Ami Klin: A new way to diagnose autism

Translator: Joseph Geni Reviewer: Morton Bast

Prevodilac: Filip Miletić Lektor: Milica A.

I always wanted to become a walking laboratory of social engagement:

Oduvek sam hteo da postanem

laboratorija društvene interakcije na dve noge,

to resonate other people's feelings, thoughts, intentions, motivations,

da rezoniram osećanja, misli, namere,

motivaciju drugih ljudi boraveći s njima.

in the act of being with them.

As a scientist, I always wanted to measure that resonance,

Kao naučnik sam oduvek hteo da izmerim tu rezonancu,

that sense of the other that happens so quickly,

osećaj drugog koji nastaje brzo,

in the blink of an eye.

u tren oka.

We intuit other people's feelings;

Predviđamo osećanja drugih.

we know the meaning of their actions even before they happen.

Svesni smo značenja njihovih dela i pre nego što se dogode.

We're always in this stance

Uvek smo u položaju

of being the object of somebody else's subjectivity.

objekta tuđe subjektivnosti.

We do that all the time. We just can't shake it off.

Neprestano je tako. Ne možemo toga da se otresemo.

To je toliko važno da čak i na sredstva koja koristimo da bismo razumeli sebe

It's so important that the very tools we use to understand ourselves,

to understand the world around us,

da bismo razumeli svet oko njih, utiče taj položaj.

are shaped by that stance.

We are social to the core.

U potpunosti smo društveni.

So my journey in autism really started

Moj put kroz autizam započeo je kad sam boravio

when I lived in a residential unit for adults with autism.

na bolničkom odeljenju za odrasle osobe sa autizmom.

Most of those individuals had spent most of their lives

Većina njih je dobar deo svog života provela

in long-stay hospitals.

u bolnicama za dug boravak.

This is a long time ago.

Bilo je to davno.

And for them, autism was devastating.

Za njih je autizam bio razoran.

They had profound intellectual disabilities.

Imali su teška intelektualna oštećenja.

They didn't talk.

Nisu govorili.

But most of all,

Još je značajnije da su bili izuzetno izolovani

they were extraordinarily isolated from the world around them,

od okolnog sveta, od svog okruženja

from their environment

and from the people.

i od ljudi.

In fact, at the time, if you walked into a school

Ako biste tada ušli u školu za osobe sa autizmom,

for individuals with autism,

you'd hear a lot of noise,

čuli biste mnogo buke,

plenty of commotion, actions, people doing things.

meteža, pokreta, ljudi koji svašta rade.

But they're always doing things by themselves.

Ali su to uvek radili sami.

So they may be looking at a light in the ceiling,

Možda bi gledali svetlo na plafonu

or they may be isolated in the corner,

ili bi se osamili u ćošku

or they might be engaged in these repetitive movements,

ili bi samo ponavljali pokrete,

in self-stimulatory movements that led them nowhere.

auto-stimulatorne pokrete koji ničemu ne vode.

Extremely, extremely isolated.

Izuzetno, izuzetno izolovani.

Well, now we know that autism is this disruption,

Danas znamo da je autizam

izvestan poremećaj i to poremećaj one rezonance

the disruption of this resonance that I am telling you about.

koju sam pomenuo.

These are survival skills.

To su veštine preživljavanja.

These are survival skills that we inherited

To su veštine preživljavanja koje smo nasledili

over many, many hundreds of thousands of years of evolution.

kroz mnogo stotina hiljada godina evolucije.

You see, babies are born in a state of utter fragility.

Vidite, bebe se rađaju potpuno krhke.

Without the caregiver, they wouldn't survive,

Bez negovatelja ne bi preživele,

pa je logično što ih je priroda obdarila

so it stands to reason that nature would endow them

with these mechanisms of survival.

mehanizmima preživljavanja.

They orient to the caregiver.

Okreću se negovatelju.

From the first days and weeks of life,

Počev od prvih dana i nedelja života,

babies prefer to hear human sounds,

bebe radije slušaju ljudske zvuke nego prosto zvuke okruženja.

rather than just sounds in the environment.

They prefer to look at people rather than at things,

Radije posmatraju ljude nego predmete,

and even as they're looking at people, they look at people's eyes,

a i kad posmatraju ljude, posmatraju oči.

because the eye is the window to the other person's experiences,

Zato što je oko prozor u iskustva druge osobe,

so much so that they even prefer to look at people

do te mere da radije posmatraju ljude

who are looking at them rather than people who are looking away.

koji njih posmatraju, nego ljude koji gledaju nešto drugo.

