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TEDxPeachtree

Ami Klin: A new way to diagnose autism

アミ・クリン: 自閉症 新たな診断法

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自閉症スペクトラムの早期診断が関係者全員の人生の向上につながることがある。しかし自閉症を引き起こす要因が複雑に連関しているせいで、症状の予期は信じがたいほど難しい。TEDxPeachtreeで、アミ・クリンは、視線を追跡して赤ん坊が持つ社会と関わる能力を測定し、自閉症が深刻化する危険性を確実に認定するという、自閉症を早期発見の為の新たな診断法について語る。(TEDxPeachTreeにて撮影)

- Autism researcher
Ami Klin is an award winning autism spectrum disorder researcher finding new avenues for early diagnosis. Full bio

I always wanted to become
いつも思っていました
00:17
a walking laboratory of social engagement,
社会につながる活動を
実地に研究し
00:18
to resonate other people's feelings, thoughts,
人々に寄り添い
その感情や思考-
00:21
intentions, motivations, in the act of being with them.
意思 欲求に共感したいと
00:25
As a scientist, I always wanted to measure that resonance,
科学者としては ずっと
その共感を測定したいと願っていました
00:30
that sense of the other that happens so quickly,
「他者と共にいる」という-
00:36
in the blink of an eye.
瞬時に生まれる感覚
00:39
We intuit other people's feelings.
人の気持ちは直感でわかります
00:41
We know the meaning of their actions
人の行為の意味は
00:43
even before they happen.
あらかじめ わかってしまいます
00:44
We're always in this stance of being
我々は常に
00:47
the object of somebody else's subjectivity.
他者の主観の対象という立場に置かれています
00:49
We do that all the time. We just can't shake it off.
途切れることなく
避けることもできません
00:52
It's so important that the very tools that we use
大変重要なことで
00:55
to understand ourselves, to understand
自分や周りの世界を-
00:57
the world around them, is shaped by that stance.
理解する手段はまさにその立場から形づくられます
00:59
We are social to the core.
人は 骨の髄まで
社会的です
01:04
So my journey in autism really started when I lived
自閉症の探求の出発点は
01:07
in a residential unit for adults with autism.
成人の自閉症者用の施設でした
01:10
Most of those individuals had spent most of their lives
昔の事ですが
そこの人達は
01:13
in long-stay hospitals. This is a long time ago.
人生の大半を
病院で過ごしてきた人ばかり
01:17
And for them, autism was devastating.
彼らにとって 自閉症は
災いでした
01:20
They had profound intellectual disabilities.
深刻な知的障害を持ち
01:25
They didn't talk. But most of all,
口も利けない
でも最悪なのは-
01:28
they were extraordinarily isolated
極めて孤立していたこと
01:31
from the world around them, from their environment
自分たちを取り巻く
世界や環境や
01:35
and from the people.
人から孤立しているのです
01:38
In fact, at the time, if you walked into a school
当時の自閉症者の学校は
01:41
for individuals with autism, you'd hear a lot of noise,
騒がしく 落ち着きがなくて
01:44
plenty of commotion, actions, people doing things,
何かしている人がいても
その人達は決まって
01:48
but they're always doing things by themselves.
独りぼっちでした
01:53
So they may be looking at a light in the ceiling,
天井の照明を見つめたり
01:57
or they may be isolated in the corner,
部屋の隅に引きこもったり
02:01
or they might be engaged in these repetitive movements,
何の意味もない
自己刺激運動を
02:04
in self-stimulatory movements that led them nowhere.
延々と繰り返すのに
夢中だったり
02:08
Extremely, extremely isolated.
非常に根の深い孤立です
02:12
Well, now we know that autism
自閉症とは
このように
02:15
is this disruption, the disruption of this resonance
他者への共感が
断絶した状態だと
02:19
that I am telling you.
今は分かっています
02:23
These are survival skills.
共感は 数十万年の
02:25
These are survival skills that we inherited
進化の歴史の中で
02:27
over many, many hundreds of thousands of years
人類が受け継いできた
02:29
of evolution.
生存の為の知恵です
02:32
You see, babies are born in a state of utter fragility.
赤ん坊は無力なので
生き延びるには 誰かに-
02:34
Without the caregiver, they wouldn't survive, so it stands
世話をしてもらいます
02:39
to reason that nature would endow them with
彼らに共感能力が
02:41
these mechanisms of survival.
