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

Translator: Albana Lapaj Reviewer: Helena Bedalli

"Why?"

"Pse?"

"Why?" is a question

"Pse?" eshte nje pyetje

that parents ask me all the time.

qe prinderit ma bejne vazhdimisht.

"Why did my child develop autism?"

"Pse femija im ka autizem?"

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

Si pediater, si gjeneticien, si studiues,

we try and address that question.

ne mundohemi ti pergjigjemi kesaj pyetjeje.

But autism is not a single condition.

Por autizmi nuk eshte nje crregullim i vetem.

It's actually a spectrum of disorders,

Ne fakt ai perfshin nje spekter crregullimesh,

a spectrum that ranges, for instance,

qe varion, per shembull,

from Justin, a 13-year-old boy

nga Justin, nje djalosh 13-te vjecar

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

qe eshte jo-verbal, qe s'mund te flasi,

who communicates by using an iPad

qe komunikon duke perdorur nje iPad

to touch pictures to communicate

duke prekur fotot per te komunikuar

his thoughts and his concerns,

mendimet dhe shqetesimet e veta,

a little boy who, when he gets upset,

nje djale i vogel, qe kur merzitet,

will start rocking,

fillon te lekundet para-mbrapa,

and eventually, when he's disturbed enough,

dhe kur eshte mjaftueshem i shqetesuar,

will bang his head to the point

perplas koken deri ne ate pike

that he can actually cut it open and require stitches.

qe mund ta presi dhe te kete nevoje per qepje.

That same diagnosis of autism, though,

Por, e njejta diagnoze e autizmit,

also applies to Gabriel,

i pershtatet gjithashtu Gabrielit,

another 13-year-old boy

nje tjeter djalosh 13-te vjecar

who has quite a different set of challenges.

qe ka nje set krejt tjeter sfidash.

He's actually quite remarkably gifted in mathematics.

Ai ka ne fakt nje dhunti shume te madhe ne matematike.

He can multiple three numbers by three numbers

Ai mund te shumezoje dy numra treshifore

in his head with ease,

shume lehte me mendje,

yet when it comes to trying to have a conversation,

nderkohe kur bie fjala per te bere nje bisede,

he has great difficulty.

ai ka veshtiresi te medha.

He doesn't make eye contact.

Ai nuk vendos kontakt me sy.

He has difficulty starting a conversation,

Ai ka veshtiresi ne fillimin e nje bisede,

feels awkward,

ndjehet cuditshem,

and when he gets nervous,

dhe kur nervozohet,

he actually shuts down.

ai mbyllet ne vetvete.

Yet both of these boys

Por nderkohe te dy keta djem

have the same diagnosis of autism spectrum disorder.

kane te njejten diagnoze te crregullimit te spektrit te autizmit.

One of the things that concerns us

Nje prej gjerave qe na shqeteson

is whether or not there really is

eshte nese ka apo jo realisht

an epidemic of autism.

nje epidemi autizmi.

These days, one in 88 children

Keto dite, nje ne 88 femije

will be diagnosed with autism,

do te diagnostifikohen me autizem,

and the question is,

dhe pyetja eshte,

why does this graph look this way?

pse shkon grafiku ne kete menyre?

Has that number been increasing

Eshte rritur numri

dramatically over time?

dramatikisht gjate kohes?

Or is it because we have now started labeling

Apo ka ndodhur sepse tani kemi filluar ti etiketojme

individuals with autism,

individet me autizem,

simply giving them a diagnosis

thjesht duke u vene diagnoze

when they were still present there before

nderkohe qe ishin prezente edhe me pare

yet simply didn't have that label?

por thjesht nuk kishin ate etikete?

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

Dhe ne fakt, ne fund te viteve '80, dhe fillimi i viteve '90,

legislation was passed

u miratua legjislacioni

that actually provided individuals with autism

qe siguroi individet me autizem

with resources, with access to educational materials

me burime, me akses ne materiale edukative

that would help them.

qe do i ndihmonte ata.

