TED2015
Steve Silberman: The forgotten history of autism
史蒂夫 希尔伯曼: 自闭症被湮没的历史
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几十年前, 几乎很少有医护工作者听说过自闭症。在1975年，每1500个孩子里只有一个被诊断有自闭症。而如今，每68个孩子中就有一个类似的自闭案例。是什么导致了这种比例的陡升？史蒂夫指出了历史上的一段“自闭症觉醒风潮” — 一些医生推出了一种接受度更广的观点，造就了一段未能预知的大众文化，并提供了一项新的诊断方法。但要进行深入探究，我们需要了解一位名叫汉斯·阿斯伯格的医生。他在1944年发表了一篇极具研究价值的论文，然而由于种种原因，他与他的这篇文章被埋没了，人们也因此错失了一次正确认识自闭症的机会。
【本段演讲是TED2015由Pop-up杂志策划的一部分。详情点击popupmagazine.com或者推特@popupmag】
Steve Silberman - Writer and editor
Steve Silberman is a writer and contributing editor for Wired who covers science and society. His newest book explores neurodiversity and the link between autism and genius. Full bio
Steve Silberman is a writer and contributing editor for Wired who covers science and society. His newest book explores neurodiversity and the link between autism and genius. Full bio
Double-click the English transcript below to play the video.
00:12
Just after Christmas last year,
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就在去年圣诞节过后，
00:15
132 kids in California got the measles
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加州有132个孩子感染了麻疹,
00:19
by either visiting Disneyland
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原因是他们去过了迪斯尼乐园，
00:21
or being exposed to someone
who'd been there.
who'd been there.
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或是接触了某些去过迪斯尼的孩子。
00:24
The virus then hopped the Canadian border,
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之后病毒还窜到了美加边境，
00:27
infecting more than
100 children in Quebec.
100 children in Quebec.
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感染了在魁北克的100多个孩子。
00:30
One of the tragic things
about this outbreak
about this outbreak
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这次的麻疹爆发中让人非常痛心的是，
00:33
is that measles, which can be fatal
to a child with a weakened immune system,
to a child with a weakened immune system,
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尽管麻疹对于抵抗力低的
孩子可能致命，
孩子可能致命，
它同时也是世界上
最容易预防的疾病之一。
最容易预防的疾病之一。
00:39
is one of the most easily
preventable diseases in the world.
preventable diseases in the world.
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00:43
An effective vaccine against it
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能够有效预防麻疹的疫苗
00:45
has been available for more
than half a century,
than half a century,
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早在半个多世纪前就已经面世，
00:48
but many of the kids involved
in the Disneyland outbreak
in the Disneyland outbreak
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但在这次的迪斯尼麻疹大爆发中，
00:51
had not been vaccinated
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很多被感染的孩子都未接种过疫苗，
00:53
because their parents were afraid
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因为他们的家长担心
00:56
of something allegedly even worse:
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接种疫苗可能会导致一个
更“严重”的问题：
更“严重”的问题：
00:59
autism.
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自闭症。
01:00
But wait -- wasn't the paper
that sparked the controversy
that sparked the controversy
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但是—— 回想一下，那篇
01:04
about autism and vaccines
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引发此争议的报道
01:06
debunked, retracted,
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不是早已经被英国医学周刊
01:08
and branded a deliberate fraud
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揭发、撤回，并且被证实是
刻意的欺诈造谣吗？
01:11
by the British Medical Journal?
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01:13
Don't most science-savvy people
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难道略懂些科学的人们
01:15
know that the theory
that vaccines cause autism is B.S.?
that vaccines cause autism is B.S.?
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不知道所谓“疫苗引发自闭症”的
理论是胡说八道吗？
理论是胡说八道吗？
01:19
I think most of you do,
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我相信大多数人是知道的。
01:21
but millions of parents worldwide
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但是世界上还是有很多家长
01:23
continue to fear that vaccines
put their kids at risk for autism.
put their kids at risk for autism.
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仍然担心注射疫苗会带来
患上自闭症的风险。
患上自闭症的风险。
01:28
Why?
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为什么会这样？
01:30
Here's why.
