TED2014
Wendy Chung: Autism — what we know (and what we don't know yet)
Vendi Čang (Wendy Chung): Autizam - ono što znamo (i ono što još ne znamo)
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U ovom govoru o činjenicama, genetičar Vendi Čang deli sa nama saznanja o autizmu - na primer, to da autizam ima mnogostruke uzroke koji se možda prepliću. Gledajući dalje od zabrinutosti i brige kojom je okruženo postavljanje dijagnoze, Čang i njen tim razmatraju šta smo do sada saznali pomoću studija, lečenja i pažljivog slušanja.
Wendy Chung - Geneticist
At the Simons Foundation, Wendy Chung is working to characterize behavior, brain structure and function in people with genetic variations that may relate to autism. Full bio
At the Simons Foundation, Wendy Chung is working to characterize behavior, brain structure and function in people with genetic variations that may relate to autism. Full bio
Double-click the English transcript below to play the video.
00:12
"Why?"
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‚‚Zašto?"
00:14
"Why?" is a question
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‚‚Zašto?" je pitanje
00:15
that parents ask me all the time.
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koje mi roditelji stalno postavljaju.
00:18
"Why did my child develop autism?"
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‚‚Zašto se kod mog deteta
razvio autizam?"
razvio autizam?"
00:21
As a pediatrician, as a geneticist, as a researcher,
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Kao pedijatar, kao genetičar,
kao istraživač,
kao istraživač,
00:25
we try and address that question.
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pokušavam da odgovorim na ovo pitanje.
00:28
But autism is not a single condition.
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Autizam nije jednostavno stanje.
00:30
It's actually a spectrum of disorders,
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To je spektar poremećaja,
00:32
a spectrum that ranges, for instance,
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spektar koji obuhvata, na primer,
00:35
from Justin, a 13-year-old boy
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Džastina, trinaestogodišnjaka
00:37
who's not verbal, who can't speak,
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koji ne može da govori,
00:41
who communicates by using an iPad
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koji komunicira pomoću ajpeda,
00:43
to touch pictures to communicate
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dodirujući slike da bi izrazio
00:45
his thoughts and his concerns,
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svoje misli i probleme,
00:47
a little boy who, when he gets upset,
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jedan mali dečak koji, kad se uznemiri,
00:49
will start rocking,
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počinje da se ljulja,
00:51
and eventually, when he's disturbed enough,
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a kad je već mnogo uznemiren,
00:52
will bang his head to the point
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toliko se udara glavom
00:54
that he can actually cut it open and require stitches.
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da se raseče i mora da se zašije.
00:58
That same diagnosis of autism, though,
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Autizam je dijagnostikovan
01:00
also applies to Gabriel,
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i kod Gabrijela,
01:02
another 13-year-old boy
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drugog trinaestogodišnjaka,
01:04
who has quite a different set of challenges.
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koji ima sasvim drugačije izazove.
01:07
He's actually quite remarkably gifted in mathematics.
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Izuzetno je nadaren za matematiku.
01:10
He can multiple three numbers by three numbers
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On sa lakoćom pomnoži
trocifreni broj sa trocifrenim
trocifreni broj sa trocifrenim
01:12
in his head with ease,
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napamet,
01:14
yet when it comes to trying to have a conversation,
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međutim, kad treba da razgovara,
01:18
he has great difficulty.
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ima velike poteškoće.
01:20
He doesn't make eye contact.
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Ne uspostavlja kontakt očima.
01:22
He has difficulty starting a conversation,
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Teško započinje razgovor,
01:24
feels awkward,
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oseća se neugodno,
01:26
and when he gets nervous,
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a kada se iznervira,
01:27
he actually shuts down.
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on se blokira.
01:29
Yet both of these boys
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Ipak, ova dva dečaka
01:31
have the same diagnosis of
autism spectrum disorder.
autism spectrum disorder.
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imaju istu dijagnozu, a to je
spektar autističnih poremećaja.
spektar autističnih poremećaja.
01:35
One of the things that concerns us
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Jedna od stvari koja nas brine
01:37
is whether or not there really is
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je da li zaista postoji
01:39
an epidemic of autism.
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epidemija autizma.
01:41
These days, one in 88 children
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Danas, kod svakog 88. deteta
01:43
will be diagnosed with autism,
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je dijagnostikovan autizam
01:45
and the question is,
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i pitanje je
01:47
why does this graph look this way?
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zašto ovaj grafikon izgleda ovako?
01:49
Has that number been increasing
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Da li se brojka vremenom
01:51
dramatically over time?
