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

Why you should listen

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

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

Ami Klin: A new way to diagnose autism

阿米克林:診斷自閉症的新方法

Filmed:
674,356 views

如果能夠早早診斷出泛自閉症,就能提升相關人等的生活品質。但由於成因複雜,泛自閉症的預測也就難上加難。阿米克林在 TEDxPeachtree 的演說中,描述了一種早期偵測的新方法:利用眼球追蹤技術來評估嬰兒是否具備社交技巧。這種技術能夠可靠地評估嬰兒是否有罹患自閉症的風險。
- Autism researcher
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成為
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我總是想成為
00:18
a walking步行 laboratory實驗室 of social社會 engagement訂婚,
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人際交流的行動實驗室
00:21
to resonate諧振 other people's人們 feelings情懷, thoughts思念,
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藉由和別人在一起
00:25
intentions意圖, motivations動機, in the act法案 of being存在 with them.
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來體會他們的感受、想法、意圖與動機
00:30
As a scientist科學家, I always wanted to measure測量 that resonance諧振,
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身為科學家,我總希望能度量這種人與人之間
00:36
that sense of the other that happens發生 so quickly很快,
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身為科學家,我總希望能度量這種人與人之間
00:39
in the blink of an eye.
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瞬間即生的共鳴感
00:41
We intuit意會 other people's人們 feelings情懷.
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我們能自然領會別人的感受
00:43
We know the meaning含義 of their actions行動
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甚至在他們行動以前
00:44
even before they happen發生.
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就知道行動所代表的意義
00:47
We're always in this stance姿態 of being存在
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無論何時
00:49
the object目的 of somebody else's別人的 subjectivity主觀性.
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我們總是某人主觀意識中的客體
00:52
We do that all the time. We just can't shake it off.
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這是我們無法擺脫的一點
00:55
It's so important重要 that the very tools工具 that we use
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這很重要
00:57
to understand理解 ourselves我們自己, to understand理解
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我們正是仰賴這一點
00:59
the world世界 around them, is shaped成形 by that stance姿態.
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來學會了解我們自己及周遭的世界
01:04
We are social社會 to the core核心.
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我們完完全全是社會動物
01:07
So my journey旅程 in autism自閉症 really started開始 when I lived生活
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我對自閉症的了解是從我住進一個
01:10
in a residential住宅 unit單元 for adults成年人 with autism自閉症.
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為自閉症患者而設的成人之家中開始的
01:13
Most of those individuals個人 had spent花費 most of their lives生活
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他們多數都在醫院裡度過大部分的人生
01:17
in long-stay長期逗留 hospitals醫院. This is a long time ago.
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這是很久以前的事了
01:20
And for them, autism自閉症 was devastating破壞性的.
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對他們來說,自閉症是場災難
01:25
They had profound深刻 intellectual知識分子 disabilities殘疾人.
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他們有嚴重的智力障礙、不說話
01:28
They didn't talk. But most of all,
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更糟的是
01:31
they were extraordinarily異常 isolated孤立
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他們極度封閉在自己的世界裡
01:35
from the world世界 around them, from their environment環境
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與周遭的環境隔絕
01:38
and from the people.
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與他人隔絕
01:41
In fact事實, at the time, if you walked into a school學校
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如果你走進一所當時的自閉症特教學校
01:44
for individuals個人 with autism自閉症, you'd hear a lot of noise噪聲,
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事實上你會聽到很多聲音
01:48
plenty豐富 of commotion騷動, actions行動, people doing things,
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喧鬧聲、人們做各種事情的聲音
01:53
but they're always doing things by themselves他們自己.
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但他們總是各自做自己的事
01:57
So they may可能 be looking at a light in the ceiling天花板,
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可能在看天花板上的燈
02:01
or they may可能 be isolated孤立 in the corner,
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可能獨自待在角落
02:04
or they might威力 be engaged訂婚 in these repetitive重複 movements運動,
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或反覆做一些無意義的動作
02:08
in self-stimulatory自我刺激 movements運動 that led them nowhere無處.
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來達到自我刺激的目的
02:12
Extremely非常, extremely非常 isolated孤立.
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極度地封閉在自己的世界裡
02:15
Well, now we know that autism自閉症
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如今我們知道
02:19
is this disruption瓦解, the disruption瓦解 of this resonance諧振
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是自閉症使他們無法
02:23
that I am telling告訴 you.
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與他人產生共鳴感
02:25
These are survival生存 skills技能.
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但這是生存本能
02:27
These are survival生存 skills技能 that we inherited遺傳
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是經由數十萬年的演化
02:29
over many許多, many許多 hundreds數以百計 of thousands數千 of years年份
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所傳承下來的生存本能
02:32
of evolution演化.
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所傳承下來的生存本能
02:34
You see, babies嬰兒 are born天生 in a state of utter說出 fragility脆弱性.
