TEDxPeachtree
Ami Klin: A new way to diagnose autism
Ami Klin：诊断自闭症的新方法
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较早地诊断出自闭症能提高患者及其家人的生活质量，但自闭症错综复杂的病因却让其很难预测。Ami Klin讲述了一种较早诊断自闭症的新方法，即利用眼球追踪技术来衡量婴儿的社交互动能力，并测量出他们患自闭症的可能性。（拍摄于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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我一直都想成为
00:18
a walking laboratory of social engagement,
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社会交往中的一个能活动的实验室
00:21
to resonate other people's feelings, thoughts,
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在于他人相处时，理解他们的感受与思想,
00:25
intentions, motivations, in the act of being with them.
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意图和动机,从而产生共鸣.
00:30
As a scientist, I always wanted to measure that resonance,
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作为一个科学家,我总想度量这种共鸣的感受
00:36
that sense of the other that happens so quickly,
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这种感受瞬间产生,
00:39
in the blink of an eye.
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仿佛在眨眼之间.
00:41
We intuit other people's feelings.
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我们凭直觉理解别人的感受
00:43
We know the meaning of their actions
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了解其行为所代表的意义
00:44
even before they happen.
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甚至在某个行为产生之前
00:47
We're always in this stance of being
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我们总是
00:49
the object of somebody else's subjectivity.
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别人主观意识里的客体
00:52
We do that all the time. We just can't shake it off.
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一直都是这样. 我们就是没法摆脱.
00:55
It's so important that the very tools that we use
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而这一点又十分的重要,
00:57
to understand ourselves, to understand
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以至于我们用来了解自我与世界的每一种工具
00:59
the world around them, is shaped by that stance.
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都深受这一状况的影响
01:04
We are social to the core.
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人类本质上都是社会性的(群居的)
01:07
So my journey in autism really started when I lived
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因此，我真正的自闭症之旅始于
01:10
in a residential unit for adults with autism.
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我住进一个为成人自闭症患者设立的寓所
01:13
Most of those individuals had spent most of their lives
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他们中的大多数人生活的大部分时间
01:17
in long-stay hospitals. This is a long time ago.
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都在医院里度过. 这是很久以前的事了.
01:20
And for them, autism was devastating.
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对他们来说,自闭症是及其可怕的.
01:25
They had profound intellectual disabilities.
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他们有严重的智力障碍
01:28
They didn't talk. But most of all,
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他们不说话. 但最糟糕的是,
01:31
they were extraordinarily isolated
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他们极度封闭,生活在自己的世界里
01:35
from the world around them, from their environment
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与周围的环境隔绝
01:38
and from the people.
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与人隔绝
01:41
In fact, at the time, if you walked into a school
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实际上,如果你走进一个为自闭症患者开办的学校
01:44
for individuals with autism, you'd hear a lot of noise,
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你会听到很多嘈杂的声音
01:48
plenty of commotion, actions, people doing things,
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各种喧闹，各种动作，
都在做着些什么
都在做着些什么
01:53
but they're always doing things by themselves.
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但他们总是各自做各自的事
01:57
So they may be looking at a light in the ceiling,
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有的人可能在看天花板上的一盏灯
02:01
or they may be isolated in the corner,
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有的人可能缩在一个角落里
02:04
or they might be engaged in these repetitive movements,
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他们可能不断地重复这些动作
02:08
in self-stimulatory movements that led them nowhere.
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这些自我刺激的动作毫无意义
02:12
Extremely, extremely isolated.
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他们极度地封闭.
02:15
Well, now we know that autism
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现在我们知道了,自闭症是一种功能的混乱
02:19
is this disruption, the disruption of this resonance
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即共鸣功能的混乱，
02:23
that I am telling you.
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就是我刚才提到的
02:25
These are survival skills.
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这些是生存的基本技能
02:27
These are survival skills that we inherited
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这些生存技能是我们继承而来的
02:29
over many, many hundreds of thousands of years
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经由很多很多年的
02:32
of evolution.
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进化而来的
02:34
You see, babies are born in a state of utter fragility.
