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

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2014-04-28・ 21927    3362


In this calm and factual talk, geneticist Wendy Chung shares what we know about autism spectrum disorder — for example, that autism has multiple, perhaps interlocking, causes. Looking beyond the worry and concern that can surround a diagnosis, Chung and her team look at what we've learned through studies, treatments and careful listening. TEDTalks is a daily video podcast of the best talks and performances from the TED Conference, where the world's leading thinkers and doers give the talk of their lives in 18 minutes (or less). Look for talks on Technology, Entertainment and Design -- plus science, business, global issues, the arts and much more. Find closed captions and translated subtitles in many languages at http://www.ted.com/translate Follow TED news on Twitter: http://www.twitter.com/tednews Like TED on Facebook: https://www.facebook.com/TED Subscribe to our channel: http://www.youtube.com/user/TEDtalksDirector

Instruction

Double-click on the English captions to play the video from there.

Translator: Norzaiha Norhan Reviewer: Najibah Abu Bakar
00:12
"Why?"
"Kenapa?"
00:14
"Why?" is a question
"Kenapa?" merupakan soalan
00:15
that parents ask me all the time.
yang ibu bapa selalu tanya kepada saya.
00:18
"Why did my child develop autism?"
"Kenapa anak saya alami autisme?"
00:21
As a pediatrician, as a geneticist, as a researcher,
Sebagai pakar kanak-kanak, pakar genetik dan penyelidik,
00:25
we try and address that question.
kami cuba jawab soalan itu.
00:28
But autism is not a single condition.
Namun, autisme bukan kondisi tunggal.
00:30
It's actually a spectrum of disorders,
Sebenarnya, ia spektrum gangguan.
00:32
a spectrum that ranges, for instance,
Ia spektrum yang pelbagai, contohnya,
00:35
from Justin, a 13-year-old boy
Justin, budak lelaki 13 tahun
00:37
who's not verbal, who can't speak,
yang tidak verbal, tak bercakap.
00:41
who communicates by using an iPad
Dia berkomunikasi melalui iPad
00:43
to touch pictures to communicate
dengan menyentuh gambar untuk menyampaikan
00:45
his thoughts and his concerns,
fikiran dan kebimbangannya.
00:47
a little boy who, when he gets upset,
Dia budak kecil. Apabila ada sesuatu tak kena
00:49
will start rocking,
dia akan goyangkan tubuhnya
00:51
and eventually, when he's disturbed enough,
dan lama kelamaan jika amat runsing
00:52
will bang his head to the point
akan menghantukkan kepalanya hinggakan
00:54
that he can actually cut it open and require stitches.
kepalanya luka dan perlukan jahitan.
00:58
That same diagnosis of autism, though,
Namun, diagnosis autisme yang sama
01:00
also applies to Gabriel,
juga digunakan pada Gabriel,
01:02
another 13-year-old boy
seorang lagi budak lelaki berumur 13 tahun
01:04
who has quite a different set of challenges.
yang mempunyai cabaran berbeza.
01:07
He's actually quite remarkably gifted in mathematics.
Dia sebenarnya amat berbakat dalam subjek Matematik.
01:10
He can multiple three numbers by three numbers
Dia boleh darab tiga nombor dengan tiga nombor lain
01:12
in his head with ease,
di dalam kepalanya dengan mudah.
01:14
yet when it comes to trying to have a conversation,
Namun, apabila cuba untuk berbual
01:18
he has great difficulty.
dia menghadapi kesukaran.
01:20
He doesn't make eye contact.
Dia tak dapat pandang mata seseorang.
01:22
He has difficulty starting a conversation,
Sukar untuknya mulakan perbualan.
01:24
feels awkward,
Dia rasa kekok
01:26
and when he gets nervous,
dan apabila dia gementar
01:27
he actually shuts down.
dia terus gugup.
01:29
Yet both of these boys
Namun begitu, kedua-duanya
01:31
have the same diagnosis of autism spectrum disorder.
mempunyai diagnosis yang sama: gangguan spektrum autisme.