あるのは自然な事なのです
02:44
They orient to the caregiver.
赤ん坊は世話をする人の方を向きます
02:47
From the first days and weeks of life,
産まれた日や最初の数週間から
02:50
babies prefer to hear human sounds rather than just
ただの物音より
人の立てる音を
02:53
sounds in the environment.
好むのです
02:57
They prefer to look at people rather than at things,
彼らは物よりも
02:59
and even as they're looking at people,
人を見るのを好み
03:01
they look at people's eyes, because
特に人の目を見つめます
03:03
the eye is the window to the other person's experiences,
目は 他人の経験に通じる
窓だからです
03:05
so much so that they even prefer to look at people who are
だから 彼らは
03:09
looking at them rather than people who are looking away.
自分を見ている人の事を
見るのです
03:12
Well, they orient to the caregiver.
世話をする人を
03:16
The caregiver seeks the baby.
その逆も言えます
03:19
And it's out of this mutually reinforcing choreography
互いに与えあう
このダンスこそ
03:21
that a lot that is of importance to the emergence of mind,
社会的な精神 頭脳が
03:24
the social mind, the social brain, depends on.
誕生するのに
極めて重要な事なのです
03:28
We always think about autism
自閉症は
03:33
as something that happens later on in life.
もっと大きくなってから発症するものと
考えられてきましたが
03:36
It doesn't. It begins with the beginning of life.
それは間違いです
生まれつきのものなのです
03:41
As babies engage with caregivers, they soon realize
世話をする人と交流し
赤ん坊は気付く
03:46
that, well, there is something in between the ears
「両耳の間には何かがあるな」
03:50
that is very important --
重要なもの
03:55
it's invisible, you can't see -- but is really critical,
目には見えないが
とても大事なもの
03:56
and that thing is called attention.
「注目」です
04:00
And they learn soon enough, even before they can
赤ん坊はたちどころに学びます
04:02
utter one word that they can take that attention
言葉を話す前から
04:05
and move somewhere in order to get things they want.
欲しいものを得るには
この「注目」をとらえて動かせばいいのです
04:07
They also learn to follow other people's gaze,
人の視線を追う事も学ぶ
04:13
because whatever people are looking at is
人が見る物 それは
04:16
what they are thinking about.
頭に思い浮かべている物ですから
04:18
And soon enough, they start to learn about the meaning
そしてすぐ 物の意味を
04:22
of things, because when somebody is looking at something
学び始めます
何故なら 人は-
04:25
or somebody is pointing at something,
何かを見たり指差す時
04:28
they're not just getting a directional cue,
ただ方向を示すだけでなく
04:30
they are getting the other person's meaning
その物が持つ意味を
04:33
of that thing, the attitude, and soon enough
他人に対して示しているからです
04:36
they start building this body of meanings,
赤ん坊はすぐ
この意味のシステムを築き始めます
04:39
but meanings that were acquired within the realm
でも 交流なしには
04:43
of social interaction.
「意味」を学ぶことはできません
04:45
Those are meanings that are acquired as part
体験を共有して
04:48
of their shared experiences with others.
初めて 物の「意味」を
学ぶ事ができるのです
04:49
Well, this is a little 15-month-old little girl,
この小さな女の子は
1歳3カ月で
04:53
and she has autism.
自閉症です
05:00
And I am coming so close to her that I am maybe
顔から5センチまで
近づいても
05:04
two inches from her face, and she's quite oblivious to me.
全然私に気付いていません
05:07
Imagine if I did that to you,
もし5センチまで
05:12
and I came two inches from your face.
顔を近づけられたらどうします?
05:13
You'd do probably two things, wouldn't you?
たぶん 二つに一つ
05:15
You would recoil. You would call the police. (Laughter)
後ずさりするか
警察を呼ぶか (笑)
05:17
You would do something, because it's literally impossible
何かはするでしょう
05:21
to penetrate somebody's physical space
領域を侵されると
人は
05:24
and not get a reaction.
必ず反応するのです
05:26
We do so, remember, intuitively, effortlessly.
本能的に 自然に
そうするのです
05:28
This is our body wisdom. It's not something that is
これは体の働き
05:31
mediated by our language. Our body just knows that,
言葉に関係なく
体はそう動くものです
05:33
and we've known that for a long time.
ずっと昔からそうなのです
05:37
And this is not something that happens to humans only.