Well, they orient to the caregiver.

Dakle, usmerene su prema negovatelju.

The caregiver seeks the baby.

Negovatelj traži bebu.

And it's out of this mutually reinforcing choreography

Od te uzajamno osnažujuće koreografije

that a lot that is of importance to the emergence of mind --

zavisi mnogo toga značajnog za pojavljivanje uma,

the social mind, the social brain -- depends on.

društvenog uma, društvenog mozga.

We always think about autism

Uvek razmišljamo o autizmu

as something that happens later on in life.

kao nečemu što se događa u kasnijim godinama.

It doesn't; it begins with the beginning of life.

Nije tako. Počinje na početku života.

As babies engage with caregivers, they soon realize that, well,

Kad bebe komuniciraju sa negovateljem, ubrzo shvate

da postoji nešto između ušiju

there is something between the ears that is very important --

što je veoma važno -

it's invisible, you can't see it, but it's really critical.

nevidljivo je, ali je jako bitno

And that thing is called attention.

i zove se pažnja.

And they learn soon enough,

Nauče vrlo brzo, i pre nego što nauče

even before they can utter one word,

da probrbljaju ijednu reč, da tu pažnju mogu da uzmu

that they can take that attention and move somewhere

i premeste je negde da bi uredile stvari kako žele.

in order to get things they want.

They also learn to follow other people's gazes,

Takođe nauče da prate pogled drugih ljudi,

because whatever people are looking at is what they are thinking about.

jer o onome što posmatraju

ljudi i razmišljaju.

And soon enough, they start to learn about the meaning of things,

Vrlo brzo počinju da shvataju značenje stvari,

because when somebody is looking at something

budući da, kad neko nešto posmatra

or somebody is pointing at something,

ili neko nešto pokazuje,

ne dobijaju samo prostorno uputstvo,

they're not just getting a directional cue.

They are getting the other person's meaning of that thing,

već i značenje koje ta osoba pripisuje toj stvari, stav,

the attitude.

And soon enough, they start building this body of meanings,

a ubrzo počinju da formiraju skup značenja

but meanings that were acquired within the realm of social interaction.

i to značenja usvojenih u okviru

društvene interakcije.

Those are meanings that are acquired

Ta značenja se usvajaju kao deo

iskustava podeljenih sa drugima.

as part of their shared experiences with others.

Well, this is a 15-month-old little girl,

Pa, ova devojčica stara 15 meseci

ima autizam.

and she has autism.

And I am coming so close to her that I am maybe two inches from her face,

Toliko sam joj se približio da sam na možda

pet centimetara od njenog lica, a ona me uopšte ne primećuje.

and she's quite oblivious to me.

Imagine if I did that to you, came two inches from your face.

Zamislite da to vama uradim,

da vam se približim na pet centimetara od lica.

You'd do probably two things, wouldn't you?

Verovatno biste uradili dve stvari.

You would recoil. You would call the police.

Odskočili biste. Pozvali biste policiju.

(Laughter)

(Smeh)

You would do something,

Nešto biste uradili, jer je doslovno nemoguće

because it's literally impossible to penetrate somebody's physical space

ući u nečiji fizički prostor,

and not get that reaction.

a da ta osoba ne odreaguje.

We do so, remember, intuitively, effortlessly.

Prisetite se, to činimo intuitivno, bez napora.

This is our body wisdom;

To je naša telsna mudrost.

it's not something mediated by our language.

Ona se ne prenosi jezikom.

Our body just knows that.

Naše telo je toga svesno, a i mi smo toga već dugo svesni.

And we've known that for a long time.

And this is not something that happens to humans only.

A ne dešava se ovo samo ljudima.

It happens to some of our phyletic cousins,

Dešava se i nekim čovekovim rođacima,

because if you're a monkey, and you look at another monkey,

budući da, ako ste majmun

i gledate drugog majmuna,

and that monkey has a higher hierarchy position than you,

a taj majmun je na višoj hijerarhijskoj poziciji od vas,

and that is considered to be a signal or threat,

što se smatra za signal ili pretnju,

well, you are not going to be alive for long.

pa, nećete dugo poživeti.