With that increased awareness, more parents,

Me kete rritje ndergjegjesimi, me shume prinder,

more pediatricians, more educators

me shume pediater, me shume edukatore

learned to recognize the features of autism.

mesuan te njohin karakteristikat e autizmit.

As a result of that, more individuals were diagnosed

Si rezultat i kesaj, me shume individe u diagnostifikuan

and got access to the resources they needed.

dhe paten akses tek burimet qe kishin nevoje.

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

Pervec kesaj, kemi ndryshuar perkufizimin me kalimin e kohes,

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

keshtu qe ne fakt kemi zgjeruar perkufizimin e autizmit,

and that accounts for some of

dhe kjo shpjegon nje pjese

the increased prevalence that we see.

te rritjes se perhapjes qe shohim.

The next question everyone wonders is,

Pyetja tjeter qe te gjithe bejne eshte,

what caused autism?

cfare e shkakton autizmin?

And a common misconception

Dhe nje keqkuptim i zakonshem

is that vaccines cause autism.

eshte qe vaksinat shkaktojne autizmin.

But let me be very clear:

Por me lini te jem shume e qarte:

Vaccines do not cause autism.

Vaksinat nuk shkaktojne autizem.

(Applause)

(Duartrokitje)

In fact, the original research study

Ne fakt, studimi kerkimor origjinal

that suggested that was the case

qe sugjeroi qe ky ishte shkaku

was completely fraudulent.

ishte krejtesisht mashtrim.

It was actually retracted from the journal Lancet,

U terhoq nga revista Lancet,

in which it was published,

ne te cilen ishte publikuar,

and that author, a physician,

dhe autorit, nje mjek,

had his medical license taken away from him.

iu hoq licenca e ushtrimit te profesionit.

(Applause)

(Duartrokitje)

The Institute of Medicine,

Instituti i Mjekesise,

The Centers for Disease Control,

Qendra per Kontrollin e Semundjeve,

have repeatedly investigated this

kane hetuar vazhdimisht rreth kesaj

and there is no credible evidence

dhe nuk ka prova te besueshme

that vaccines cause autism.

qe vaksinat shkaktojne autizem.

Furthermore,

Me tej,

one of the ingredients in vaccines,

nje prej perbersve te vaksinave,

something called thimerosal,

dicka e quajtur thimerosal,

was thought to be what the cause of autism was.

mendohej te ishte ai qe shkaktonte autizmin.

That was actually removed from vaccines

Ai u hoq nga vaksinat

in the year 1992,

ne vitin 1992,

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

dhe mund ta shihni qe nuk pati realisht nje efekt

in what happened with the prevalence of autism.

ne ate qe ndodhi me perhapjen e autizmit.

So again, there is no evidence

Keshtu qe serish, nuk ka prova

that this is the answer.

qe kjo eshte pergjigjja.

So the question remains, what does cause autism?

Keshtu qe pyetja qendron, cfare e shkakton autizmin?

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

Ne fakt, ndoshta nuk ka nje pergjigje te vetme.

Just as autism is a spectrum,

Ashtu si autizmi eshte nje spekter,

there's a spectrum of etiologies,

ka gjithashtu nje spekter te etiologjise,

a spectrum of causes.

nje spekter te shkaqeve.

Based on epidemiological data,

Bazuar ne te dhena epidemiologjike,

we know that one of the causes,

dime qe nje prej shkaqeve,

or one of the associations, I should say,

ose nje nga asocimet, mund te them,

is advanced paternal age,

eshte mosha e madhe e babait,

that is, increasing age of the father

qe do te thote rritja e moshes se babait

at the time of conception.

ne momentin e konceptimit.

In addition, another vulnerable

Pervec kesaj, nje tjeter periudhe

and critical period in terms of development

delikate dhe kritike ne termat e zhvillimit

is when the mother is pregnant.

eshte kur nena eshte shtatzane.

During that period, while the fetal brain is developing,

Gjate kesaj periudhe, nderkohe qe truri i fetusit po zhvillohet,

we know that exposure to certain agents

dime qe ekspozimi ndaj disa faktoreve

can actually increase the risk of autism.

mund te rrisi rrezikun e autizmit.