01:35
One of the things that concerns us
Antara yang membimbangkan kami
01:37
is whether or not there really is
adalah hakikat sama ada wujudnya
01:39
an epidemic of autism.
epidemik autisme.
01:41
These days, one in 88 children
Masa kini, seorang dalam 88 kanak-kanak
01:43
will be diagnosed with autism,
akan ada diagnosis autisme
01:45
and the question is,
dan persoalannya adalah
01:47
why does this graph look this way?
kenapa graf berbentuk begini?
01:49
Has that number been increasing
Adakah jumlahnya bertambah
01:51
dramatically over time?
dengan dramatik selama ini
01:53
Or is it because we have now started labeling
atau adakah kita berikan label
01:57
individuals with autism,
individu dengan autisme
01:59
simply giving them a diagnosis
dengan memberikan mereka diagnosis
02:01
when they were still present there before
walaupun ada simptom-simptom sama
02:04
yet simply didn't have that label?
tapi tidak dilabel begitu?
02:06
And in fact, in the late 1980s, the early 1990s,
Sebenarnya, lewat 1980-an, awal 1990-an,
02:10
legislation was passed
undang-undang telah digubal
02:11
that actually provided individuals with autism
yang memberikan individu autisme
02:14
with resources, with access to educational materials
dengan sumber dan akses kepada bahan pendidikan
02:18
that would help them.
yang akan membantu mereka.
02:20
With that increased awareness, more parents,
Dengan kesedaran yang meningkat itu, lebih ramai ibu bapa,
02:23
more pediatricians, more educators
pakar kanak-kanak, pendidik
02:26
learned to recognize the features of autism.
akan dapat mengenalpasti ciri-ciri autisme.
02:29
As a result of that, more individuals were diagnosed
Hasilnya, lebih ramai individu didiagnosis
02:33
and got access to the resources they needed.
dan dapat akses kepada sumber yang mereka perlukan.
02:36
In addition, we've changed our definition over time,
Tambahan lagi, kami juga ubah definisinya.
02:40
so in fact we've widened the definition of autism,
Hatta, definisi autime lebih luas
02:43
and that accounts for some of
dan itu antara sebab
02:44
the increased prevalence that we see.
peningkatan mendadak yang dapat dilihat.
02:47
The next question everyone wonders is,
Persoalan seterusnya adalah
02:50
what caused autism?
"Apa yang menyebabkan autisme?"
02:51
And a common misconception
Salah faham biasa adalah
02:54
is that vaccines cause autism.
vaksin menyebabkan autisme.
02:57
But let me be very clear:
Biar saya terangkan dengan jelas:
03:00
Vaccines do not cause autism.
vaksin tak menyebabkan autisme.
03:05
(Applause)
(Tepukan)
03:11
In fact, the original research study
Hakikatnya, kajian asal
03:13
that suggested that was the case
yang mencadangkannya
03:15
was completely fraudulent.
adalah satu penipuan.
03:18
It was actually retracted from the journal Lancet,
Ia telah ditarik balik daripada jurnal Lancet
03:21
in which it was published,
yang telah menerbitkannya
03:23
and that author, a physician,
dan penulis itu, seorang doktor
03:25
had his medical license taken away from him.
lesen kedoktorannya telah dibatalkan.
03:28
(Applause)
(Tepukan)
03:32
The Institute of Medicine,
Institut Perubatan,
03:34
The Centers for Disease Control,
Pusat Kawalan Penyakit
03:35
have repeatedly investigated this
telah berkali-kali menyiasat
03:38
and there is no credible evidence
dan dapati tiada bukti sahih
03:41
that vaccines cause autism.
yang menunjukkan vaksin punca autisme.
03:44
Furthermore,
Selain daripada itu,
03:46
one of the ingredients in vaccines,
salah satu bahan di dalam vaksin,
03:48
something called thimerosal,
sesuatu yang dipanggil "thimerosal",
03:50
was thought to be what the cause of autism was.
yang dianggap penyebab autisme,
03:53
That was actually removed from vaccines
dikeluarkan daripada pembuatan vaksin
03:56
in the year 1992,
pada tahun 1992.