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dramatično povećava?
01:53
Or is it because we have now started labeling
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Ili je to zato što smo počeli
da etiketiramo
da etiketiramo
01:57
individuals with autism,
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osobe sa autizmom
01:59
simply giving them a diagnosis
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jednostavno postavljajući im dijagnozu,
02:01
when they were still present there before
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iako su one i ranije postojale
02:04
yet simply didn't have that label?
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ali nisu bile etiketirane?
02:06
And in fact, in the late 1980s, the early 1990s,
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U stvari, krajem '80-ih
i početkom '90-ih godina,
i početkom '90-ih godina,
02:10
legislation was passed
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donet je zakon
02:11
that actually provided individuals with autism
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koji je osobama sa autizmom
02:14
with resources, with access to educational materials
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obezbedio pristup obrazovnim materijalima
02:18
that would help them.
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koji bi im bili od pomoći.
02:20
With that increased awareness, more parents,
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Time je podignuta svest,
pa je sve više roditelja,
pa je sve više roditelja,
02:23
more pediatricians, more educators
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sve više pedijatara i vaspitača
02:26
learned to recognize the features of autism.
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naučilo da prepozna odlike autizma.
02:29
As a result of that, more individuals were diagnosed
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Kao rezultat toga,
bilo je više postavljenih dijagnoza
bilo je više postavljenih dijagnoza
02:33
and got access to the resources they needed.
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i tim osobama je omogućen pristup
potrebnim resursima.
potrebnim resursima.
02:36
In addition, we've changed our definition over time,
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Vremenom se promenila i definicija,
02:40
so in fact we've widened the definition of autism,
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proširili smo pojam autizma,
02:43
and that accounts for some of
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i zbog toga imamo
02:44
the increased prevalence that we see.
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ovu povećanu rasprostranjenost.
02:47
The next question everyone wonders is,
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Sledeće pitanje koje svi postavljaju je:
02:50
what caused autism?
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šta je uzrok autizma?
Uobičajena zabluda je
02:51
And a common misconception
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02:54
is that vaccines cause autism.
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da su vakcine uzrok autizma.
02:57
But let me be very clear:
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Da pojasnim.
03:00
Vaccines do not cause autism.
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Vakcine ne prouzrokuju autizam.
03:05
(Applause)
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(Aplauz)
03:11
In fact, the original research study
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Originalna istarživačka studija
03:13
that suggested that was the case
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koja je to nagoveštavala
03:15
was completely fraudulent.
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bila je lažna.
03:18
It was actually retracted from the journal Lancet,
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Povučena je iz časopisa Lanset
03:21
in which it was published,
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u kojem je i štampana,
03:23
and that author, a physician,
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a autoru teksta, lekaru,
03:25
had his medical license taken away from him.
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oduzeta je dozvola za rad.
03:28
(Applause)
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(Aplauz)
03:32
The Institute of Medicine,
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Medicinski institut
03:34
The Centers for Disease Control,
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i Centar za kontrolu bolesti
03:35
have repeatedly investigated this
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u više navrata je istraživao ovu temu
03:38
and there is no credible evidence
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i nisu našli uverljiv dokaz o tome
03:41
that vaccines cause autism.
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da su vakcine uzrok autizma.
03:44
Furthermore,
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Osim toga, mislilo se da je
03:46
one of the ingredients in vaccines,
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jedan od sastojaka vakcine,
03:48
something called thimerosal,
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timerosal,
03:50
was thought to be what the cause of autism was.
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uzrok autizmu.
03:53
That was actually removed from vaccines
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Sastojak je odstranjen iz vakcina
03:56
in the year 1992,
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1992. godine
03:57
and you can see that it really did not have an effect
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i vidi se da nije imao uticaja
04:00
in what happened with the prevalence of autism.
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na porast autizma.
04:03
So again, there is no evidence
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Ponavljam, nema dokaza
04:05
that this is the answer.
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da je to zbog vakcina.
04:07
So the question remains, what does cause autism?
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Ostaje dakle pitanje,
šta je uzrok autizma?
šta je uzrok autizma?
04:11
In fact, there's probably not one single answer.
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Verovatno nema jednostavnog odgovora.
04:14
Just as autism is a spectrum,
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Autizam je čitav spektar
04:16
there's a spectrum of etiologies,
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etiologija,
04:18
a spectrum of causes.
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spektar uzroka.