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我来告诉你为什么。
01:32
This is a graph of autism
prevalence estimates rising over time.
prevalence estimates rising over time.
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这是显示自闭症患者数量
普遍性上升的一个统计图表。
普遍性上升的一个统计图表。
01:37
For most of the 20th century,
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在几乎整个20世纪，
01:39
autism was considered
an incredibly rare condition.
an incredibly rare condition.
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自闭症都被认为是一种
极其罕见的疾病。
极其罕见的疾病。
01:43
The few psychologists and pediatricians
who'd even heard of it
who'd even heard of it
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少数几个听说过它的
心理学家和儿科医生，
心理学家和儿科医生，
01:46
figured they would get through
their entire careers
their entire careers
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觉得可能在他们的整个职业生涯中
01:49
without seeing a single case.
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也不会遇到一个这样的病例。
01:52
For decades, the prevalence estimates
remained stable
remained stable
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几十年间，
自闭症患者的统计数量都维持稳定，
自闭症患者的统计数量都维持稳定，
01:55
at just three or four children in 10,000.
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在1万个孩子中大概有3到4例。
01:58
But then, in the 1990s,
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但是到了90年代，
02:00
the numbers started to skyrocket.
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数字开始飞速上升。
02:03
Fundraising organizations
like Autism Speaks
like Autism Speaks
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像Autism Speaks这样的募款机构
02:06
routinely refer to autism as an epidemic,
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常常将自闭症描述为一种流行病，
02:09
as if you could catch it
from another kid at Disneyland.
from another kid at Disneyland.
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就好像你去趟迪斯尼乐园
就能被传染一样。
就能被传染一样。
02:13
So what's going on?
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那么到底发生了什么呢？
02:14
If it isn't vaccines, what is it?
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如果不是疫苗的问题，
那原因究竟何在？
那原因究竟何在？
02:18
If you ask the folks down at
the Centers for Disease Control in Atlanta
the Centers for Disease Control in Atlanta
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如果你去问亚特兰大疾控中心的人，
02:22
what's going on,
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这究竟是怎么回事，
他们的解释多半是“评估标准变松了”，
02:23
they tend to rely on phrases like
"broadened diagnostic criteria"
"broadened diagnostic criteria"
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02:28
and "better case finding"
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或是“找到病例的能力变强了”，
02:30
to explain these rising numbers.
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所以统计数量上升了。
02:32
But that kind of language
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但是这些话
02:34
doesn't do much to allay
the fears of a young mother
the fears of a young mother
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并不能减轻年轻母亲们的恐惧，
02:37
who is searching her
two-year-old's face for eye contact.
two-year-old's face for eye contact.
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尤其是当她发现自己两岁的
孩子目光游移不定时。
孩子目光游移不定时。
02:42
If the diagnostic criteria
had to be broadened,
had to be broadened,
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如果诊断标准需要放宽，
02:45
why were they so narrow
in the first place?
in the first place?
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为什么标准在一开始如此严苛？
02:48
Why were cases of autism
so hard to find
so hard to find
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为什么自闭症的病例
02:51
before the 1990s?
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在1990年代之前如此难找？
02:53
Five years ago, I decided to try
to uncover the answers to these questions.
to uncover the answers to these questions.
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五年前，我决定试着
找出这些问题的答案。
找出这些问题的答案。
02:59
I learned that what happened
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我的发现是，
03:01
has less to do with the slow and cautious
progress of science
progress of science
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这个数量的上升并非是由于
科学进展的缓慢和谨慎，
科学进展的缓慢和谨慎，
03:05
than it does with the seductive
power of storytelling.
power of storytelling.
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更多的是因为故事叙述在诱导大众。
03:08
For most of the 20th century,
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在整个20世纪，
03:10
clinicians told one story
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医学界都用一个故事来解释
03:13
about what autism is
and how it was discovered,
and how it was discovered,
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什么是自闭症以及它的发现过程。
03:16
but that story turned out to be wrong,
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但是那个故事后来被证明是错的，
03:19
and the consequences of it
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而这个故事所造成的后果
03:21
are having a devastating impact
on global public health.
on global public health.
