Autism — what we know (and what we don't know yet) | Wendy Chung

Prevoditelj: Senzos Osijek Recezent: Ivan Stamenković

"Why?"

“Zašto?”

"Why?" is a question

“Zašto?” je pitanje

that parents ask me all the time.

koje mi roditelji stalno postavljaju.

"Why did my child develop autism?"

“Zašto je moje dijete autistično?”

As a pediatrician, as a geneticist, as a researcher,

Kao pedijatri, genetičari i istraživači,

we try and address that question.

pokušavamo odgovoriti na to pitanje.

But autism is not a single condition.

Ali autizam nije jednostavno stanje.

It's actually a spectrum of disorders,

Zapravo je čitav niz poremećaja,

a spectrum that ranges, for instance,

u spektru koji se proteže na primjerima,

from Justin, a 13-year-old boy

od trinaestogodišnjeg Justina

who's not verbal, who can't speak,

koji ne posjeduje verbalne sposobnosti, pa ne može pričati

who communicates by using an iPad

a komunicira koristeći se iPad-om

to touch pictures to communicate

dodirujući slike kako bi izrazio

his thoughts and his concerns,

svoje misli i osjećaje,

a little boy who, when he gets upset,

mladić koji se, kad se uzruja,

will start rocking,

počne mahnito tresti.

and eventually, when he's disturbed enough,

a nakon što se dovoljno jako uznemiri,

will bang his head to the point

počne udarati glavom

that he can actually cut it open and require stitches.

do te mjere da je razbije, pa mu je potrebno šivanje.

That same diagnosis of autism, though,

Ista ta dijagnoza,

also applies to Gabriel,

odnosi se i na Gabriela,

another 13-year-old boy

također trinaestogodišnjaka

who has quite a different set of challenges.

čiji su izazovi poprilično drugačiji.

He's actually quite remarkably gifted in mathematics.

On je zapravo izvanredno nadaren za matematiku.

He can multiple three numbers by three numbers

Može pomnožiti tri broja s tri broja

in his head with ease,

napamet s lakoćom,

yet when it comes to trying to have a conversation,

ipak, kad bi pokušao razgovarati,

he has great difficulty.

suočava se s velikim poteškoćama.

He doesn't make eye contact.

Ne uspostavlja kontakt očima.

He has difficulty starting a conversation,

Teško mu je započeti razgovor,

feels awkward,

osjeća se čudno,

and when he gets nervous,

a kad se uznemiri,

he actually shuts down.

doslovno se isključi.

Yet both of these boys

Ipak, obojici mladića

have the same diagnosis of autism spectrum disorder.

dijagnosticiran je isti autistični poremećaj sa spektrom.

One of the things that concerns us

Jedna od stvari koja nas brine

is whether or not there really is

jest dolazi li ili ne

an epidemic of autism.

do epidemije autizma.

These days, one in 88 children

Ovih dana, jednom od 88-ero djece

will be diagnosed with autism,

bit će dijagnosticiran autizam,

and the question is,

a pitanje glasi,

why does this graph look this way?

zašto ovaj grafikon izgleda ovako?

Has that number been increasing

Je li se taj broj povećavao

dramatically over time?

dramatično kroz vrijeme?

Or is it because we have now started labeling

Ili je to zato što smo sada počeli etiketirati

individuals with autism,

autistične pojedince,

simply giving them a diagnosis

jednostavno im dajući dijagnozu

when they were still present there before

iako je i prije postojala

yet simply didn't have that label?

ali nije imala tu etiketu?

And in fact, in the late 1980s, the early 1990s,

Zapravo, u kasnim 80-tima i ranim 90-tima,

legislation was passed

prošao je zakon

that actually provided individuals with autism

koji je omogućio autističnim pojedincima

with resources, with access to educational materials

pristup izvorima i materijalima za učenje

that would help them.

koji bi im pomogli.

With that increased awareness, more parents,

S tim povećanjem svijesti, sve više roditelja,

more pediatricians, more educators

sve više pedijatara i obrazovnih djelatnika

learned to recognize the features of autism.

naučilo je prepoznati karakteristike autizma.

As a result of that, more individuals were diagnosed

Kao rezultat toga, sve više pojedinaca je dobilo dijagnozu

and got access to the resources they needed.

i pristup izvorima informacija koji su im neophodni.

In addition, we've changed our definition over time,

Dodatno, s vremenom smo promjenili našu definiciju,

so in fact we've widened the definition of autism,

pa smo zapravo proširili definiciju autizma,

and that accounts for some of

što je djelomice rezultiralo

the increased prevalence that we see.

povećanju rasprostranjenosti koje vidimo.