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大家都知道,婴儿生来是很脆弱的
02:39
Without the caregiver, they wouldn't survive, so it stands
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没有人照顾,他们活不下去
02:41
to reason that nature would endow them with
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所以很合理地, 大自然赋予他们
02:44
these mechanisms of survival.
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一种生存机制.
02:47
They orient to the caregiver.
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他们会亲近照顾者
02:50
From the first days and weeks of life,
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在人们出生后的几天到几周里
02:53
babies prefer to hear human sounds rather than just
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婴儿更偏好人的声音
02:57
sounds in the environment.
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相比环境的声音,他们喜欢人声.
02:59
They prefer to look at people rather than at things,
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他们喜欢盯着人看,胜过盯着东西看.
03:01
and even as they're looking at people,
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甚至当他们看着人时,
03:03
they look at people's eyes, because
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他们会看人的眼睛
03:05
the eye is the window to the other person's experiences,
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因为眼睛就是人生经验的一个窗口
03:09
so much so that they even prefer to look at people who are
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因此他们会更喜欢盯着那些正看着他们的人
03:12
looking at them rather than people who are looking away.
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而不是那些没有看他们的人
03:16
Well, they orient to the caregiver.
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他们会亲近照顾他们的人
03:19
The caregiver seeks the baby.
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而照顾者也会亲近婴儿
03:21
And it's out of this mutually reinforcing choreography
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在这种双向互助、一来一往如同舞蹈一样的过程中
03:24
that a lot that is of importance to the emergence of mind,
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对人的思想慢慢形成至关重要的各种因素便产生了
03:28
the social mind, the social brain, depends on.
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人的社会心理,社会大脑也借此形成.
03:33
We always think about autism
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我们总以为自闭症
03:36
as something that happens later on in life.
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是后天形成的
03:41
It doesn't. It begins with the beginning of life.
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其实并非如此.
自闭症在孩子出生的时候就有了.
自闭症在孩子出生的时候就有了.
03:46
As babies engage with caregivers, they soon realize
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当婴儿和照顾者在一起时,
他们很快便意识到
他们很快便意识到
03:50
that, well, there is something in between the ears
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在两个人的耳朵之间
03:55
that is very important --
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存在着很重要的东西
03:56
it's invisible, you can't see -- but is really critical,
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这种东西是无形的,你看不见,
但却非常重要
但却非常重要
04:00
and that thing is called attention.
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这种东西就是所谓的注意力
04:02
And they learn soon enough, even before they can
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他们很快就能学会
04:05
utter one word that they can take that attention
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甚至在他们会开口说话前,他们转移自己的注意力
04:07
and move somewhere in order to get things they want.
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以得到自己想要的东西
04:13
They also learn to follow other people's gaze,
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他们也会跟随着别人的目光
04:16
because whatever people are looking at is
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因为人的目光所到之处
04:18
what they are thinking about.
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就是他们心中所想
04:22
And soon enough, they start to learn about the meaning
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很快地,他们开始了解事物的意义
04:25
of things, because when somebody is looking at something
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因为当某个人看着一个东西
04:28
or somebody is pointing at something,
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或指着一个东西时
04:30
they're not just getting a directional cue,
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交流的对方并不仅仅获得一个方向的信息
04:33
they are getting the other person's meaning
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也获得了他人
04:36
of that thing, the attitude, and soon enough
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对事物意义的理解以及态度
04:39
they start building this body of meanings,
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很快地他们开始建立这个意义的系统
04:43
but meanings that were acquired within the realm
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但这一系统中意义
04:45
of social interaction.
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要求他们与人进行互动而获得
04:48
Those are meanings that are acquired as part
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这些意义
04:49
of their shared experiences with others.
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是通过他们与人分享自己的经验而得到的
04:53
Well, this is a little 15-month-old little girl,
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有个15个月大的小女孩
05:00
and she has autism.
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她有自闭症
05:04
And I am coming so close to her that I am maybe
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我靠她非常地近
05:07
two inches from her face, and she's quite oblivious to me.
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大概离她的脸只有2英寸,她却完全不理睬我
05:12
Imagine if I did that to you,
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想象一下我对你这么做,
05:13
and I came two inches from your face.