03:57
and you can see that it really did not have an effect
Seperti yang anda boleh lihat, tiada kesan
04:00
in what happened with the prevalence of autism.
dengan peningkatan autisme.
04:03
So again, there is no evidence
Jadi sekali lagi, tiada bukti
04:05
that this is the answer.
yang ini adalah jawapannya.
04:07
So the question remains, what does cause autism?
Jadi persoalannya tetap sama, apakah punca autisme?
04:11
In fact, there's probably not one single answer.
Sebenarnya, tidak ada satu jawapan pasti.
04:14
Just as autism is a spectrum,
Sama seperti autisme satu spektrum,
04:16
there's a spectrum of etiologies,
terdapat spektrum etiologinya,
04:18
a spectrum of causes.
spektrum punca-puncanya.
04:19
Based on epidemiological data,
Berdasarkan data epidemiologi
04:21
we know that one of the causes,
kita tahu bahawa salah satu puncanya
04:23
or one of the associations, I should say,
atau salah satu punca yang boleh dikaitkan
04:25
is advanced paternal age,
adalah usia lanjut si bapa.
04:28
that is, increasing age of the father
Maksudnya, kelanjutan usia si bapa
04:30
at the time of conception.
pada waktu kehamilan.
04:32
In addition, another vulnerable
Selain daripada itu, satu lagi waktu lemah
04:34
and critical period in terms of development
dan kritikal dalam aspek perkembangan
04:37
is when the mother is pregnant.
adalah waktu si ibu mengandung.
04:39
During that period, while the fetal brain is developing,
Pada waktu itu, semasa otak bayi sedang berkembang
04:42
we know that exposure to certain agents
kita tahu ada pendedahan terhadap agen tertentu
04:43
can actually increase the risk of autism.
yang dapat meningkatkan risiko autisme.
04:47
In particular, there's a medication, valproic acid,
Secara spesifiknya, terdapat ubat, asid valproik
04:49
which mothers with epilepsy sometimes take,
yang ada kalanya diambil si ibu yang alami sawan
04:52
we know can increase that risk of autism.
yang kami tahu akan meningkatkan risiko autisme.
04:56
In addition, there can be some infectious agents
Selain daripada itu, ada agen yang berjangkit
04:58
that can also cause autism.
yang boleh menyebabkan autisme.
05:01
And one of the things I'm going to spend
Salah satu perkara yang saya
05:02
a lot of time focusing on
akan tumpukan
05:05
are the genes that can cause autism.
adalah gen yang menyebabkan autisme.
05:07
I'm focusing on this not because genes
Saya fokus pada gen
05:10
are the only cause of autism,
bukan kerana ia satu-satunya penyebab autisme,
05:12
but it's a cause of autism
tapi ia penyebab autisme
05:13
that we can readily define
yang lebih mudah untuk dedifinisikan
05:15
and be able to better understand the biology
dan biologinya lebih mudah difahami
05:18
and understand better how the brain works
serta lebih mudah untuk memahami cara otak berfungsi
05:20
so that we can come up with strategies
supaya kami boleh fikirkan strategi
05:22
to be able to intervene.
untuk menghalangnya.
05:25
One of the genetic factors that we don't understand,
Salah satu faktor genetik yang kami tak fahami
05:27
however, is the difference that we see
adalah perbezaan yang boleh dilihat
05:31
in terms of males and females.
antara lelaki dan perempuan.
05:33
Males are affected four to one compared to females
Nisbah lelaki adalah empat berbanding setiap seorang perempuan
05:36
with autism,
yang alami autisme
05:37
and we really don't understand what that cause is.
dan kami tak tahu puncanya.
05:41
One of the ways that we can understand
Salah satu perkara yang kami faham
05:42
that genetics is a factor
berkenaan gen sebagai faktor
05:44
is by looking at something called
adalah perihal sesuatu yang dipanggil
05:46
the concordance rate.
kadar kesejajaran.
05:47
In other words, if one sibling has autism,
Dalam erti kata lain, jika seseorang mempunyai autisme
05:51
what's the probability
apakah kebarangkalian
05:52
that another sibling in that family will have autism?
adik-beradik dalam keluarga yang sama mengalami autisme?