The next question everyone wonders is,

Sljedeće pitanje koje si svi postavljaju je,

what caused autism?

što uzrokuje autizam?

And a common misconception

I uvriježena je zabluda

is that vaccines cause autism.

da ga uzrokuje cjepivo.

But let me be very clear:

I dopustite mi da budem vrlo jasna:

Vaccines do not cause autism.

Cjepivo ne uzrokuje autizam.

(Applause)

(Pljesak)

In fact, the original research study

U stvari, originalno istraživanje

that suggested that was the case

koje je ukazivalo na to

was completely fraudulent.

bilo je u potpunosti varljivo.

It was actually retracted from the journal Lancet,

To je zapravo izvedeno iz časopisa Lancet,

in which it was published,

u kojem je objavljeno,

and that author, a physician,

a autoru, liječniku,

had his medical license taken away from him.

je oduzeta liječnička dozvola.

(Applause)

(Pljesak)

The Institute of Medicine,

Medicinski Institut

The Centers for Disease Control,

Centar za Kontrolu Bolesti,

have repeatedly investigated this

opetovano je istražio ovo

and there is no credible evidence

i ne postoje uvjerljivi dokazi

that vaccines cause autism.

da cjepiva uzrokuju autizam.

Furthermore,

Nadalje,

one of the ingredients in vaccines,

za jedan od sastojaka u cjepivu,

something called thimerosal,

nazvan thimerosal,

was thought to be what the cause of autism was.

se mislilo da je uzročnik autizma.

That was actually removed from vaccines

Stoga su taj sastojak povukli iz cjepiva

in the year 1992,

1992. godine,

and you can see that it really did not have an effect

a ipak možete vidjeti da to nije nikako utjecalo

in what happened with the prevalence of autism.

na rasprostranjivanje autizma.

So again, there is no evidence

Stoga ponavljam, ne postoji dokaz

that this is the answer.

da je ovo odgovor.

So the question remains, what does cause autism?

Stoga, pitanje i dalje ostaje, što uzrokuje autizam?

In fact, there's probably not one single answer.

U stvari, vjerojatno ne postoji jednoznačan odgovor.

Just as autism is a spectrum,

Baš kao što je autizam spektar,

there's a spectrum of etiologies,

postoji spektar etiologija,

a spectrum of causes.

čitav niz uzroka.

Based on epidemiological data,

Na temelju epidemioloških podataka,

we know that one of the causes,

znamo da je jedan od uzročnika,

or one of the associations, I should say,

ili jedna od naznaka, rekla bih,

is advanced paternal age,

roditeljstvo u starijoj dobi,

that is, increasing age of the father

što će reći, što stariji otac

at the time of conception.

u trenutku začeća.

In addition, another vulnerable

Drugi ranjiv

and critical period in terms of development

i kritičan trenutak u smislu razvoja

is when the mother is pregnant.

je kad je majka trudna.

During that period, while the fetal brain is developing,

U tom vremenu, dok se mozak fetusa razvija,

we know that exposure to certain agents

znamo da izloženost određenim tvarima

can actually increase the risk of autism.

može povećati rizik od autizma.

In particular, there's a medication, valproic acid,

Konkretno, postoji lijek, valproična kiselina,

which mothers with epilepsy sometimes take,

koji ponekad uzimaju majke s poremećajem epilepsije,

we know can increase that risk of autism.

za koji znamo da povećava rizik od autizma.

In addition, there can be some infectious agents

Također, postoje zarazne tvari,

that can also cause autism.

koje također mogu uzrokovati autizam.

And one of the things I'm going to spend

I jedna od stvari na koje ću se

a lot of time focusing on

posebno usredotočiti

are the genes that can cause autism.

jesu geni koji uzrokuju autizam.

I'm focusing on this not because genes

Ne činim to jer

are the only cause of autism,

su geni jedini uzrok autizma,

but it's a cause of autism

već stoga što je to uzrok

that we can readily define

koji možemo spremno definirati

and be able to better understand the biology

i biti bolji u razumijevanju biologije

and understand better how the brain works

i boljem razumijevanju kako funkcionira mozak

so that we can come up with strategies

kako bismo osmislili strategije

to be able to intervene.

koje nam omogućuju intervenciju.

One of the genetic factors that we don't understand,

Jedan od generičkih faktora, a koji ne razumijemo,

however, is the difference that we see

jest razlika koju vidimo

in terms of males and females.

između muškaraca i žena.