04:19
Based on epidemiological data,
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Prema epidemiološkim podacima,
04:21
we know that one of the causes,
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znamo jedan od uzroka
04:23
or one of the associations, I should say,
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ili saveznika, rekla bih,
04:25
is advanced paternal age,
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a to je kasno roditeljstvo
04:28
that is, increasing age of the father
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odnosno starija dob oca
04:30
at the time of conception.
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u vreme začeća.
04:32
In addition, another vulnerable
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Pored ovoga, još jedan ranjiv
04:34
and critical period in terms of development
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i kritičan period u smislu razvoja bolesti
04:37
is when the mother is pregnant.
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je trudnoća majke.
04:39
During that period, while
the fetal brain is developing,
the fetal brain is developing,
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Dok se razvija mozak fetusa,
04:42
we know that exposure to certain agents
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znamo da izloženost nekim činiocima
04:43
can actually increase the risk of autism.
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može povećati rizik za pojavu autizma.
04:47
In particular, there's a medication, valproic acid,
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Tačnije, postoji lek, valproična kiselina,
04:49
which mothers with epilepsy sometimes take,
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koji epileptične majke ponekad uzimaju,
04:52
we know can increase that risk of autism.
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a to može povećati rizik
za pojavu autizma.
za pojavu autizma.
04:56
In addition, there can be some infectious agents
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Takođe mogu postojati infekcije
04:58
that can also cause autism.
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koje mogu prouzrokovati autizam.
05:01
And one of the things I'm going to spend
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Nešto čemu ću posvetiti mnogo vremena
05:02
a lot of time focusing on
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su geni koji mogu
05:05
are the genes that can cause autism.
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da prouzrokuju autizam.
05:07
I'm focusing on this not because genes
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Ne samo zbog toga što su geni
05:10
are the only cause of autism,
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jedini uzročnici autizma,
05:12
but it's a cause of autism
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već uzrok autizma
05:13
that we can readily define
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možemo lako definisati
05:15
and be able to better understand the biology
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i razumeti bolje biologiju
05:18
and understand better how the brain works
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i to kako radi mozak,
05:20
so that we can come up with strategies
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i onda možemo da smislimo
05:22
to be able to intervene.
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strategije za delovanje.
05:25
One of the genetic factors that we don't understand,
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Jedan od genetskih faktora
koje ne razumemo
koje ne razumemo
05:27
however, is the difference that we see
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je razlika koju vidimo
05:31
in terms of males and females.
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u smislu muško-žensko.
05:33
Males are affected four to one compared to females
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Muškarci, u odnosu na žene,
pogođeni su autizmom
pogođeni su autizmom
05:36
with autism,
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u odnosu 4:1
05:37
and we really don't understand what that cause is.
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i zaista ne razumemo uzrok tome.
05:41
One of the ways that we can understand
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Jedan od načina da razumemo
05:42
that genetics is a factor
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da je uzrok tome genetika,
05:44
is by looking at something called
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je da osmotrimo takozvanu
05:46
the concordance rate.
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stopu podudarnosti.
05:47
In other words, if one sibling has autism,
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Drugim rečima, ako jedan od braće
ima autizam,
ima autizam,
05:51
what's the probability
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kolika je verovatnoća
05:52
that another sibling in that family will have autism?
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da će ga i drugi imati?
05:55
And we can look in particular
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Naročito možemo posmatrati
05:57
at three types of siblings:
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tri vrste braće:
05:59
identical twins,
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identične blizance,
06:01
twins that actually share 100 percent
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one koji dele 100 posto
06:03
of their genetic information
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genetičkih informacija,
06:05
and shared the same intrauterine environment,
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kao i intrauterinu sredinu,
06:08
versus fraternal twins,
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naspram dvojajčanih blizanaca
06:10
twins that actually share 50 percent
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koji dele 50 posto
06:12
of their genetic information,
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genetičkih informacija,
06:14
versus regular siblings,
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nasuprot obične braće -
06:15
brother-sister, sister-sister,
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brata i sestre, dve sestre,
06:17
also sharing 50 percent of their genetic information,
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koje takođe dele 50 posto
genetičkih informacija
genetičkih informacija
06:20
yet not sharing the same intrauterine environment.
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ali ne dele istu intrauterinu okolinu.
06:23
And when you look at those concordance ratios,
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Posmatrajući stopu podudarnosti
06:25
one of the striking things that you will see
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upečatljivo je da je
06:27
is that in identical twins,
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kod identičnih blizanaca
06:30
that concordance rate is 77 percent.
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stopa podudarnosti 77 posto.
06:33
Remarkably, though,
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Upadljivo je,
06:34
it's not 100 percent.
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da stopa nije 100 posto.