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离你的脸2英寸那么近
05:15
You'd do probably two things, wouldn't you?
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你很有可能会有种反应,对吧?
05:17
You would recoil. You would call the police. (Laughter)
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你可能会往后退,或者叫警察. (笑声)
05:21
You would do something, because it's literally impossible
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你一定会做点什么.
05:24
to penetrate somebody's physical space
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因为你进去了别人的空间
05:26
and not get a reaction.
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而不引起反应是不可能的.
05:28
We do so, remember, intuitively, effortlessly.
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对我们而言，这是自然而然，毫不费劲的.
05:31
This is our body wisdom. It's not something that is
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这是我们身体的智慧. 并不是语言教会我们的.
05:33
mediated by our language. Our body just knows that,
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我们的身体就是知道如何反应,
05:37
and we've known that for a long time.
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这是我们早就知道的事实.
05:40
And this is not something that happens to humans only.
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不光是人类会有如此反应.
05:43
It happens to some of our phylatic cousins,
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对于我们进化上的远亲,也是如此
05:46
because if you're a monkey,
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如果你是一只猴子
05:48
and you look at another monkey,
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你正在看着另一只猴子
05:50
and that monkey has a higher hierarchy position than you,
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另一只猴子比你的等级更高
05:54
and that is considered to be a signal or threat,
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如果这被看成是一种信号或威胁,
05:58
well, you are not going to be alive for long.
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你是不会活很久的
06:01
So something that in other species are survival mechanisms,
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这对其他动物来说是不可缺少的生存技能
06:05
without them they wouldn't basically live,
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离开这些技能他们活不下去
06:09
we bring into the context of human beings,
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而对于人类社会来说
06:11
and this is what we need to simply act, act socially.
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我们就需要这样反应，互动性的反应
06:15
Now, she is oblivious to me, and I am so close to her,
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她那样地对我不理不睬，可我离她那么近
06:18
and you think, maybe she can see you,
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可能你觉得，她看得见你
06:20
maybe she can hear you.
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也许她听得到你
06:22
Well, a few minutes later, she goes to the corner of
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可是，几分钟以后，
她会走到屋子里的某个角落
她会走到屋子里的某个角落
06:24
the room, and she finds a tiny little piece of candy, an M&M.
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发现地上的小糖果，MM糖。
06:30
So I could not attract her attention,
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我根本吸引不了她的注意力
06:35
but something, a thing, did.
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但有的东西，某个小物件，却可以！
06:37
Now, most of us make a big dichotomy
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如今，大多数人都会将物的世界与人的世界
06:40
between the world of things and the world of people.
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分得一清二楚
06:44
Now, for this girl, that division line is not so clear,
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但是对这个自闭症女孩而言，
这个分割线却不是很清晰
这个分割线却不是很清晰
06:49
and the world of people is not attracting her
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人的世界并不吸引她
06:52
as much as we would like.
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但却能吸引我们
06:53
Now remember that we learn a great deal
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我们能从分享经验当中
06:55
by sharing experiences.
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学到很多东西
06:58
Now, what she is doing right now is that
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但这个自闭症女孩所做的事情
07:01
her path of learning is diverging moment by moment
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使得她的学习方式越来越偏离正常的轨道，
07:05
as she is isolating herself further and further.
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因为她不断地封闭自己
07:09
So we feel sometimes that the brain is deterministic,
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有时候我们会觉得大脑是决定性的
07:12
the brain determines who we are going to be.
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它决定我们将要成为什么样的人
07:15
But in fact the brain also becomes who we are,
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但实际上大脑也会被我们的行为影响
07:18
and at the same time that her behaviors are taking away
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当她越来越孤僻
07:22
from the realm of social interaction, this is what's happening
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互动越来越少的时候
07:25
with her mind and this is what's happening with her brain.
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她的思想和大脑也受到行为的影响
07:30
Well, autism is the most strongly genetic condition
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在所有成长障碍中，
07:36
of all developmental disorders,
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自闭症与基因的关系最大，
07:39
and it's a brain disorder.