05:55
And we can look in particular
Kita boleh lihat secara lebih dekat
05:57
at three types of siblings:
tiga jenis adik-beradik:
05:59
identical twins,
kembar seiras,
06:01
twins that actually share 100 percent
kembar yang berkongsi 100 peratus
06:03
of their genetic information
maklumat genetik
06:05
and shared the same intrauterine environment,
dan berkongsi persekitaran intrauterin yang sama,
06:08
versus fraternal twins,
dengan kembar tak seiras,
06:10
twins that actually share 50 percent
kembar yang berkongsi 50 peratus
06:12
of their genetic information,
maklumat genetik
06:14
versus regular siblings,
berbanding adik-beradik biasa,
06:15
brother-sister, sister-sister,
abang-adik, kakak-adik,
06:17
also sharing 50 percent of their genetic information,
yang juga berkongsi 50 peratus maklumat genetik
06:20
yet not sharing the same intrauterine environment.
namun tak berkongsi persekitaran intrauterin yang sama.
06:23
And when you look at those concordance ratios,
Apabila kita lihat ratio kesejajarannya,
06:25
one of the striking things that you will see
salah satu perkara menarik yang boleh dilihat
06:27
is that in identical twins,
adalah pasangan kembar seiras
06:30
that concordance rate is 77 percent.
mempunyai kadar kesejajaran sebanyak 77 peratus.
06:33
Remarkably, though,
Namun yang ajaibnya,
06:34
it's not 100 percent.
ia bukan 100 peratus.
06:36
It is not that genes account for all of the risk for autism,
Maksudnya, gen bukanlah punca mutlak autisme
06:40
but yet they account for a lot of that risk,
namun is penyumbang terbesar risiko autisme
06:42
because when you look at fraternal twins,
kerana apabila kita lihat kembar tak seiras,
06:45
that concordance rate is only 31 percent.
kadar kesejajarannya hanyalah 31 peratus.
06:48
On the other hand, there is a difference
Walau bagaimanapun, ada beza
06:50
between those fraternal twins and the siblings,
antara kembar tak seiras dan adik beradik biasa
06:53
suggesting that there are common exposures
yang menunjukkan pendedahan sama
06:55
for those fraternal twins
untuk kembar tak seiras
06:57
that may not be shared as commonly
mungkin tidak dikongsi
06:59
with siblings alone.
dengan adik beradik biasa.
07:01
So this provides some of the data
Jadi ini memberikan data
07:03
that autism is genetic.
yang punca autisme mungkin genetik.
07:04
Well, how genetic is it?
Berapa banyak faktor genetik itu?
07:06
When we compare it to other conditions
Apabila kami bandingkan dengan kondisi lain
07:08
that we're familiar with,
yang kami tahu
07:10
things like cancer, heart disease, diabetes,
seperti kanser, sakit jantung, diabetes.
07:14
in fact, genetics plays a much larger role in autism
Hakikatnya, genetik mainkan peranan lebih besar dalam autisme
07:18
than it does in any of these other conditions.
berbanding kondisi-kondisi lain.
07:20
But with this, that doesn't tell us what the genes are.
Namun, ia tak beritahu kami gen yang menjadi puncanya.
07:23
It doesn't even tell us in any one child,
Ia juga tak beritahu kami dalam seorang kanak-kanak
07:26
is it one gene
adakah hanya satu gen
07:28
or potentially a combination of genes?
atau kemungkinan yang ia kombinasi beberapa gen?
07:30
And so in fact, in some individuals with autism,
Jadi, bagi sebahagian individu yang alami autisme
07:33
it is genetic!
ia adalah genetik!
07:36
That is, that it is one single,
Itulah satu-satunya
07:38
powerful, deterministic gene
gen kuat yang menghasilkan
07:40
that causes the autism.
dan menjadi punca autisme.