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

Ne vecanti, eshte nje mjekim, acidi valproic,

which mothers with epilepsy sometimes take,

qe nenat me epilepsi marrin ndonjehere,

we know can increase that risk of autism.

i cili e dime qe mund te rrisi rrezikun ndaj autizmit.

In addition, there can be some infectious agents

Vec kesaj, mund te kete faktore infektues

that can also cause autism.

qe mund te shkaktojne gjithashtu autizem.

And one of the things I'm going to spend

Dhe nje nga keto gjera mbi te cilen do harxhoj

a lot of time focusing on

goxha kohe duke u fokusuar

are the genes that can cause autism.

jane gjenet qe shkaktojne autizmin.

I'm focusing on this not because genes

Po fokusohem mbi kete jo sepse gjenet

are the only cause of autism,

jane shkaku i vetem i autizmit,

but it's a cause of autism

por jane nje shkak i autizmit

that we can readily define

te cilin mund ta percaktojme lehtesisht

and be able to better understand the biology

dhe te jemi te afte ta kuptojme me mire biologjine

and understand better how the brain works

dhe te kuptojme me mire si punon truri

so that we can come up with strategies

qe te mund te krijojme nje strategji

to be able to intervene.

me te cilen mund te nderhyjme.

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

Nje nga shkaqet gjenetike qe nuk kuptojme,

however, is the difference that we see

prapseprap, eshte diferenca qe shohim

in terms of males and females.

ne lidhje me meshkujt dhe femrat.

Males are affected four to one compared to females

Meshkujt jane te prekur 4 me 1 krahasuar me femrat

with autism,

me autizem,

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

dhe ne nuk arrijme te kuptojme realisht kush eshte shkaku i kesaj.

One of the ways that we can understand

Nje nga menyrat qe mund te kuptojme

that genetics is a factor

qe gjenetika eshte nje faktor

is by looking at something called

eshte duke pare tek dicka e quajtur

the concordance rate.

shkalla e perputhjes.

In other words, if one sibling has autism,

Me fjale te tjera, nese nje vella ose moter ka autizem,

what's the probability

kush eshte probabiliteti

that another sibling in that family will have autism?

qe vellai ose motra tjeter ne ate familje te kete autizem?

And we can look in particular

Dhe mund te shohim vecmas

at three types of siblings:

tre lloj lidhjesh:

identical twins,

binjake identike,

twins that actually share 100 percent

binjake qe ndajne 100%

of their genetic information

te informacionit te tyre gjenetik

and shared the same intrauterine environment,

dhe qe kane ndare te njejtin ambient brendauterin,

versus fraternal twins,

kundrejt binjakeve heterozigot,

twins that actually share 50 percent

binjake qe ndajne vetem 50%

of their genetic information,

te informacionit te tyre gjenetik,

versus regular siblings,

kundrejt vellezerve/motrave normale,

brother-sister, sister-sister,

vella-moter, moter-moter,

also sharing 50 percent of their genetic information,

qe gjithashtu ndajne 50% te informacionit te tyre gjenetik,

yet not sharing the same intrauterine environment.

nderkohe nuk kane ndare te njejtin ambient brendauterin.

And when you look at those concordance ratios,

Dhe kur sheh keto raporte konkordance,

one of the striking things that you will see

nje nga gjerat qe te bejne me shume pershtypje,

is that in identical twins,

eshte qe binjaket identike,

that concordance rate is 77 percent.

raporti i konkordances eshte 77 perqind.

Remarkably, though,

Cuditerisht,

it's not 100 percent.

nuk eshte 100 perqind.

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

Nuk eshte se genet jane pergjejgjes per te gjitha rreziqet per autizem,

but yet they account for a lot of that risk,

por jane pergjejgjes per nje pjese te mire te tyre,

because when you look at fraternal twins,

sepse kur sheh binjaket heterozigot,

that concordance rate is only 31 percent.

kane konkordance vetem prej 31 perqind.