06:36
It is not that genes account
for all of the risk for autism,
for all of the risk for autism,
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Nisu samo geni uzročnici autizma,
06:40
but yet they account for a lot of that risk,
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iako su nosioci rizika,
06:42
because when you look at fraternal twins,
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jer kad pogledate dvojajčane blizance,
06:45
that concordance rate is only 31 percent.
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njihova stopa podudarnosti
je samo 31 posto.
je samo 31 posto.
06:48
On the other hand, there is a difference
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S druge strane, ima razlike
06:50
between those fraternal twins and the siblings,
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između dvojajčanih blizanaca
i obične braće.
i obične braće.
06:53
suggesting that there are common exposures
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Postoji zajednička izloženost
06:55
for those fraternal twins
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kod dvojajčanih blizanaca
06:57
that may not be shared as commonly
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koja nije uobičajena
06:59
with siblings alone.
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kod obične braće.
07:01
So this provides some of the data
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Ovo nam pruža podatke
07:03
that autism is genetic.
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da je autizam nasledna bolest.
07:04
Well, how genetic is it?
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Ali, koliko je nasledna?
07:06
When we compare it to other conditions
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Kada ga uporedimo
07:08
that we're familiar with,
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sa drugim poznatim stanjima
07:10
things like cancer, heart disease, diabetes,
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kao što su kancer,
bolesti srca, dijabetes,
bolesti srca, dijabetes,
07:14
in fact, genetics plays a much larger role in autism
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u autizmu genetika igra veću ulogu
07:18
than it does in any of these other conditions.
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nego u ostalim navedenim bolestima.
07:20
But with this, that doesn't
tell us what the genes are.
tell us what the genes are.
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Ali još uvek ne znamo koji su to geni.
07:23
It doesn't even tell us in any one child,
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Ne možemo utvrditi ni kod jednog deteta
07:26
is it one gene
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da li je to jedan gen
07:28
or potentially a combination of genes?
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ili možda kombinacija gena.
07:30
And so in fact, in some individuals with autism,
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Kod nekih ljudi
07:33
it is genetic!
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autizam je genetski!
07:36
That is, that it is one single,
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To znači da postoji jedan jedini
07:38
powerful, deterministic gene
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moćni, deterministički gen
07:40
that causes the autism.
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koji je uzrok autizma.
07:42
However, in other individuals,
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Kod nekih drugih osoba
07:44
it's genetic, that is,
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je takođe genetski -
07:46
that it's actually a combination of genes
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kombinacija gena
07:49
in part with the developmental process
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i razvojni proces
07:52
that ultimately determines that risk for autism.
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na kraju određuju rizik od autizma.
07:55
We don't know in any one person, necessarily,
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Ne možemo odrediti ni u jednom slučaju
07:58
which of those two answers it is
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koji je od ova dva odgovora tačan
08:00
until we start digging deeper.
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dok ne zagrebemo dublje.
08:02
So the question becomes,
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1287
Pitanje je, dakle,
08:03
how can we start to identify
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kako možemo identifikovati
08:06
what exactly those genes are.
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1872
koji su to geni?
08:07
And let me pose something
196
475912
1109
Sad ću vam predstaviti nešto
08:09
that might not be intuitive.
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2190
što ne mora biti intuitivno.
08:11
In certain individuals,
198
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2359
Određene osobe
08:13
they can have autism
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1724
mogu imati autizam
08:15
for a reason that is genetic
200
483294
2453
zbog genetskih razloga,
08:17
but yet not because of autism running in the family.
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485747
3564
a ne naslednih.
08:21
And the reason is because in certain individuals,
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2379
To je zato što neke osobe
08:23
they can actually have genetic changes or mutations
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mogu imati genetske promene ili mutacije
08:26
that are not passed down from the mother
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3043
koje ne potiču od majke
08:29
or from the father,
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1487
ili od oca
08:31
but actually start brand new in them,
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499281
2733
nego počinju u njima samima,
08:34
mutations that are present
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502014
1587
to su mutacije koje su prisutne
08:35
in the egg or the sperm
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1403
u jajašcu ili u spermi
08:37
at the time of conception
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1613
u vreme začeća
08:38
but have not been passed down
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506617
1742
ali se ne prenose
08:40
generation through generation within the family.
211
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3006
sa generacije na generaciju
unutar porodice.
unutar porodice.
08:43
And we can actually use that strategy
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2181
Ovu strategiju možemo koristiti
08:45
to now understand and to identify
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2334
da bismo razumeli i identifikovali
08:47
those genes causing autism in those individuals.