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正对全球公共健康带来灾难性的影响。
03:25
There was a second,
more accurate story of autism
more accurate story of autism
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然后又有了第二个关于自闭症的故事，
03:28
which had been lost and forgotten
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其准确性更高，但却鲜为人知，
03:31
in obscure corners
of the clinical literature.
of the clinical literature.
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仅在临床研究文献中偶尔提及。
03:34
This second story tells us everything
about how we got here
about how we got here
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第二个故事叙述了我们是
如何走到了今天这个地步，
如何走到了今天这个地步，
03:38
and where we need to go next.
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以及我们之后应该做些什么。
03:41
The first story starts with a child
psychiatrist at Johns Hopkins Hospital
psychiatrist at Johns Hopkins Hospital
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第一个故事开始于约翰霍普金斯医院，
一位叫做
一位叫做
03:45
named Leo Kanner.
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Leopard Kanner的儿童精神病医生。
03:47
In 1943, Kanner published a paper
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在1943年，Kanner发表了一篇论文，
03:51
describing 11 young patients
who seemed to inhabit private worlds,
who seemed to inhabit private worlds,
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描述了11个活在他们自己世界的孩子，
03:56
ignoring the people around them,
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他们忽略身边的所有人，
03:58
even their own parents.
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甚至他们的父母。
04:00
They could amuse themselves for hours
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他们可以自娱自乐长达几个小时，
仅仅只是自己拍手，
04:02
by flapping their hands
in front of their faces,
in front of their faces,
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04:05
but they were panicked by little things
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但他们很容易被小事惊扰，
04:07
like their favorite toy
being moved from its usual place
being moved from its usual place
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比如他们最喜欢的玩具
没有被放到通常的位置。
04:10
without their knowledge.
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04:12
Based on the patients
who were brought to his clinic,
who were brought to his clinic,
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基于他所接触的这些病患的情况，
04:15
Kanner speculated
that autism is very rare.
that autism is very rare.
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Kanner推测自闭症非常罕见。
04:19
By the 1950s, as the world's
leading authority on the subject,
leading authority on the subject,
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到50年代，他作为世界上
研究自闭症的权威，
研究自闭症的权威，
04:23
he declared that he had seen
less than 150 true cases of his syndrome
less than 150 true cases of his syndrome
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宣称自己只接触了不到
150个“真正病例”，
150个“真正病例”，
04:29
while fielding referrals from
as far away as South Africa.
as far away as South Africa.
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而慕名而来的诸多患者中
甚至有人来自南非。
甚至有人来自南非。
04:33
That's actually not surprising,
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这其实也不奇怪。
04:35
because Kanner's criteria
for diagnosing autism
for diagnosing autism
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因为Kanner诊断自闭症的标准
04:39
were incredibly selective.
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非常苛刻。
04:41
For example, he discouraged giving
the diagnosis to children who had seizures
the diagnosis to children who had seizures
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比如他不主张对将患有癫痫的
孩子诊断为自闭症，
孩子诊断为自闭症，
04:46
but now we know that epilepsy
is very common in autism.
is very common in autism.
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但现在我们知道癫痫在自闭症中很常见。
04:50
He once bragged that he had turned
nine out of 10 kids
nine out of 10 kids
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他曾经吹嘘说其他医生介绍来的
04:53
referred to his office as autistic
by other clinicians
by other clinicians
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疑似自闭症的患者中，十个有九个
04:57
without giving them an autism diagnosis.
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都不应该被诊断为自闭症。
05:00
Kanner was a smart guy,
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Kanner是个很聪明的医生，
但他的许多理论都经不起推敲。
05:02
but a number of his theories
didn't pan out.
didn't pan out.
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05:05
He classified autism as a form
of infantile psychosis
of infantile psychosis
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他将自闭症归类于一种儿童精神错乱，
05:08
caused by cold and unaffectionate parents.
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是由于缺少来自父母的关爱。
05:12
These children, he said,
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他说，这些孩子
05:14
had been kept neatly
in a refrigerator that didn't defrost.
in a refrigerator that didn't defrost.