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你們都知道,新生兒是全然無助的
02:39
Without沒有 the caregiver護理人員, they wouldn't不會 survive生存, so it stands站立
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沒有人照顧便不能生存
02:41
to reason原因 that nature性質 would endow賦予 them with
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所以大自然賦予他們
02:44
these mechanisms機制 of survival生存.
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這些生存的機制
02:47
They orient東方 to the caregiver護理人員.
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他們會追尋照顧他們的人
02:50
From the first days and weeks of life,
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從出生後的幾天到幾周內
02:53
babies嬰兒 prefer比較喜歡 to hear human人的 sounds聲音 rather than just
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嬰兒就偏好人聲
02:57
sounds聲音 in the environment環境.
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而不是周遭的其他聲音
02:59
They prefer比較喜歡 to look at people rather than at things,
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他們偏好看著人而不是其他東西
03:01
and even as they're looking at people,
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當他們對著人看時
03:03
they look at people's人們 eyes眼睛, because
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他們甚至會盯著人的眼睛看
03:05
the eye is the window窗口 to the other person's人的 experiences經驗,
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因為眼睛是通往他人經驗的途徑
03:09
so much so that they even prefer比較喜歡 to look at people who are
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所以他們甚至會偏好盯著正在看他們的人
03:12
looking at them rather than people who are looking away.
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而不是看著旁邊的人
03:16
Well, they orient東方 to the caregiver護理人員.
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他們追尋照顧他們的人
03:19
The caregiver護理人員 seeks尋求 the baby寶寶.
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照顧者則追尋著嬰兒
03:21
And it's out of this mutually相互 reinforcing加強 choreography編舞
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人的心智,尤其是社會性的心智
03:24
that a lot that is of importance重要性 to the emergence緊急情況 of mind心神,
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就是在這如舞步般的過程中
03:28
the social社會 mind心神, the social社會 brain, depends依靠 on.
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一來一往、逐漸成形
03:33
We always think about autism自閉症
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我們總以為自閉症
03:36
as something that happens發生 later後來 on in life.
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是出生成長後逐漸形成的
03:41
It doesn't. It begins開始 with the beginning開始 of life.
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不是這樣的。它在出生時就發生了
03:46
As babies嬰兒 engage從事 with caregivers護理人員, they soon不久 realize實現
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當嬰兒接觸到照顧他們的人
03:50
that, well, there is something in between之間 the ears耳朵
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他們很快就理解到,在兩耳間
03:55
that is very important重要 --
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有些非常重要的東西
03:56
it's invisible無形, you can't see -- but is really critical危急,
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那是看不到、但非常重要的東西─
04:00
and that thing is called attention注意.
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就是別人對他們的關注
04:02
And they learn學習 soon不久 enough足夠, even before they can
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在能夠開口說話前
04:05
utter說出 one word that they can take that attention注意
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他們就先學會藉由吸引別人的注意
04:07
and move移動 somewhere某處 in order訂購 to get things they want.
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來得到自己想要的
04:13
They also learn學習 to follow跟隨 other people's人們 gaze凝視,
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他們也學會跟隨別人的目光
04:16
because whatever隨你 people are looking at is
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因為別人目光所及
04:18
what they are thinking思維 about.
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就是他們心中所想
04:22
And soon不久 enough足夠, they start開始 to learn學習 about the meaning含義
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很快地,他們就開始學習事物的意義
04:25
of things, because when somebody is looking at something
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因為當某人看著一樣東西
04:28
or somebody is pointing指點 at something,
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或是指著一樣東西
04:30
they're not just getting得到 a directional定向 cue球桿,
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那並不只代表了一個方向
04:33
they are getting得到 the other person's人的 meaning含義
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也代表了這樣東西對這個人的意義
04:36
of that thing, the attitude態度, and soon不久 enough足夠
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這個人對這樣東西的看法
04:39
they start開始 building建造 this body身體 of meanings含義,
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他們開始架構事物的意義
04:43
but meanings含義 that were acquired後天 within the realm領域
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那些他們在跟別人互動的過程中
04:45
of social社會 interaction相互作用.
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所學習到的意義
04:48
Those are meanings含義 that are acquired後天 as part部分
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這些都是從與他人共享的經驗中
04:49
of their shared共享 experiences經驗 with others其他.
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所學習到的
04:53
Well, this is a little 15-month-old個月大 little girl女孩,
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這是一個十五個月大
05:00
and she has autism自閉症.
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患有自閉症的小女孩
05:04
And I am coming未來 so close to her that I am maybe
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我已經靠近到離她的臉只有五公分
05:07
two inches英寸 from her face面對, and she's quite相當 oblivious渾然不覺 to me.