Males are affected four to one compared to females

Muškarci su naspram žena pogođeni u omjeru četiri naprema jedan

with autism,

autizmom,

and we really don't understand what that cause is.

i mi zaista ne razumijemo zašto.

One of the ways that we can understand

Jedan od načina kako smo spoznali

that genetics is a factor

da je genetika faktor

is by looking at something called

jest gledajući nešto što se naziva

the concordance rate.

stopa podudarnosti.

In other words, if one sibling has autism,

Drugim riječima, ako je jedno od braće/sestara autistično,

what's the probability

koja je vjerojatnost

that another sibling in that family will have autism?

da će drugi član obitelji biti autističan?

And we can look in particular

Konkretno, možemo promotriti

at three types of siblings:

tri vrste srodstva:

identical twins,

jednojajčane blizance,

twins that actually share 100 percent

blizance koji dijele sto posto

of their genetic information

svojih gena

and shared the same intrauterine environment,

i koji su dijelili jednako materično okruženje,

versus fraternal twins,

nasuprot dvojajčanih blizanaca,

twins that actually share 50 percent

blizanaca koji dijele pedeset posto

of their genetic information,

svojih genetskih informacija,

versus regular siblings,

nasuprot običnih,

brother-sister, sister-sister,

braće i sestara,

also sharing 50 percent of their genetic information,

koji također dijele pedeset posto svog genetskog koda,

yet not sharing the same intrauterine environment.

ali ne dijele unutarmaterično okruženje.

And when you look at those concordance ratios,

I kad se pogledaju te stope podudarnosti,

one of the striking things that you will see

jedna od zapanjujućih stvari koja je vidljiva

is that in identical twins,

je da kod jednojajčani blizanci,

that concordance rate is 77 percent.

stopa podudarnosti iznosi 77 posto.

Remarkably, though,

Iako osobito visok postotak,

it's not 100 percent.

nije stopostotan.

It is not that genes account for all of the risk for autism,

Znači nije sav rizik na genima,

but yet they account for a lot of that risk,

ali geni igraju značajnu ulogu,

because when you look at fraternal twins,

jer ako promotrimo dvojajčane blizance,

that concordance rate is only 31 percent.

vidimo da je stopa podudarnosti samo 31 posto.

On the other hand, there is a difference

S druge strane, postoji razlika

between those fraternal twins and the siblings,

između dvojajčanih blizanaca i ostalih braće/sestara,

suggesting that there are common exposures

koja ukazuje da postoje zajedničke izloženosti

for those fraternal twins

kod dvojajčanih blizanaca

that may not be shared as commonly

koje se neće tako često pojaviti

with siblings alone.

kod ostalih braće/sestara.

So this provides some of the data

Dakle to nam govori u prilog tome

that autism is genetic.

da je autizam genetski.

Well, how genetic is it?

Međutim, koliko je genetski?

When we compare it to other conditions

Kad ga usporedimo s ostalim bolestima

that we're familiar with,

s kojima smo upoznati,

things like cancer, heart disease, diabetes,

bolestima kao što su rak, srčana oboljenja ili dijabetes

in fact, genetics plays a much larger role in autism

genetika igra znatno značajniju ulogu u autizmu

than it does in any of these other conditions.

nego što je to slučaj u ostalim navedenim bolestima.

But with this, that doesn't tell us what the genes are.

Ali s tim, ne govori nam koji su to geni.

It doesn't even tell us in any one child,

Čak nam ne govori ni u jednom dijetetu,

is it one gene

je li to stvar jednog gena

or potentially a combination of genes?

ili potencijalno kombinacije više gena?

And so in fact, in some individuals with autism,

Zapravo, kod nekih pojedinaca s autizmom,

it is genetic!

to jest genetski!

That is, that it is one single,

To jest, to je jedan jedini,

powerful, deterministic gene

moćan, deterministički gen

that causes the autism.

koji uzrokuje autizam.

However, in other individuals,

Međutim, kod drugih pojedinaca,

it's genetic, that is,

je genetski, što će reći,

that it's actually a combination of genes

da je zapravo kombinacija gena

in part with the developmental process

zajedno s razvojnim procesom

that ultimately determines that risk for autism.

koji konačno određuje rizik od autizma.

We don't know in any one person, necessarily,

Ni za jednu osobu ne možemo nužno tvrditi,

which of those two answers it is

koji je slučaj od ova dva navedena

until we start digging deeper.

dok ne počnemo kopati dublje.