On the other hand, there is a difference

Nga ana tjeter, ka nje diference

between those fraternal twins and the siblings,

midis binjake heterozigote dhe vellezerve/motrave normale,

suggesting that there are common exposures

qe sugjeron qe ka ekspozime te perbashketa

for those fraternal twins

per binjaket heterozigot

that may not be shared as commonly

qe nuk ndahen aq shpesh

with siblings alone.

midis vellezerve / motrave normal.

So this provides some of the data

Keshtu qe kjo na jep disa te dhena

that autism is genetic.

qe autizmi eshte gjenetik.

Well, how genetic is it?

Por, sa gjenetik eshte?

When we compare it to other conditions

Kur e krahasojme me semundje te tjera

that we're familiar with,

te cilat i njohim me teper,

things like cancer, heart disease, diabetes,

si per shembull kanceri, semundjet e zemres, diabeti,

in fact, genetics plays a much larger role in autism

ne fakt, gjenetika luan nje rol me te madh ne autizem

than it does in any of these other conditions.

sesa ne secilen prej ketyre semundjeve.

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

Por me kete, nuk na thote cfare jane gjenet.

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

Nuk na thote as nese ne nje femije,

is it one gene

eshte nje gjen

or potentially a combination of genes?

apo nje kombinim gjenesh?

And so in fact, in some individuals with autism,

Dhe ne fakt, tek disa individe me autizem,

it is genetic!

eshte gjenetike!

That is, that it is one single,

Kjo eshte, eshte nje gjen i vetem,

powerful, deterministic gene

i fuqishem dhe determinues,

that causes the autism.

qe shkakton autizmin.

However, in other individuals,

Sidoqofte, ne individe te tjere,

it's genetic, that is,

eshte gjenetike, qe do te thote,

that it's actually a combination of genes

qe eshte realisht nje kombinim gjenesh

in part with the developmental process

pjeserisht me procesin e zhvillimit

that ultimately determines that risk for autism.

qe percakton perfundimisht rrezikun e autizmit.

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

Jo domosdoshmerisht e dime per cdo person,

which of those two answers it is

cila eshte pergjigjja nga keto te dyja

until we start digging deeper.

deri ne momentin qe do fillojme te germojme me thelle.

So the question becomes,

Keshtu qe pyetja behet,

how can we start to identify

si mund te fillojme te identifikojme

what exactly those genes are.

cfare jane tamam keto gjene.

And let me pose something

Me lini te parashtroj dicka

that might not be intuitive.

qe ndoshta nuk eshte intuitive.

In certain individuals,

Ne disa individe,

they can have autism

ata mund te kene autizem

for a reason that is genetic

per nje arsye qe eshte gjenetike

but yet not because of autism running in the family.

por jo sepse autizmi rrjedh ne familje.

And the reason is because in certain individuals,

Dhe arsyeja eshte qe ne disa individe,

they can actually have genetic changes or mutations

mund te ndodhin ndryshime gjenetike ose mutacione

that are not passed down from the mother

qe nuk trashegohen nga nena

or from the father,

apo babai,

but actually start brand new in them,

por fillojne krejt te reja tek keta individe.

mutations that are present

mutacione qe jane prezente

in the egg or the sperm

tek veza ose sperma

at the time of conception

ne momentin e konceptimit

but have not been passed down

por qe nuk jane trasheguar

generation through generation within the family.

brez pas brezi brenda familjes.

And we can actually use that strategy

Faktikisht, mund te perdorim kete strategji

to now understand and to identify

per te kuptuar dhe identifikuar

those genes causing autism in those individuals.

gjenet qe shkaktojne autizmin te keta individe.

So in fact, at the Simons Foundation,

Keshtu qe ne fakt, tek Fondacioni Simons,

we took 2,600 individuals

ne perzgjodhem 2,600 individe

that had no family history of autism,

qe nuk kishin histori familjare autizmi,

and we took that child and their mother and father

dhe morem femijen se bashku me nenen dhe babain

and used them to try and understand

dhe i perdorem ne perpjekje per te kuptuar

what were those genes

cfare ishin ato gjene

causing autism in those cases?

qe shkaktonin autizem ne ato raste?