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她卻完全無視於我
05:12
Imagine想像 if I did that to you,
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想像一下我對你做同樣的事
05:13
and I came來了 two inches英寸 from your face面對.
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我向你靠近到離你的臉只有五公分
05:15
You'd do probably大概 two things, wouldn't不會 you?
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你可能會有兩個反應
05:17
You would recoil畏縮. You would call the police警察. (Laughter笑聲)
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你會向後退、或是叫警察(笑聲)
05:21
You would do something, because it's literally按照字面 impossible不可能
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你一定會做點什麼
05:24
to penetrate穿透 somebody's某人的 physical物理 space空間
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因為侵犯到某人的空間而不引起任何反應
05:26
and not get a reaction反應.
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實在是不太可能的事
05:28
We do so, remember記得, intuitively直觀地, effortlessly毫不費力.
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記住,這是我們不加思索的直覺反應
05:31
This is our body身體 wisdom智慧. It's not something that is
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是我們身體自然的判斷
05:33
mediated by our language語言. Our body身體 just knows知道 that,
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不需要言語作為媒介
05:37
and we've我們已經 known已知 that for a long time.
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我們的身體本來就知道該這樣做
05:40
And this is not something that happens發生 to humans人類 only.
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而這並不是人類獨有的
05:43
It happens發生 to some of our phylaticphylatic cousins表兄弟,
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我們在演化上的遠親也是如此
05:46
because if you're a monkey,
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因為如果你是隻猴子
05:48
and you look at another另一個 monkey,
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你這樣看著另一隻地位比你高的猴子
05:50
and that monkey has a higher更高 hierarchy等級制度 position位置 than you,
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你這樣看著另一隻地位比你高的猴子
05:54
and that is considered考慮 to be a signal信號 or threat威脅,
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而你的舉動被認為是一種暗示或威脅
05:58
well, you are not going to be alive for long.
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你就活不久了
06:01
So something that in other species種類 are survival生存 mechanisms機制,
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這對其他物種來說
06:05
without them they wouldn't不會 basically基本上 live生活,
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是不可或缺的生存本能
06:09
we bring帶來 into the context上下文 of human人的 beings眾生,
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對人類而言
06:11
and this is what we need to simply只是 act法案, act法案 socially社交上.
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則是產生人際互動的基本條件
06:15
Now, she is oblivious渾然不覺 to me, and I am so close to her,
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好,我離她這麼近她還是無視於我
06:18
and you think, maybe she can see you,
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你們可能會想
06:20
maybe she can hear you.
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她也許看得見或聽得見我
06:22
Well, a few少數 minutes分鐘 later後來, she goes to the corner of
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幾分鐘後她到房間的角落去了
06:24
the room房間, and she finds認定 a tiny little piece of candy糖果, an M&M.
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找到一小顆M&M's巧克力
06:30
So I could not attract吸引 her attention注意,
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所以我不能吸引她的注意
06:35
but something, a thing, did.
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但是某樣東西卻可以
06:37
Now, most of us make a big dichotomy二分法
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好,我們多數人會用二分法來看這世界─
06:40
between之間 the world世界 of things and the world世界 of people.
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物品的世界、人的世界
06:44
Now, for this girl女孩, that division line is not so clear明確,
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但對這女孩來說,人與物的分別
06:49
and the world世界 of people is not attracting吸引 her
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不是那麼清楚,而人的世界
06:52
as much as we would like.
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並不像我們所想的那樣吸引她
06:53
Now remember記得 that we learn學習 a great deal合同
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要記住
06:55
by sharing分享 experiences經驗.
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我們很多的學習都是從經驗分享而來
06:58
Now, what she is doing right now is that
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現在在她身上發生的事是
07:01
her path路徑 of learning學習 is diverging發散 moment時刻 by moment時刻
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她的學習隨著她越來越封閉自己
07:05
as she is isolating隔離 herself她自己 further進一步 and further進一步.
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而逐漸走上不同的道路
07:09
So we feel sometimes有時 that the brain is deterministic確定性,
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所以有時候我們會覺得
07:12
the brain determines確定 who we are going to be.
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大腦決定了我們會成為怎樣的人
07:15
But in fact事實 the brain also becomes who we are,
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但事實上我們也會影響大腦的發展
07:18
and at the same相同 time that her behaviors行為 are taking服用 away
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所以當她跟別人的互動越來越少
07:22
from the realm領域 of social社會 interaction相互作用, this is what's happening事件
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在此同時
07:25
with her mind心神 and this is what's happening事件 with her brain.
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這對她的心智及大腦都造成影響
07:30
Well, autism自閉症 is the most strongly非常 genetic遺傳 condition條件
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自閉症是所有發展障礙中
07:36
of all developmental發展的 disorders障礙,
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與基因關聯最強的一種
07:39
and it's a brain disorder紊亂.
