TEDxPeachtree
Ami Klin: A new way to diagnose autism
Ami Klin: Novi način dijagnostikovanja autizma
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Rano dijagnostikovanje poremećaja autističnog spektra može poboljšati živote i obolelih i ljudi u njihovoj okolini, ali je zbog složene mreže uzroka veoma teško bilo šta predvideti. Na TEDxPeachTree, Ami Klin opisuje novi metod ranog otkrića bolesti, koji koristi tehnologiju praćenja očnih pokreta da bi se bebama izmerile sposobnosti društvene interakcije i pouzdano odredio rizik od nastanka autizma. (Snimljeno na TEDxPeachTree.)
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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Oduvek sam hteo da postanem
00:18
a walking laboratory of social engagement,
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laboratorija društvene interakcije
na dve noge,
na dve noge,
00:21
to resonate other people's feelings, thoughts,
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da rezoniram osećanja, misli, namere,
00:25
intentions, motivations, in the act of being with them.
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motivaciju drugih ljudi
boraveći s njima.
boraveći s njima.
00:30
As a scientist, I always wanted to measure that resonance,
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Kao naučnik sam oduvek hteo
da izmerim tu rezonancu,
da izmerim tu rezonancu,
00:36
that sense of the other that happens so quickly,
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osećaj drugog koji nastaje brzo,
00:39
in the blink of an eye.
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u tren oka.
00:41
We intuit other people's feelings.
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Predviđamo osećanja drugih.
00:43
We know the meaning of their actions
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Svesni smo značenja njihovih dela
00:44
even before they happen.
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i pre nego što se dogode.
00:47
We're always in this stance of being
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Uvek smo u položaju
00:49
the object of somebody else's subjectivity.
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objekta tuđe subjektivnosti.
00:52
We do that all the time. We just can't shake it off.
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Neprestano je tako.
Ne možemo toga da se otresemo.
Ne možemo toga da se otresemo.
00:55
It's so important that the very tools that we use
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To je toliko važno
da čak i na sredstva koja koristimo
da čak i na sredstva koja koristimo
00:57
to understand ourselves, to understand
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da bismo razumeli sebe,
da bismo razumeli
da bismo razumeli
00:59
the world around them, is shaped by that stance.
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svet oko njih,
utiče taj položaj.
utiče taj položaj.
01:04
We are social to the core.
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U potpunosti smo društveni.
01:07
So my journey in autism really started when I lived
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Moj put kroz autizam započeo je
kad sam boravio
kad sam boravio
01:10
in a residential unit for adults with autism.
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na bolničkom odeljenju
za odrasle osobe sa autizmom.
za odrasle osobe sa autizmom.
01:13
Most of those individuals had spent most of their lives
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Većina njih je dobar
deo svog života provela
deo svog života provela
01:17
in long-stay hospitals. This is a long time ago.
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u bolnicama za dug boravak.
Bilo je to davno.
Bilo je to davno.
01:20
And for them, autism was devastating.
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Za njih je autizam bio razoran.
01:25
They had profound intellectual disabilities.
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Imali su teška intelektualna oštećenja.
01:28
They didn't talk. But most of all,
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Nisu govorili.
Još je značajnije
Još je značajnije
01:31
they were extraordinarily isolated
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da su bili izuzetno izolovani
01:35
from the world around them, from their environment
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od okolnog sveta,
od svog okruženja
od svog okruženja
01:38
and from the people.
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i od ljudi.
01:41
In fact, at the time, if you walked into a school
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Ako biste tada ušli u školu
01:44
for individuals with autism, you'd hear a lot of noise,
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za osobe sa autizmom,
čuli biste mnogo buke,
čuli biste mnogo buke,
01:48
plenty of commotion, actions, people doing things,
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meteža, pokreta, ljudi koji svašta rade,
01:53
but they're always doing things by themselves.
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ali su to uvek radili sami.
01:57
So they may be looking at a light in the ceiling,
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Možda bi gledali
svetlo na plafonu
svetlo na plafonu
02:01
or they may be isolated in the corner,
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ili bi se osamili u ćošku
02:04
or they might be engaged in these repetitive movements,
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ili bi samo ponavljali pokrete,
02:08
in self-stimulatory movements that led them nowhere.
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auto-stimulatorne pokrete
koji ničemu ne vode.
koji ničemu ne vode.
02:12
Extremely, extremely isolated.
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Izuzetno, izuzetno izolovani.
02:15
Well, now we know that autism
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Danas znamo da je autizam
02:19
is this disruption, the disruption of this resonance
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izvestan poremećaj
i to poremećaj one rezonance
i to poremećaj one rezonance
02:23
that I am telling you.
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koju sam pomenuo.
02:25
These are survival skills.
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To su veštine preživljavanja.
02:27
These are survival skills that we inherited
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To su veštine preživljavanja
koje smo nasledili
koje smo nasledili
02:29
over many, many hundreds of thousands of years
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kroz mnogo stotina hiljada godina
02:32
of evolution.
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evolucije.
02:34
You see, babies are born in a state of utter fragility.
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Vidite, bebe se rađaju
potpuno krhke.
potpuno krhke.
02:39
Without the caregiver, they wouldn't survive, so it stands
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Bez negovatelja ne bi preživele,
pa je logično
pa je logično
02:41
to reason that nature would endow them with
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što ih je priroda obdarila
02:44
these mechanisms of survival.