To do that, we actually had to comprehensively

Per ta bere kete, na u desh faktikisht qe ne menyre gjitheperfshirese

be able to look at all that genetic information

te ishim te afte te shihnim gjithe informacionin gjenetik

and determine what those differences were

dhe te percaktonim cilat ishin diferencat

between the mother, the father and the child.

midis nenes, babait dhe femijes.

In doing so, I apologize,

Duke bere kete, kerkoj ndjese,

I'm going to use an outdated analogy

do te perdor nje analogji te vjeteruar

of encyclopedias rather than Wikipedia,

enciklopedie te ngjashem me Wikipedia,

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

por do e bej kete ne perpjekje per te saktesuar piken

that as we did this inventory,

qe nderkohe qe beme kete inventar

we needed to be able to look at

patem nevoje te shihnim nje

massive amounts of information.

sasi shume te madhe informacioni.

Our genetic information is organized

Informacioni jone gjenetik eshte i organizuar

into a set of 46 volumes,

ne nje set prej 46 volumesh,

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

dhe kur e beme kete, duhet te ishim te afte te shpjegonim

for each of those 46 volumes,

per secilen nga keto 46 volume,

because in some cases with autism,

sepse ne disa raste me autizem,

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

ndodh qe mungon vetem nje volum.

We had to get more granular than that, though,

Megjithate na u desh te shihnim me ne imtesi,

and so we had to start opening those books,

keshtu qe filluam te hapnim librat,

and in some cases, the genetic change

dhe ne disa raste, ndryshimet gjenetike

was more subtle.

ishin me pak te dukshme.

It might have been a single paragraph that was missing,

Mund te ishte nje paragraf i vetem qe mungonte,

or yet, even more subtle than that,

ose, akoma me pak e dukshme se kjo,

a single letter,

nje germe e vetme,

one out of three billion letters

nga ato tre miljard germa

that was changed, that was altered,

qe ishte ndryshuar, transformuar,

yet had profound effects

nderkohe kishte efekte te thella

in terms of how the brain functions

ne menyren si truri funksionon

and affects behavior.

dhe ndikon sjelljen.

In doing this within these families,

Duke bere kete me ato familje

we were able to account for approximately

ishim te afte te shpjegonim rreth

25 percent of the individuals

25 perqind te individeve

and determine that there was a single

dhe te percaktonim qe ka nje faktor

powerful genetic factor

te vetem te fuqishem gjenetik

that caused autism within those families.

qe shkaktonte autizmin ne ato familje.

On the other hand, there's 75 percent

Ne anen tjeter, eshte 75 perqindshi

that we still haven't figured out.

qe nuk kemi arritur te kuptojme ende.

As we did this, though,

Megjithate, nderkohe qe benim kete,

it was really quite humbling,

ishte me te vertet perulese,

because we realized that there was not simply

sepse kuptuam qe nuk kishte thjesht

one gene for autism.

nje gjen te vetem per autizmin.

In fact, the current estimates are

Ne fakt, vleresimet e tanishme tregojne

that there are 200 to 400 different genes

qe ka 200 deri ne 400 gjene te ndryshme

that can cause autism.

qe mund te shkaktojne autizem.

And that explains, in part,

Dhe kjo shpjegon, pjeserisht,

why we see such a broad spectrum

pse shohim nje spekter kaq te gjere

in terms of its effects.

duke iu referuar efekteve.

Although there are that many genes,

Megjithese ka kaq shume gene,

there is some method to the madness.

"cmeduria ndjek nje metode".

It's not simply random

Nuk eshte thjesht e rastesishme

200, 400 different genes,

200, 400 gene te ndryshem,

but in fact they fit together.

ne fakt ata perputhen se bashku.

They fit together in a pathway.

Perputhen ne rrugen qe ndjekin.

They fit together in a network

Perputhen ne nje rrjet

that's starting to make sense now

qe fillon te bej kuptim tani

in terms of how the brain functions.

ne menyren se si truri funksionon.