人間だけではありません
05:40
It happens to some of our phylatic cousins,
人間に近い動物たちもです
05:43
because if you're a monkey,
あなたが猿で
05:46
and you look at another monkey,
他の猿を見ていて
05:48
and that monkey has a higher hierarchy position than you,
その猿があなたより
地位が高ければ
05:50
and that is considered to be a signal or threat,
合図 または威嚇とみなされ
05:54
well, you are not going to be alive for long.
あなたの命はそこまでです
05:58
So something that in other species are survival mechanisms,
他の動物にとっては不可欠の-
06:01
without them they wouldn't basically live,
生き残る為の知恵ですが
06:05
we bring into the context of human beings,
人間にとっては単に
06:09
and this is what we need to simply act, act socially.
社会的活動に必要な事
というだけです
06:11
Now, she is oblivious to me, and I am so close to her,
こんな近くにいれば
06:15
and you think, maybe she can see you,
私が見えたり
06:18
maybe she can hear you.
声が聞こえたりすると思います
06:20
Well, a few minutes later, she goes to the corner of
数分後 この子は
06:22
the room, and she finds a tiny little piece of candy, an M&M.
部屋の隅に行き
ちっちゃなキャンディを見つけます
06:24
So I could not attract her attention,
彼女の「注意」は私には向かなくても
06:30
but something, a thing, did.
何か物には向くのです
06:35
Now, most of us make a big dichotomy
ほとんどの人にとって
06:37
between the world of things and the world of people.
「物の世界」と「人の世界」があります
06:40
Now, for this girl, that division line is not so clear,
この子にとって その境界は
定かでなく
06:44
and the world of people is not attracting her
人の世界に対する興味は
期待されるほど
06:49
as much as we would like.
強くありません
06:52
Now remember that we learn a great deal
「体験の共有」を通じて
06:53
by sharing experiences.
人は多くを学ぶことを思い出してください
06:55
Now, what she is doing right now is that
彼女が今のように
自分の中に
06:58
her path of learning is diverging moment by moment
閉じこもれば閉じこもるほど
07:01
as she is isolating herself further and further.
学びの道からどんどん
外れていくのです
07:05
So we feel sometimes that the brain is deterministic,
脳の将来の姿は決まっていて
07:09
the brain determines who we are going to be.
その脳がどんな人になるか決めると思いがちです
07:12
But in fact the brain also becomes who we are,
実は脳も私達自身になる
07:15
and at the same time that her behaviors are taking away
この子の行動が
社会的交流から
07:18
from the realm of social interaction, this is what's happening
切り離される時
精神や脳にも
07:22
with her mind and this is what's happening with her brain.
そういう事が起こっているのです
07:25
Well, autism is the most strongly genetic condition
自閉症は
あらゆる発達障害の中で 一番強く
07:30
of all developmental disorders,
遺伝的条件に支配されるものであり
07:36
and it's a brain disorder.
脳の障害なのです
07:39
It's a disorder that begins much prior to the time
子供が生まれるより
07:42
that the child is born.
ずっと前から始まっています
07:45
We now know that there is a very broad spectrum of autism.
自閉症スペクトラムは
幅広く
07:48
There are those individuals who are profoundly
重い知的障害の人も
07:51
intellectually disabled, but there are those that are gifted.
才能のある人もいます
07:54
There are those individuals who don't talk at all.
全く口を利かない人
07:57
There are those individuals who talk too much.
しゃべりすぎる人も
07:59
There are those individuals that if you observe them
止められなければ
08:01
in their school, you see them running the periphery fence
学校のフェンス沿いに一日中
08:04
of the school all day if you let them,
走っている人もいます
08:07
to those individuals who cannot stop coming to you
人のところに来て
08:09
and trying to engage you repeatedly, relentlessly,
繰り返し 執拗に
08:11
but often in an awkward fashion,
気を惹こうとするけれど
08:13
without that immediate resonance.
他人の心をはかり知ることができない人も
います
08:17
Well, this is much more prevalent than we thought at the time.
かつて思われたよりも症状を持つ人は
ずっとたくさんいました
08:21
When I started in this field, we thought that there were
この分野で働き始めたとき自閉症は稀で-
08:25
four individuals with autism per 10,000,
1万人中4人程度だと
08:26
a very rare condition.
考えられていました
08:29
Well, now we know it's more like one in 100.