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就像被放到了一个无法解冻的冰箱里。
05:19
At the same time, however,
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然而同时，
05:21
Kanner noticed that some
of his young patients
of his young patients
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Kanner也注意到他的一些幼年患者
05:24
had special abilities
that clustered in certain areas
that clustered in certain areas
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在某些领域有着特殊的天赋，
05:27
like music, math and memory.
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比如音乐，数学和记忆力方面。
05:30
One boy in his clinic
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他的诊所中的一个男孩
05:32
could distinguish between 18 symphonies
before he turned two.
before he turned two.
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在两岁前就可以辨别18首交响乐。
05:37
When his mother put on
one of his favorite records,
one of his favorite records,
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当他的母亲播放他最喜欢的曲子，
05:40
he would correctly declare,
"Beethoven!"
"Beethoven!"
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他会正确地说出 “贝多芬！”
05:43
But Kanner took a dim view
of these abilities,
of these abilities,
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但是Kanner对这些能力并不感冒，
05:46
claiming that the kids
were just regurgitating things
were just regurgitating things
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声称孩子们只是在重复
05:50
they'd heard their pompous parents say,
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他们爱慕虚荣的父母所说的话，
05:52
desperate to earn their approval.
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急切地想要赢得父母的赞许。
05:55
As a result, autism became
a source of shame and stigma for families,
a source of shame and stigma for families,
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因此，自闭症患儿成了家庭的耻辱，
06:00
and two generations of autistic children
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整整两代自闭症儿童
06:03
were shipped off to institutions
for their own good,
for their own good,
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都被送到了精神病院接受治疗，
06:06
becoming invisible to the world at large.
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对整个世界而言，
他们几乎是不存在的。
他们几乎是不存在的。
06:10
Amazingly, it wasn't until the 1970s
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直到上世纪70年代，
研究人员才开始质疑Kanner
所谓“自闭症罕见”的理论。
所谓“自闭症罕见”的理论。
06:14
that researchers began to test
Kanner's theory that autism was rare.
Kanner's theory that autism was rare.
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06:19
Lorna Wing was a cognitive
psychologist in London
psychologist in London
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Lorna Wing是伦敦一位认知心理学家，
06:23
who thought that Kanner's theory
of refrigerator parenting
of refrigerator parenting
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她认为Kanner的“冰箱养育”的理论
06:26
were "bloody stupid," as she told me.
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“极其愚蠢”， 她这么对我说。
06:29
She and her husband John were warm
and affectionate people,
and affectionate people,
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她和她的丈夫John是温暖热情的人，
而他们有一个极度自闭的女儿Susie。
06:33
and they had a profoundly
autistic daughter named Susie.
autistic daughter named Susie.
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06:37
Lorna and John knew how hard it was
to raise a child like Susie
to raise a child like Susie
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Lorna和John知道
养育Susie这样的孩子困难重重，
养育Susie这样的孩子困难重重，
06:41
without support services,
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他们无法获得支持性服务，
06:43
special education,
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也不能让她接受特殊教育，
06:45
and the other resources that are
out of reach without a diagnosis.
out of reach without a diagnosis.
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因为没有自闭症的诊断书，
很多资源都无法获取。
很多资源都无法获取。
06:49
To make the case
to the National Health Service
to the National Health Service
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为了向国家医疗保健系统证明，
06:52
that more resources were needed
for autistic children and their families,
for autistic children and their families,
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自闭症儿童和他们的家庭
需要更多的资源，
需要更多的资源，
Lorna和她的同事Judith Gould
06:57
Lorna and her colleague Judith Gould
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06:59
decided to do something that should
have been done 30 years earlier.
have been done 30 years earlier.
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决定去做一些三十年前
就应该被完成的事情，
就应该被完成的事情，
07:04
They undertook a study of autism
prevalence in the general population.
prevalence in the general population.
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他们在普通人群中进行了
自闭症普及性的研究，
自闭症普及性的研究，
07:09
They pounded the pavement
in a London suburb called Camberwell
in a London suburb called Camberwell
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他们在伦敦Camberwell郊区四处奔走，
07:13
to try to find autistic children
in the community.
in the community.