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mehanizmima preživljavanja.
02:47
They orient to the caregiver.
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Okreću se negovatelju.
02:50
From the first days and weeks of life,
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Počev od prvih dana
i nedelja života,
i nedelja života,
02:53
babies prefer to hear human sounds rather than just
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bebe radije slušaju ljudske zvuke
nego prosto
nego prosto
02:57
sounds in the environment.
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zvuke okruženja.
02:59
They prefer to look at people rather than at things,
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Radije posmatraju ljude
nego predmete,
nego predmete,
03:01
and even as they're looking at people,
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a i kad posmatraju ljude,
03:03
they look at people's eyes, because
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posmatraju oči, zato što je
03:05
the eye is the window to the other person's experiences,
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oko prozor u iskustva druge osobe,
03:09
so much so that they even prefer to look at people who are
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do te mere da radije posmatraju ljude
03:12
looking at them rather than people who are looking away.
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koji njih posmatraju,
nego ljude koji gledaju nešto drugo.
nego ljude koji gledaju nešto drugo.
03:16
Well, they orient to the caregiver.
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Dakle, usmerene su
prema negovatelju.
prema negovatelju.
03:19
The caregiver seeks the baby.
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Negovatelj traži bebu.
03:21
And it's out of this mutually reinforcing choreography
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Od te uzajamno
osnažujuće koreografije
osnažujuće koreografije
03:24
that a lot that is of importance to the emergence of mind,
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zavisi mnogo toga značajnog
za pojavljivanje uma,
za pojavljivanje uma,
03:28
the social mind, the social brain, depends on.
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društvenog uma, društvenog mozga.
03:33
We always think about autism
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Uvek razmišljamo o autizmu
03:36
as something that happens later on in life.
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kao nečemu što se događa
u kasnijim godinama.
u kasnijim godinama.
03:41
It doesn't. It begins with the beginning of life.
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Nije tako.
Počinje na početku života.
Počinje na početku života.
03:46
As babies engage with caregivers, they soon realize
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Kad bebe komuniciraju sa negovateljem,
ubrzo shvate
ubrzo shvate
03:50
that, well, there is something in between the ears
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da postoji nešto između ušiju
03:55
that is very important --
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što je veoma važno -
03:56
it's invisible, you can't see -- but is really critical,
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nevidljivo je,
ali je jako bitno
ali je jako bitno
04:00
and that thing is called attention.
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i zove se pažnja.
04:02
And they learn soon enough, even before they can
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Nauče vrlo brzo,
i pre nego što nauče
i pre nego što nauče
04:05
utter one word that they can take that attention
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da probrbljaju ijednu reč,
da tu pažnju mogu da uzmu
da tu pažnju mogu da uzmu
04:07
and move somewhere in order to get things they want.
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i premeste je negde
da bi uredile stvari kako žele.
da bi uredile stvari kako žele.
04:13
They also learn to follow other people's gaze,
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Takođe nauče da prate
pogled drugih ljudi,
pogled drugih ljudi,
04:16
because whatever people are looking at is
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jer o onome što posmatraju
04:18
what they are thinking about.
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ljudi i razmišljaju.
04:22
And soon enough, they start to learn about the meaning
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Vrlo brzo počinju
da shvataju značenje
da shvataju značenje
04:25
of things, because when somebody is looking at something
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stvari, budući da,
kad neko nešto posmatra
kad neko nešto posmatra
04:28
or somebody is pointing at something,
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ili neko nešto pokazuje,
04:30
they're not just getting a directional cue,
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ne dobijaju samo
prostorno uputstvo,
prostorno uputstvo,
04:33
they are getting the other person's meaning
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već i značenje koje ta osoba
04:36
of that thing, the attitude, and soon enough
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pripisuje toj stvari,
stavu, a ubrzo
stavu, a ubrzo
04:39
they start building this body of meanings,
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počinju da formiraju
skup značenja
skup značenja
04:43
but meanings that were acquired within the realm
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i to značenja
usvojenih u okviru
usvojenih u okviru
04:45
of social interaction.
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društvene interakcije.
04:48
Those are meanings that are acquired as part
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Ta značenja se usvajaju kao deo
04:49
of their shared experiences with others.
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iskustava podeljenih sa drugima.
04:53
Well, this is a little 15-month-old little girl,
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Pa, ova devojčica
stara 15 meseci
stara 15 meseci
05:00
and she has autism.
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ima autizam.
05:04
And I am coming so close to her that I am maybe
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Toliko sam joj se približio
da sam na možda
da sam na možda
05:07
two inches from her face, and she's quite oblivious to me.
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pet centimetara od njenog lica,
a ona me uopšte ne primećuje.
a ona me uopšte ne primećuje.
05:12
Imagine if I did that to you,
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Zamislite da to vama uradim,
05:13
and I came two inches from your face.
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da vam se približim
na pet centimetara od lica.
na pet centimetara od lica.
05:15
You'd do probably two things, wouldn't you?
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Verovatno biste uradili dve stvari.
05:17
You would recoil. You would call the police. (Laughter)
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Odskočili biste.
