TEDxPeachtree
Ami Klin: A new way to diagnose autism
アミ・クリン: 自閉症 新たな診断法
Filmed:
Readability: 3.9
674,356 views
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）
Ami Klin - Autism researcher
Ami Klin is an award winning autism spectrum disorder researcher finding new avenues for early diagnosis. Full bio
Ami Klin is an award winning autism spectrum disorder researcher finding new avenues for early diagnosis. Full bio
Double-click the English transcript below to play the video.
00:17
I always wanted to become
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いつも思っていました
00:18
a walking laboratory of social engagement,
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社会につながる活動を
実地に研究し
実地に研究し
00:21
to resonate other people's feelings, thoughts,
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人々に寄り添い
その感情や思考-
その感情や思考-
00:25
intentions, motivations, in the act of being with them.
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意思 欲求に共感したいと
00:30
As a scientist, I always wanted to measure that resonance,
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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
その共感を測定したいと願っていました
00:36
that sense of the other that happens so quickly,
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｢他者と共にいる」という－
00:39
in the blink of an eye.
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瞬時に生まれる感覚
00:41
We intuit other people's feelings.
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人の気持ちは直感でわかります
00:43
We know the meaning of their actions
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人の行為の意味は
00:44
even before they happen.
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あらかじめ わかってしまいます
00:47
We're always in this stance of being
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我々は常に
00:49
the object of somebody else's subjectivity.
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他者の主観の対象という立場に置かれています
00:52
We do that all the time. We just can't shake it off.
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途切れることなく
避けることもできません
避けることもできません
00:55
It's so important that the very tools that we use
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大変重要なことで
00:57
to understand ourselves, to understand
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自分や周りの世界を－
00:59
the world around them, is shaped by that stance.
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理解する手段はまさにその立場から形づくられます
01:04
We are social to the core.
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人は 骨の髄まで
社会的です
社会的です
01:07
So my journey in autism really started when I lived
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自閉症の探求の出発点は
01:10
in a residential unit for adults with autism.
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成人の自閉症者用の施設でした
01:13
Most of those individuals had spent most of their lives
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昔の事ですが
そこの人達は
そこの人達は
01:17
in long-stay hospitals. This is a long time ago.
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人生の大半を
病院で過ごしてきた人ばかり
病院で過ごしてきた人ばかり
01:20
And for them, autism was devastating.
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彼らにとって 自閉症は
災いでした
災いでした
01:25
They had profound intellectual disabilities.
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深刻な知的障害を持ち
01:28
They didn't talk. But most of all,
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口も利けない
でも最悪なのは－
でも最悪なのは－
01:31
they were extraordinarily isolated
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極めて孤立していたこと
01:35
from the world around them, from their environment
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自分たちを取り巻く
世界や環境や
世界や環境や
01:38
and from the people.
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人から孤立しているのです
01:41
In fact, at the time, if you walked into a school
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当時の自閉症者の学校は
01:44
for individuals with autism, you'd hear a lot of noise,
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騒がしく 落ち着きがなくて
01:48
plenty of commotion, actions, people doing things,
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何かしている人がいても
その人達は決まって
その人達は決まって
01:53
but they're always doing things by themselves.
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独りぼっちでした
01:57
So they may be looking at a light in the ceiling,
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天井の照明を見つめたり
02:01
or they may be isolated in the corner,
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部屋の隅に引きこもったり
02:04
or they might be engaged in these repetitive movements,
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何の意味もない
自己刺激運動を
自己刺激運動を
02:08
in self-stimulatory movements that led them nowhere.
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延々と繰り返すのに
夢中だったり
夢中だったり
02:12
Extremely, extremely isolated.
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非常に根の深い孤立です
02:15
Well, now we know that autism
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自閉症とは
このように
このように
02:19
is this disruption, the disruption of this resonance
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他者への共感が
断絶した状態だと
断絶した状態だと
02:23
that I am telling you.
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今は分かっています
02:25
These are survival skills.
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共感は 数十万年の
02:27
These are survival skills that we inherited
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進化の歴史の中で
02:29
over many, many hundreds of thousands of years
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人類が受け継いできた
02:32
of evolution.
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生存の為の知恵です
02:34
You see, babies are born in a state of utter fragility.
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赤ん坊は無力なので
生き延びるには 誰かに－
生き延びるには 誰かに－
02:39
Without the caregiver, they wouldn't survive, so it stands
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世話をしてもらいます
02:41
to reason that nature would endow them with
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彼らに共感能力が
02:44
these mechanisms of survival.