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去寻找社区中的自闭症儿童。
07:17
What they saw made clear
that Kanner's model was way too narrow,
that Kanner's model was way too narrow,
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他们的发现证实了
Kanner的理论模式过于狭隘，
Kanner的理论模式过于狭隘，
07:21
while the reality of autism
was much more colorful and diverse.
was much more colorful and diverse.
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而自闭症的现实情况却
十分丰富和多元化。
十分丰富和多元化。
07:26
Some kids couldn't talk at all,
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有些孩子完全不能说话，
07:28
while others waxed on at length
about their fascination with astrophysics,
about their fascination with astrophysics,
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而有些孩子却能对天文物理学，
恐龙或者皇室族谱
恐龙或者皇室族谱
07:33
dinosaurs or the genealogy of royalty.
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这些他们感兴趣的事情侃侃而谈。
07:37
In other words, these children
didn't fit into nice, neat boxes,
didn't fit into nice, neat boxes,
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也就是说，这些孩子并非
一个模子里刻出来的，
一个模子里刻出来的，
07:42
as Judith put it,
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Judith这样形容道，
07:43
and they saw lots of them,
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他们看到了很多自闭症儿童，
07:45
way more than Kanner's monolithic model
would have predicted.
would have predicted.
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远远超出了Kanner单一的
理论模型所能涵盖的范围。
理论模型所能涵盖的范围。
07:49
At first, they were at a loss
to make sense of their data.
to make sense of their data.
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一开始，他们对自己的数据感到茫然。
07:53
How had no one noticed
these children before?
these children before?
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之前怎么会没人注意到这些孩子呢？
但是Loran提到了在1944年发表的
07:56
But then Lorna came upon a reference
to a paper that had been published
to a paper that had been published
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07:59
in German in 1944,
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一篇德语论文，
08:02
the year after Kanner's paper,
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就在Kanner论文发表的一年后，
08:04
and then forgotten,
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而这篇文章却被人遗忘，
08:06
buried with the ashes of a terrible time
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被一段可怕时光的余烬埋葬，
08:09
that no one wanted to remember
or think about.
or think about.
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没人愿意记得或者想起这段时光。
08:12
Kanner knew about this competing paper,
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Kanner知道这篇观点不同的文章，
08:15
but scrupulously avoided
mentioning it in his own work.
mentioning it in his own work.
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但是在他自己的文章中完全没有提及。
这篇德语论文甚至没有被译成英文，
08:19
It had never even
been translated into English,
been translated into English,
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08:22
but luckily, Lorna's husband spoke German,
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但幸运的是，Lorna的丈夫懂德语，
08:25
and he translated it for her.
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他为Lorna翻译了这篇文章。
08:27
The paper offered
an alternate story of autism.
an alternate story of autism.
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这篇论文讲述了有关
自闭症的另一个故事。
自闭症的另一个故事。
08:31
Its author was a man named Hans Asperger,
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故事的作者叫做Hans Asperger，
08:34
who ran a combination clinic
and residential school
and residential school
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他在1930年代在Vienna地区
08:37
in Vienna in the 1930s.
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开了一家综合诊所
和一所寄宿学校。
和一所寄宿学校。
08:40
Asperger's ideas about teaching children
with learning differences
with learning differences
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Asperger对于不同孩子
采取不同教学方法的理念
采取不同教学方法的理念
08:44
were progressive even
by contemporary standards.
by contemporary standards.
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即便在现代也非常先进。
08:47
Mornings at his clinic began
with exercise classes set to music,
with exercise classes set to music,
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在他的诊所，孩子们早上练习音乐，
08:51
and the children put on plays
on Sunday afternoons.
on Sunday afternoons.
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星期天下午会进行表演。
08:55
Instead of blaming parents
for causing autism,
for causing autism,
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Asperger没有责备父母导致了自闭症，
08:58
Asperger framed it as a lifelong,
polygenetic disability
polygenetic disability
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而是将自闭症描述为一种
多诱因的终身缺陷。
多诱因的终身缺陷。
09:03
that requires compassionate forms
of support and accommodations
of support and accommodations
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这种缺陷一生都需要人们
09:07
over the course of one's whole life.