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自闭症是脑部神经错乱引起的
07:42
It's a disorder that begins much prior to the time
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这种紊乱在孩子早在出生之前
07:45
that the child is born.
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就开始形成了
07:48
We now know that there is a very broad spectrum of autism.
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我们现在知道自闭症有很多不同的种类
07:51
There are those individuals who are profoundly
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有很多自闭症患者有严重的智力障碍
07:54
intellectually disabled, but there are those that are gifted.
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但也有很多天赋异禀
07:57
There are those individuals who don't talk at all.
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有的患者完全不讲话
07:59
There are those individuals who talk too much.
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又有的会一直说个不停
08:01
There are those individuals that if you observe them
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有的患者如果你到他们学校里去观察他们
08:04
in their school, you see them running the periphery fence
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他们会一直围着学校的围墙跑个不停
08:07
of the school all day if you let them,
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如果你不阻止他们（他们会一直跑）
08:09
to those individuals who cannot stop coming to you
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有的人会一直不停地跑到你面前来
08:11
and trying to engage you repeatedly, relentlessly,
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不断地想引起你的注意
08:13
but often in an awkward fashion,
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但他们的方式常有点奇怪
08:17
without that immediate resonance.
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从而无法引起你的共鸣
08:21
Well, this is much more prevalent than we thought at the time.
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自闭症如今要更普遍得多，
08:25
When I started in this field, we thought that there were
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我刚开始进入这个领域时，
08:26
four individuals with autism per 10,000,
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我们以为一万个人里差不多有四个自闭症患者
08:29
a very rare condition.
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因而，自闭症显得比较罕见
08:31
Well, now we know it's more like one in 100.
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但现在我们知道，100个人里大概就有一个自闭症患者
08:35
There are millions of individuals with autism all around us.
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我们的身边有着数百万的患有自闭症的人
08:40
The societal cost of this condition is huge.
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社会为此而消耗的成本极大
08:44
In the U.S. alone, maybe 35 to 80 billion dollars,
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仅美国这一花费大概就达到了350亿到800亿美元，
08:47
and you know what? Most of those funds are associated
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大家知道么，这些经费的很大一部分
08:50
with adolescents and particularly adults
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都被用在青少年，
08:52
who are severely disabled,
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尤其是那些患有严重障碍的成年人
08:55
individuals who need wrap-around services, services
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以及那些需要全方位密集照顾的患者身上
08:57
that are very, very intensive, and those services
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需要极为高强度的照顾
08:59
can cost in excess of 60 to 80,000 dollars a year.
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这样的服务大概每年需要花费6万到8万美元
09:04
Those are individuals who did not benefit from early treatment,
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有的人没有获得早期的治疗
09:07
because now we know that autism creates itself
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而我们知道，自闭症随着学习方式的不断偏离
09:12
as they diverge in that pathway of learning
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而逐渐恶化
09:14
that I mentioned to you.
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就像我刚才提过的那样
09:17
Were we to be able to identify this condition
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我们能否及早发现自闭症的症状
09:19
at an earlier point, and intervene and treat,
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进行干预与治疗呢?
09:23
I can tell you, and this has been probably
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我可以跟大家说,这个想法
09:25
something that has changed my life in the past 10 years,
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在过去十年大大的改变了我的生活
09:28
this notion that we can absolutely attenuate
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我们完全可以
09:32
this condition.
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减轻自闭症的症状
09:34
Also, we have a window of opportunity, because
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但是,我们的机会并不多
09:37
the brain is malleable for just so long,
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因为大脑的可塑性只有那么一阵
09:40
and that window of opportunity happens
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而这为数不多的机会时间
09:41
in the first three years of life.
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是人生命的前三年
09:43
It's not that that window closes. It doesn't.
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这并不是说之后就没有机会了，不是这样的
09:46
But it diminishes considerably.