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あるのは自然な事なのです
02:47
They orient to the caregiver.
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赤ん坊は世話をする人の方を向きます
02:50
From the first days and weeks of life,
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産まれた日や最初の数週間から
02:53
babies prefer to hear human sounds rather than just
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ただの物音より
人の立てる音を
人の立てる音を
02:57
sounds in the environment.
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好むのです
02:59
They prefer to look at people rather than at things,
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彼らは物よりも
03:01
and even as they're looking at people,
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人を見るのを好み
03:03
they look at people's eyes, because
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特に人の目を見つめます
03:05
the eye is the window to the other person's experiences,
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目は 他人の経験に通じる
窓だからです
窓だからです
03:09
so much so that they even prefer to look at people who are
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だから 彼らは
03:12
looking at them rather than people who are looking away.
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自分を見ている人の事を
見るのです
見るのです
03:16
Well, they orient to the caregiver.
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世話をする人を
03:19
The caregiver seeks the baby.
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その逆も言えます
03:21
And it's out of this mutually reinforcing choreography
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互いに与えあう
このダンスこそ
このダンスこそ
03:24
that a lot that is of importance to the emergence of mind,
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社会的な精神 頭脳が
03:28
the social mind, the social brain, depends on.
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誕生するのに
極めて重要な事なのです
極めて重要な事なのです
03:33
We always think about autism
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自閉症は
03:36
as something that happens later on in life.
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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
考えられてきましたが
03:41
It doesn't. It begins with the beginning of life.
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それは間違いです
生まれつきのものなのです
生まれつきのものなのです
03:46
As babies engage with caregivers, they soon realize
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世話をする人と交流し
赤ん坊は気付く
赤ん坊は気付く
03:50
that, well, there is something in between the ears
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「両耳の間には何かがあるな」
03:55
that is very important --
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重要なもの
03:56
it's invisible, you can't see -- but is really critical,
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目には見えないが
とても大事なもの
とても大事なもの
04:00
and that thing is called attention.
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｢注目｣です
04:02
And they learn soon enough, even before they can
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赤ん坊はたちどころに学びます
04:05
utter one word that they can take that attention
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言葉を話す前から
04:07
and move somewhere in order to get things they want.
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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
この｢注目｣をとらえて動かせばいいのです
04:13
They also learn to follow other people's gaze,
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人の視線を追う事も学ぶ
04:16
because whatever people are looking at is
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人が見る物 それは
04:18
what they are thinking about.
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頭に思い浮かべている物ですから
04:22
And soon enough, they start to learn about the meaning
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そしてすぐ 物の意味を
04:25
of things, because when somebody is looking at something
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学び始めます
何故なら 人は－
何故なら 人は－
04:28
or somebody is pointing at something,
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何かを見たり指差す時
04:30
they're not just getting a directional cue,
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ただ方向を示すだけでなく
04:33
they are getting the other person's meaning
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その物が持つ意味を
04:36
of that thing, the attitude, and soon enough
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他人に対して示しているからです
04:39
they start building this body of meanings,
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赤ん坊はすぐ
この意味のシステムを築き始めます
この意味のシステムを築き始めます
04:43
but meanings that were acquired within the realm
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でも 交流なしには
04:45
of social interaction.
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｢意味｣を学ぶことはできません
04:48
Those are meanings that are acquired as part
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体験を共有して
04:49
of their shared experiences with others.
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初めて 物の｢意味｣を
学ぶ事ができるのです
学ぶ事ができるのです
04:53
Well, this is a little 15-month-old little girl,
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この小さな女の子は
1歳3カ月で
1歳3カ月で
05:00
and she has autism.
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自閉症です
05:04
And I am coming so close to her that I am maybe
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顔から5センチまで
近づいても
近づいても
05:07
two inches from her face, and she's quite oblivious to me.
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全然私に気付いていません
05:12
Imagine if I did that to you,
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もし5センチまで
05:13
and I came two inches from your face.
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顔を近づけられたらどうします？
05:15
You'd do probably two things, wouldn't you?
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たぶん 二つに一つ
05:17
You would recoil. You would call the police. (Laughter)
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後ずさりするか
警察を呼ぶか (笑)
警察を呼ぶか (笑)
05:21
You would do something, because it's literally impossible
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何かはするでしょう
05:24
to penetrate somebody's physical space
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領域を侵されると
人は
人は
05:26
and not get a reaction.