07:42
However, in other individuals,
Namun, bagi individu lain
07:44
it's genetic, that is,
ia genetik, maksudnya,
07:46
that it's actually a combination of genes
ia kombinasi genetik
07:49
in part with the developmental process
bersama proses perkembangan
07:52
that ultimately determines that risk for autism.
yang akhirnya menentukan risiko autisme.
07:55
We don't know in any one person, necessarily,
Kami tak dapat pastikan dalam diri seseorang
07:58
which of those two answers it is
antara kedua jawapan itu
08:00
until we start digging deeper.
hingga kami kaji sedalam-dalamnya.
08:02
So the question becomes,
Jadi persoalannya sekarang,
08:03
how can we start to identify
bagaimana nak mula kenal pasti
08:06
what exactly those genes are.
gen tersebut?
08:07
And let me pose something
Biar saya tanya sesuatu
08:09
that might not be intuitive.
yang mungkin tak begitu intuitif.
08:11
In certain individuals,
Bagi sesetengah individu,
08:13
they can have autism
mereka alami autisme
08:15
for a reason that is genetic
mungkin disebabkan genetik
08:17
but yet not because of autism running in the family.
namun bukan sebab ada autisme di kalangan ahli keluarga.
08:21
And the reason is because in certain individuals,
Ini kerana bagi sesetengah individu itu
08:23
they can actually have genetic changes or mutations
mungkin berlaku perubahan genetik atau mutasi
08:26
that are not passed down from the mother
yang tidak diturunkan daripada ibu
08:29
or from the father,
atau daripada ayah,
08:31
but actually start brand new in them,
tapi sesuatu yang baru berlaku dalam diri mereka sendiri.
08:34
mutations that are present
Mutasi mungkin berlaku
08:35
in the egg or the sperm
semasa di tahap telur atau sperma
08:37
at the time of conception
pada waktu kehamilan
08:38
but have not been passed down
tetapi tidak diturunkan
08:40
generation through generation within the family.
dari satu generasi ke satu generasi dalam keluarga.
08:43
And we can actually use that strategy
Kami dapat guna strategi itu
08:45
to now understand and to identify
untuk memahami dan kenal pasti
08:47
those genes causing autism in those individuals.
gen yang menyebabkan autisme dalam individu tersebut.
08:50
So in fact, at the Simons Foundation,
Jadi di Yayasan Simons
08:52
we took 2,600 individuals
kami ambil 2,600 individu
08:55
that had no family history of autism,
yang tiada sejarah autisme dalam keluarga
08:58
and we took that child and their mother and father
dan kami ambil anak serta ibu bapanya
09:01
and used them to try and understand
dan gunakan mereka untuk cuba memahami
09:04
what were those genes
gen-gen
09:05
causing autism in those cases?
yang menjadi punca autisme dalam kes mereka.
09:08
To do that, we actually had to comprehensively
Untuk berbuat begitu, kami melihat secara komprehensif
09:11
be able to look at all that genetic information
semua maklumat genetik
09:13
and determine what those differences were
dan pastikan perbezaannya
09:15
between the mother, the father and the child.
antara ibu, bapa dan kanak-kanak tersebut.
09:19
In doing so, I apologize,
Dalam berbuat begitu, saya ingin minta maaf.
09:21
I'm going to use an outdated analogy
Saya akan guna analogi lapuk
09:23
of encyclopedias rather than Wikipedia,
iaitu ensiklopedia dan bukan Wikipedia,
09:26
but I'm going to do so to try and help make the point
tapi saya buat begitu untuk cuba buktikan sesuatu.
09:29
that as we did this inventory,
Sambil melakukan inventori ini,
09:31
we needed to be able to look at
kami perlu melihat
09:33
massive amounts of information.
maklumat yang amat banyak.
09:35
Our genetic information is organized
Maklumat genetik kita di susun
09:37
into a set of 46 volumes,
dalam set 46 jilid
09:40
and when we did that, we had to be able to account
dan apabila kami berbuat begitu kami perlu kira
09:42
for each of those 46 volumes,
setiap satu daripada 46 jilid,
09:44
because in some cases with autism,
kerana dalam sesetengah kes autisme,
09:46
there's actually a single volume that's missing.
sebenarnya ada satu jilid yang hilang.