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one gene koji su uzrok autizma
kod tih pojedinaca.
kod tih pojedinaca.
08:50
So in fact, at the Simons Foundation,
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518980
2010
U fondaciji Sajmons uzeli smo
u posmatranje
u posmatranje
08:52
we took 2,600 individuals
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2726
2600 osoba
08:55
that had no family history of autism,
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523716
2711
koje u porodici nisu imale autizam.
08:58
and we took that child and their mother and father
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526427
3170
Posmatrali smo to dete
i njegove majku i oca
i njegove majku i oca
09:01
and used them to try and understand
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529597
2471
da bismo shvatili
09:04
what were those genes
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532068
1619
koji su to geni
09:05
causing autism in those cases?
221
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2318
koji su prouzrokovali autizam
u ovim slučajevima.
u ovim slučajevima.
09:08
To do that, we actually had to comprehensively
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3067
Morali smo sveobuhvatno
09:11
be able to look at all that genetic information
223
539072
2730
da proučimo genetske informacije
09:13
and determine what those differences were
224
541802
2182
i da odredimo razlike
09:15
between the mother, the father and the child.
225
543984
3701
između majke, oca i deteta.
09:19
In doing so, I apologize,
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547685
1954
Tokom tog izučavanja, izvinite,
09:21
I'm going to use an outdated analogy
227
549639
1884
sada ću upotrebiti jednu
prevaziđenu analogiju
prevaziđenu analogiju
09:23
of encyclopedias rather than Wikipedia,
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551523
2658
iz enciklopedije, a ne iz Vikipedije,
09:26
but I'm going to do so to try and help make the point
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2999
ali to činim da bih istakla da
09:29
that as we did this inventory,
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2358
dok smo ovo otkrivali,
09:31
we needed to be able to look at
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1593
morali smo da pregledamo
09:33
massive amounts of information.
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2173
ogromnu količinu podataka.
09:35
Our genetic information is organized
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563304
2287
Naše genetske informacije su složene
09:37
into a set of 46 volumes,
234
565591
2887
u 46 tomova
09:40
and when we did that, we had to be able to account
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568478
1909
i kad smo to završili,
09:42
for each of those 46 volumes,
236
570387
1984
morali smo da uzmemo u obzir
svih 46 tomova
svih 46 tomova
09:44
because in some cases with autism,
237
572371
1853
jer u nekim slučajevima autizma
09:46
there's actually a single volume that's missing.
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2456
može nedostajati jedan tom.
09:48
We had to get more granular than that, though,
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576680
2310
Morali smo da budemo sitničavi
09:50
and so we had to start opening those books,
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578990
2320
i počeli smo da otvaramo knjige,
09:53
and in some cases, the genetic change
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581310
1880
i u nekim slučajevima genetska promena
09:55
was more subtle.
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1388
je bila suptilnija.
09:56
It might have been a single
paragraph that was missing,
paragraph that was missing,
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584578
3186
Negde je nedostajao samo jedan pasus
09:59
or yet, even more subtle than that,
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587764
3278
ili, još suptilnije,
10:03
a single letter,
245
591042
1692
samo jedno slovo,
10:04
one out of three billion letters
246
592734
2802
jedno od tri milijarde slova
10:07
that was changed, that was altered,
247
595536
2274
koje se promenilo,
10:09
yet had profound effects
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597810
1597
a ipak je imalo dubok uticaj
10:11
in terms of how the brain functions
249
599407
1913
na moždane funkcije
10:13
and affects behavior.
250
601320
1817
i ponašanje.
10:15
In doing this within these families,
251
603137
2377
Tokom proučavanja ovih porodica
10:17
we were able to account for approximately
252
605514
2318
mogli smo proceniti približno
10:19
25 percent of the individuals
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607832
2325
25 posto osoba
10:22
and determine that there was a single
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610157
2547
i odrediti da je postojao jedan jedini
10:24
powerful genetic factor
255
612704
2196
moćni genetski faktor
10:26
that caused autism within those families.
256
614900
3124
koji je bio uzročnik autizma
u tim porodicama.
u tim porodicama.
10:30
On the other hand, there's 75 percent
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618024
2252
Sa druge strane, u 75 posto slučajeva
10:32
that we still haven't figured out.
258
620276
2451
nismo otkrili uzrok.
10:34
As we did this, though,
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622727
1470
Ovo je bilo
10:36
it was really quite humbling,
260
624197
2094
prilično obeshrabrujuće
10:38
because we realized that there was not simply
261
626291
2365
jer smo shvatili da ne postoji samo
jedan gen
jedan gen
10:40
one gene for autism.