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必ず反応するのです
05:28
We do so, remember, intuitively, effortlessly.
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本能的に 自然に
そうするのです
そうするのです
05:31
This is our body wisdom. It's not something that is
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これは体の働き
05:33
mediated by our language. Our body just knows that,
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言葉に関係なく
体はそう動くものです
体はそう動くものです
05:37
and we've known that for a long time.
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ずっと昔からそうなのです
05:40
And this is not something that happens to humans only.
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人間だけではありません
05:43
It happens to some of our phylatic cousins,
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人間に近い動物たちもです
05:46
because if you're a monkey,
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あなたが猿で
05:48
and you look at another monkey,
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他の猿を見ていて
05:50
and that monkey has a higher hierarchy position than you,
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その猿があなたより
地位が高ければ
地位が高ければ
05:54
and that is considered to be a signal or threat,
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合図 または威嚇とみなされ
05:58
well, you are not going to be alive for long.
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あなたの命はそこまでです
06:01
So something that in other species are survival mechanisms,
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他の動物にとっては不可欠の－
06:05
without them they wouldn't basically live,
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生き残る為の知恵ですが
06:09
we bring into the context of human beings,
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人間にとっては単に
06:11
and this is what we need to simply act, act socially.
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社会的活動に必要な事
というだけです
というだけです
06:15
Now, she is oblivious to me, and I am so close to her,
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こんな近くにいれば
06:18
and you think, maybe she can see you,
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私が見えたり
06:20
maybe she can hear you.
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声が聞こえたりすると思います
06:22
Well, a few minutes later, she goes to the corner of
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数分後 この子は
06:24
the room, and she finds a tiny little piece of candy, an M&M.
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部屋の隅に行き
ちっちゃなキャンディを見つけます
ちっちゃなキャンディを見つけます
06:30
So I could not attract her attention,
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彼女の「注意」は私には向かなくても
06:35
but something, a thing, did.
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何か物には向くのです
06:37
Now, most of us make a big dichotomy
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ほとんどの人にとって
06:40
between the world of things and the world of people.
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｢物の世界｣と｢人の世界」があります
06:44
Now, for this girl, that division line is not so clear,
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この子にとって その境界は
定かでなく
定かでなく
06:49
and the world of people is not attracting her
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人の世界に対する興味は
期待されるほど
期待されるほど
06:52
as much as we would like.
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強くありません
06:53
Now remember that we learn a great deal
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｢体験の共有」を通じて
06:55
by sharing experiences.
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人は多くを学ぶことを思い出してください
06:58
Now, what she is doing right now is that
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彼女が今のように
自分の中に
自分の中に
07:01
her path of learning is diverging moment by moment
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閉じこもれば閉じこもるほど
07:05
as she is isolating herself further and further.
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学びの道からどんどん
外れていくのです
外れていくのです
07:09
So we feel sometimes that the brain is deterministic,
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脳の将来の姿は決まっていて
07:12
the brain determines who we are going to be.
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その脳がどんな人になるか決めると思いがちです
07:15
But in fact the brain also becomes who we are,
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実は脳も私達自身になる
07:18
and at the same time that her behaviors are taking away
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この子の行動が
社会的交流から
社会的交流から
07:22
from the realm of social interaction, this is what's happening
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切り離される時
精神や脳にも
精神や脳にも
07:25
with her mind and this is what's happening with her brain.
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そういう事が起こっているのです
07:30
Well, autism is the most strongly genetic condition
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自閉症は
あらゆる発達障害の中で 一番強く
あらゆる発達障害の中で 一番強く
07:36
of all developmental disorders,
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遺伝的条件に支配されるものであり
07:39
and it's a brain disorder.
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脳の障害なのです
07:42
It's a disorder that begins much prior to the time
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子供が生まれるより
07:45
that the child is born.
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ずっと前から始まっています
07:48
We now know that there is a very broad spectrum of autism.
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自閉症スペクトラムは
幅広く
幅広く
07:51
There are those individuals who are profoundly
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重い知的障害の人も
07:54
intellectually disabled, but there are those that are gifted.
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才能のある人もいます
07:57
There are those individuals who don't talk at all.
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全く口を利かない人
07:59
There are those individuals who talk too much.