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但机会确实是越来越小
09:50
And yet, the median age of diagnosis in this country
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在美国，被诊断出自闭症的年龄
09:53
is still about five years,
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仍然在五岁左右
09:55
and in disadvantaged populations,
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但在一些贫困地区
09:57
the populations that don't have access to clinical services,
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或一些医疗条件不好的地区
10:01
rural populations, minorities,
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农村人口以及少数族裔自闭症患者
10:04
the age of diagnosis is later still,
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被确诊的年龄还要滞后
10:06
which is almost as if I were to tell you that we are
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这就好像我们要和他们说
10:09
condemning those communities to have individuals
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那些社区的自闭症患情况
10:11
with autism whose condition is going to be more severe.
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会越来越严重
10:16
So I feel that we have a bio-ethical imperative.
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所以我觉得我们在生物伦理上负有责任。
10:19
The science is there,
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技术已经有了
10:21
but no science is of relevance if it doesn't have an impact
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但技术如果无法对社区产生影响
10:24
on the community, and we just can't afford
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那么技术也就不存在，我们若不抓住机会，
10:28
that missed opportunity,
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后果将不是我们所能负担的。
10:30
because children with autism become adults with autism,
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因为自闭症孩子会变成患有自闭症的成人，
10:33
and we feel that those things that we can do
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我们能为孩子们、为他们的家庭做的事情
10:38
for these children, for those families, early on,
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如果早一点做到，
10:40
will have lifetime consequences,
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将会产生影响终身的作用，
10:42
for the child, for the family, and for the community at large.
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不管是对孩子，还是对其家庭以及社区而言都是如此
10:46
So this is our view of autism.
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这就是我们对于自闭症的看法
10:49
There are over a hundred genes that are associated
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和自闭症有关的基因多达一百个
10:52
with autism. In fact, we believe that there are going to be
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实际上，我们相信，很有可能
10:54
something between 300 and 600 genes associated with autism,
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将会有300到600个基因是与自闭症有关的
10:59
and genetic anomalies, much more than just genes.
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不仅仅是基因，而是基因异常
11:02
And we actually have a bit of a question here,
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这时候我们遇到一个问题
11:07
because if there are so many different causes of autism,
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既然有那么多引起自闭症的原因
11:10
how do you go from those liabilities
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那我们可不可以根据这些异常基因
11:13
to the actual syndrome? Because people like myself,
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来追查具体的症状呢？
像我这样的人
像我这样的人
11:16
when we walk into a playroom,
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当我们进入一个游戏室时，
11:19
we recognize a child as having autism.
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我们就能判断一个孩子是否有自闭症
11:22
So how do you go from multiple causes
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那要怎样从很多的形成原因中
11:24
to a syndrome that has some homogeneity?
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追查一系列相似的症状呢？
11:28
And the answer is, what lies in between,
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答案就在成因与症状之间，
11:30
which is development.
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即孩子的成长
11:33
And in fact, we are very interested in those first
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事实上，我们对孩子两岁前的生活非常感兴趣
11:36
two years of life, because those liabilities
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因为那些不利因素
11:39
don't necessarily convert into autism.
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未必一定会演变成自闭症
11:42
Autism creates itself.
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自闭症会自行形成
11:44
Were we to be able to intervene during those years of life,
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我们能否在那些年里进行干预？
11:49
we might attenuate for some, and God knows,
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我们也许能减轻一些症状，谁知道呢！
11:52
maybe even prevent for others.
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也许还能阻止一些人得上自闭症
11:55
So how do we do that?
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那我们该怎么做呢？
11:57
How do we enter that feeling of resonance,
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我们怎么样能引起共鸣？
12:00
how do we enter another person's being?
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怎么样进入到别人的存在当中？
12:04
I remember when I interacted with that 15-month-older,
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我记得当我和那个15个月大的孩子在一起互动时，
12:08
that the thing that came to mind was,
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我脑子里只有一件事
12:10
"How do you come into her world?
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“怎么样才能进入到她的世界呢？“
12:12
Is she thinking about me? Is she thinking about others?"
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”她是在想着我么？还是她正在想着别人？”
12:17
Well, it's hard to do that, so we had to create
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这很难做到，我们必须倚靠技术
12:21
the technologies. We had to basically step inside a body.
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我们必须到她身体内部的世界中去
12:24
We had to see the world through her eyes.