262
628656
1941
koji je uzročnik autizma.
10:42
In fact, the current estimates are
263
630597
1749
Sadašnja procena je da
10:44
that there are 200 to 400 different genes
264
632346
2752
postoji između 200 i 400 različitih gena
10:47
that can cause autism.
265
635098
1892
urzočnika autizma.
10:48
And that explains, in part,
266
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1369
Ovo je delimično objašnjenje
10:50
why we see such a broad spectrum
267
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2117
zašto postoji tako širok spektar
10:52
in terms of its effects.
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2043
njegovih efekata.
10:54
Although there are that many genes,
269
642519
2225
Iako ima toliko mnogo gena,
10:56
there is some method to the madness.
270
644744
2348
postoji neki sistem u tom ludilu.
10:59
It's not simply random
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647092
1948
Nije samo nasumično
11:01
200, 400 different genes,
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2230
200 ili 400 različitih gena,
11:03
but in fact they fit together.
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1794
nego se oni u potpunosti uklapaju.
11:05
They fit together in a pathway.
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653064
1866
Uklapaju se na putanji.
11:06
They fit together in a network
275
654930
1472
Uklapaju se u mrežu
11:08
that's starting to make sense now
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1832
koja sad ima smisla
11:10
in terms of how the brain functions.
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658234
2698
iz ugla funkcionisanja mozga.
11:12
We're starting to have a bottom-up approach
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2146
Počinjemo da primenjujemo pristup
odozdo nagore,
odozdo nagore,
11:15
where we're identifying those genes,
279
663078
1709
da identifikujemo gene,
11:16
those proteins, those molecules,
280
664787
2478
proteine, molekule,
11:19
understanding how they interact together
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1910
otkrivamo u kakvoj su interakciji
11:21
to make that neuron work,
282
669175
1397
da bi taj neuron funkcionisao,
11:22
understanding how those neurons interact together
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2737
da shvatamo kako neuroni međusobno deluju
11:25
to make circuits work,
284
673309
1219
da bi obezbedili da mreža radi,
11:26
and understand how those circuits work
285
674528
2016
i da razumemo kako te mreže rade
11:28
to now control behavior,
286
676544
1826
i upravljaju ponašanjem,
11:30
and understand that both in individuals with autism
287
678370
2800
i da razumemo to,
kako kod osoba sa autizmom,
kako kod osoba sa autizmom,
11:33
as well as individuals who have normal cognition.
288
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3901
tako i kod osoba sa normalnom spoznajom.
11:37
But early diagnosis is a key for us.
289
685071
2458
Ključ za uspeh je rana dijagnoza.
11:39
Being able to make that diagnosis
290
687529
1959
Sposobnost da postavimo dijagnozu
11:41
of someone who's susceptible
291
689488
1507
kod nekoga ko je prijemčiv
11:42
at a time in a window
292
690995
2055
na vreme,
11:45
where we have the ability to transform,
293
693050
2347
kad još možemo da transformišemo,
11:47
to be able to impact
294
695397
1603
kad još možemo imati uticaja
11:49
that growing, developing brain is critical.
295
697000
2740
na moždani razvoj.
11:51
And so folks like Ami Klin have developed methods
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699740
3809
Ami Klin je razvio metodu
11:55
to be able to take infants, small babies,
297
703549
2568
koja kod novorođenčadi omogućuje
11:58
and be able to use biomarkers,
298
706117
2533
upotrebu biomarkera,
12:00
in this case eye contact and eye tracking,
299
708650
3338
u ovom slučaju kontakt očima
i praćenje oka,
i praćenje oka,
12:03
to identify an infant at risk.
300
711988
2086
da bi se otkrio rizik od bolesti.
12:06
This particular infant, you can see,
301
714074
2165
Ova beba, vidite,
12:08
making very good eye contact with this woman
302
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2201
ostvaruje veoma dobar vizuelni kontakt
sa ovom ženom,
sa ovom ženom,
12:10
as she's singing "Itsy, Bitsy Spider,"
303
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2360
dok ona peva pesmicu,
12:12
in fact is not going to develop autism.
304
720800
3040
i kod nje se neće razviti autizam.
12:15
This baby we know is going to be in the clear.
305
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2880
Ova beba će biti bezbedna.
12:18
On the other hand, this other baby
306
726720
2360
S druge strane, kod ove druge bebe
12:21
is going to go on to develop autism.
307
729080
2335
će se razviti autizam.