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同情的支持和理解。
在Asperger的诊所里，
他没有把孩子当做病人，
他没有把孩子当做病人，
09:10
Rather than treating the kids
in his clinic like patients,
in his clinic like patients,
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09:13
Asperger called them
his little professors,
his little professors,
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而是把他们叫做小教授们，
09:16
and enlisted their help in developing
methods of education
methods of education
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并且在教育方法的建立上
寻求他们的帮助，
寻求他们的帮助，
09:20
that were particularly suited to them.
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而这也正是他们所需要的。
09:22
Crucially, Asperger viewed autism
as a diverse continuum
as a diverse continuum
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重要的是，Asperger认为
自闭症是一种多元的疾病，
自闭症是一种多元的疾病，
包括了无数的不同缺陷和天赋。
09:28
that spans an astonishing range
of giftedness and disability.
of giftedness and disability.
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09:33
He believed that autism
and autistic traits are common
and autistic traits are common
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他相信自闭症和
自闭症的特征都很常见，
自闭症的特征都很常见，
09:37
and always have been,
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自始至终都如此，
09:38
seeing aspects of this continuum
in familiar archetypes from pop culture
in familiar archetypes from pop culture
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可以在身边熟悉的原型中
找到这种共性，
找到这种共性，
09:44
like the socially awkward scientist
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比如有社交障碍的科学家
09:46
and the absent-minded professor.
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和心不在焉的教授。
09:49
He went so far as to say,
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他得出的结论是，
09:51
it seems that for success
in science and art,
in science and art,
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要在科学或者艺术方面获得成功，
09:54
a dash of autism is essential.
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一定程度的自闭是至关重要的。
09:58
Lorna and Judith realized that Kanner
had been as wrong about autism being rare
had been as wrong about autism being rare
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Lorna和Judith意识到Kanner在
“自闭症是罕见的”和“父母导致了自闭症”
“自闭症是罕见的”和“父母导致了自闭症”
10:03
as he had been about parents causing it.
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这两点上同样都是错误的。
10:05
Over the next several years,
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2044
之后的若干年里，
10:07
they quietly worked with
the American Psychiatric Association
the American Psychiatric Association
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他们低调地和美国精神病学会合作，
10:11
to broaden the criteria for diagnosis
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2600
拓宽了诊断自闭症的标准，
10:13
to reflect the diversity of what
they called "the autism spectrum."
they called "the autism spectrum."
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来反映他们所说的
“自闭症谱图”的多样性。
“自闭症谱图”的多样性。
10:17
In the late '80s and early 1990s,
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在80年代晚期和90年代初期，
10:20
their changes went into effect,
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2298
他们提出的改变有了成效，
10:22
swapping out Kanner's narrow model
190
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换掉了Kanner狭隘的模型，
10:25
for Asperger's broad and inclusive one.
191
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3575
取而代之的是Asperger广泛
又更全面的模型。
又更全面的模型。
10:28
These changes weren't
happening in a vacuum.
happening in a vacuum.
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2671
这些改变并不是凭空出现的。
10:31
By coincidence, as Lorna and Judith
worked behind the scenes
worked behind the scenes
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3854
巧合的是，当Lorna和Judith
私下努力进行
私下努力进行
10:35
to reform the criteria,
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评估标准的改革时，
10:37
people all over the world were seeing
an autistic adult for the first time.
an autistic adult for the first time.
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全世界的人们第一次见到了一位
患有自闭症的成年人。
患有自闭症的成年人。
10:42
Before "Rain Man" came out in 1988,
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在1988年“雨人”（电影）出现之前，
只有一小部分内部专家了解
自闭症的症状。
自闭症的症状。
10:45
only a tiny, ingrown circle of experts
knew what autism looked like,
knew what autism looked like,
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4659
10:50
but after Dustin Hoffman's unforgettable
performance as Raymond Babbitt
performance as Raymond Babbitt
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4760
但在Dustin Hoffman扮演了
Raymond Babbitt之后，
Raymond Babbitt之后，
10:54
earned "Rain Man" four Academy Awards,
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3135
这场令人难忘的表演给
“雨人”赢得了四项奥斯卡大奖，
“雨人”赢得了四项奥斯卡大奖，
10:58
pediatricians, psychologists,
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2740
全世界的儿科医生，心理学家，
11:00
teachers and parents all over the world
knew what autism looked like.
knew what autism looked like.