We're starting to have a bottom-up approach

Po fillojme te kemi nje qasje nga poshte-lart

where we're identifying those genes,

ku po identifikojme keto gjene,

those proteins, those molecules,

proteina, molekula,

understanding how they interact together

po kuptojme se si bashkepunojne

to make that neuron work,

qe ta bejne ate neuron te punoje,

understanding how those neurons interact together

po kuptojme se si keto neurone bashkeveprojne

to make circuits work,

qe te bejne qarqet te punojne,

and understand how those circuits work

dhe te kuptojme se si keto qarqe punojne

to now control behavior,

per te kontrolluar sjelljen,

and understand that both in individuals with autism

dhe te kuptojme kete si tek individet me autizem

as well as individuals who have normal cognition.

po ashtu edhe tek ata me kognicion normal.

But early diagnosis is a key for us.

Por celesi per ne eshte diagnoza e hershme.

Being able to make that diagnosis

Te jesh ne gjendje te diagnostikosh

of someone who's susceptible

dike qe eshte i prekshem

at a time in a window

ne nje hapsire kohore

where we have the ability to transform,

ku kemi aftesine per te trasformuar,

to be able to impact

aftesine per te ndikuar

that growing, developing brain is critical.

tek truri qe eshte duke u rritur e zhvilluar, kjo eshte kritike.

And so folks like Ami Klin have developed methods

Dhe keshtu njerez si Ami Klin kane zhvilluar metoda

to be able to take infants, small babies,

per te qene te afte te marim foshje, femije te vegjel,

and be able to use biomarkers,

dhe te mundim te perdorim shenuesit biologjike,

in this case eye contact and eye tracking,

ne kete rast jane kontakti me sy dhe ndjekja me sy,

to identify an infant at risk.

per te identifikuar nje foshnje ne rrezik.

This particular infant, you can see,

Kjo foshnje ne vecanti, sic mund ta shihni,

making very good eye contact with this woman

po mban kontakt shume te mire me sy me kete grua

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

nderkohe qe ajo kendon: Itsy, Bitsy Spider",

in fact is not going to develop autism.

ne fakt nuk do te zhvilloje autizem.

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

Ky femije e dime qe do jete i sigurt.

On the other hand, this other baby

Nga ana tjeter, ky femija tjeter

is going to go on to develop autism.

do te zhvilloje autizem.

In this particular child, you can see,

Tek ky femije ne vecanti, mund te shihni

qe nuk ka kontakt te mire me sy.

it's not making good eye contact.

Instead of the eyes focusing in

Ne vend qe syte te fokusohen

and having that social connection,

dhe te krijojne mardhenien sociale,

duke pare tek goja, duke pare tek hunda

looking at the mouth, looking at the nose,

looking off in another direction,

duke drejtuar syte ne drejtim tjeter,

but not again socially connecting,

por perseri pa krijuar mardhenie sociale,

dhe po te jemi ne gjendje ta bejme kete ne nje shkalle te gjere,

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

te kontrollojme foshnjet, te kontrollojme femijet per autizem,

screen infants, screen children for autism,

nepermjet dickaje shume te qendrueshme, shume te besueshme,

through something very robust, very reliable,

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

do te jete shume ndihmuese per ne

able to intervene at an early stage

ne lidhje me nderhyrjen ne nje stad te hershem

when we can have the greatest impact.

ku mund te kemi dhe ndikimin me te madh.

How are we going to intervene?

Si do te nderhyjme?

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

Me shume mundesi do te jete nje kombinim faktoresh.

Pjeserisht, ne disa individe,

In part, in some individuals,

ne do perpiqemi te perdorim medikamente.

we're going to try and use medications.

And so in fact, identifying the genes for autism

Dhe keshtu ne fakt, identifikimi i geneve per autizem

is important for us

eshte e rendesishme per ne

to identify drug targets,

per te identifikuar objektivat e medikamenteve,

to identify things that we might be able to impact

per te identifikuar gjera te cilat mund te jemi ne gjendje te ndikojme

and can be certain that that's really

dhe te jemi te sigurt qe kjo eshte

what we need to do in autism.

realisht cfare duhet te bejme ne autizem.

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

Por kjo nuk do te jete pergjigjja e vetme.

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

Pertej vetem medikamenteve, do te perdorim strategji edukimi.