現在の研究では
割合は100人中1人
08:31
There are millions of individuals with autism all around us.
数百万の自閉症者がいる
計算になります
08:35
The societal cost of this condition is huge.
関連する社会保障費は
莫大で
08:40
In the U.S. alone, maybe 35 to 80 billion dollars,
米国だけで350~800億ドル
08:44
and you know what? Most of those funds are associated
この費用の大半は
08:47
with adolescents and particularly adults
深刻な障害を持ち
08:50
who are severely disabled,
総合的で徹底的な
08:52
individuals who need wrap-around services, services
ケアを必要とする
08:55
that are very, very intensive, and those services
若者や大人のための
08:57
can cost in excess of 60 to 80,000 dollars a year.
一年で6~8万ドルかかる
ケアです
08:59
Those are individuals who did not benefit from early treatment,
早期療育の恩恵にあずからなかった
人たちです
09:04
because now we know that autism creates itself
お話した通り 自閉症は
学習の道筋から
09:07
as they diverge in that pathway of learning
逸れていくことで
重症化すると
09:12
that I mentioned to you.
判明しています
09:14
Were we to be able to identify this condition
もし 早い段階で
09:17
at an earlier point, and intervene and treat,
症状に気付き
療育を受けさせるとどうなるか
09:19
I can tell you, and this has been probably
ここ10年の 私の人生に
09:23
something that has changed my life in the past 10 years,
影響を与えた事なのですが
09:25
this notion that we can absolutely attenuate
早期療育によって
我々は症状を-
09:28
this condition.
軽減できるのです
09:32
Also, we have a window of opportunity, because
チャンスはあります
09:34
the brain is malleable for just so long,
脳が柔軟な時期は
充分長い
09:37
and that window of opportunity happens
産まれてから3歳までが
09:40
in the first three years of life.
その時期です
09:41
It's not that that window closes. It doesn't.
その後も改善の可能性は
閉ざされません
09:43
But it diminishes considerably.
ただ効果は大幅に減るのです
09:46
And yet, the median age of diagnosis in this country
米国で自閉症と診断される-
09:50
is still about five years,
平均年齢は5歳
09:53
and in disadvantaged populations,
田舎に住む人や
09:55
the populations that don't have access to clinical services,
マイノリティーは
医療サービスを受けにくく
09:57
rural populations, minorities,
診断される年齢は更に上がります
10:01
the age of diagnosis is later still,
こんなことを言うとまるで
10:04
which is almost as if I were to tell you that we are
そういうコミュニティーに対して
10:06
condemning those communities to have individuals
自閉症の人がいて
10:09
with autism whose condition is going to be more severe.
その症状はこれから
さらに悪化すると告げているみたいです
10:11
So I feel that we have a bio-ethical imperative.
生命倫理上 責任を感じます
10:16
The science is there,
科学の存在は
10:19
but no science is of relevance if it doesn't have an impact
社会の役に立たなければ意味がない
10:21
on the community, and we just can't afford
だから私達は
療育のチャンスを
10:24
that missed opportunity,
逃してはならない
10:28
because children with autism become adults with autism,
成長しても彼らは自閉症です
10:30
and we feel that those things that we can do
この子達や その家族の為
もっと早くに-
10:33
for these children, for those families, early on,
何かできたなら
10:38
will have lifetime consequences,
子どもや家族や地域には
10:40
for the child, for the family, and for the community at large.
決定的な変化が起こるでしょう
10:42
So this is our view of autism.
これが我々の見解です
10:46
There are over a hundred genes that are associated
自閉症に関連する遺伝子は
10:49
with autism. In fact, we believe that there are going to be
現在100を超え
10:52
something between 300 and 600 genes associated with autism,
やがてその数は
300~600になると
10:54
and genetic anomalies, much more than just genes.
信じられています
10:59
And we actually have a bit of a question here,
ここで疑問が一つ
出てきます
11:02
because if there are so many different causes of autism,
自閉症の原因因子が
数多いなら
11:07
how do you go from those liabilities
それらの障害からどのようにして
11:10
to the actual syndrome? Because people like myself,
実際の症候群になるのでしょうか
11:13
when we walk into a playroom,
専門家は遊び場に行けば
11:16
we recognize a child as having autism.
自閉症の子が見分けられます
11:19
So how do you go from multiple causes
数ある原因因子から-
11:22
to a syndrome that has some homogeneity?