So the question becomes,

Sada se pitamo,

how can we start to identify

kako početi identificirati

what exactly those genes are.

koji su to točno geni.

And let me pose something

Dopustite da predložim nešto

that might not be intuitive.

što možda nije intuitivno.

In certain individuals,

Kod određenih pojedinaca,

they can have autism

oni mogu imati autizam

for a reason that is genetic

zbog genetičkih razloga

but yet not because of autism running in the family.

ali ne zato što se autizam javlja u obitelji.

And the reason is because in certain individuals,

A razlog je zato što određeni pojedinci,

they can actually have genetic changes or mutations

oni mogu zapravo imati genetske promjene ili mutacije

that are not passed down from the mother

koje nisu prenesene od majke

or from the father,

ili od oca

but actually start brand new in them,

već počinju kao novi u njima,

mutations that are present

mutacije koje su prisutne

in the egg or the sperm

u jajašcu ili spermiju

at the time of conception

u trenutku začeća

but have not been passed down

ali nisu prenošene

generation through generation within the family.

generaciju kroz generaciju unutar obitelji.

And we can actually use that strategy

I zapravo možemo koristiti tu strategiju

to now understand and to identify

da razumijemo i identificiramo

those genes causing autism in those individuals.

one gene koji uzrokuju autizam u tih pojedinaca.

So in fact, at the Simons Foundation,

Zapravo, u Simons Fondaciji

we took 2,600 individuals

uzeli smo oko 2.600 pojedinaca

that had no family history of autism,

koji nisu imali autizam u obiteljskoj povijesti,

and we took that child and their mother and father

uzeli smo to dijete, te negovu majku i oca

and used them to try and understand

i koristili smo ih kako bi pokušali razumjeti

what were those genes

koji su to geni

causing autism in those cases?

što uzrokuju autizam u tim slučajevima?

To do that, we actually had to comprehensively

Kako bi smo to učinili, morali smo zapravo opsežno

be able to look at all that genetic information

pregledavati sve njihove genetske informacije

and determine what those differences were

i odrediti koje su to razlike

between the mother, the father and the child.

između majke, oca i djeteta.

In doing so, I apologize,

Kako bi to uradili, ispričavam se,

I'm going to use an outdated analogy

koristit ću jedno zastarjelu analogiju

of encyclopedias rather than Wikipedia,

enciklopedija, a ne Wikipedije,

but I'm going to do so to try and help make the point

ali učinit ću to kako bi pokušala i pomogla stvoriti smisao

that as we did this inventory,

da dok smo radili inventar,

we needed to be able to look at

trebala nam je mogućnost gledanja natrag

massive amounts of information.

na veliku količinu informacija.

Our genetic information is organized

Naše genetičke informacije su organizirane

into a set of 46 volumes,

u setu od 46 svezaka,

and when we did that, we had to be able to account

i kada smo to učinili, morali smo biti u mogućnost koristiti

for each of those 46 volumes,

svaki od tih 46 svezaka,

because in some cases with autism,

jer u nekim slučajevima autizma,

there's actually a single volume that's missing.

zapravo nedostaje jedan svezak.

We had to get more granular than that, though,

Morali smo biti još temeljitiji,

and so we had to start opening those books,

morali smo početi otvarati te knjige,

and in some cases, the genetic change

i u nekim slučajevima, genetske razlike

was more subtle.

su bile više suptilne.

It might have been a single paragraph that was missing,

To je možda bio jedan odlomak koji je nedostajao,

or yet, even more subtle than that,

ili možda čak suptilnije od toga,

a single letter,

samo slovo,

one out of three billion letters

jedno od tri milijarde slova

that was changed, that was altered,

koje je promjenjeno, koje je drugačije,

yet had profound effects

ali ipak ima dubok učinak

in terms of how the brain functions

govoreći o tome kako mozak funkcionira

and affects behavior.

i utječe na ponašanje.

In doing this within these families,

Radeći ovo s obiteljima,

we were able to account for approximately

uspjeli smo utvrditi za otprilike

25 percent of the individuals

25% pojedinaca

and determine that there was a single

i odrediti da postoji jedan

powerful genetic factor

snažan genetski faktor

that caused autism within those families.

koji uzrokuje autizam unutar tih obitelji.

On the other hand, there's 75 percent

U drugu ruku, postoji 75%

that we still haven't figured out.

koje još nismo otkrili.