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它是一種腦部疾病
07:42
It's a disorder紊亂 that begins開始 much prior to the time
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是一種早在出生前就發生的疾病
07:45
that the child兒童 is born天生.
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是一種早在出生前就發生的疾病
07:48
We now know that there is a very broad廣闊 spectrum光譜 of autism自閉症.
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我們現在知道了
07:51
There are those individuals個人 who are profoundly深深
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自閉症會以很多不同樣貌顯現
07:54
intellectually知性上 disabled, but there are those that are gifted天才.
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有些人有嚴重的智力障礙
07:57
There are those individuals個人 who don't talk at all.
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有些人則是有特殊的天份
07:59
There are those individuals個人 who talk too much.
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有些人完全不說話,有些人卻說個不停
08:01
There are those individuals個人 that if you observe them
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如果你到他們的學校去
08:04
in their school學校, you see them running賽跑 the periphery周邊 fence籬笆
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你可能會看到有些人若未經制止
08:07
of the school學校 all day if you let them,
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會繞著學校的圍籬跑個不停
08:09
to those individuals個人 who cannot不能 stop coming未來 to you
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有些人則會不斷試圖引起你的注意
08:11
and trying to engage從事 you repeatedly反复, relentlessly無情,
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有些人則會不斷試圖引起你的注意
08:13
but often經常 in an awkward尷尬 fashion時尚,
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但他們使用的方式通常讓人感到不舒服
08:17
without that immediate即時 resonance諧振.
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也無法引起別人共鳴
08:21
Well, this is much more prevalent流行 than we thought at the time.
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這種狀況遠比我們當初想的要普遍
08:25
When I started開始 in this field領域, we thought that there were
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當我剛踏入這個領域時
08:26
four individuals個人 with autism自閉症 per 10,000,
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我們認為每一萬人中約有四人患有自閉症
08:29
a very rare罕見 condition條件.
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算是一種很罕見的疾病
08:31
Well, now we know it's more like one in 100.
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現在我們知道大約每百人中就有一個
08:35
There are millions百萬 of individuals個人 with autism自閉症 all around us.
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我們周遭有幾百萬的人患有自閉症
08:40
The societal社會的 cost成本 of this condition條件 is huge巨大.
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這種疾病的社會成本很大
08:44
In the U.S. alone單獨, maybe 35 to 80 billion十億 dollars美元,
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只在美國,也許就要花上350億到800億美金
08:47
and you know what? Most of those funds資金 are associated相關
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而你們知道嗎?
08:50
with adolescents青少年 and particularly尤其 adults成年人
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絕大多數的經費都被用在
08:52
who are severely嚴重 disabled,
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青少年及有嚴重障礙的成人身上
08:55
individuals個人 who need wrap-around環繞式 services服務, services服務
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他們需要非常密集的全方位服務
08:57
that are very, very intensive集約, and those services服務
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他們需要非常密集的全方位服務
08:59
can cost成本 in excess過量 of 60 to 80,000 dollars美元 a year.
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每年就需要六到八萬美金以上的費用
09:04
Those are individuals個人 who did not benefit效益 from early treatment治療,
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這些都是未從早期療育獲益的人
09:07
because now we know that autism自閉症 creates創建 itself本身
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因為我們現在知道,當他們的學習
09:12
as they diverge偏離 in that pathway of learning學習
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像我之前說的那樣走上另一條路時
09:14
that I mentioned提到 to you.
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自閉症的狀況就會越加惡化
09:17
Were we to be able能夠 to identify鑑定 this condition條件
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如果我們能做到早期發現
09:19
at an earlier point, and intervene干預 and treat對待,
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並且在早期就介入治療
09:23
I can tell you, and this has been probably大概
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我告訴你們
09:25
something that has changed my life in the past過去 10 years年份,
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我們絕對可以減輕自閉症的症狀
09:28
this notion概念 that we can absolutely絕對 attenuate衰減
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這個想法在過去十年裡
09:32
this condition條件.
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改變了我的人生
09:34
Also, we have a window窗口 of opportunity機會, because
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但我們只有一小段時間可以採取行動
09:37
the brain is malleable可鍛鑄 for just so long,
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因為大腦只在那一段時間裡有可塑性
09:40
and that window窗口 of opportunity機會 happens發生
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這段寶貴的時間是在三歲以前
09:41
in the first three years年份 of life.
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這段寶貴的時間是在三歲以前
09:43
It's not that that window窗口 closes關閉. It doesn't.
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並不是說在那之後就完全沒有機會了
09:46
But it diminishes減少 considerably相當.