共通点のある症候群が発生するのはなぜか
11:24
And the answer is, what lies in between,
因子と症候群を結ぶ物
11:28
which is development.
それは発達です
11:30
And in fact, we are very interested in those first
因子は必ずしも自閉症へと
11:33
two years of life, because those liabilities
発展するわけではないので
11:36
don't necessarily convert into autism.
2歳になるまでが重要なのです
11:39
Autism creates itself.
自閉症は自己強化します
11:42
Were we to be able to intervene during those years of life,
2歳になる前に診断・療育等
医療が介入できれば
11:44
we might attenuate for some, and God knows,
症状を緩和したり
11:49
maybe even prevent for others.
未然に防ぐ事さえ可能かもしれません
11:52
So how do we do that?
でもどうすればよいのでしょうか
11:55
How do we enter that feeling of resonance,
どうすれば 彼らの感情を呼び覚まし
11:57
how do we enter another person's being?
他者に共感させることができるでしょうか
12:00
I remember when I interacted with that 15-month-older,
先程の15か月の女の子とふれあった時も
12:04
that the thing that came to mind was,
彼女の身になって
12:08
"How do you come into her world?
考えるのは難しいことでした
12:10
Is she thinking about me? Is she thinking about others?"
「彼女は私や他人の事を
考えるのか?」と
12:12
Well, it's hard to do that, so we had to create
だから方法を編み出しました
12:17
the technologies. We had to basically step inside a body.
要するに彼女の中に入りこんで
12:21
We had to see the world through her eyes.
彼女の目で世界を見られれば良いのです
12:24
And so in the past many years we've been building
視線を追いかける新技術を
12:28
these new technologies that are based on eye tracking.
長い年月をかけて開発しました
12:31
We can see moment by moment
子供が何に注目しているのか
12:35
what children are engaging with.
秒単位で見る事ができます
12:38
Well, this is my colleague Warren Jones, with whom
同僚のウォレンと私は
12:41
we've been building these methods, these studies,
開発に12年かけました
12:44
for the past 12 years,
この生後5か月の赤ん坊は
12:47
and you see there a happy five-month-older,
母親や周りの人々等
12:49
it's a five-month little boy who is going to watch things
彼の世界にあるものを
見ています
12:51
that are brought from his world,
でも彼はそれだけではなく
12:57
his mom, the caregiver, but also experiences
託児所で経験する事も
13:00
that he would have were he to be in his daycare.
目にするのです
13:02
What we want is to embrace that world
我々はその世界を捉えて
研究室に
13:07
and bring it into our laboratory,
持っていきたい
13:10
but in order for us to do that, we had to create
その為には
13:11
these very sophisticated measures,
非常に精緻な技術が必要でした
13:14
measures of how people, how little babies,
大人や幼児 新生児達が
13:17
how newborns, engage with the world,
世界にどう注目するのか
13:21
moment by moment,
刻々ととらえます
13:24
what is important, and what is not.
何が重要で 何が重要でないか
13:25
Well, we created those measures, and here,
それを示す指標を作りました
13:29
what you see is what we call a funnel of attention.
「注目のじょうご」と呼びます
13:32
You're watching a video.
自閉症でない2歳児に
13:35
Those frames are separated by about a second
フレームが約1秒区切りの-
13:37
through the eyes of 35 typically developing
ビデオを見せた時の目の動きです
13:40
two-year-olds,
フレームを
13:43
and we freeze one frame,
停止すると そういう子達は
13:44
and this is what the typical children are doing.
目をこう動かします
13:47
In this scan pass, in green here, are two-year-olds with autism.
緑色の部分は
自閉症の子です
13:50
So on that frame, the children who are typical
つまり 自閉症でない子が
13:55
are watching this,
フレームの中に見るのは
13:58
the emotion of expression of that little boy
女の子とけんか中の-
14:01
as he's fighting a little bit with the little girl.
男の子の感情表現ですが
14:04
What are the children with autism doing?
自閉症の子はと言うと
14:07
They are focusing on the revolving door,
回転ドアが開閉する様子に
14:09
opening and shutting.
注目しています
14:12
Well, I can tell you that this divergence
今 お見せした
14:14
that you're seeing here
違いは
14:17
doesn't happen only in our five-minute experiment.