Pozvali biste policiju. (Smeh)
Pozvali biste policiju. (Smeh)
05:21
You would do something, because it's literally impossible
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Nešto biste uradili,
jer je doslovno nemoguće
jer je doslovno nemoguće
05:24
to penetrate somebody's physical space
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ući u nečiji fizički prostor,
05:26
and not get a reaction.
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a da ta osoba ne odreaguje.
05:28
We do so, remember, intuitively, effortlessly.
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Prisetite se, to činimo intuitivno,
bez napora.
bez napora.
05:31
This is our body wisdom. It's not something that is
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To je naša telsna mudrost.
Ona se
Ona se
05:33
mediated by our language. Our body just knows that,
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ne prenosi jezikom.
Naše telo je toga svesno,
Naše telo je toga svesno,
05:37
and we've known that for a long time.
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a i mi smo toga već dugo svesni.
05:40
And this is not something that happens to humans only.
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A ne dešava se ovo samo ljudima.
05:43
It happens to some of our phylatic cousins,
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Dešava se i nekim čovekovim rođacima,
05:46
because if you're a monkey,
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budući da, ako ste majmun
05:48
and you look at another monkey,
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i gledate drugog majmuna,
05:50
and that monkey has a higher hierarchy position than you,
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a taj majmun je na višoj
hijerarhijskoj poziciji od vas,
hijerarhijskoj poziciji od vas,
05:54
and that is considered to be a signal or threat,
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što se smatra za signal ili pretnju,
05:58
well, you are not going to be alive for long.
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pa, nećete dugo poživeti.
06:01
So something that in other species are survival mechanisms,
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Ono što su kod drugih vrsta
mehanizmi preživljavanja,
mehanizmi preživljavanja,
06:05
without them they wouldn't basically live,
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bez čega ne bi opstale,
06:09
we bring into the context of human beings,
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unosimo u kontekst ljudskih bića
06:11
and this is what we need to simply act, act socially.
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i na osnovu toga moramo
da društveno delujemo.
da društveno delujemo.
06:15
Now, she is oblivious to me, and I am so close to her,
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Dakle, ona mene ne primećuje,
a toliko sam joj blizu,
a toliko sam joj blizu,
06:18
and you think, maybe she can see you,
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pomislićete, možda vas vidi,
06:20
maybe she can hear you.
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možda vas čuje.
06:22
Well, a few minutes later, she goes to the corner of
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Nakon nekoliko minuta,
otišla je do ugla
otišla je do ugla
06:24
the room, and she finds a tiny little piece of candy, an M&M.
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sobe i pronašla
mali slatkiš, bombonicu.
mali slatkiš, bombonicu.
06:30
So I could not attract her attention,
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Ja nisam uspeo
da joj privučem pažnju,
da joj privučem pažnju,
06:35
but something, a thing, did.
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ali nešto, predmet, jeste.
06:37
Now, most of us make a big dichotomy
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Većina nas vrlo jasno razlikuje
06:40
between the world of things and the world of people.
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svet predmeta i svet ljudi.
06:44
Now, for this girl, that division line is not so clear,
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Linija koja ih razdvaja kod ove devojčice
nije potpuno jasna
nije potpuno jasna
06:49
and the world of people is not attracting her
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i svet ljudi je ne privlači
06:52
as much as we would like.
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koliko bismo želeli.
06:53
Now remember that we learn a great deal
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Prisetite se da mnogo saznajemo
06:55
by sharing experiences.
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deleći svoja iskustva.
06:58
Now, what she is doing right now is that
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Upravo se sada
07:01
her path of learning is diverging moment by moment
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njena putanja saznanja
svakog trenutka sve više razilazi,
svakog trenutka sve više razilazi,
07:05
as she is isolating herself further and further.
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a ona se sve više izoluje.
07:09
So we feel sometimes that the brain is deterministic,
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Ponekad bismo rekli
da nas mozak određuje,
da nas mozak određuje,
07:12
the brain determines who we are going to be.
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da on određuje ko ćemo postati.
07:15
But in fact the brain also becomes who we are,
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U stvari i mozak postaje
ono što smo mi
ono što smo mi
07:18
and at the same time that her behaviors are taking away
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i u trenutku kad je
njeno ponašanje udaljava
njeno ponašanje udaljava
07:22
from the realm of social interaction, this is what's happening
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od okrilja društvene interakcije,
to se događa
to se događa
07:25
with her mind and this is what's happening with her brain.
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i njenom umu,
odnosno njenom mozgu.
odnosno njenom mozgu.
07:30
Well, autism is the most strongly genetic condition
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Autizam je genetski uslovljen više
07:36
of all developmental disorders,
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od bilo kog drugog
razvojnog poremećaja,
razvojnog poremećaja,
07:39
and it's a brain disorder.
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a reč je o moždanom poremećaju.
07:42
It's a disorder that begins much prior to the time
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To je poremećaj koji
počinje mnogo pre
počinje mnogo pre
07:45
that the child is born.
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rođenja deteta.
07:48
We now know that there is a very broad spectrum of autism.
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Danas znamo da je autistični spektar
veoma širok.
veoma širok.
07:51
There are those individuals who are profoundly
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Neke osobe su teško
07:54
intellectually disabled, but there are those that are gifted.
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intelektualno zaostale,
ali su neke i nadarene.
ali su neke i nadarene.
07:57
There are those individuals who don't talk at all.
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Neke osobe uopšte ne govore.
07:59
There are those individuals who talk too much.