Individuals with autism,

Individet me autizem,

some of them are wired a little bit differently.

disa prej tyre jane te ndertuar pak ndryshe.

They learn in a different way.

Ata mesojne ne nje menyre ndryshe.

They absorb their surroundings in a different way,

Ata i perthithin ato cfare i rrethon ne nje menyre tjeter,

and we need to be able to educate them

dhe ne duhet te jemi ne gjendje ti edukojme ata

in a way that serves them best.

ne nje menyre qe u sherben me mire.

Beyond that, there are a lot of individuals

Pertej kesaj, ka shume individe

in this room who have great ideas

ne kete dhome qe kane ide shume te mira

in terms of new technologies we can use,

ne lidhje me teknologjite e re qe mund te perdorim,

everything from devices we can use to train the brain

gjithcka nga paisjet qe mund te perdorim per te trajnuar trurin

to be able to make it more efficient

per ta bere ate me efektiv

dhe per te kompesuar per zona ne te cilat

and to compensate for areas in which

it has a little bit of trouble,

has disa veshtiresi,

to even things like Google Glass.

per te shkuar deri tek gjerat si Google Glass.

You could imagine, for instance, Gabriel,

Mund ta imagjinonosh per shembull, Gabriel,

with his social awkwardness,

me ngathtesine e tij sociale,

mund te veshi Google Glass

might be able to wear Google Glass

with an earpiece in his ear,

me nje kufje ne vesh,

and have a coach be able to help him,

dhe te kete nje trajner qe mund ta ndihmoje,

be able to help think about conversations,

ta ndihmoje te mendoje rreth bisedave,

conversation-starters,

nxitjes se bisedave,

being able to even perhaps one day

te jete i afte ndoshta nje dite

per te ftuar nje vajze qe te dale me te.

invite a girl out on a date.

Gjithe keto teknologji te reja

All of these new technologies

just offer tremendous opportunities

na ofrojne mundesi te pafundme

for us to be able to impact

per te ndikuar

the individuals with autism,

tek individed me autizem,

por kemi ende nje rruge te gjate para.

but yet we have a long way to go.

As much as we know,

Per aq sa dime ne,

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

ka kaq shume qe ne nuk dime akoma,

and so I invite all of you

keshtu qe ju ftoj te gjithe ju

to be able to help us think about

te na ndihmoni te mendojme

how to do this better,

se si mund ta bejme kete me mire,

to use as a community our collective wisdom

ta perdorim si nje komunitet diturine tone kolektive

to be able to make a difference,

per te bere nje diference,

and in particular,

dhe ne vecanti,

for the individuals in families with autism,

per individet ne familje me autizem,

I invite you to join the interactive autism network,

ju ftoj ti bashkoheni rrjetit nderveprues te autizmit,

to be part of the solution to this,

te jeni pjese e zgjidhjes se kesaj,

sepse do duhen shume prej nesh

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

to think about what's important,

per te menduar cfare eshte e rendesishme,

cfare do te ishte nje diference kuptimplote.

what's going to be a meaningful difference.

As we think about something

Nderkohe qe mendojme rreth dickaje

that's potentially a solution,

qe eshte zgjidhje potencialisht,

how well does it work?

sa mire funksionon?

A eshte dicka qe do te beje nje diference reale

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

in your lives, as an individual,

ne jetet tona, si individe,

as a family with autism?

si nje familje me autizem?

We're going to need individuals of all ages,

Do te na duhen individe nga te gjitha moshat,

from the young to the old,

nga te rinjte deri tek te moshuarit,

and with all different shapes and sizes

dhe nga te gjitha format dhe permasat

of the autism spectrum disorder

te spektrit te crregullimit te autizmit

to make sure that we can have an impact.

qe te jemi te sigurt qe do te kemi efekt.

So I invite all of you to join the mission

Keshtu qe ju ftoj te gjithe juve ti bashkoheni ketij misioni

and to help to be able to make the lives

dhe te na ndihmoni te bejme jetet

of individuals with autism

e individeve me autizem

shume me te mira dhe te pasura.

so much better and so much richer.

Thank you.

Ju falemnderit!

(Duartrokitje)

(Applause)