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4690
老师们和家长们都知道了
自闭症的症状。
自闭症的症状。
11:05
Coincidentally, at the same time,
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2925
巧合的是，与此同时，
11:08
the first easy-to-use clinical tests
for diagnosing autism were introduced.
for diagnosing autism were introduced.
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5130
第一个简便的诊断自闭症的
临床测试出现了。
临床测试出现了。
11:13
You no longer had to have a connection
to that tiny circle of experts
to that tiny circle of experts
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4690
你不再需要认识那一小部分专家
11:18
to get your child evaluated.
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2578
来给自己的孩子进行诊断。
11:21
The combination of "Rain Man,"
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2113
“雨人”，
11:23
the changes to the criteria,
and the introduction of these tests
and the introduction of these tests
207
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4179
评估标准的变化，
以及这些测试的组合，
以及这些测试的组合，
11:27
created a network effect,
208
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2275
产生了一种网络效应，
11:29
a perfect storm of autism awareness.
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3530
一场对自闭症认知的完美风暴。
11:33
The number of diagnoses started to soar,
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3018
自闭症患者的确诊数目开始激增，
11:36
just as Lorna and Judith predicted,
indeed hoped, that it would,
indeed hoped, that it would,
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就像Lorna和Judith预测
而且希望的那样，
而且希望的那样，
11:41
enabling autistic people
and their families
and their families
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自闭症患者和他们的家庭
11:44
to finally get the support
and services they deserved.
and services they deserved.
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3692
最终会得到他们应得的支持和服务。
11:47
Then Andrew Wakefield came along
214
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2066
之后Andrew Wakefield出现了，
11:49
to blame the spike
in diagnoses on vaccines,
in diagnoses on vaccines,
215
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3855
将自闭症归咎于疫苗接种，
11:53
a simple, powerful,
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2113
这是一个简单，有力，
11:55
and seductively believable story
217
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2786
又容易令人信服故事，
11:58
that was as wrong as Kanner's theory
218
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2368
这故事和Kanner的
12:00
that autism was rare.
219
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2253
自闭症很罕见的理论一样错误。
12:03
If the CDC's current estimate,
220
711239
3471
如果疾控中心目前的
“美国每68个孩子中就有一个
患有自闭症”的估计是正确的，
患有自闭症”的估计是正确的，
12:06
that one in 68 kids in America
are on the spectrum, is correct,
are on the spectrum, is correct,
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12:11
autistics are one of the largest
minority groups in the world.
minority groups in the world.
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自闭症患者就是世界上
最大的少数群体之一。
最大的少数群体之一。
12:15
In recent years, autistic people
have come together on the Internet
have come together on the Internet
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在最近几年里，
自闭症患者在网上聚集起来，
自闭症患者在网上聚集起来，
12:19
to reject the notion that they
are puzzles to be solved
are puzzles to be solved
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来反驳他们是“下一代医学进展
12:22
by the next medical breakthrough,
225
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2183
才能解决的谜题”的说法，
12:24
coining the term "neurodiversity"
226
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2461
他们创造了一个词，“神经多样性”，
12:27
to celebrate the varieties
of human cognition.
of human cognition.
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3288
来赞美人类认知的多元化。
12:31
One way to understand neurodiversity
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2391
一种理解“神经多样性”的方法
12:33
is to think in terms
of human operating systems.
of human operating systems.
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3669
是从人类的（大脑）操作系统来思考。
12:37
Just because a P.C. is not running Windows
doesn't mean that it's broken.
doesn't mean that it's broken.
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一个电脑不运行Windows系统
并不表示它坏了。
并不表示它坏了。
12:42
By autistic standards,
the normal human brain
the normal human brain
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从自闭的标准来说，
正常的人类大脑
正常的人类大脑
12:45
is easily distractable,
232
753869
2020
很容易分心，
12:47
obsessively social,
233
755889
1788
喜欢社交，
12:49
and suffers from a deficit
of attention to detail.
of attention to detail.