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Neke osobe govore previše.
08:01
There are those individuals that if you observe them
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Ako biste neke
od tih osoba posmatrali
od tih osoba posmatrali
08:04
in their school, you see them running the periphery fence
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u školi, trčali bi uz ogradu
08:07
of the school all day if you let them,
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školskog dvorišta ceo dan
ako biste im samo dozvolili,
ako biste im samo dozvolili,
08:09
to those individuals who cannot stop coming to you
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a neke pak ne možete sprečiti
da vam prilaze
da vam prilaze
08:11
and trying to engage you repeatedly, relentlessly,
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i iznova pokušavaju da komuniciraju
s vama, neumorno,
s vama, neumorno,
08:13
but often in an awkward fashion,
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ali često na čudan način,
08:17
without that immediate resonance.
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bez one neposredne rezonance.
08:21
Well, this is much more prevalent than we thought at the time.
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Autizam je mnogo češći
nego što smo ranije mislili.
nego što smo ranije mislili.
08:25
When I started in this field, we thought that there were
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Kada sam počeo ovim da se bavim,
smatralo se da
smatralo se da
08:26
four individuals with autism per 10,000,
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od 10.000 osoba 4 imaju autizam,
08:29
a very rare condition.
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veoma retku bolest.
08:31
Well, now we know it's more like one in 100.
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Danas smo bliži zaključku
da oboli 1 od 100 osoba.
da oboli 1 od 100 osoba.
08:35
There are millions of individuals with autism all around us.
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Milioni osoba sa autizmom
žive u našem okruženju.
žive u našem okruženju.
08:40
The societal cost of this condition is huge.
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Cena koju plaća društvo
je ogromna.
je ogromna.
08:44
In the U.S. alone, maybe 35 to 80 billion dollars,
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Samo u SAD, oko
35 do 80 milijardi dolara.
35 do 80 milijardi dolara.
08:47
and you know what? Most of those funds are associated
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Pri tome je većina
sredstava povezana
sredstava povezana
08:50
with adolescents and particularly adults
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sa adolescentima
i naročito odraslima
i naročito odraslima
08:52
who are severely disabled,
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koji su teško hendikepirani,
08:55
individuals who need wrap-around services, services
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kojima je potrebna
sveobuhvatna nega
sveobuhvatna nega
08:57
that are very, very intensive, and those services
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koja je veoma intenzivna
08:59
can cost in excess of 60 to 80,000 dollars a year.
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i košta više od
60 do 80.000 dolara godišnje.
60 do 80.000 dolara godišnje.
09:04
Those are individuals who did not benefit from early treatment,
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To su osobe koje nisu prošle
kroz rano lečenje.
kroz rano lečenje.
09:07
because now we know that autism creates itself
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Naime, sada znamo
da autizam sam sebe stvara
da autizam sam sebe stvara
09:12
as they diverge in that pathway of learning
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dok nastaje jaz
u putanji saznanja,
u putanji saznanja,
09:14
that I mentioned to you.
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koji sam već pomenuo.
09:17
Were we to be able to identify this condition
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Ako bismo ovu bolest
mogli da dijagnostikujemo
mogli da dijagnostikujemo
09:19
at an earlier point, and intervene and treat,
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u ranijem stadijumu,
da intervenišemo i lečimo je,
da intervenišemo i lečimo je,
09:23
I can tell you, and this has been probably
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siguran sam, a verovatno
mi je upravo to
mi je upravo to
09:25
something that has changed my life in the past 10 years,
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promenilo život
u poslednjih 10 godina,
u poslednjih 10 godina,
09:28
this notion that we can absolutely attenuate
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da bismo značajno umanjili
09:32
this condition.
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posledice ove bolesti.
09:34
Also, we have a window of opportunity, because
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To je moguće
u ograničenom vremenskom periodu,
u ograničenom vremenskom periodu,
09:37
the brain is malleable for just so long,
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561301
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pošto se na mozak može delovati
samo izvesno vreme,
samo izvesno vreme,
09:40
and that window of opportunity happens
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a taj period se javlja
09:41
in the first three years of life.
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u toku prve tri godine života.
09:43
It's not that that window closes. It doesn't.
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Neće ta mogućnost
promene mozga nestati.
promene mozga nestati.
09:46
But it diminishes considerably.
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Ali će se znatno smanjiti.
09:50
And yet, the median age of diagnosis in this country
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Uprkos tome, srednja starost
postavljanja dijagnoze u ovoj zemlji je
postavljanja dijagnoze u ovoj zemlji je
09:53
is still about five years,
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i dalje oko pet godina,
09:55
and in disadvantaged populations,
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a u siromašnim zajednicama,
09:57
the populations that don't have access to clinical services,
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zajednicama koje nemaju pristup
zdravstvenoj zaštiti,
zdravstvenoj zaštiti,
10:01
rural populations, minorities,
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ruralnim zajednicama,
manjinama,
manjinama,
10:04
the age of diagnosis is later still,
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bolest se otkrije još kasnije
10:06
which is almost as if I were to tell you that we are
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i bilo bi skoro isto da vam kažem
10:09
condemning those communities to have individuals
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da primoravamo te zajednice
da imaju osobe
da imaju osobe
10:11
with autism whose condition is going to be more severe.