09:48
We had to get more granular than that, though,
Kami terpaksa kaji dengan lebih teliti lagi
09:50
and so we had to start opening those books,
jadi kami mula buka buku-buku itu
09:53
and in some cases, the genetic change
dan dalam sesetengah kes perubahan genetik itu
09:55
was more subtle.
amat halus sekali.
09:56
It might have been a single paragraph that was missing,
Kemungkinan ada satu perenggan yang hilang,
09:59
or yet, even more subtle than that,
ataupun, lebih halus lagi
10:03
a single letter,
satu huruf
10:04
one out of three billion letters
daripada tiga bilion huruf
10:07
that was changed, that was altered,
yang ditukar, yang diubah,
10:09
yet had profound effects
namun menyebabkan kesan mendalam
10:11
in terms of how the brain functions
dari segi cara otak berfungsi
10:13
and affects behavior.
dan kesannya pada tingkah laku.
10:15
In doing this within these families,
Dengan kajian yang melibatkan keluarga-keluarga ini,
10:17
we were able to account for approximately
kami dapat kesan lebih kurang
10:19
25 percent of the individuals
25 peratus individu
10:22
and determine that there was a single
dan menentukan yang adanya satu
10:24
powerful genetic factor
faktor genetik yang kuat
10:26
that caused autism within those families.
yang menyebabkan autisme dalam keluarga itu.
10:30
On the other hand, there's 75 percent
Walaupun begitu, ada 75 peratus
10:32
that we still haven't figured out.
yang kami masih tak dapat pastikan.
10:34
As we did this, though,
Semasa melakukan kajian ini,
10:36
it was really quite humbling,
ia pengalaman yang buat kami rasa rendah diri,
10:38
because we realized that there was not simply
kerana kami sedar yang tak ada
10:40
one gene for autism.
satu gen untuk autisme.
10:42
In fact, the current estimates are
Hakikatnya, buat masa ini dianggarkan
10:44
that there are 200 to 400 different genes
ada 200 ke 400 gen berbeza
10:47
that can cause autism.
yang boleh menyebabkan autisme.
10:48
And that explains, in part,
Itu dapat menjelaskan,
10:50
why we see such a broad spectrum
kenapa kita lihat spektrum yang luas
10:52
in terms of its effects.
berkenaan kesan-kesannya.
10:54
Although there are that many genes,
Walaupun terdapat banyak gen,
10:56
there is some method to the madness.
ada cara untuk mengenal pastinya.
10:59
It's not simply random
Ia bukan sesuatu yang rawak.
11:01
200, 400 different genes,
200, 400 gen berbeza,
11:03
but in fact they fit together.
tapi sebenarnya, ia berkelompok.
11:05
They fit together in a pathway.
Ia berkelompok di satu laluan.
11:06
They fit together in a network
Ia berkelompok dalam satu rangkaian.
11:08
that's starting to make sense now
Itu yang boleh difahami sekarang
11:10
in terms of how the brain functions.
dalam erti kata fungsi otak.
11:12
We're starting to have a bottom-up approach
Kami mulakan pendekatan bawah ke atas
11:15
where we're identifying those genes,
di mana kami mengenal pasti gen-gen,
11:16
those proteins, those molecules,
protein dan molekul tersebut
11:19
understanding how they interact together
serta memahami cara ia berinteraksi
11:21
to make that neuron work,
untuk menggerakkan neuron.
11:22
understanding how those neurons interact together
Kami cuba faham cara neuron tersebut berinteraksi
11:25
to make circuits work,
untuk menggerakkan litar
11:26
and understand how those circuits work
dan memahami cara litar berfungsi
11:28
to now control behavior,
untuk mengawal tingkah laku
11:30
and understand that both in individuals with autism
dan memahami individu autisme
11:33
as well as individuals who have normal cognition.
serta mereka yang mempunyai kognisi normal.
11:37
But early diagnosis is a key for us.
Namun diagnosis awal amat penting bagi kami.