12:23
In this particular child, you can see,
308
731415
2227
Kao što vidite, ovo dete
12:25
it's not making good eye contact.
309
733642
2201
ne ostvaruje dobar kontakt očima.
12:27
Instead of the eyes focusing in
310
735843
1967
Umesto da se oči fokusiraju
12:29
and having that social connection,
311
737810
2278
i ostvare društveni kontakt,
12:32
looking at the mouth, looking at the nose,
312
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2638
one gledaju u usta ili nos,
12:34
looking off in another direction,
313
742726
1783
gledaju u drugom smeru
12:36
but not again socially connecting,
314
744509
2913
ne ostvarujući socijalni kontakt.
12:39
and being able to do this on a very large scale,
315
747422
2713
Mogućnost da se ovo radi masovno,
12:42
screen infants, screen children for autism,
316
750135
3000
skeniranje novorođenčadi i dece
na autizam
na autizam
12:45
through something very robust, very reliable,
317
753135
2924
pomoću veoma pouzdane metode,
12:48
is going to be very helpful to us in terms of being
318
756059
2716
biće od pomoći
12:50
able to intervene at an early stage
319
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2094
da se interveniše u početnoj fazi
12:52
when we can have the greatest impact.
320
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3432
kad možemo najviše da utičemo.
12:56
How are we going to intervene?
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2246
Kako ćemo da intervenišemo?
12:58
It's probably going to be a combination of factors.
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2830
Biće to kombinacija raznih faktora.
13:01
In part, in some individuals,
323
769377
2039
Kod nekih ćemo delom
13:03
we're going to try and use medications.
324
771416
1879
pokušati sa lekovima.
13:05
And so in fact, identifying the genes for autism
325
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2722
Otkrivanje gena, uzročnika autizma
13:08
is important for us
326
776017
1526
nam je veoma važno
13:09
to identify drug targets,
327
777543
1866
da bismo odredili lekove,
13:11
to identify things that we might be able to impact
328
779409
2623
da bismo otkrili šta je
ono na šta možemo uticati
ono na šta možemo uticati
13:14
and can be certain that that's really
329
782032
1698
i da budemo sigurni
13:15
what we need to do in autism.
330
783730
1695
da je to ono što treba da činimo.
13:17
But that's not going to be the only answer.
331
785425
2741
Ali ovo neće biti jedini odgovor.
13:20
Beyond just drugs, we're going
to use educational strategies.
to use educational strategies.
332
788166
3510
Osim lekova, koristićemo
i obrazovne strategije.
i obrazovne strategije.
13:23
Individuals with autism,
333
791676
1275
Osobe sa autizmom su
13:24
some of them are wired a little bit differently.
334
792951
2297
malo drugačije sazdane.
13:27
They learn in a different way.
335
795248
1859
Oni uče na drugačiji način.
13:29
They absorb their surroundings in a different way,
336
797107
2334
Oni upijaju sredinu na drugačiji način
13:31
and we need to be able to educate them
337
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2219
i moramo se osposobiti da bi ih obrazovali
13:33
in a way that serves them best.
338
801660
3093
na način koji im najviše odgovara.
13:36
Beyond that, there are a lot of individuals
339
804753
1918
Osim toga, ovde ima mnogo osoba
13:38
in this room who have great ideas
340
806671
2146
sa sjajnim idejama
13:40
in terms of new technologies we can use,
341
808817
2544
u smislu novih tehnologija
koje možemo koristiti,
koje možemo koristiti,
13:43
everything from devices we can use to train the brain
342
811361
3119
sve od uređaja koje možemo koristiti
za treniranje mozga
za treniranje mozga
13:46
to be able to make it more efficient
343
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1549
da bi postao efikasniji
13:48
and to compensate for areas in which
344
816029
1673
i nadoknadio one oblasti
13:49
it has a little bit of trouble,
345
817702
1594
u kojima ima malo problema,
13:51
to even things like Google Glass.
346
819296
2279
možemo koristiti čak i Gugl naočare.
13:53
You could imagine, for instance, Gabriel,
347
821575
1784
Zamislite Gabrijela, na primer,
13:55
with his social awkwardness,
348
823359
1821
koji je u društvu nespretan,
13:57
might be able to wear Google Glass
349
825180
1458
da nosi Gugl naočare
13:58
with an earpiece in his ear,
350
826638
1531
sa slušalicama
14:00
and have a coach be able to help him,
351
828169
1927
i da ima trenera koji bi mu pomogao
14:02
be able to help think about conversations,
352
830096
2658
da razmišlja o konverzaciji,
o pokretanju konverzacije,
14:04
conversation-starters,
353
832754
1316
14:06
being able to even perhaps one day
354
834070
2111
da bi jednog dana možda
14:08
invite a girl out on a date.