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但是機會確實大大降低
09:50
And yet然而, the median中位數 age年齡 of diagnosis診斷 in this country國家
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目前在美國自閉症得到確診的平均年齡
09:53
is still about five years年份,
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一般還是在五歲
09:55
and in disadvantaged劣勢 populations人群,
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對於那些得不到臨床服務
09:57
the populations人群 that don't have access訪問 to clinical臨床 services服務,
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住在偏遠地區或
10:01
rural鄉村 populations人群, minorities少數民族,
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身為少數族裔的弱勢族群來說
10:04
the age年齡 of diagnosis診斷 is later後來 still,
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確診的年齡還要更晚
10:06
which哪一個 is almost幾乎 as if I were to tell you that we are
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這幾乎像是我們對這些族群宣告
10:09
condemning譴責 those communities社區 to have individuals個人
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他們的自閉症患者
10:11
with autism自閉症 whose誰的 condition條件 is going to be more severe嚴重.
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注定要陷入越來越嚴重的狀況
10:16
So I feel that we have a bio-ethical生物倫理 imperative勢在必行.
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就醫學倫理而言,我們有不可推卸的責任
10:19
The science科學 is there,
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我們已經有這些科學知識
10:21
but no science科學 is of relevance關聯 if it doesn't have an impact碰撞
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但如果它們不能為社會所用
10:24
on the community社區, and we just can't afford給予
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它們就沒有多大用處
10:28
that missed錯過 opportunity機會,
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而我們不能失去這樣的機會
10:30
because children孩子 with autism自閉症 become成為 adults成年人 with autism自閉症,
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因為患有自閉症的兒童會長大成人
10:33
and we feel that those things that we can do
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我們如果能夠及早盡我們所能
10:38
for these children孩子, for those families家庭, early on,
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為他們及他們的家庭做點事
10:40
will have lifetime一生 consequences後果,
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對這些家庭或整個社會來說
10:42
for the child兒童, for the family家庭, and for the community社區 at large.
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都會有長遠的影響
10:46
So this is our view視圖 of autism自閉症.
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這就是我們對自閉症的看法
10:49
There are over a hundred genes基因 that are associated相關
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跟自閉症有關的基因有上百個
10:52
with autism自閉症. In fact事實, we believe that there are going to be
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事實上我們相信
10:54
something between之間 300 and 600 genes基因 associated相關 with autism自閉症,
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可能有300到600個基因或基因異常
10:59
and genetic遺傳 anomalies異常, much more than just genes基因.
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與自閉症有關
11:02
And we actually其實 have a bit of a question here,
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問題來了
11:07
because if there are so many許多 different不同 causes原因 of autism自閉症,
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這麼多不同的不利因素
11:10
how do you go from those liabilities負債
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到底是怎樣發展成自閉症的呢?
11:13
to the actual實際 syndrome綜合徵? Because people like myself,
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因為當人們─ 好比我自己
11:16
when we walk步行 into a playroom遊戲室,
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走入一間遊戲室時
11:19
we recognize認識 a child兒童 as having autism自閉症.
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我們可以分辨出一個孩子是不是有自閉症
11:22
So how do you go from multiple causes原因
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到底為什麼這麼多不同成因
11:24
to a syndrome綜合徵 that has some homogeneity同質化?
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最後會導致這麼相似的症狀呢?
11:28
And the answer回答 is, what lies in between之間,
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原來答案在成因與呈現的症狀之間:
11:30
which哪一個 is development發展.
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也就是孩子的發育
11:33
And in fact事實, we are very interested有興趣 in those first
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事實上,我們對兩歲之前這段時間非常有興趣
11:36
two years年份 of life, because those liabilities負債
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因為這些不利因素並不必然發展成自閉症
11:39
don't necessarily一定 convert兌換 into autism自閉症.
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因為這些不利因素並不必然發展成自閉症
11:42
Autism自閉症 creates創建 itself本身.
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自閉症是自行形成
11:44
Were we to be able能夠 to intervene干預 during those years年份 of life,
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如果我們能在兩歲之前就介入
11:49
we might威力 attenuate衰減 for some, and God knows知道,
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我們也許可以減輕一些孩子的症狀
11:52
maybe even prevent避免 for others其他.
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誰知道,我們說不定甚至可以預防它的發生
11:55
So how do we do that?
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但我們要怎麼做呢?
11:57
How do we enter輸入 that feeling感覺 of resonance諧振,
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我們要怎麼創造共鳴感?
12:00
how do we enter輸入 another另一個 person's人的 being存在?
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又要怎麼進入另一個人的世界呢?
12:04
I remember記得 when I interacted互動 with that 15-month-older個月大的舊的,
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我記得在我跟那十五個月大的女孩互動時
12:08
that the thing that came來了 to mind心神 was,
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我心裡在想
12:10
"How do you come into her world世界?
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「要怎麼進入她的世界呢?」
12:12
Is she thinking思維 about me? Is she thinking思維 about others其他?"
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「她在想著我嗎?還是想著別人?」
12:17
Well, it's hard to do that, so we had to create創建
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嗯,這有點難做到
12:21
the technologies技術. We had to basically基本上 step inside a body身體.