この実験中だけでなく
14:18
It happens moment by moment in their real lives,
生活の中で常に発生しています
14:21
and their minds are being formed,
そして彼らの精神と脳は
14:24
and their brains are being specialized in something other
自閉症でない人の精神や脳とは
14:27
than what is happening with their typical peers.
異なるものになるのです
14:30
Well, we took a construct from
小児科の友人から
14:34
our pediatrician friends,
「発育曲線」の概念を
14:37
the concept of growth charts.
拝借しました
14:40
You know, when you take a child to the pediatrician,
小児科では 子供の
14:42
and so you have physical height, and weight.
身長・体重を
曲線に表す事ができます
14:44
Well we decided that we're going to create growth charts
我々は社会との関わりを
14:48
of social engagement,
曲線にするのです
14:51
and we sought children from the time that they are born,
誕生時から観察を始めます
14:54
and what you see here on the x-axis is two, three, four,
横軸は月齢です
2か月、3か月、4か月、5か月、
14:57
five, six months and nine, until about the age of 24 months,
6か月、と
大体24か月まで続けます
15:02
and this is the percent of their viewing time
縦軸は子供が人の目を
15:06
that they are focusing on people's eyes,
見つめた時間の割合です
15:09
and this is their growth chart.
これがその発育曲線
15:11
They start over here, they love people's eyes,
始まりはここ
人の目が好きで
15:13
and it remains quite stable.
それはほぼ変わりません
15:16
It sort of goes up a little bit in those initial months.
最初の数か月は
わずかに上昇するようです
15:18
Now, let's see what's happening with babies
自閉症の症状がある
15:22
who became autistic.
子供達の場合は
15:25
It's something very different.
全く違う曲線になる
15:27
It starts way up here, but then it's a free fall.
始まりはここですが
急激に下降する
15:29
It's very much like they brought into this world the reflex
生まれつきの反射で
人を見ますが
15:33
that orients them to people, but it has no traction.
そこには
惹きつけられません
15:37
It's almost as if that stimulus, you,
あなたがいたからといって
15:41
you're not exerting influence on what happens
彼らが日常生活を送る中での
15:44
as they navigate their daily lives.
出来事には影響しないのです
15:47
Now, we thought that those data were so powerful
こんなにはっきりしたデータが得られるなら
15:50
in a way, that we wanted to see what happened
生後6か月経過するまでに
15:56
in the first six months of life, because if you interact
何が起きるのか見てみたいと考えました
15:59
with a two- and a three-month-older,
2~3か月の子は
16:03
you'd be surprised by how social those babies are.
驚くほど社交的なものですから
16:04
And what we see in the first six months of life
生後6か月未満の子どもでも
16:09
is that those two groups can be segregated very easily.
自閉症とそうでないグループは
とても簡単に区別できます
16:11
And using these kinds of measures, and many others,
この種の評価法を使い
16:17
what we found out is that our science could, in fact,
我々の科学的手法で実際に
自閉症の症状を
16:20
identify this condition early on.
早期に特定できるとわかりました
16:24
We didn't have to wait for the behaviors of autism
自閉症特有の行動が現れる-
16:27
to emerge in the second year of life.
1歳以後まで待つ必要もありません
16:30
If we measured things that are, evolutionarily,
進化によって高度に保持され
発達の面では
16:33
highly conserved, and developmentally very early emerging,
生後数週間という
極めて早い段階から
16:36
things that are online from the first weeks of life,
現れてくる徴候を計測すれば
16:40
we could push the detection of autism
自閉症の発見を
16:43
all the way to those first months,
生後数か月まで
早める事ができるでしょう
16:45
and that's what we are doing now.
今取り組んでいることです
16:47
Now, we can create the very best technologies
子供達の自閉症診断の為の
16:52
and the very best methods to identify the children,
最も適した技術と方法の
完成です
16:55
but this would be for naught if we didn't have an impact
でも 彼らの社会生活に
16:58
on what happens in their reality in the community.
変化がなければ無駄になります
17:01
Now we want those devices, of course,
勿論 この診断法を
17:05
to be deployed by those who are in the trenches,
最前線にいる人々
つまり-
17:07
our colleagues, the primary care physicians,
あらゆる子供に会う-
17:10
who see every child,
かかりつけ医に
実践してほしいと願います
17:13
and we need to transform those technologies
この技術を活かし
17:15
into something that is going to add value to their practice,
多くの子供に会う彼らの
17:18
because they have to see so many children.