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我们要从她的眼睛看世界。
12:28
And so in the past many years we've been building
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所以过去的很多年我们都在做一项技术
12:31
these new technologies that are based on eye tracking.
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以眼球追踪为基础，
12:35
We can see moment by moment
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我们可以看到在每个不同的时刻，
12:38
what children are engaging with.
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孩子们都是被什么吸引了
12:41
Well, this is my colleague Warren Jones, with whom
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这是我的同事，Warren Jones,
12:44
we've been building these methods, these studies,
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我们一起研究创造这些方法，
12:47
for the past 12 years,
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1991
整整研究了12年，
12:49
and you see there a happy five-month-older,
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你看这是一个五个月大的婴儿
12:51
it's a five-month little boy who is going to watch things
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这个五月大的男孩将要去观看别的事物，
12:57
that are brought from his world,
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就是他世界里存在的事物，
13:00
his mom, the caregiver, but also experiences
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他的妈妈，照顾他的人，还有一些
13:02
that he would have were he to be in his daycare.
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他日间被照顾时的各种经历
13:07
What we want is to embrace that world
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我们所要做的，就是拥抱他的世界，
13:10
and bring it into our laboratory,
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并把那世界带到实验室来，
13:11
but in order for us to do that, we had to create
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但为了达到这个目的，
13:14
these very sophisticated measures,
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我们要创建很精密的测量方法，
13:17
measures of how people, how little babies,
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测量人们以及婴儿
13:21
how newborns, engage with the world,
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如何与世界互动的方法
13:24
moment by moment,
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每个时刻都要测量
13:25
what is important, and what is not.
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从而知道什么是重要的，什么是不重要的
13:29
Well, we created those measures, and here,
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我们创建了这些测量方法，
13:32
what you see is what we call a funnel of attention.
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现在大家所看到的这个东西叫 “注意力漏斗”
13:35
You're watching a video.
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你们看到的这个视频
13:37
Those frames are separated by about a second
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每幅影像的间距大约是一秒
13:40
through the eyes of 35 typically developing
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这是35个正常孩子所看到的世界
13:43
two-year-olds,
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他们都是两岁大的孩子
13:44
and we freeze one frame,
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当我们停在其中一幅影像上时
13:47
and this is what the typical children are doing.
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这是正常的孩子在做的事情
13:50
In this scan pass, in green here, are two-year-olds with autism.
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而绿色的地方，是自闭症的孩子在做的事情
13:55
So on that frame, the children who are typical
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视频停留在那个画面上时，
13:58
are watching this,
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正常孩子在看这些，
14:01
the emotion of expression of that little boy
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再看那个小男孩情绪的反应
14:04
as he's fighting a little bit with the little girl.
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那个小男孩和那个小女孩正在闹矛盾
14:07
What are the children with autism doing?
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而自闭症的孩子在做什么呢？
14:09
They are focusing on the revolving door,
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他们会注意那个不断转动的门，
14:12
opening and shutting.
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看着门开了又关，关了又开
14:14
Well, I can tell you that this divergence
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2452
我可以告诉大家，
14:17
that you're seeing here
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这里就有了差异，
14:18
doesn't happen only in our five-minute experiment.
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这不仅仅发生在我们5分钟的实验里
14:21
It happens moment by moment in their real lives,
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而在他们生活里的每一分钟都发生着，
14:24
and their minds are being formed,
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他们的心智就此而形成，
14:27
and their brains are being specialized in something other
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它们的脑子在其他的方面不断发展，
14:30
than what is happening with their typical peers.
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而这些方面与他们同龄的伙伴有所不同
14:34
Well, we took a construct from
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这里有一个结构图，
14:37
our pediatrician friends,
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这是从我们的儿科医生朋友那里拿过来的，
14:40
the concept of growth charts.
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这是一幅关于生长曲线概念的图，
14:42
You know, when you take a child to the pediatrician,
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你知道，你带一个孩子去看儿科医生时，
14:44
and so you have physical height, and weight.