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sa autizmom
u mnogo gorem stadijumu.
u mnogo gorem stadijumu.
10:16
So I feel that we have a bio-ethical imperative.
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Mislim da prema njima
imamo bio-etičku obavezu.
imamo bio-etičku obavezu.
10:19
The science is there,
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2857
Naučna saznanja postoje,
10:21
but no science is of relevance if it doesn't have an impact
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ali od njih nema koristi
ako ne utiču
ako ne utiču
10:24
on the community, and we just can't afford
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na zajednice,
a prosto ne možemo priuštiti
a prosto ne možemo priuštiti
10:28
that missed opportunity,
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1964
da propustimo tu priliku
10:30
because children with autism become adults with autism,
197
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3156
jer deca sa autizmom
postaju odrasle osobe sa autizmom
postaju odrasle osobe sa autizmom
10:33
and we feel that those things that we can do
198
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i smatramo da će ono
što možemo da učinimo
što možemo da učinimo
10:38
for these children, for those families, early on,
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za tu decu i porodice
u ranom stadijumu
u ranom stadijumu
10:40
will have lifetime consequences,
200
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imati uticaj na ceo život,
10:42
for the child, for the family, and for the community at large.
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za dete, za porodicu
i za zajednicu u celini.
i za zajednicu u celini.
10:46
So this is our view of autism.
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2720
Ovo je naše viđenje autizma.
10:49
There are over a hundred genes that are associated
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633672
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Više od stotinu gena je povezano
10:52
with autism. In fact, we believe that there are going to be
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636538
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sa autizmom. U stvari,
smatramo da će se utvrditi
smatramo da će se utvrditi
10:54
something between 300 and 600 genes associated with autism,
205
638664
4504
da je oko 300 do 600 gena
povezano sa autizmom,
povezano sa autizmom,
10:59
and genetic anomalies, much more than just genes.
206
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3671
a mnogo je i genetskih anomalija,
čak i više nego gena.
čak i više nego gena.
11:02
And we actually have a bit of a question here,
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Postavlja se jedno pitanje,
11:07
because if there are so many different causes of autism,
208
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naime, ako postoji
toliko uzročnika autizma,
toliko uzročnika autizma,
11:10
how do you go from those liabilities
209
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3015
kako da sa
podložnosti bolesti pređemo
podložnosti bolesti pređemo
11:13
to the actual syndrome? Because people like myself,
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na konkretni sindrom?
Kada ljudi poput mene
Kada ljudi poput mene
11:16
when we walk into a playroom,
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uđu u igraonicu,
11:19
we recognize a child as having autism.
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uoče dete koje ima autizam.
11:22
So how do you go from multiple causes
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2143
Kako onda da pređemo
sa mnogobrojnih uzroka
sa mnogobrojnih uzroka
11:24
to a syndrome that has some homogeneity?
214
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3450
na relativno homogen sindrom?
11:28
And the answer is, what lies in between,
215
672428
2577
Odgovor je: pomoću onoga
što se nalazi između tih pojmova,
što se nalazi između tih pojmova,
11:30
which is development.
216
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a to je razvoj.
11:33
And in fact, we are very interested in those first
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3116
I zaista nas veoma zanimaju prve dve
11:36
two years of life, because those liabilities
218
680776
2739
godine života,
jer se podložnost bolesti
jer se podložnost bolesti
11:39
don't necessarily convert into autism.
219
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2754
ne pretvori nužno u autizam.
11:42
Autism creates itself.
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2496
Autizam sam sebe stvara.
11:44
Were we to be able to intervene during those years of life,
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688765
4849
Ako bismo mogli da intervenišemo
tokom tih godina života,
tokom tih godina života,
11:49
we might attenuate for some, and God knows,
222
693614
2503
usporili bismo razvoj nekih slučajeva,
11:52
maybe even prevent for others.
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3636
a neke druge možda i sprečili.
11:55
So how do we do that?
224
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2084
Kako da to učinimo?
11:57
How do we enter that feeling of resonance,
225
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2916
Kako da prodremo
u to osećanje rezonantnosti,
u to osećanje rezonantnosti,
12:00
how do we enter another person's being?
226
704753
4025
kako da prodremo
u biće druge osobe?
u biće druge osobe?
12:04
I remember when I interacted with that 15-month-older,
227
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3498
Kad sam pokušao da komuniciram
sa onom 15-mesečnom devojčicom,
sa onom 15-mesečnom devojčicom,
12:08
that the thing that came to mind was,
228
712276
2162
palo mi je na pamet pitanje:
12:10
"How do you come into her world?
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2515
"Kako da uđemo u njen svet?
12:12
Is she thinking about me? Is she thinking about others?"
230
716953
4280
Da li razmišlja o meni?
Da li razmišlja o drugima?"
Da li razmišlja o drugima?"
12:17
Well, it's hard to do that, so we had to create
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4344
To je teško uraditi,
pa smo morali da osmislimo
pa smo morali da osmislimo
12:21
the technologies. We had to basically step inside a body.
232
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3479
tehnologiju. Praktično je trebalo
da uđemo u telo.
da uđemo u telo.
12:24
We had to see the world through her eyes.
233
729056
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Trebalo je da svet
vidimo njenim očima.
vidimo njenim očima.
12:28
And so in the past many years we've been building
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3039
Mnogo godina smo razvijali
12:31
these new technologies that are based on eye tracking.