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しゃべりすぎる人も
08:01
There are those individuals that if you observe them
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止められなければ
08:04
in their school, you see them running the periphery fence
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学校のフェンス沿いに一日中
08:07
of the school all day if you let them,
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走っている人もいます
08:09
to those individuals who cannot stop coming to you
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人のところに来て
08:11
and trying to engage you repeatedly, relentlessly,
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繰り返し 執拗に
08:13
but often in an awkward fashion,
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気を惹こうとするけれど
08:17
without that immediate resonance.
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他人の心をはかり知ることができない人も
います
います
08:21
Well, this is much more prevalent than we thought at the time.
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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
ずっとたくさんいました
08:25
When I started in this field, we thought that there were
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この分野で働き始めたとき自閉症は稀で－
08:26
four individuals with autism per 10,000,
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1万人中4人程度だと
08:29
a very rare condition.
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考えられていました
08:31
Well, now we know it's more like one in 100.
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現在の研究では
割合は100人中1人
割合は100人中1人
08:35
There are millions of individuals with autism all around us.
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数百万の自閉症者がいる
計算になります
計算になります
08:40
The societal cost of this condition is huge.
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関連する社会保障費は
莫大で
莫大で
08:44
In the U.S. alone, maybe 35 to 80 billion dollars,
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米国だけで350～800億ドル
08:47
and you know what? Most of those funds are associated
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この費用の大半は
08:50
with adolescents and particularly adults
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深刻な障害を持ち
08:52
who are severely disabled,
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総合的で徹底的な
08:55
individuals who need wrap-around services, services
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ケアを必要とする
08:57
that are very, very intensive, and those services
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若者や大人のための
08:59
can cost in excess of 60 to 80,000 dollars a year.
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一年で6～8万ドルかかる
ケアです
ケアです
09:04
Those are individuals who did not benefit from early treatment,
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早期療育の恩恵にあずからなかった
人たちです
人たちです
09:07
because now we know that autism creates itself
168
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お話した通り 自閉症は
学習の道筋から
学習の道筋から
09:12
as they diverge in that pathway of learning
169
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逸れていくことで
重症化すると
重症化すると
09:14
that I mentioned to you.
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判明しています
09:17
Were we to be able to identify this condition
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もし 早い段階で
09:19
at an earlier point, and intervene and treat,
172
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症状に気付き
療育を受けさせるとどうなるか
療育を受けさせるとどうなるか
09:23
I can tell you, and this has been probably
173
547680
1974
ここ10年の 私の人生に
09:25
something that has changed my life in the past 10 years,
174
549654
3380
影響を与えた事なのですが
09:28
this notion that we can absolutely attenuate
175
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早期療育によって
我々は症状を－
我々は症状を－
09:32
this condition.
176
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2157
軽減できるのです
09:34
Also, we have a window of opportunity, because
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チャンスはあります
09:37
the brain is malleable for just so long,
178
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3136
脳が柔軟な時期は
充分長い
充分長い
09:40
and that window of opportunity happens
179
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1352
産まれてから３歳までが
09:41
in the first three years of life.
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その時期です
09:43
It's not that that window closes. It doesn't.
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その後も改善の可能性は
閉ざされません
閉ざされません
09:46
But it diminishes considerably.
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ただ効果は大幅に減るのです
09:50
And yet, the median age of diagnosis in this country
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3104
米国で自閉症と診断される－
09:53
is still about five years,
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平均年齢は5歳
09:55
and in disadvantaged populations,
185
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田舎に住む人や
09:57
the populations that don't have access to clinical services,
186
581980
3249
マイノリティーは
医療サービスを受けにくく
医療サービスを受けにくく
10:01
rural populations, minorities,
187
585229
3109
診断される年齢は更に上がります
10:04
the age of diagnosis is later still,
188
588338
2619
こんなことを言うとまるで
10:06
which is almost as if I were to tell you that we are
189
590957
2345
そういうコミュニティーに対して
10:09
condemning those communities to have individuals
190
593302
2417
自閉症の人がいて
10:11
with autism whose condition is going to be more severe.
191
595719
4476
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
さらに悪化すると告げているみたいです
10:16
So I feel that we have a bio-ethical imperative.
