
Reading the scan, Miranda said Danny was not "perceiving" speech in the superior temporal gyrus.
Translation: Danny has what's known as an auditory processing issue. It wasn't so much that he was having trouble speaking or pronouncing things -- his brain wasn't understanding speech correctly.
Danny's problem was not a standard speech issue at all, and his years of conventional therapy were off target.
Miranda pointed out a group of squiggly lines on the scan, showing Danny was likely to have an attention problem.
In a normal EEG, those squiggly lines would not be there in the frontal lobe section of this recording. Using those tests and other physical and behavioral information, Miranda diagnosed Danny with ADHD.
"The areas of the brain that are involved in attention deficits are many, and unless you know which one specifically is the one that you're addressing, that is not functioning very well, you cannot prescribe the right medication for it," Miranda said.
For Danny, that meant the puzzle was solved in ways his grandparents never would have guessed.
"He wasn't a hyper child at all," Jeanne Rodgers said
Now on ADHD medication and specific therapy for his decoding problem, Danny has a lot to say.
"I didn't like learning. I thought it was boring ," Danny admitted in Miranda's office.
But now "it's kind of fun," he said.
"He got nine out of 10 'outstandings' on his report card! " his grandmother marveled.
Danny's unhappiness used to tear up his grandparents. Jeanne Rodgers and her husband, Howard, are spending all they can on his special therapy, and have also spent a bundle on the tests with Miranda, almost none of which were covered by insurance. But both of them said the costs have been well worth it.
Still, some leading doctors say it's too soon to use sophisticated tests like these clinically, and that people might be wasting their money on them.
Dr. Bradley Peterson, director of the Pediatric Neuropsychiatry Research program at Columbia College of Physicians and Surgeons, said the technology is not there yet.
"No test can tell you that this child has ADHD and that one doesn't," Peterson said. "At least at present day. Hopefully, in the next year or coming years, we might have that, but we don't yet."
Others who work with the technology routinely, such as Dr. Sandlan Lowe, a professor in the departments of psychiatry, physiology and neuroscience at New York University School of Medicine, said it can help in reaching a diagnosis.
"In Europe, for instance, EEG and quantitative EEG is routinely done," Lowe said. "In this country, I think there are a lot of neurologists who have the idea that it's just not that helpful. And I have to tell you that in the right hands, it's a very useful tool."
So why isn't it used more often? A number of doctors said reading the MRIs and EEGs is complicated, and not every neurologist is properly trained to read them. The tests are also expensive, and are often not covered by insurance.
Many scam artists have also claimed they could read these brain imaging tests when they could not, bilking people out of thousands of dollars.
But Miranda, as well as many patients, believe they are on the cutting edge of a new frontier in diagnosing and treating children's cognitive problems.
Jan Jensen, a nurse whose husband is a surgeon, worried about the attention problems she sawin her three children. But she wasn't happy that her family practictioner suggested prescribing Ritalin without doing any tests.
Lindsey, 12, always seemed restless and unfocused, Jensen said. Meagan, 8, was having significant trouble reading. But Jensen was especially worried about 9-year-old Zach.
"He's like the energizer bunny on crack. I'm telling you, this kid is constantly going," she said, adding he has almost no fear and little ability to understand the consequences of his actions.
All three had MRIs and quantitative EEGs, in addition to neuropsych workups. Lindsey's results weren't a surprise; she showed clear signs of attention deficit problems, Miranda said. But he recommended a different medication than Ritalin.
But the other children's data yielded some surprises. Zach's tests showed signs of ADHD but also structural problems in his brain.