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3633
novu tehnologiju
zasnovanu na praćenju oka.
zasnovanu na praćenju oka.
12:35
We can see moment by moment
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2518
U svakom trenutku možemo da vidimo
12:38
what children are engaging with.
237
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3281
sa čime deca interaguju.
12:41
Well, this is my colleague Warren Jones, with whom
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2719
Ovo je moj kolega
Voren Džouns, sa kojim
Voren Džouns, sa kojim
12:44
we've been building these methods, these studies,
239
748175
2977
razvijam ove metode i studije
12:47
for the past 12 years,
240
751152
1991
poslednjih 12 godina,
12:49
and you see there a happy five-month-older,
241
753143
2720
a tu vidite srećno dete
staro 5 meseci,
staro 5 meseci,
12:51
it's a five-month little boy who is going to watch things
242
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5823
dečaka starog 5 meseci
koji će posmatrati stvari
koji će posmatrati stvari
12:57
that are brought from his world,
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2823
uzete iz njegovog sveta,
13:00
his mom, the caregiver, but also experiences
244
764509
2579
svoju mamu, koja ga neguje,
ali će videti i iskustva
ali će videti i iskustva
13:02
that he would have were he to be in his daycare.
245
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koja bi doživeo da je u vrtiću.
13:07
What we want is to embrace that world
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2632
Želimo da obuhvatimo taj svet
13:10
and bring it into our laboratory,
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i prenesemo ga u laboratoriju,
13:11
but in order for us to do that, we had to create
248
775481
3122
ali da bismo to učinili,
morali smo da osmislimo
morali smo da osmislimo
13:14
these very sophisticated measures,
249
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3250
vrlo komplikovane postupke
13:17
measures of how people, how little babies,
250
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3427
u vezi s tim kako ljudi,
a kako male bebe,
a kako male bebe,
13:21
how newborns, engage with the world,
251
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2983
novorođenčad,
interaguju sa svetom
interaguju sa svetom
13:24
moment by moment,
252
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1627
u bilo kom trenutku,
13:25
what is important, and what is not.
253
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3273
šta je bitno,
a šta nije.
a šta nije.
13:29
Well, we created those measures, and here,
254
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2941
Osmislili smo te postupke i ovde
13:32
what you see is what we call a funnel of attention.
255
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vidite ono što nazivamo
levak pažnje.
levak pažnje.
13:35
You're watching a video.
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2333
Gledate video snimak,
13:37
Those frames are separated by about a second
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u kome se sličice smenjuju
otprilike svake sekunde,
otprilike svake sekunde,
13:40
through the eyes of 35 typically developing
258
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2768
očima 35 dvogodišnjaka
13:43
two-year-olds,
259
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1282
normalnog razvoja,
13:44
and we freeze one frame,
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2975
i ako zamrznemo jednu sličicu,
13:47
and this is what the typical children are doing.
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3501
ovo će većina dece uraditi.
13:50
In this scan pass, in green here, are two-year-olds with autism.
262
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4441
A ovde su zelenom bojom prikazani
dvogodišnjaci sa autizmom.
dvogodišnjaci sa autizmom.
13:55
So on that frame, the children who are typical
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Na toj sličici
deca normalnog razvoja
deca normalnog razvoja
13:58
are watching this,
264
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2955
posmatraju ovo,
14:01
the emotion of expression of that little boy
265
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2549
emotivni izraz tog dečaka
14:04
as he's fighting a little bit with the little girl.
266
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dok se malo svađa sa ovom devojčicom.
14:07
What are the children with autism doing?
267
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Šta rade deca sa autizmom?
14:09
They are focusing on the revolving door,
268
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Ona pažnju usmeravaju
na vrata
na vrata
14:12
opening and shutting.
269
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2091
koja se otvaraju i zatvaraju.
14:14
Well, I can tell you that this divergence
270
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2452
Mogu da vam kažem
da se razlika
da se razlika
14:17
that you're seeing here
271
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869
koju ovde vidite
14:18
doesn't happen only in our five-minute experiment.
272
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ne događa jedino
u našem petominutnom eksperimentu.
u našem petominutnom eksperimentu.
14:21
It happens moment by moment in their real lives,
273
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Događa se neprekidno
u njihovim stvarnim životima,
u njihovim stvarnim životima,
14:24
and their minds are being formed,
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2720
pri čemu se obrazuje njihov um
14:27
and their brains are being specialized in something other
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i mozak im se usmerava
ka nečem drugom
ka nečem drugom
14:30
than what is happening with their typical peers.
276
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3779
od onoga što se dešava
sa njihovim zdravim vršnjacima.
sa njihovim zdravim vršnjacima.
14:34
Well, we took a construct from
277
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3187
Osnovu smo uzeli
14:37
our pediatrician friends,
278
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3194
od naših kolega pedijatara
14:40
the concept of growth charts.
279
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1927
u vidu grafikona rasta.
14:42
You know, when you take a child to the pediatrician,
280
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1969
Znate, kada odvedete dete kod pedijatra
14:44
and so you have physical height, and weight.
281
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i izmere mu visinu i težinu.