As we did this, though,

Kako smo ovo radili,

it was really quite humbling,

to je bilo zapravo poražavajuće

because we realized that there was not simply

jer smo shvatili da jednostavno ne postoji

one gene for autism.

jedan gen za autizam.

In fact, the current estimates are

Zapravo, trenutne pretpostavke su

that there are 200 to 400 different genes

da postoji između 200 i 400 različitih gena

that can cause autism.

koji mogu uzrokovati autizam.

And that explains, in part,

To objašnjava, djelomično,

why we see such a broad spectrum

zašto vidimo tako širok spektar

in terms of its effects.

govoreći o njegovim učincima.

Although there are that many genes,

Iako postoji tako puno gena,

there is some method to the madness.

postoje neke metode u ovom ludilu.

It's not simply random

Nisu jednostavno nasumice

200, 400 different genes,

200, 400 različitih gena,

but in fact they fit together.

već se oni zajedno slažu.

They fit together in a pathway.

Zajedno se slažu u putu nastanka.

They fit together in a network

Slažu se zajedno u mreži

that's starting to make sense now

koja počinje imati smisla sada

in terms of how the brain functions.

govoreći o tome kako mozak funkcionira.

We're starting to have a bottom-up approach

Počinjemo koristiti pristup odozdo prema gore

where we're identifying those genes,

gdje identificiramo te gene,

those proteins, those molecules,

te proteine, te molekule,

understanding how they interact together

razumijevajući kako međusobno djeluju

to make that neuron work,

i ostvaruju rad neurona,

understanding how those neurons interact together

razumijevajući kako ti neuroni djeluju međusobno

to make circuits work,

u omogućavanju rada krugova,

and understand how those circuits work

i razumijevajući kako ti krugovi rade,

to now control behavior,

te kako kontroliraju ponašanje,

and understand that both in individuals with autism

i razumijevajući to i kod pojedinaca s autizmom

as well as individuals who have normal cognition.

kao i kod pojedinaca koji imaju normalne kognitivne sposobnosti.

But early diagnosis is a key for us.

Rana dijagnoza je ključ za nas.

Being able to make that diagnosis

Mogućnost dijagnosticiranja

of someone who's susceptible

nekoga tko je podložan

at a time in a window

u to vrijeme u okviru

where we have the ability to transform,

gdje imamo mogućnost promijeniti,

to be able to impact

gdje možemo utjecati

that growing, developing brain is critical.

na rastući, razvijajući mozak je kritično.

And so folks like Ami Klin have developed methods

Ljudi poput Ami Klin su razvili metode

to be able to take infants, small babies,

koje omogućuju na novorođenčadi i malim bebama

and be able to use biomarkers,

koristiti biomarkere,

in this case eye contact and eye tracking,

u ovom slučaju kontakt očima i praćenje očima

to identify an infant at risk.

kako bi identificirali rizično novorođenče.

This particular infant, you can see,

Ovo određeno novorođenče, vidite,

making very good eye contact with this woman

ostvaruje jako dobar kontakt očima s ovom ženom

as she's singing "Itsy, Bitsy Spider,"

dok ona pjeva „Itsy, Bitsy Spider,“

in fact is not going to develop autism.

i ono neće razviti autizam.

This baby we know is going to be in the clear.

Ova beba koju smo upoznali će biti dobro.

On the other hand, this other baby

U drugu ruku, kod ove druge bebe

is going to go on to develop autism.

razvit će se autizam.

In this particular child, you can see,

Kod ovog djeteta, vidite,

it's not making good eye contact.

ne ostvaruje dobar kontakt očima.

Instead of the eyes focusing in

Umjesto fokusa očiju

and having that social connection,

i ostvarivanja društvenog kontakta,

looking at the mouth, looking at the nose,

gledau usta, gleda u nos,

looking off in another direction,

gleda dalje u drugom smjeru,

but not again socially connecting,

i dalje ne ostvaruje društveni kontakt,

and being able to do this on a very large scale,

i ako ovo radimo u velikom razmjeru,

screen infants, screen children for autism,

pregledavanje novorođenčadi, pregledavanje djece zbog autizma,

through something very robust, very reliable,

kroz nešto vrlo robusno, vrlo pouzdano,

is going to be very helpful to us in terms of being

bit će nam veoma korisno u smislu

able to intervene at an early stage

da ćemo moći intervenirati vrlo rano

when we can have the greatest impact.

kada možemo imati najbolji učinak.

How are we going to intervene?

Kako ćemo intervenirati?

It's probably going to be a combination of factors.

To će vjerojatno biti kombinacija faktora.