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生命倫理上 責任を感じます
10:19
The science is there,
193
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2857
科学の存在は
10:21
but no science is of relevance if it doesn't have an impact
194
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3058
社会の役に立たなければ意味がない
10:24
on the community, and we just can't afford
195
609083
3658
だから私達は
療育のチャンスを
療育のチャンスを
10:28
that missed opportunity,
196
612741
1964
逃してはならない
10:30
because children with autism become adults with autism,
197
614705
3156
成長しても彼らは自閉症です
10:33
and we feel that those things that we can do
198
617861
4278
この子達や その家族の為
もっと早くに－
もっと早くに－
10:38
for these children, for those families, early on,
199
622139
2323
何かできたなら
10:40
will have lifetime consequences,
200
624462
2394
子どもや家族や地域には
10:42
for the child, for the family, and for the community at large.
201
626856
4096
決定的な変化が起こるでしょう
10:46
So this is our view of autism.
202
630952
2720
これが我々の見解です
10:49
There are over a hundred genes that are associated
203
633672
2866
自閉症に関連する遺伝子は
10:52
with autism. In fact, we believe that there are going to be
204
636538
2126
現在100を超え
10:54
something between 300 and 600 genes associated with autism,
205
638664
4504
やがてその数は
300～600になると
300～600になると
10:59
and genetic anomalies, much more than just genes.
206
643168
3671
信じられています
11:02
And we actually have a bit of a question here,
207
646839
4591
ここで疑問が一つ
出てきます
出てきます
11:07
because if there are so many different causes of autism,
208
651430
3485
自閉症の原因因子が
数多いなら
数多いなら
11:10
how do you go from those liabilities
209
654915
3015
それらの障害からどのようにして
11:13
to the actual syndrome? Because people like myself,
210
657930
3000
実際の症候群になるのでしょうか
11:16
when we walk into a playroom,
211
660930
2685
専門家は遊び場に行けば
11:19
we recognize a child as having autism.
212
663615
3220
自閉症の子が見分けられます
11:22
So how do you go from multiple causes
213
666835
2143
数ある原因因子から－
11:24
to a syndrome that has some homogeneity?
214
668978
3450
共通点のある症候群が発生するのはなぜか
11:28
And the answer is, what lies in between,
215
672428
2577
因子と症候群を結ぶ物
11:30
which is development.
216
675005
2655
それは発達です
11:33
And in fact, we are very interested in those first
217
677660
3116
因子は必ずしも自閉症へと
11:36
two years of life, because those liabilities
218
680776
2739
発展するわけではないので
11:39
don't necessarily convert into autism.
219
683515
2754
2歳になるまでが重要なのです
11:42
Autism creates itself.
220
686269
2496
自閉症は自己強化します
11:44
Were we to be able to intervene during those years of life,
221
688765
4849
2歳になる前に診断・療育等
医療が介入できれば
医療が介入できれば
11:49
we might attenuate for some, and God knows,
222
693614
2503
症状を緩和したり
11:52
maybe even prevent for others.
223
696117
3636
未然に防ぐ事さえ可能かもしれません
11:55
So how do we do that?
224
699753
2084
でもどうすればよいのでしょうか
11:57
How do we enter that feeling of resonance,
225
701837
2916
どうすれば 彼らの感情を呼び覚まし
12:00
how do we enter another person's being?
226
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4025
他者に共感させることができるでしょうか
12:04
I remember when I interacted with that 15-month-older,
227
708778
3498
先程の15か月の女の子とふれあった時も
12:08
that the thing that came to mind was,
228
712276
2162
彼女の身になって
12:10
"How do you come into her world?
229
714438
2515
考えるのは難しいことでした
12:12
Is she thinking about me? Is she thinking about others?"
230
716953
4280
｢彼女は私や他人の事を
考えるのか？」と
考えるのか？」と
12:17
Well, it's hard to do that, so we had to create
231
721233
4344
だから方法を編み出しました
12:21
the technologies. We had to basically step inside a body.
232
725577
3479
要するに彼女の中に入りこんで
12:24
We had to see the world through her eyes.
233
729056
3929
彼女の目で世界を見られれば良いのです
12:28
And so in the past many years we've been building
234
732985
3039
視線を追いかける新技術を
12:31
these new technologies that are based on eye tracking.
235
736024
3633
長い年月をかけて開発しました
12:35
We can see moment by moment
236
739657
2518
子供が何に注目しているのか
12:38
what children are engaging with.