So something that in other species are survival mechanisms,

Ono što su kod drugih vrsta mehanizmi preživljavanja,

without which they wouldn't basically live,

bez čega ne bi opstale,

we bring into the context of human beings,

unosimo u kontekst ljudskih bića

and this is what we need to simply act, socially.

i na osnovu toga moramo da društveno delujemo.

Now, she is oblivious to me and I'm so close to her,

Dakle, ona mene ne primećuje, a toliko sam joj blizu,

and you think, maybe she can see you,

pomislićete, možda vas vidi,

maybe she can hear you.

možda vas čuje.

Well, a few minutes later,

Nakon nekoliko minuta, otišla je do ugla sobe

she goes to the corner of the room,

and she finds a tiny little piece of candy, an M&M.

i pronašla mali slatkiš, bombonicu.

So I could not attract her attention,

Ja nisam uspeo da joj privučem pažnju,

but something -- a thing -- did.

ali nešto, predmet, jeste.

Now, most of us make a big dichotomy

Većina nas vrlo jasno razlikuje

between the world of things and the world of people.

svet predmeta i svet ljudi.

Now, for this girl, that division line is not so clear,

Linija koja ih razdvaja kod ove devojčice nije potpuno jasna

and the world of people is not attracting her

i svet ljudi je ne privlači

as much as we would like.

koliko bismo želeli.

Now, remember that we learn a great deal by sharing experiences.

Prisetite se da mnogo saznajemo

deleći svoja iskustva.

What she is doing right now is that her path of learning is diverging,

Upravo se sada

njena putanja saznanja svakog trenutka sve više razilazi,

moment by moment,

as she is isolating herself further and further.

a ona se sve više izoluje.

So we feel sometimes that the brain is deterministic,

Ponekad bismo rekli da nas mozak određuje,

the brain determines who we're going to be.

da on određuje ko ćemo postati.

But, in fact, the brain also becomes who we are,

U stvari i mozak postaje ono što smo mi

and at the same time that her behaviors are taking away

i u trenutku kad je njeno ponašanje udaljava

from the realm of social interaction,

od okrilja društvene interakcije,

this is what's happening with her mind,

to se događa i njenom umu, odnosno njenom mozgu.

and this is what's happening with her brain.

Well, autism is the most strongly genetic condition

Autizam je genetski uslovljen više

of all developmental disorders.

od bilo kog drugog razvojnog poremećaja.

And it's a brain disorder.

A reč je o moždanom poremećaju.

It's a disorder that begins much prior to the time

To je poremećaj koji počinje mnogo pre rođenja deteta.

that the child is born.

We now know that there is a very broad spectrum of autism.

Danas znamo da je autistični spektar veoma širok.

There are those individuals who are profoundly intellectually disabled

Neke osobe su teško intelektualno zaostale,

but there are those that are gifted.

ali su neke i nadarene.

There are those individuals who don't talk at all;

Neke osobe uopšte ne govore.

Neke osobe govore previše.

there are those individuals who talk too much.

There are those individuals that if you observe them in their school,

Ako biste neke od tih osoba posmatrali u školi,

trčali bi uz ogradu

you see them running the periphery fence all the school day if you let them,

školskog dvorišta ceo dan ako biste im dozvolili,

to those individuals who cannot stop coming to you

a neke pak ne možete sprečiti da vam prilaze

i iznova pokušavaju da komuniciraju s vama, neumorno,

and trying to engage you repeatedly, relentlessly,

but often in an awkward fashion,

ali često na čudan način,

bez one neposredne rezonance.

without that immediate resonance.

Well, this is much more prevalent than we thought at the time.

Autizam je mnogo češći nego što smo ranije mislili.

When I started in this field,

Kada sam počeo ovim da se bavim,

we thought there were four individuals with autism per 10,000 --

smatralo se da od 10.000 osoba 4 imaju autizam,

veoma retku bolest.

a very rare condition.

Well, now we know it's more like one in 100.

Danas smo bliži zaključku da oboli 1 od 100 osoba.

There are millions of individuals with autism all around us.

Milioni osoba sa autizmom žive u našem okruženju.

The societal cost of this condition is huge,

Cena koju plaća društvo je ogromna.

in the US alone, maybe 35 to 80 billion dollars.

Samo u SAD, oko 35 do 80 milijardi dolara.

And you know what?

Pri tome je većina sredstava povezana

Most of those funds are associated with adolescents and particularly adults

sa adolescentima i naročito odraslima

who are severely disabled,

koji su teško ometeni,

individuals who need wraparound services --

kojima je potrebna sveobuhvatna nega

services that are very, very intensive.

koja je veoma intenzivna

And those services can cost in excess of 60,000 to 80,000 dollars a year.

i košta više od 60 do 80.000 dolara godišnje.