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所以我們必須創造這樣的技術
12:24
We had to see the world世界 through通過 her eyes眼睛.
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好透過她的眼睛來看這個世界
12:28
And so in the past過去 many許多 years年份 we've我們已經 been building建造
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所以過去幾年中我們都在發展
12:31
these new technologies技術 that are based基於 on eye tracking追踪.
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這種以眼球追蹤為基礎的新技術
12:35
We can see moment時刻 by moment時刻
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我們可以每時每刻地看到
12:38
what children孩子 are engaging with.
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什麼吸引了孩子的注意
12:41
Well, this is my colleague同事 Warren養兔場 Jones瓊斯, with whom
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這是我同事瓦倫 ‧ 瓊斯
12:44
we've我們已經 been building建造 these methods方法, these studies學習,
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在過去十二年中
12:47
for the past過去 12 years年份,
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1991
我們一起做研究、發展這些方法
12:49
and you see there a happy快樂 five-month-older五個月較老,
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這是一個快樂的男孩
12:51
it's a five-month五個月 little boy男孩 who is going to watch things
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五個月大
12:57
that are brought from his world世界,
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正要用眼睛去探索這個世界
13:00
his mom媽媽, the caregiver護理人員, but also experiences經驗
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看看他媽媽、照顧他的人
13:02
that he would have were he to be in his daycare日托.
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還有其他在托兒所裡可能看見的事物
13:07
What we want is to embrace擁抱 that world世界
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我們想要做的是把他所經驗到的世界
13:10
and bring帶來 it into our laboratory實驗室,
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帶進我們的實驗室
13:11
but in order訂購 for us to do that, we had to create創建
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但要做到這點
13:14
these very sophisticated複雜的 measures措施,
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我們必須要能夠精密地測量
13:17
measures措施 of how people, how little babies嬰兒,
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人們以及嬰幼兒
13:21
how newborns新生兒, engage從事 with the world世界,
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在每時每刻中是怎樣與這個世界互動
13:24
moment時刻 by moment時刻,
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什麼對他們來說是重要的
13:25
what is important重要, and what is not.
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什麼又是不重要的
13:29
Well, we created創建 those measures措施, and here,
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我們發展出了一些評量方法
13:32
what you see is what we call a funnel漏斗 of attention注意.
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這裡看到的是注意力的漏斗模型
13:35
You're watching觀看 a video視頻.
256
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你們看到的是一段影片的紀錄
13:37
Those frames are separated分離 by about a second第二
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每個影像的間距大概是一秒鐘
13:40
through通過 the eyes眼睛 of 35 typically一般 developing發展
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這是35個正常發展的兩歲幼兒
13:43
two-year-olds兩歲的孩子,
259
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眼中所看到的世界
13:44
and we freeze凍結 one frame,
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我們現在停在其中一刻
13:47
and this is what the typical典型 children孩子 are doing.
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這是正常發展的兩歲幼兒在做的事
13:50
In this scan掃描 pass通過, in green綠色 here, are two-year-olds兩歲的孩子 with autism自閉症.
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綠色的這些則是有自閉症的孩子做的事
13:55
So on that frame, the children孩子 who are typical典型
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所以在那一刻
13:58
are watching觀看 this,
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正常的孩子在看這個
14:01
the emotion情感 of expression表達 of that little boy男孩
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一個小男孩在跟一個小女孩吵架
14:04
as he's fighting戰鬥 a little bit with the little girl女孩.
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所表現出的情緒反應
14:07
What are the children孩子 with autism自閉症 doing?
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有自閉症的孩子又在做些什麼呢?
14:09
They are focusing調焦 on the revolving旋轉 door,
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他們專心地看著旋轉門開開關關
14:12
opening開盤 and shutting關閉.
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他們專心地看著旋轉門開開關關
14:14
Well, I can tell you that this divergence差異
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我可以告訴你們
14:17
that you're seeing眼看 here
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你們所看到的這些差異
14:18
doesn't happen發生 only in our five-minute五分鐘 experiment實驗.
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並不只發生在我們進行實驗的五分鐘裡
14:21
It happens發生 moment時刻 by moment時刻 in their real真實 lives生活,
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他們真實生活裡的每時每刻都是這樣的
14:24
and their minds頭腦 are being存在 formed形成,
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2720
而他們的心智隨之成形
14:27
and their brains大腦 are being存在 specialized專門 in something other
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他們的大腦也以
14:30
than what is happening事件 with their typical典型 peers同行.
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與其他孩子不同的方式成長
14:34
Well, we took a construct構造 from
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我們從當小兒科醫生的朋友處
14:37
our pediatrician兒科醫師 friends朋友,
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我們從當小兒科醫生的朋友處
14:40
the concept概念 of growth發展 charts圖表.