237
742175
3281
秒単位で見る事ができます
12:41
Well, this is my colleague Warren Jones, with whom
238
745456
2719
同僚のウォレンと私は
12:44
we've been building these methods, these studies,
239
748175
2977
開発に12年かけました
12:47
for the past 12 years,
240
751152
1991
この生後5か月の赤ん坊は
12:49
and you see there a happy five-month-older,
241
753143
2720
母親や周りの人々等
12:51
it's a five-month little boy who is going to watch things
242
755863
5823
彼の世界にあるものを
見ています
見ています
12:57
that are brought from his world,
243
761686
2823
でも彼はそれだけではなく
13:00
his mom, the caregiver, but also experiences
244
764509
2579
託児所で経験する事も
13:02
that he would have were he to be in his daycare.
245
767088
4432
目にするのです
13:07
What we want is to embrace that world
246
771520
2632
我々はその世界を捉えて
研究室に
研究室に
13:10
and bring it into our laboratory,
247
774152
1329
持っていきたい
13:11
but in order for us to do that, we had to create
248
775481
3122
その為には
13:14
these very sophisticated measures,
249
778603
3250
非常に精緻な技術が必要でした
13:17
measures of how people, how little babies,
250
781853
3427
大人や幼児 新生児達が
13:21
how newborns, engage with the world,
251
785280
2983
世界にどう注目するのか
13:24
moment by moment,
252
788263
1627
刻々ととらえます
13:25
what is important, and what is not.
253
789890
3273
何が重要で 何が重要でないか
13:29
Well, we created those measures, and here,
254
793163
2941
それを示す指標を作りました
13:32
what you see is what we call a funnel of attention.
255
796104
3399
｢注目のじょうご」と呼びます
13:35
You're watching a video.
256
799503
2333
自閉症でない2歳児に
13:37
Those frames are separated by about a second
257
801836
2658
フレームが約1秒区切りの－
13:40
through the eyes of 35 typically developing
258
804494
2768
ビデオを見せた時の目の動きです
13:43
two-year-olds,
259
807262
1282
フレームを
13:44
and we freeze one frame,
260
808544
2975
停止すると そういう子達は
13:47
and this is what the typical children are doing.
261
811519
3501
目をこう動かします
13:50
In this scan pass, in green here, are two-year-olds with autism.
262
815020
4441
緑色の部分は
自閉症の子です
自閉症の子です
13:55
So on that frame, the children who are typical
263
819461
3623
つまり 自閉症でない子が
13:58
are watching this,
264
823084
2955
フレームの中に見るのは
14:01
the emotion of expression of that little boy
265
826039
2549
女の子とけんか中の－
14:04
as he's fighting a little bit with the little girl.
266
828588
2910
男の子の感情表現ですが
14:07
What are the children with autism doing?
267
831498
2060
自閉症の子はと言うと
14:09
They are focusing on the revolving door,
268
833558
3445
回転ドアが開閉する様子に
14:12
opening and shutting.
269
837003
2091
注目しています
14:14
Well, I can tell you that this divergence
270
839094
2452
今 お見せした
14:17
that you're seeing here
271
841546
869
違いは
14:18
doesn't happen only in our five-minute experiment.
272
842415
3190
この実験中だけでなく
14:21
It happens moment by moment in their real lives,
273
845605
3401
生活の中で常に発生しています
14:24
and their minds are being formed,
274
849006
2720
そして彼らの精神と脳は
14:27
and their brains are being specialized in something other
275
851726
3080
自閉症でない人の精神や脳とは
14:30
than what is happening with their typical peers.
276
854806
3779
異なるものになるのです
14:34
Well, we took a construct from
277
858585
3187
小児科の友人から
14:37
our pediatrician friends,
278
861772
3194
｢発育曲線｣の概念を
14:40
the concept of growth charts.
279
864966
1927
拝借しました
14:42
You know, when you take a child to the pediatrician,
280
866893
1969
小児科では 子供の
14:44
and so you have physical height, and weight.
281
868862
4204
身長・体重を
曲線に表す事ができます
曲線に表す事ができます
14:48
Well we decided that we're going to create growth charts
282
873066
2829
我々は社会との関わりを
14:51
of social engagement,
283
875895
2459
曲線にするのです
14:54
and we sought children from the time that they are born,
284
878354
2801
誕生時から観察を始めます
14:57
and what you see here on the x-axis is two, three, four,
285
881155
5829
横軸は月齢です
2か月、3か月、4か月、5か月、
2か月、3か月、4か月、5か月、
15:02
five, six months and nine, until about the age of 24 months,
286
886984
3840
6か月、と
大体24か月まで続けます
大体24か月まで続けます
15:06
and this is the percent of their viewing time
287
890824
2731
縦軸は子供が人の目を
15:09
that they are focusing on people's eyes,
288
893555
1696
見つめた時間の割合です
15:11
and this is their growth chart.