In part, in some individuals,

Djelomično, kod nekih pojedinaca

we're going to try and use medications.

ćemo pokušati koristiti lijekove.

And so in fact, identifying the genes for autism

I zapravo, detekcija gena za autizam

is important for us

je važna za nas

to identify drug targets,

kako bi identificirali cilj lijeka,

to identify things that we might be able to impact

kako bi identificirali ono na što možemo utjecati

and can be certain that that's really

i biti sigurni da je to upravo

what we need to do in autism.

ono što trebamo činiti u autizmu.

But that's not going to be the only answer.

Ali to neće biti jedini odgovor.

Beyond just drugs, we're going to use educational strategies.

Osim lijekova koristit ćemo edukacijske strategije.

Individuals with autism,

Pojedinci s autizmom,

some of them are wired a little bit differently.

neki od njih imaju drugačije neuronske mreže.

They learn in a different way.

Uče na drugačiji način.

They absorb their surroundings in a different way,

Upijaju okolinu na drugačiji način,

and we need to be able to educate them

i trebamo ih učiti

in a way that serves them best.

na način koji je najbolji za njih.

Beyond that, there are a lot of individuals

Osim toga, ovdje postoji mnogo pojedinaca

in this room who have great ideas

u ovoj prostoriji koji imaju velike ideje

in terms of new technologies we can use,

govoreći o novim tehnologijama koje možemo koristiti

everything from devices we can use to train the brain

sve od uređaja koje možemo koristiti za treniranje mozga

to be able to make it more efficient

kako bi bio učinkovitiji

and to compensate for areas in which

i nadomjestiti za dijelove u kojima

it has a little bit of trouble,

ima malo problema,

to even things like Google Glass.

pa čak i stvari poput Google naočala.

You could imagine, for instance, Gabriel,

Možete zamisliti,na primjer Gabriela

with his social awkwardness,

s njegovom društvenom nespretnošću,

might be able to wear Google Glass

možda može nositi Google naočale

with an earpiece in his ear,

sa slušalicama u ušima,

and have a coach be able to help him,

i tako mu trener može pomoći

be able to help think about conversations,

može pomoći da razmišlja o razgovorima,

conversation-starters,

započinjanju razgovora,

being able to even perhaps one day

možda će jednog dana čak moći

invite a girl out on a date.

pitati djevojku za spoj.

All of these new technologies

Sve ove nove tehnologije

just offer tremendous opportunities

nam daju odlične prilike

for us to be able to impact

za ostvarivanje učinka

the individuals with autism,

kod pojedinaca s autizmom,

but yet we have a long way to go.

ali još smo na dugačkom putu.

As much as we know,

Koliko god da znamo,

there is so much more that we don't know,

postoji puno toga što ne znamo,

and so I invite all of you

i zato vas sve pozivam

to be able to help us think about

da nam pomognete razmisliti o

how to do this better,

tome kako ovo učiniti bolje,

to use as a community our collective wisdom

da kao društvo koristimo zajedničku mudrost

to be able to make a difference,

kako bi došlo do promjene,

and in particular,

točnije

for the individuals in families with autism,

za pojedince u obiteljima s autizmom,

I invite you to join the interactive autism network,

pozivam vas da se uključite u interaktivnu mrežu autizma,

to be part of the solution to this,

da budete dio rješenja

because it's going to take really a lot of us

jer trebat će stvarno puno nas

to think about what's important,

kako bi razmislili što je to bitno,

what's going to be a meaningful difference.

što će biti bitna razlika.

As we think about something

Dok razmišljamo o nečem,

that's potentially a solution,

što je potencijalno rješenje,

how well does it work?

koliko je to uspješno?

Is it something that's really going to make a difference

Je li to nešto što će stvarno napraviti razliku

in your lives, as an individual,

u vašim životima, kao pojedinca,

as a family with autism?

kao obitelji s autizmom?

We're going to need individuals of all ages,

Trebat će nam pojedinci svih uzrasta,

from the young to the old,

od mladih do starih,

and with all different shapes and sizes

sa različitim oblicima i veličinama

of the autism spectrum disorder

spektra autističnog poremećaja

to make sure that we can have an impact.

kako bi bili sigurni da ostvarujemo učinak.

So I invite all of you to join the mission

Pozivam vas se da se priključite misiji

and to help to be able to make the lives

i pomognete da učinimo živote

of individuals with autism

pojedinaca s autizmom

so much better and so much richer.

mnogo boljima i bogatijima.

Thank you.

Hvala vam.

(Applause)

(Pljesak)