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借用了生長曲線圖的概念
14:42
You know, when you take a child兒童 to the pediatrician兒科醫師,
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當你帶小孩去看小兒科醫生時
14:44
and so you have physical物理 height高度, and weight重量.
281
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你可以由此得知他的身高體重
14:48
Well we decided決定 that we're going to create創建 growth發展 charts圖表
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所以我們決定要做出
14:51
of social社會 engagement訂婚,
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社交發展的曲線圖來
14:54
and we sought追捧 children孩子 from the time that they are born天生,
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我們徵求新生兒來參與研究
14:57
and what you see here on the x-axisx軸 is two, three, four,
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5829
在這X軸上是以月來看
15:02
five, six months個月 and nine, until直到 about the age年齡 of 24 months個月,
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從兩個月到24個月
15:06
and this is the percent百分 of their viewing觀看 time
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這是他們盯著人眼看的時間百分比
15:09
that they are focusing調焦 on people's人們 eyes眼睛,
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這是他們盯著人眼看的時間百分比
15:11
and this is their growth發展 chart圖表.
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這就是他們的發展曲線圖
15:13
They start開始 over here, they love people's人們 eyes眼睛,
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他們一開始就喜歡看著別人的眼睛
15:16
and it remains遺跡 quite相當 stable穩定.
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這點一直沒有改變
15:18
It sort分類 of goes up a little bit in those initial初始 months個月.
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在最初的幾個月中它還上升了一點
15:22
Now, let's see what's happening事件 with babies嬰兒
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現在讓我們看看
15:25
who became成為 autistic自閉症.
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後來被診斷出自閉症的孩子的發展曲線
15:27
It's something very different不同.
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它看起來就很不一樣了
15:29
It starts啟動 way up here, but then it's a free自由 fall秋季.
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它一開始在上面這邊,再來就一直下降
15:33
It's very much like they brought into this world世界 the reflex反射
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就像他們生來具有追尋他人的本能
15:37
that orients定向 them to people, but it has no traction牽引.
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但這本能無法持續下去
15:41
It's almost幾乎 as if that stimulus刺激物, you,
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這幾乎像是「你」作為一個外界刺激
15:44
you're not exerting發揮 influence影響 on what happens發生
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在他們探索日常生活的過程中
15:47
as they navigate導航 their daily日常 lives生活.
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無足輕重
15:50
Now, we thought that those data數據 were so powerful強大
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這些資料讓我們很想看看
15:56
in a way, that we wanted to see what happened發生
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出生後六個月的期間發生了什麼事
15:59
in the first six months個月 of life, because if you interact相互作用
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因為如果你試著跟兩、三個月大的嬰兒互動
16:03
with a two-二- and a three-month-older三個月年長,
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因為如果你試著跟兩、三個月大的嬰兒互動
16:04
you'd be surprised詫異 by how social社會 those babies嬰兒 are.
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你會訝異他們是多麼善於與人接觸
16:09
And what we see in the first six months個月 of life
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我們在這頭六個月中所看到的是
16:11
is that those two groups can be segregated隔離 very easily容易.
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這兩組嬰兒有非常明顯的分別
16:17
And using運用 these kinds of measures措施, and many許多 others其他,
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運用這些或者其他各類的測量方法
16:20
what we found發現 out is that our science科學 could, in fact事實,
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我們發現現代科學事實上可以做到
16:24
identify鑑定 this condition條件 early on.
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早期發現這些狀況
16:27
We didn't have to wait for the behaviors行為 of autism自閉症
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我們不用等到兩歲來看
16:30
to emerge出現 in the second第二 year of life.
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自閉症的行為是否出現
16:33
If we measured測量 things that are, evolutionarily進化,
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如果我們測量那些演化上保存下來的
16:36
highly高度 conserved保守, and developmentally發育 very early emerging新興,
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在早期發展就會出現的東西
16:40
things that are online線上 from the first weeks of life,
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那些在出生後頭幾周就應該發生的事
16:43
we could push the detection發現 of autism自閉症
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我們就能把診斷自閉症的時間
16:45
all the way to those first months個月,
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提早到出生後頭幾個月
16:47
and that's what we are doing now.
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這就是我們現在在做的
16:52
Now, we can create創建 the very best最好 technologies技術
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是的,我們可以發展出最好的科技
16:55
and the very best最好 methods方法 to identify鑑定 the children孩子,
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最好的方法來找出這些孩子
16:58
but this would be for naught if we didn't have an impact碰撞
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但如果我們不能改變他們所處的現實環境
17:01
on what happens發生 in their reality現實 in the community社區.