11:39
Being able to make that diagnosis
Jika kami dapat buat diagnosis
11:41
of someone who's susceptible
ke atas seseorang yang berkemungkinan alaminya
11:42
at a time in a window
pada tingkap masa
11:45
where we have the ability to transform,
di mana kami mampu buat perubahan
11:47
to be able to impact
dan beri impak
11:49
that growing, developing brain is critical.
kepada otak yang sedang berkembang itu sesuatu yang kritikal.
11:51
And so folks like Ami Klin have developed methods
Ami Klin contohnya, wujudkan cara
11:55
to be able to take infants, small babies,
untuk uji bayi kecil
11:58
and be able to use biomarkers,
dan guna penanda bio,
12:00
in this case eye contact and eye tracking,
dalam kes ini hubungan mata dan mengesan pergerakan mata,
12:03
to identify an infant at risk.
untuk mengenal pasti bayi yang berisiko.
12:06
This particular infant, you can see,
Bayi ini, seperti yang anda boleh lihat,
12:08
making very good eye contact with this woman
memandang mata wanita ini dengan baik sekali
12:10
as she's singing "Itsy, Bitsy Spider,"
sambil dia menyanyi, "Itsy, Bitsy Spider"
12:12
in fact is not going to develop autism.
menunjukkan dia takkan alami autisme.
12:15
This baby we know is going to be in the clear.
Bayi ini, kami tahu, tiada masalah tersebut.
12:18
On the other hand, this other baby
Bayi yang ini pula
12:21
is going to go on to develop autism.
akan alami autisme.
12:23
In this particular child, you can see,
Bayi ini, seperti yang anda boleh lihat,
12:25
it's not making good eye contact.
tidak memandang mata.
12:27
Instead of the eyes focusing in
Dia tidak fokus pada mata
12:29
and having that social connection,
dan tiada hubungan sosial.
12:32
looking at the mouth, looking at the nose,
Dia memandang mulut, hidung,
12:34
looking off in another direction,
melihat arah lain,
12:36
but not again socially connecting,
tapi tiada hubungan sosial.
12:39
and being able to do this on a very large scale,
Melakukan saringan ini pada skala lebih besar,
12:42
screen infants, screen children for autism,
menyaring bayi, menyaring kanak-kanak untuk autisme
12:45
through something very robust, very reliable,
melalui sesuatu yang teguh, boleh dipercayai
12:48
is going to be very helpful to us in terms of being
amat menolong kami dalam erti kata
12:50
able to intervene at an early stage
menghalangnya pada tahap awal
12:52
when we can have the greatest impact.
waktu impak terhebat boleh berlaku.
12:56
How are we going to intervene?
Bagaimana kami nak menghalangnya?
12:58
It's probably going to be a combination of factors.
Ia mungkin kombinasi beberapa faktor.
13:01
In part, in some individuals,
Bagi sesetengah individu,
13:03
we're going to try and use medications.
kami akan cuba beri ubat.
13:05
And so in fact, identifying the genes for autism
Jadi, dalam mengenal pasti gen untuk autisme
13:08
is important for us
penting untuk kami
13:09
to identify drug targets,
mengenal pasti sasaran ubat,
13:11
to identify things that we might be able to impact
untuk mengenal pasti perkara yang akan beri impak
13:14
and can be certain that that's really
dan kami boleh pastikan yang ia benar-benar
13:15
what we need to do in autism.
apa yang kami perlukan untuk autisme.
13:17
But that's not going to be the only answer.
Namun bukan itu saja jawapannya.
13:20
Beyond just drugs, we're going to use educational strategies.
Selain daripada ubat, kami akan guna strategi pendidikan.
13:23
Individuals with autism,
Bagi individu autisme,
13:24
some of them are wired a little bit differently.
ada yang litar otak mereka sedikit berbeza.
13:27
They learn in a different way.
Mereka belajar dengan cara berbeza.
13:29
They absorb their surroundings in a different way,
Mereka faham persekitaran mereka dengan cara berbeza
13:31
and we need to be able to educate them
dan kita perlu ajar mereka
13:33
in a way that serves them best.
dengan cara yang paling sesuai dengan mereka.