診断の価値を高めなければなりません
17:21
And we want to do that universally
見逃がしのないよう
17:23
so that we don't miss any child,
徹底してほしいのです
17:25
but this would be immoral
ただ 介入し治療するための-
17:27
if we also did not have an infrastructure for intervention,
環境が整っていなければ
この診断はモラルに
17:30
for treatment.
反します
17:34
We need to be able to work with the families,
必要なのは
自閉症児の-
17:36
to support the families, to manage those first years
家族を助け
最初の数年を乗り切る事
17:38
with them. We need to be able to really go
「誰でも診断を受けられる」
から
17:42
from universal screening to universal access to treatment,
「誰でも治療を受けられる」
まで進めるべきです
17:46
because those treatments are going to change
療育は自閉症児だけでなく
17:50
these children's and those families' lives.
家族の人生も
変えるのですから
17:53
Now, when we think about what we [can] do
研究の初期にできなかった
いろいろなことを
17:56
in those first years,
振り返ってみると
18:01
I can tell you,
こう思います
18:04
having been in this field for so long,
長年続けてきたことで
18:06
one feels really rejuvenated.
この分野は盛んになってきたと感じます
18:09
There is a sense that the science that one worked on
取り組んできた科学を基に
18:12
can actually have an impact on realities,
状況を変えられるようになったという
手ごたえもあります
18:16
preventing, in fact, those experiences
自閉症に関わり始めた頃のように
18:20
that I really started in my journey in this field.
どうする事もできない状態だなどと
18:23
I thought at the time that this was an intractable condition.
感じることははなくなりました
18:27
No longer. We can do a great deal of things.
状況は変化し
多くの事が可能になりました
18:30
And the idea is not to cure autism.
「自閉症を治す」という
18:34
That's not the idea.
考え方ではありません
18:36
What we want is to make sure
ときに見られる
壊滅的な事態が
18:39
that those individuals with autism can be free from
自閉症の患者に生じるのを
18:41
the devastating consequences that come with it at times,
確実に避けられるようにしたいのです
18:44
the profound intellectual disabilities, the lack of language,
重度の知的障害や
言語の欠如
18:48
the profound, profound isolation.
深刻な孤立などです
18:51
We feel that individuals with autism, in fact,
実際 自閉症者は
18:55
have a very special perspective on the world,
特別な物の見方を有しているようです
18:57
and we need diversity, and they can work extremely well
多様性は必要ですし
ある種の能力においては
19:00
in some areas of strength:
非常に優秀です
19:03
predictable situations, situations that can be defined.
予測可能な状況や
定義可能な状況です
19:05
Because after all, they learn about the world almost like
世界に「おいて」どう機能するかでなく
19:09
about it, rather than learning how to function in it.
世界に「ついて」
彼らは学ぶのですから
19:12
But this is a strength, if you're working, for example,
これは例えばテクノロジー向きの
19:17
in technology.
能力ですが
19:19
And there are those individuals who have incredible
驚くべき芸術的才能を
19:21
artistic abilities.
持つ人もいます
19:24
We want them to be free of that.
つらい目にあわないだけでなく
19:25
We want that the next generations of individuals with autism
次世代の自閉症者は
19:27
will be able not only to express their strengths
強みを発揮して
19:30
but to fulfill their promise.
才能を開花させてほしいと願います
19:34
Well thank you for listening to me. (Applause)
ご清聴ありがとうございます(拍手)
19:36
Translated by Mami Kawade
Reviewed by Ayumi Narita

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About the speaker:

Ami Klin - Autism researcher
Ami Klin is an award winning autism spectrum disorder researcher finding new avenues for early diagnosis.

Why you should listen

Born in Brazil to Holocaust survivors, Ami Klin is the Georgia Research Alliance Eminent Scholar Professor and Chief of the Division of Autism and Developmental Disabilities at Emory University School of Medicine, and Director of the Marcus Autism Center, a subsidiary of Children’s Healthcare of Atlanta. After studying psychology, political science and history at Hebrew University in Jerusalem, Klin received his PhD in Psychology at the University of London in 1988. He completed clinical and research post-doctoral fellowships at the Yale Child Study Center at the Yale University School of Medicine -- where he would direct the Autism Program as Harris Professor of Child Psychology & Psychiatry. He has written in over over 180 publications, including five books on the subject of Autism.

More profile about the speaker
Ami Klin | Speaker | TED.com