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這些都是徒勞無功
17:05
Now we want those devices設備, of course課程,
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當然我們會希望這些工具
17:07
to be deployed部署 by those who are in the trenches戰壕,
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能被送到那些第一線工作人員的手中
17:10
our colleagues同事, the primary care關心 physicians醫師,
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我們的同業
17:13
who see every一切 child兒童,
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還有那些負責替孩子們看診的醫生
17:15
and we need to transform轉變 those technologies技術
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我們必須要把這些科技轉變成
17:18
into something that is going to add value to their practice實踐,
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能在實務上發揮價值的東西
17:21
because they have to see so many許多 children孩子.
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因為他們必須面對很多的孩子
17:23
And we want to do that universally舉世
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我們希望把它變成一個普遍性的措施
17:25
so that we don't miss小姐 any child兒童,
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不要漏失任何一個孩子
17:27
but this would be immoral不道德
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但如果我們沒有介入及治療的配套措施
17:30
if we also did not have an infrastructure基礎設施 for intervention介入,
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但如果我們沒有介入及治療的配套措施
17:34
for treatment治療.
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這就會是不道德的
17:36
We need to be able能夠 to work with the families家庭,
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我們必須要和這些家庭一起合作
17:38
to support支持 the families家庭, to manage管理 those first years年份
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去支持他們度過頭幾年的時間
17:42
with them. We need to be able能夠 to really go
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我們必須從普遍性的篩選
17:46
from universal普遍 screening篩查 to universal普遍 access訪問 to treatment治療,
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做到普遍性的治療
17:50
because those treatments治療 are going to change更改
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因為這些治療將會改變這些孩子
17:53
these children's兒童 and those families'家庭' lives生活.
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以及他們家人的人生
17:56
Now, when we think about what we [can] do
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一想到在這生命的頭幾年中
18:01
in those first years年份,
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我們能夠做些什麼
18:04
I can tell you,
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我告訴你
18:06
having been in this field領域 for so long,
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即使在這領域工作了這麼久
18:09
one feels感覺 really rejuvenated煥發青春.
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我還是感到充滿了幹勁
18:12
There is a sense that the science科學 that one worked工作 on
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覺得我所鑽研的科學
18:16
can actually其實 have an impact碰撞 on realities現實,
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能夠真正有所貢獻
18:20
preventing防止, in fact事實, those experiences經驗
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讓其他人不會再有
18:23
that I really started開始 in my journey旅程 in this field領域.
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我初踏入這領域時的那種經驗
18:27
I thought at the time that this was an intractable棘手 condition條件.
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那時我以為這是沒法治療的症狀
18:30
No longer. We can do a great deal合同 of things.
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不再是這樣了,我們有很多事可以做
18:34
And the idea理念 is not to cure治愈 autism自閉症.
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但重點並不在治癒自閉症
18:36
That's not the idea理念.
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不是的
18:39
What we want is to make sure
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我們是想讓那些患有自閉症的人
18:41
that those individuals個人 with autism自閉症 can be free自由 from
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可以不必承受它的嚴重後果─
18:44
the devastating破壞性的 consequences後果 that come with it at times,
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可以不必承受它的嚴重後果─
18:48
the profound深刻 intellectual知識分子 disabilities殘疾人, the lack缺乏 of language語言,
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嚴重的智力障礙、語言發展的缺乏
18:51
the profound深刻, profound深刻 isolation隔離.
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以及全然地封閉
18:55
We feel that individuals個人 with autism自閉症, in fact事實,
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我們認為自閉症患者
18:57
have a very special特別 perspective透視 on the world世界,
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事實上擁有很特別的世界觀
19:00
and we need diversity多樣, and they can work extremely非常 well
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我們的社會需要多元性
19:03
in some areas of strength強度:
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而他們可以在穩定、明確的狀況下
19:05
predictable可預測 situations情況, situations情況 that can be defined定義.
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發揮他們的長處
19:09
Because after all, they learn學習 about the world世界 almost幾乎 like
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畢竟他們專注於了解世界本來的面貌
19:12
about it, rather than learning學習 how to function功能 in it.
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而不是學習如何生活其中
19:17
But this is a strength強度, if you're working加工, for example,
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如果你在科技業工作
19:19
in technology技術.
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這就是項長處
19:21
And there are those individuals個人 who have incredible難以置信
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另外還有一些人
19:24
artistic藝術的 abilities能力.
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他們擁有非凡的藝術才能
19:25
We want them to be free自由 of that.
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我們希望他們可以不受自閉症所限
19:27
We want that the next下一個 generations of individuals個人 with autism自閉症
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我們想讓未來的自閉症患者
19:30
will be able能夠 not only to express表現 their strengths優勢
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不但可以發揮他們的長處
19:34
but to fulfill履行 their promise諾言.
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也可以達成他們的夢想
19:36
Well thank you for listening to me. (Applause掌聲)
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謝謝你們來聽我的演講(掌聲)
Translated by Yanne C
Reviewed by Anny Chung

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

Why you should listen

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

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