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你会得到他的身高，体重
14:48
Well we decided that we're going to create growth charts
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所以我们决定我们要作出一个
14:51
of social engagement,
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社交发展的成长图
14:54
and we sought children from the time that they are born,
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我们找了很多孩子参与实验，从他们出生开始
14:57
and what you see here on the x-axis is two, three, four,
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5829
大家可以看到X轴上写着2，3，4，
15:02
five, six months and nine, until about the age of 24 months,
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3840
5，6，到9，一直到大概24个月
15:06
and this is the percent of their viewing time
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这些是他们盯着人的眼睛
15:09
that they are focusing on people's eyes,
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看的时间百分比，
15:11
and this is their growth chart.
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这就是他们的成长表
15:13
They start over here, they love people's eyes,
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他们爱看人的眼睛，从这里开始，
15:16
and it remains quite stable.
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基本上很平稳，
15:18
It sort of goes up a little bit in those initial months.
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在最初的几个月里它还上升了一些.
15:22
Now, let's see what's happening with babies
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我们再来看看
15:25
who became autistic.
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这些有自闭症的孩子的曲线.
15:27
It's something very different.
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非常的不同
15:29
It starts way up here, but then it's a free fall.
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3790
刚开始很高，然后就一直下降。
15:33
It's very much like they brought into this world the reflex
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这表明，他们本来具有追寻人眼神的能力
15:37
that orients them to people, but it has no traction.
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但后来却不再被吸引了
15:41
It's almost as if that stimulus, you,
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这就是说，你，作为一个外界的刺激
15:44
you're not exerting influence on what happens
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你对他们产生不了影响了
15:47
as they navigate their daily lives.
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在他们探索日常生活的过程中你不无关紧要
15:50
Now, we thought that those data were so powerful
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6022
这些数据如此重要，
15:56
in a way, that we wanted to see what happened
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以致于我们非常想知道在出生后的六个月里，
15:59
in the first six months of life, because if you interact
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到底发生了什么，
16:03
with a two- and a three-month-older,
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1337
因为当你开始与一个两三个月大的孩子互动时，
16:04
you'd be surprised by how social those babies are.
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你会对这些孩子的社会性感到惊讶
16:09
And what we see in the first six months of life
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2607
我们在那六个月看到了一个情况，
16:11
is that those two groups can be segregated very easily.
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这两组孩子很容易被区分开来
16:17
And using these kinds of measures, and many others,
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通过这些方法或者其它的方法，
16:20
what we found out is that our science could, in fact,
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我们发现，实际上我们的科学，
16:24
identify this condition early on.
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是可以及早地诊断出自闭症的
16:27
We didn't have to wait for the behaviors of autism
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2904
我们不需要等到第二年
16:30
to emerge in the second year of life.
313
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3148
自闭症的症状开始出现时才确诊
16:33
If we measured things that are, evolutionarily,
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3262
如果我们测量的东西是进化而来，
16:36
highly conserved, and developmentally very early emerging,
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4122
并保存下来的，且出现的时间非常早的话，
16:40
things that are online from the first weeks of life,
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2701
尤其是出生后几周就出现的症状，
16:43
we could push the detection of autism
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1862
我们就可以将对其诊断提前到，
16:45
all the way to those first months,
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2464
提早到出生后的两个月内，
16:47
and that's what we are doing now.
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这就使我们如今在研究的内容，
16:52
Now, we can create the very best technologies
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现在，我们可以创造出最好的科学技术，
16:55
and the very best methods to identify the children,
321
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3605
还有最好的方法来争端那些患自闭症的孩子
16:58
but this would be for naught if we didn't have an impact
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3143
但如果我们不能改变他们的现实情况，
17:01
on what happens in their reality in the community.
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这一切都徒劳无功.
17:05
Now we want those devices, of course,
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当然了，我们现在需要各种设备
17:07
to be deployed by those who are in the trenches,
325
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2853
能被送到第一线的工作人员那里
17:10
our colleagues, the primary care physicians,
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2523
我们的同事，那些坐诊的医生，
17:13
who see every child,
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2705
他们能见到每个孩子，
17:15
and we need to transform those technologies
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2143
我们需要把这些技术，
17:18
into something that is going to add value to their practice,
329
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3105
转变成对他们的工作有实际用处和价值的东西，
17:21
because they have to see so many children.