289
895251
2360
これがその発育曲線
15:13
They start over here, they love people's eyes,
290
897611
3030
始まりはここ
人の目が好きで
人の目が好きで
15:16
and it remains quite stable.
291
900641
2454
それはほぼ変わりません
15:18
It sort of goes up a little bit in those initial months.
292
903095
3926
最初の数か月は
わずかに上昇するようです
わずかに上昇するようです
15:22
Now, let's see what's happening with babies
293
907021
2294
自閉症の症状がある
15:25
who became autistic.
294
909315
2508
子供達の場合は
15:27
It's something very different.
295
911823
2205
全く違う曲線になる
15:29
It starts way up here, but then it's a free fall.
296
914028
3790
始まりはここですが
急激に下降する
急激に下降する
15:33
It's very much like they brought into this world the reflex
297
917818
3419
生まれつきの反射で
人を見ますが
人を見ますが
15:37
that orients them to people, but it has no traction.
298
921237
3931
そこには
惹きつけられません
惹きつけられません
15:41
It's almost as if that stimulus, you,
299
925168
3070
あなたがいたからといって
15:44
you're not exerting influence on what happens
300
928238
2901
彼らが日常生活を送る中での
15:47
as they navigate their daily lives.
301
931139
3891
出来事には影響しないのです
15:50
Now, we thought that those data were so powerful
302
935030
6022
こんなにはっきりしたデータが得られるなら
15:56
in a way, that we wanted to see what happened
303
941052
3008
生後6か月経過するまでに
15:59
in the first six months of life, because if you interact
304
944060
3393
何が起きるのか見てみたいと考えました
16:03
with a two- and a three-month-older,
305
947453
1337
2～3か月の子は
16:04
you'd be surprised by how social those babies are.
306
948790
4552
驚くほど社交的なものですから
16:09
And what we see in the first six months of life
307
953342
2607
生後6か月未満の子どもでも
16:11
is that those two groups can be segregated very easily.
308
955949
6138
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
とても簡単に区別できます
16:17
And using these kinds of measures, and many others,
309
962087
2874
この種の評価法を使い
16:20
what we found out is that our science could, in fact,
310
964961
4016
我々の科学的手法で実際に
自閉症の症状を
自閉症の症状を
16:24
identify this condition early on.
311
968977
2641
早期に特定できるとわかりました
16:27
We didn't have to wait for the behaviors of autism
312
971618
2904
自閉症特有の行動が現れる－
16:30
to emerge in the second year of life.
313
974522
3148
1歳以後まで待つ必要もありません
16:33
If we measured things that are, evolutionarily,
314
977670
3262
進化によって高度に保持され
発達の面では
発達の面では
16:36
highly conserved, and developmentally very early emerging,
315
980932
4122
生後数週間という
極めて早い段階から
極めて早い段階から
16:40
things that are online from the first weeks of life,
316
985054
2701
現れてくる徴候を計測すれば
16:43
we could push the detection of autism
317
987755
1862
自閉症の発見を
16:45
all the way to those first months,
318
989617
2464
生後数か月まで
早める事ができるでしょう
早める事ができるでしょう
16:47
and that's what we are doing now.
319
992081
4141
今取り組んでいることです
16:52
Now, we can create the very best technologies
320
996222
3068
子供達の自閉症診断の為の
16:55
and the very best methods to identify the children,
321
999290
3605
最も適した技術と方法の
完成です
完成です
16:58
but this would be for naught if we didn't have an impact
322
1002895
3143
でも 彼らの社会生活に
17:01
on what happens in their reality in the community.
323
1006038
3642
変化がなければ無駄になります
17:05
Now we want those devices, of course,
324
1009680
2306
勿論 この診断法を
17:07
to be deployed by those who are in the trenches,
325
1011986
2853
最前線にいる人々
つまり－
つまり－
17:10
our colleagues, the primary care physicians,
326
1014839
2523
あらゆる子供に会う－
17:13
who see every child,
327
1017362
2705
かかりつけ医に
実践してほしいと願います
実践してほしいと願います
17:15
and we need to transform those technologies
328
1020067
2143
この技術を活かし
17:18
into something that is going to add value to their practice,
329
1022210
3105
多くの子供に会う彼らの
17:21
because they have to see so many children.