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而且对细节不太关注。
12:52
To be sure, autistic people
have a hard time
have a hard time
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诚然，自闭症患者痛苦地生活在
12:55
living in a world not built for them.
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763992
2276
一个不是为他们创造的世界里。
12:58
[Seventy] years later, we're still
catching up to Asperger,
catching up to Asperger,
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4252
（七十）年以后，
我们还在努力追随Asperger的先进想法，
我们还在努力追随Asperger的先进想法，
13:02
who believed that the "cure"
for the most disabling aspects of autism
for the most disabling aspects of autism
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4083
他认为对于自闭症最糟糕的
那些方面的“治疗方法”
那些方面的“治疗方法”
13:06
is to be found in understanding teachers,
239
774603
2926
是让患者有体贴的老师，
13:09
accommodating employers,
240
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2136
有包容心的上司，
13:11
supportive communities,
241
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1857
支持他们的社会，
以及相信他们孩子潜力的父母。
13:13
and parents who have faith
in their children's potential.
in their children's potential.
242
781522
3344
13:16
An autistic woman
named Zosia Zaks once said,
named Zosia Zaks once said,
243
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3042
一个患有自闭症的男性
Zosia Zaks曾经说过，
Zosia Zaks曾经说过，
13:19
"We need all hands on deck
to right the ship of humanity."
to right the ship of humanity."
244
787908
5303
“我们需要双手扶着甲板
来扶正人性的船舶。”
来扶正人性的船舶。”
13:25
As we sail into an uncertain future,
245
793211
2553
当我们走向未知的未来时，
13:27
we need every form
of human intelligence on the planet
of human intelligence on the planet
246
795764
3738
我们需要地球上
每个拥有智慧的人类，
每个拥有智慧的人类，
13:31
working together to tackle
the challenges that we face as a society.
the challenges that we face as a society.
247
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5967
团结起来，一起努力
解决遇到的问题。
解决遇到的问题。
13:37
We can't afford to waste a brain.
248
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2322
每个人的智慧都举足轻重。
13:39
Thank you.
249
807791
2345
谢谢。
13:42
(Applause)
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810136
4000
（掌声）
Reviewed by Michael Ge 葛叔
ABOUT THE SPEAKER
Steve Silberman - Writer and editorSteve Silberman is a writer and contributing editor for Wired who covers science and society. His newest book explores neurodiversity and the link between autism and genius.
Why you should listen
Steve Silberman is a writer and contributing editor for Wired and other national magazines. In 2001, he published "The Geek Syndrome," one of the first articles in the mainstream press to probe the complex relationship between autism and genius. The article was praised by experts in the field like neurologist Oliver Sacks and author Temple Grandin, but as time went on, Silberman was haunted by the biggest question that he had left unanswered: Why have rates of autism diagnosis increased so steeply in the past 30 years?
This question has become particularly pressing in the face of a resurgence of measles, mumps, pertussis and other childhood diseases worldwide due to parental fears of vaccines, despite numerous studies debunking their alleged connection to autism. To solve that medical mystery for his new book, NeuroTribes: The Legacy of Autism and the Future of Neurodiversity, due out in August 2015, Silberman went back to the first years of autism research, where he uncovered a series of events -- some long forgotten, and others deliberately buried -- that will require the history of autism to be rewritten.
A former teaching assistant for the poet Allen Ginsberg, Silberman has won numerous awards over the years for his science coverage in the New Yorker, Nature and many other national and international magazines.
More profile about the speakerThis question has become particularly pressing in the face of a resurgence of measles, mumps, pertussis and other childhood diseases worldwide due to parental fears of vaccines, despite numerous studies debunking their alleged connection to autism. To solve that medical mystery for his new book, NeuroTribes: The Legacy of Autism and the Future of Neurodiversity, due out in August 2015, Silberman went back to the first years of autism research, where he uncovered a series of events -- some long forgotten, and others deliberately buried -- that will require the history of autism to be rewritten.
A former teaching assistant for the poet Allen Ginsberg, Silberman has won numerous awards over the years for his science coverage in the New Yorker, Nature and many other national and international magazines.
Steve Silberman | Speaker | TED.com