too show abnormalities in the frontal lobe. While these studies have clearly shown that there is a neurological basis to these disorders, they are not very helpful in making a diagnosis; if a child has a BEAM map showing frontal lobe dysfunction, do they have ADHD or schizophrenia? Or are they part of the 5-10% of the population who will show frontal lobe problems without any clinical symptoms (in other words, a false positive)?
Parents, schools, teachers, and children would all benefit from the development of a technology that would accurately and definitively diagnose learning disorders. As Ms. Shankardass rightly points out, these are neurological disorders and thus it makes sense to attempt the diagnosis with neurological techniques. However, I very much doubt that these expensive and time-consuming tests really add any diagnostic utility over a combination of detailed history-taking, close observation of the child in the classroom, and current psycho-educational testing.