330
1025315
2205
診断の価値を高めなければなりません
17:23
And we want to do that universally
331
1027520
2074
見逃がしのないよう
17:25
so that we don't miss any child,
332
1029594
2133
徹底してほしいのです
17:27
but this would be immoral
333
1031727
2453
ただ 介入し治療するための－
17:30
if we also did not have an infrastructure for intervention,
334
1034180
4901
環境が整っていなければ
この診断はモラルに
この診断はモラルに
17:34
for treatment.
335
1039081
1247
反します
17:36
We need to be able to work with the families,
336
1040328
2536
必要なのは
自閉症児の－
自閉症児の－
17:38
to support the families, to manage those first years
337
1042864
3415
家族を助け
最初の数年を乗り切る事
最初の数年を乗り切る事
17:42
with them. We need to be able to really go
338
1046279
3912
「誰でも診断を受けられる」
から
から
17:46
from universal screening to universal access to treatment,
339
1050191
4157
｢誰でも治療を受けられる」
まで進めるべきです
まで進めるべきです
17:50
because those treatments are going to change
340
1054348
3103
療育は自閉症児だけでなく
17:53
these children's and those families' lives.
341
1057451
3579
家族の人生も
変えるのですから
変えるのですから
17:56
Now, when we think about what we [can] do
342
1061030
4257
研究の初期にできなかった
いろいろなことを
いろいろなことを
18:01
in those first years,
343
1065287
3223
振り返ってみると
18:04
I can tell you,
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こう思います
18:06
having been in this field for so long,
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長年続けてきたことで
18:09
one feels really rejuvenated.
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この分野は盛んになってきたと感じます
18:12
There is a sense that the science that one worked on
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取り組んできた科学を基に
18:16
can actually have an impact on realities,
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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
手ごたえもあります
18:20
preventing, in fact, those experiences
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自閉症に関わり始めた頃のように
18:23
that I really started in my journey in this field.
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どうする事もできない状態だなどと
18:27
I thought at the time that this was an intractable condition.
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感じることははなくなりました
18:30
No longer. We can do a great deal of things.
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状況は変化し
多くの事が可能になりました
多くの事が可能になりました
18:34
And the idea is not to cure autism.
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｢自閉症を治す」という
18:36
That's not the idea.
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考え方ではありません
18:39
What we want is to make sure
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ときに見られる
壊滅的な事態が
壊滅的な事態が
18:41
that those individuals with autism can be free from
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自閉症の患者に生じるのを
18:44
the devastating consequences that come with it at times,
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確実に避けられるようにしたいのです
18:48
the profound intellectual disabilities, the lack of language,
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重度の知的障害や
言語の欠如
言語の欠如
18:51
the profound, profound isolation.
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深刻な孤立などです
18:55
We feel that individuals with autism, in fact,
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実際 自閉症者は
18:57
have a very special perspective on the world,
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特別な物の見方を有しているようです
19:00
and we need diversity, and they can work extremely well
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多様性は必要ですし
ある種の能力においては
ある種の能力においては
19:03
in some areas of strength:
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非常に優秀です
19:05
predictable situations, situations that can be defined.
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予測可能な状況や
定義可能な状況です
定義可能な状況です
19:09
Because after all, they learn about the world almost like
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世界に「おいて」どう機能するかでなく
19:12
about it, rather than learning how to function in it.
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世界に「ついて」
彼らは学ぶのですから
彼らは学ぶのですから
19:17
But this is a strength, if you're working, for example,
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これは例えばテクノロジー向きの
19:19
in technology.
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能力ですが
19:21
And there are those individuals who have incredible
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驚くべき芸術的才能を
19:24
artistic abilities.
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持つ人もいます
19:25
We want them to be free of that.
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つらい目にあわないだけでなく
19:27
We want that the next generations of individuals with autism
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次世代の自閉症者は
19:30
will be able not only to express their strengths
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強みを発揮して
19:34
but to fulfill their promise.
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才能を開花させてほしいと願います
19:36
Well thank you for listening to me. (Applause)
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ご清聴ありがとうございます(拍手)
ABOUT THE SPEAKER
Ami Klin - Autism researcherAmi 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.
Ami Klin | Speaker | TED.com