355
836181
2368
pozvao i devojku na satanak.
14:10
All of these new technologies
356
838549
2212
Sve ove nove tehnologije nam
14:12
just offer tremendous opportunities
357
840761
2006
nude ogromne mogućnosti
14:14
for us to be able to impact
358
842767
1905
da utičemo
14:16
the individuals with autism,
359
844672
2685
na osobe sa autizmom,
14:19
but yet we have a long way to go.
360
847357
2536
ali predstoji nam još dugačak put.
14:21
As much as we know,
361
849893
1310
Mnogo znamo,
14:23
there is so much more that we don't know,
362
851203
2957
ali ima još mnogo toga što ne znamo,
14:26
and so I invite all of you
363
854160
2133
zato vas sve pozivam
14:28
to be able to help us think about
364
856293
2242
da razmislite o ovome,
14:30
how to do this better,
365
858535
1411
kako da ovo poboljšamo,
14:31
to use as a community our collective wisdom
366
859946
2879
kako da kao društvo
upotrebimo zajedničku mudrost
upotrebimo zajedničku mudrost
14:34
to be able to make a difference,
367
862825
1806
da bismo napravili promenu,
14:36
and in particular,
368
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1257
a posebno,
14:37
for the individuals in families with autism,
369
865888
2704
pozivam porodice
koje imaju člana obolelog od autizma
koje imaju člana obolelog od autizma
14:40
I invite you to join the interactive autism network,
370
868592
3255
da se pridruže
interaktivnoj mreži o autizmu
interaktivnoj mreži o autizmu
14:43
to be part of the solution to this,
371
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2194
i da budu deo rešenja ovog problema,
14:46
because it's going to take really a lot of us
372
874041
2879
jer će biti potrebno mnogo nas
14:48
to think about what's important,
373
876920
2270
da misli o tome šta je važno,
14:51
what's going to be a meaningful difference.
374
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1925
šta je to što će predstavljati
značajnu razliku.
značajnu razliku.
14:53
As we think about something
375
881115
1505
Dok razmišljamo o nečemu
14:54
that's potentially a solution,
376
882620
1832
što je moguće rešenje,
14:56
how well does it work?
377
884452
1659
koliko dobro to funkcioniše?
14:58
Is it something that's really
going to make a difference
going to make a difference
378
886111
1948
Da li će to stvarno promeniti nešto
15:00
in your lives, as an individual,
379
888059
2369
u vašim životima kao pojedinca,
15:02
as a family with autism?
380
890428
1653
kao porodice sa autizmom?
15:04
We're going to need individuals of all ages,
381
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2420
Trebaće nam osobe svih uzrasta,
15:06
from the young to the old,
382
894501
1727
i mladi i stari,
15:08
and with all different shapes and sizes
383
896228
2159
sa svim oblicima i razmerama
15:10
of the autism spectrum disorder
384
898387
1837
poremećaja koji se zove autizam
15:12
to make sure that we can have an impact.
385
900224
2176
da bismo se uverili
da možemo imati uticaj.
da možemo imati uticaj.
15:14
So I invite all of you to join the mission
386
902400
2205
Pozivam vas sve da se pridružite misiji
15:16
and to help to be able to make the lives
387
904605
2974
i pomognete da životi
15:19
of individuals with autism
388
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osoba sa autizmom
15:21
so much better and so much richer.
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postanu bolji i bogatiji.
15:23
Thank you.
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Hvala vam.
15:25
(Applause)
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ABOUT THE SPEAKER
Wendy Chung - GeneticistAt the Simons Foundation, Wendy Chung is working to characterize behavior, brain structure and function in people with genetic variations that may relate to autism.
Why you should listen
Wendy Chung is the director of clinical research at the Simons Foundation Autism Research Initiative, which does both basic and applied science to serve people affected by autism spectrum disorders. She's the principal investigator of the foundation's Simons Variation in Individuals Project, which characterizes behavior and brain structure and function in participants with genetic copy number variants such as those at 16p11.2, which are believed to play a role in spectrum disorders.
Chung also directs the clinical genetics program at Columbia University. In assessing and treating kids with autism spectrum disorders and intellectual disabilities, she uses advanced genomic diagnostics to explore the genetic basis of neurological conditions. She thinks deeply about the ethical and emotional questions around genetic medicine and genetic testing.
Wendy Chung | Speaker | TED.com