Those are individuals who did not benefit from early treatment,

To su osobe koje nisu prošle kroz rano lečenje.

because now we know that autism creates itself

Naime, sada znamo da autizam sam sebe stvara

as individuals diverge in that pathway of learning that I mentioned to you.

dok nastaje jaz u putanji saznanja,

koji sam već pomenuo.

Were we to be able to identify this condition

Ako bismo ovu bolest mogli da dijagnostikujemo

at an earlier point, and intervene and treat --

u ranijem stadijumu, da intervenišemo i lečimo je,

I can tell you, this has been probably something that has changed my life

siguran sam, a verovatno mi je upravo to promenilo život u poslednjih 10 godina,

in the past 10 years,

this notion that we can absolutely attenuate this condition.

da bismo značajno umanjili

posledice ove bolesti.

Also, we have a window of opportunity,

To je moguće u ograničenom vremenskom periodu,

because the brain is malleable for just so long,

pošto se na mozak može delovati samo izvesno vreme,

and that window of opportunity happens in the first three years of life.

a taj period se javlja

u toku prve tri godine života.

It's not that that window closes; it doesn't.

Neće ta mogućnost promene mozga nestati.

But it diminishes considerably.

Ali će se znatno smanjiti.

And yet, the median age of diagnosis in this country

Uprkos tome, srednja starost postavljanja dijagnoze u ovoj zemlji je

is still about five years,

i dalje oko pet godina,

and in disadvantaged populations,

a u siromašnim zajednicama,

the populations that don't have access to clinical services,

zajednicama koje nemaju pristup zdravstvenoj zaštiti,

rural populations, minorities,

ruralnim zajednicama, manjinama,

the age of diagnosis is later still,

bolest se otkrije još kasnije

which is almost as if I were to tell you

i bilo bi skoro isto da vam kažem

that we are condemning those communities to have individuals with autism

da primoravamo te zajednice da imaju osobe

sa autizmom u mnogo gorem stadijumu.

whose condition is going to be more severe.

So I feel that we have a bioethical imperative.

Mislim da prema njima imamo bio-etičku obavezu.

The science is there.

Naučna saznanja postoje,

ali od njih nema koristi ako ne utiču na zajednice,

But no science is of relevance

if it doesn't have an impact on the community.

And we just can't afford that missed opportunity,

a prosto ne možemo priuštiti da propustimo tu priliku

because children with autism become adults with autism.

jer deca sa autizmom postaju odrasle osobe sa autizmom.

And we feel that those things we can do

I smatramo da će ono što možemo da učinimo

for these children, for those families, early on,

za tu decu i porodice u ranom stadijumu

will have lifetime consequences --

imati uticaj na ceo život,

za dete, za porodicu i za zajednicu u celini.

for the child, for the family, and for the community at large.

So this is our view of autism.

Ovo je naše viđenje autizma.

There are over a hundred genes that are associated with autism.

Više od stotinu gena je povezano sa autizmom.

In fact, we believe there are going to be

U stvari, smatramo da će se utvrditi

something between 300 and 600 genes associated with autism,

da je oko 300 do 600 gena povezano sa autizmom,

and genetic anomalies, much more than just genes.

a mnogo je i genetskih anomalija, čak i više nego gena.

And we actually have a bit of a question here,

Postavlja se jedno pitanje.

because if there are so many different causes of autism,

Naime, ako postoji toliko uzročnika autizma,

how do you go from those liabilities to the actual syndrome?

kako da sa podložnosti bolesti pređemo

na konkretni sindrom?

Because people like myself,

Kada ljudi poput mene uđu u igraonicu,

when we walk into a playroom,

we recognize a child as having autism.

uoče dete koje ima autizam.

So how do you go from multiple causes

Kako onda da pređemo sa mnogobrojnih uzroka

na relativno homogen sindrom?

to a syndrome that has some homogeneity?

And the answer is what lies in between,

Odgovor je: pomoću onoga što se nalazi između tih pojmova,

which is development.

a to je razvoj.

And in fact, we are very interested in those first two years of life,

I zaista nas veoma zanimaju prve dve godine života,

because those liabilities don't necessarily convert into autism.

jer se podložnost bolesti ne pretvori nužno u autizam.

Autism creates itself.