14:48
Well we decided that we're going to create growth charts
282
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Mi smo rešili da napravimo
grafikone rasta
grafikone rasta
14:51
of social engagement,
283
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2459
socijalne interakcije
14:54
and we sought children from the time that they are born,
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2801
i ispitivali smo decu
od vremena kada su rođena,
od vremena kada su rođena,
14:57
and what you see here on the x-axis is two, three, four,
285
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5829
a na X-osi vidite dva, tri, četiri,
15:02
five, six months and nine, until about the age of 24 months,
286
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3840
pet, šest, devet meseci,
sve do starosti od 24 meseca,
sve do starosti od 24 meseca,
15:06
and this is the percent of their viewing time
287
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2731
a ovo je procenat
vremena koje provedu gledajući,
vremena koje provedu gledajući,
15:09
that they are focusing on people's eyes,
288
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i to gledajući oči ljudi,
15:11
and this is their growth chart.
289
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2360
a ovo je grafikon rasta.
15:13
They start over here, they love people's eyes,
290
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Ovde počinje,
obožavaju oči drugih ljudi
obožavaju oči drugih ljudi
15:16
and it remains quite stable.
291
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2454
i situacija je prilično stabilna.
15:18
It sort of goes up a little bit in those initial months.
292
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Možda se malo poveća
u prvim mesecima.
u prvim mesecima.
15:22
Now, let's see what's happening with babies
293
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Da vidimo sad šta se dešava
sa decom
sa decom
15:25
who became autistic.
294
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2508
koja dobiju autizam.
15:27
It's something very different.
295
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2205
Potpuno drugačija situacija.
15:29
It starts way up here, but then it's a free fall.
296
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3790
Počinje ovako visoko,
ali onda samo opada.
ali onda samo opada.
15:33
It's very much like they brought into this world the reflex
297
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3419
Kao da su na svet
došli s refleksom
došli s refleksom
15:37
that orients them to people, but it has no traction.
298
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3931
koji ih orijentiše prema ljudima,
ali nema trenja.
ali nema trenja.
15:41
It's almost as if that stimulus, you,
299
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3070
Kao da stimulus, vi,
15:44
you're not exerting influence on what happens
300
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2901
nema nikakvog dejstva
na to što se događa
na to što se događa
15:47
as they navigate their daily lives.
301
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3891
dok se oni kreću
kroz svakodnevni život.
kroz svakodnevni život.
15:50
Now, we thought that those data were so powerful
302
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6022
Zaključili smo da su ovi podaci
veoma značajni,
veoma značajni,
15:56
in a way, that we wanted to see what happened
303
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pa smo hteli da vidimo
šta će se desiti
šta će se desiti
15:59
in the first six months of life, because if you interact
304
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3393
u prvih šest meseci života, pošto,
ako biste pokušali da uspostavite kontakt
ako biste pokušali da uspostavite kontakt
16:03
with a two- and a three-month-older,
305
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1337
sa bebom starom dva ili tri meseca,
16:04
you'd be surprised by how social those babies are.
306
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4552
iznenadili biste se
koliko su bebe društvene.
koliko su bebe društvene.
16:09
And what we see in the first six months of life
307
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2607
Uočili smo da se u prvih šest meseci
16:11
is that those two groups can be segregated very easily.
308
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6138
te dve grupe mogu
vrlo jednostavno razgraničiti.
vrlo jednostavno razgraničiti.
16:17
And using these kinds of measures, and many others,
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Korišćenjem ovakvih
i mnogih drugih postupaka
i mnogih drugih postupaka
16:20
what we found out is that our science could, in fact,
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otkrili smo da bi se pomoću
naših naučnih saznanja
naših naučnih saznanja
16:24
identify this condition early on.
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ovo oboljenje moglo
primetiti u ranom stadijumu.
primetiti u ranom stadijumu.
16:27
We didn't have to wait for the behaviors of autism
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Nije bilo potrebe da čekamo
da se autističko ponašanje
da se autističko ponašanje
16:30
to emerge in the second year of life.
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pojavi u drugoj godini života.
16:33
If we measured things that are, evolutionarily,
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Ako bismo merili stvari
koje su, evolucionarno,
koje su, evolucionarno,
16:36
highly conserved, and developmentally very early emerging,
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teško dostupne, a u razvoju se pojavljuju
vrlo rano,
vrlo rano,
16:40
things that are online from the first weeks of life,
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stvari koje se javljaju
u prvim nedeljama života,
u prvim nedeljama života,
16:43
we could push the detection of autism
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pomerili bismo otkrivanje autizma
16:45
all the way to those first months,
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na prve mesece
16:47
and that's what we are doing now.
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i upravo to sada radimo.
16:52
Now, we can create the very best technologies
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Čak i da stvorimo
najbolju tehnologiju
najbolju tehnologiju
16:55
and the very best methods to identify the children,
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i najbolje metode
za prepoznavanje obolele dece,
za prepoznavanje obolele dece,
16:58
but this would be for naught if we didn't have an impact
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ne bismo dobili rezultate
ako ne bi bilo uticaja
ako ne bi bilo uticaja
17:01
on what happens in their reality in the community.
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na ono što se zaista događa
u zajednici.
u zajednici.