13:36
Beyond that, there are a lot of individuals
Selain daripada itu, terdapat ramai individu
13:38
in this room who have great ideas
di dalam blik ini yang mempunyai idea hebat
13:40
in terms of new technologies we can use,
dalam hal teknologi baru yang kita boleh gunakan,
13:43
everything from devices we can use to train the brain
daripada peralatan yang kita boleh guna untuk latih otak
13:46
to be able to make it more efficient
jadikannya lebih efisien
13:48
and to compensate for areas in which
dan mengimbangi kekurangan dalam hal
13:49
it has a little bit of trouble,
yang mereka hadapi masalah,
13:51
to even things like Google Glass.
hinggalah ke sesuatu seperti Google Glass.
13:53
You could imagine, for instance, Gabriel,
Anda boleh bayangkan, contohnya, Gabriel,
13:55
with his social awkwardness,
dengan rasa kekoknya untuk bersosial
13:57
might be able to wear Google Glass
mungkin boleh pakai Google Glass
13:58
with an earpiece in his ear,
dengan peranti di telinga
14:00
and have a coach be able to help him,
dan jurulatih yang boleh membantunya
14:02
be able to help think about conversations,
tolong dia fikir tentang perbualan,
14:04
conversation-starters,
topik untuk mulakan perbualan,
14:06
being able to even perhaps one day
dan membantu mungkin satu hari nanti
14:08
invite a girl out on a date.
ajak gadis ke luar berjanji temu.
14:10
All of these new technologies
Kesemua teknologi baru ini
14:12
just offer tremendous opportunities
menawarkan peluang baik
14:14
for us to be able to impact
untuk kita beri impak
14:16
the individuals with autism,
kepada individu autisme,
14:19
but yet we have a long way to go.
tapi perjalanan kita masih jauh.
14:21
As much as we know,
Walaupun banyak kita tahu,
14:23
there is so much more that we don't know,
masih banyak lagi yang kita tak tahu.
14:26
and so I invite all of you
Jadi saya ajak kamu semua
14:28
to be able to help us think about
tolong kami fikirkan
14:30
how to do this better,
cara untuk lakukannya dengan lebih baik.
14:31
to use as a community our collective wisdom
Gunakan kebijaksanaan bersama dalam komuniti
14:34
to be able to make a difference,
untuk melakukan perbezaan
14:36
and in particular,
dan secara khususnya
14:37
for the individuals in families with autism,
untuk individu dalam keluarga autisme,
14:40
I invite you to join the interactive autism network,
saya ajak anda sertai rangkaian autisme interaktif
14:43
to be part of the solution to this,
sebagai sebahagian daripada solusi autisme
14:46
because it's going to take really a lot of us
kerana ia memerlukan kita semua
14:48
to think about what's important,
untuk fikirkan perkara penting.
14:51
what's going to be a meaningful difference.
Apa yang akan bawa perbezaan bermakna?
14:53
As we think about something
Sambil kita fikirkan sesuatu
14:54
that's potentially a solution,
yang ada potensi jadi solusi,
14:56
how well does it work?
bagaimana dengan keberkesanannya?
14:58
Is it something that's really going to make a difference
Adakah ia sesuatu yang akan bawa perbezaan
15:00
in your lives, as an individual,
dalam hidup anda, sebagai individu,
15:02
as a family with autism?
sebagai keluarga yang ada autisme?
15:04
We're going to need individuals of all ages,
Kita perlukan semua orang dari semua peringkat umur
15:06
from the young to the old,
dari yang muda hingga ke tua
15:08
and with all different shapes and sizes
dengan fizikal yang berbeza
15:10
of the autism spectrum disorder
dalam gangguan spektrum autisme
15:12
to make sure that we can have an impact.
untuk pastikan yang kita boleh beri kesan.
15:14
So I invite all of you to join the mission
Saya mengajak anda semua untuk sertai misi
15:16
and to help to be able to make the lives
dan menolong
15:19
of individuals with autism
individu autisme
15:21
so much better and so much richer.
hidup lebih baik dan bermakna.
15:23
Thank you.
Terima kasih.
(Tepukan)
15:25
(Applause)
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