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2205
因为他们要帮助那么多孩子，
17:23
And we want to do that universally
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我们希望我们的成果能广泛推广，
17:25
so that we don't miss any child,
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这样我们就不会漏掉任何一个孩子，
17:27
but this would be immoral
333
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2453
但如果没有完善的基础设施，
17:30
if we also did not have an infrastructure for intervention,
334
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4901
和干预治疗的方法
17:34
for treatment.
335
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1247
那这也是违反这会责任与道德，
17:36
We need to be able to work with the families,
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我们需要能够与家庭合作，
17:38
to support the families, to manage those first years
337
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3415
去支持那些家庭，在最开始的几年里与他们一起，
17:42
with them. We need to be able to really go
338
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3912
我们需要从诊断他们是否患病，
17:46
from universal screening to universal access to treatment,
339
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4157
发展到普遍有效的治疗方法，
17:50
because those treatments are going to change
340
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3103
因为这些治疗将会改变
17:53
these children's and those families' lives.
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3579
孩子与他们家人的生活
17:56
Now, when we think about what we [can] do
342
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4257
现在，我们要想想我们能做些什么，
18:01
in those first years,
343
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3223
我可以告诉大家，
18:04
I can tell you,
344
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2400
在这个领域这么多年，
18:06
having been in this field for so long,
345
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2827
最开始的几年，
18:09
one feels really rejuvenated.
346
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3095
人会觉得自己很年轻充满干劲，
18:12
There is a sense that the science that one worked on
347
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3832
会感觉我自己所钻研的科学
18:16
can actually have an impact on realities,
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真的能给现实带来影响，
18:20
preventing, in fact, those experiences
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可以让其他人不再重蹈我的覆辙
18:23
that I really started in my journey in this field.
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不走我走过的老路，
18:27
I thought at the time that this was an intractable condition.
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我那时以为自闭症是个无法治愈的疾病
18:30
No longer. We can do a great deal of things.
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但如今再也不这么想了。
我们可以做很多事情。
我们可以做很多事情。
18:34
And the idea is not to cure autism.
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我们的想法并不是说要完全治愈自闭症。
18:36
That's not the idea.
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那不是我们要的。
18:39
What we want is to make sure
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我们要的，是要确认，
18:41
that those individuals with autism can be free from
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那些患了自闭症的人
18:44
the devastating consequences that come with it at times,
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能从那些可怕的结果中释放出来，得到自由
18:48
the profound intellectual disabilities, the lack of language,
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不再是严重的智障，或者是语言能力的缺失，
18:51
the profound, profound isolation.
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也不再极度的封闭
18:55
We feel that individuals with autism, in fact,
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我们觉得实际上自闭症患者，
18:57
have a very special perspective on the world,
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看待世界的视角非常的特别，
19:00
and we need diversity, and they can work extremely well
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我们需要这样的多样性，
他们能做得特别好，
他们能做得特别好，
19:03
in some areas of strength:
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在一些他们擅长的领域，
19:05
predictable situations, situations that can be defined.
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在可预测的情况下，可掌控的情况下。
19:09
Because after all, they learn about the world almost like
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毕竟他们专注于世界本来的面貌，
19:12
about it, rather than learning how to function in it.
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而不是学习怎样在世界上生存，
19:17
But this is a strength, if you're working, for example,
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这就是一个长项。
例如，当你的工作在技术层面时
例如，当你的工作在技术层面时
19:19
in technology.
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这就是一个长项。
19:21
And there are those individuals who have incredible
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还有一些人，具有极高的天分
19:24
artistic abilities.
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艺术上的天分
19:25
We want them to be free of that.
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我们希望他们也能自由施展，
19:27
We want that the next generations of individuals with autism
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我们希望下一代患有自闭症的人
19:30
will be able not only to express their strengths
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不仅能发挥他们的长处，
19:34
but to fulfill their promise.
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更能实现他们美好的梦想。
19:36
Well thank you for listening to me. (Applause)
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谢谢（掌声）
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