17:05
Now we want those devices, of course,
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Želimo da te uređaje
17:07
to be deployed by those who are in the trenches,
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razdelimo pravim borcima,
17:10
our colleagues, the primary care physicians,
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našim kolegama,
lekarima primarne zdravstvene zaštite,
lekarima primarne zdravstvene zaštite,
17:13
who see every child,
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koji pregledaju svako dete,
17:15
and we need to transform those technologies
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a tu tehnologiju moramo preobraziti
17:18
into something that is going to add value to their practice,
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u nešto što povećava
vrednost njihove prakse,
vrednost njihove prakse,
17:21
because they have to see so many children.
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jer moraju da pregledaju
toliko dece.
toliko dece.
17:23
And we want to do that universally
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Želimo da ti pregledi budu univerzalni
17:25
so that we don't miss any child,
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da ne bismo propustili
nijedno dete,
nijedno dete,
17:27
but this would be immoral
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ali bi to bilo amoralno
17:30
if we also did not have an infrastructure for intervention,
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ako ne bismo imali
infrastrukturu za intervenciju,
infrastrukturu za intervenciju,
17:34
for treatment.
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za lečenje.
17:36
We need to be able to work with the families,
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Moramo biti u mogućnosti
da sarađujemo sa porodicama,
da sarađujemo sa porodicama,
17:38
to support the families, to manage those first years
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da podržavamo porodice,
upravljamo prvim godinama života
upravljamo prvim godinama života
17:42
with them. We need to be able to really go
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zajedno s njima.
Moramo biti u mogućnosti
Moramo biti u mogućnosti
17:46
from universal screening to universal access to treatment,
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da sa univerzalnih pregleda
pređemo na univerzalan pristup lečenju,
pređemo na univerzalan pristup lečenju,
17:50
because those treatments are going to change
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jer će to lečenje promeniti
17:53
these children's and those families' lives.
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živote te dece i njihovih porodica.
17:56
Now, when we think about what we [can] do
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Kad razmišljamo o tome
šta možemo učiniti
šta možemo učiniti
18:01
in those first years,
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u prvim godinama,
18:04
I can tell you,
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znate šta,
18:06
having been in this field for so long,
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posle ovoliko vremena
u ovoj oblasti,
u ovoj oblasti,
18:09
one feels really rejuvenated.
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osećam se podmlađeno.
18:12
There is a sense that the science that one worked on
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Imam utisak
da nauka na kojoj smo radili
da nauka na kojoj smo radili
18:16
can actually have an impact on realities,
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može zaista da utiče na stvarnost,
18:20
preventing, in fact, those experiences
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odnosno da spreči iskustva
18:23
that I really started in my journey in this field.
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kojim je započeo
moj put kroz ovu oblast.
moj put kroz ovu oblast.
18:27
I thought at the time that this was an intractable condition.
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Tada sam mislio
da je ovo neizlečiva bolest.
da je ovo neizlečiva bolest.
18:30
No longer. We can do a great deal of things.
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Više nije tako.
Možemo mnogo da promenimo.
Možemo mnogo da promenimo.
18:34
And the idea is not to cure autism.
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Ne nameravamo da izlečimo autizam.
18:36
That's not the idea.
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Nije nam to cilj.
18:39
What we want is to make sure
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Želimo da se postaramo
18:41
that those individuals with autism can be free from
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da osobe sa autizmom
mogu da budu oslobođene
mogu da budu oslobođene
18:44
the devastating consequences that come with it at times,
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razarajućih posledica
koje ta bolest ponekad donosi,
koje ta bolest ponekad donosi,
18:48
the profound intellectual disabilities, the lack of language,
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teškog intelektualnog zaostatka,
nemogućnosti govora,
nemogućnosti govora,
18:51
the profound, profound isolation.
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veoma duboke izolovanosti.
18:55
We feel that individuals with autism, in fact,
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Zapravo mislimo da osobe sa autizmom
18:57
have a very special perspective on the world,
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imaju poseban pogled na svet,
19:00
and we need diversity, and they can work extremely well
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pri tom nam je raznovrsnost potrebna,
a oni odlično funkcionišu
a oni odlično funkcionišu
19:03
in some areas of strength:
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u pojedinim oblastima:
19:05
predictable situations, situations that can be defined.
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u predvidivim situacijama,
situacijama koje se mogu definisati.
situacijama koje se mogu definisati.
19:09
Because after all, they learn about the world almost like
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Oni o svetu i uče
skoro kao da se radi o nečem
skoro kao da se radi o nečem
19:12
about it, rather than learning how to function in it.
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odvojenom, umesto da uče
kako da funkcionišu unutar njega.
kako da funkcionišu unutar njega.
19:17
But this is a strength, if you're working, for example,
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Međutim, to je pozitivno
ako se, recimo, bavite
ako se, recimo, bavite
19:19
in technology.
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tehnologijom.
19:21
And there are those individuals who have incredible
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Postoje i osobe
sa izvanrednim
sa izvanrednim
19:24
artistic abilities.
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umetničkim darom.
19:25
We want them to be free of that.
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Želimo da ih oslobodimo.
19:27
We want that the next generations of individuals with autism
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Želimo da naredne generacije
osoba sa autizmom
osoba sa autizmom
19:30
will be able not only to express their strengths
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budu u stanju da
iskažu svoje veštine,
iskažu svoje veštine,
19:34
but to fulfill their promise.
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ali i da ispune obećanja.
19:36
Well thank you for listening to me. (Applause)
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Hvala vam što ste me saslušali.
(Aplauz)
(Aplauz)
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