Autizam sam sebe stvara.

Were we to be able to intervene during those years of life,

Ako bismo mogli da intervenišemo tokom tih godina života,

we might attenuate for some, and God knows, maybe even prevent for others.

usporili bismo razvoj nekih slučajeva,

a neke druge možda i sprečili.

So how do we do that?

Kako da to učinimo?

How do we enter that feeling of resonance,

Kako da prodremo u to osećanje rezonantnosti,

how do we enter another person's being?

kako da prodremo u biće druge osobe?

I remember when I interacted with that 15-month-old,

Kad sam pokušao da komuniciram sa onom 15-mesečnom devojčicom,

the thing that came to my mind was,

palo mi je na pamet pitanje:

"How do you come into her world?

"Kako da uđemo u njen svet?

Is she thinking about me? Is she thinking about others?"

Da li razmišlja o meni? Da li razmišlja o drugima?"

Well, it's hard to do that,

To je teško uraditi, pa smo morali da osmislimo tehnologiju.

so we had to create the technologies.

We had to basically step inside a body.

Praktično je trebalo da uđemo u telo.

We had to see the world through her eyes.

Trebalo je da svet vidimo njenim očima.

And so in the past many years,

Mnogo godina smo razvijali

we've been building these new technologies

novu tehnologiju zasnovanu na praćenju oka.

that are based on eye tracking.

We can see, moment by moment, what children are engaging with.

U svakom trenutku možemo da vidimo

sa čime deca interaguju.

Ovo je moj kolega Voren Džouns,

This is my colleague, Warren Jones,

with whom we've been building these methods, these studies,

sa kojim razvijam ove metode i studije

for the past 12 years.

poslednjih 12 godina,

And you see there a happy five-month-old,

a tu vidite srećno dete staro 5 meseci,

a five-month little boy who is going to watch things

dečaka starog 5 meseci koji će posmatrati stvari

that are brought from his world:

uzete iz njegovog sveta,

his mom, the caregiver,

svoju mamu, koja ga neguje, ali će videti i iskustva

but also experiences that he would have were he to be in his daycare.

koja bi doživeo da je u vrtiću.

What we want is to embrace that world and bring it into our laboratory,

Želimo da obuhvatimo taj svet

i prenesemo ga u laboratoriju,

but in order for us to do that,

ali da bismo to učinili, morali smo da osmislimo

we had to create these very sophisticated measures,

vrlo komplikovane postupke

measures of how people, how little babies,

u vezi s tim kako ljudi, a kako male bebe,

how newborns, engage with the world, moment by moment.

novorođenčad, interaguju sa svetom

u bilo kom trenutku,

What is important and what is not.

šta je bitno, a šta nije.

Well, we created those measures,

Osmislili smo te postupke i ovde

and here, what you see is what we call a funnel of attention.

vidite ono što nazivamo levak pažnje.

You're watching a video --

Gledate video snimak,

those frames are separated by about a second --

u kome se sličice smenjuju otprilike svake sekunde,

through the eyes of 35 typically developing two-year-olds.

očima 35 dvogodišnjaka

normalnog razvoja,

And we freeze one frame,

i ako zamrznemo jednu sličicu,

and this is what the typical children are doing.

ovo će većina dece uraditi.

A ovde su zelenom bojom prikazani dvogodišnjaci sa autizmom.

In this scan pass, in green here, are two-year-olds with autism.

So on that frame, the children who are typical are watching this,

Na toj sličici deca normalnog razvoja

posmatraju ovo,

the emotion of expression of that little boy

emotivni izraz tog dečaka

as he's fighting a little bit with the little girl.

dok se malo svađa sa ovom devojčicom.

What are the children with autism doing?

Šta rade deca sa autizmom?

They are focusing on the revolving door,

Ona pažnju usmeravaju na vrata

opening and shutting.

koja se otvaraju i zatvaraju.

Well, I can tell you that this divergence that you're seeing here

Mogu da vam kažem da se razlika koju ovde vidite

doesn't happen only in our five-minute experiment.

ne događa jedino u našem petominutnom eksperimentu.

It happens moment by moment in their real lives,

Događa se neprekidno u njihovim stvarnim životima,

and their minds are being formed and their brains are being specialized

pri čemu se obrazuje njihov um

i mozak im se usmerava ka nečem drugom

in something other than what is happening with their typical peers.

od onoga što se dešava sa njihovim zdravim vršnjacima.

Well, we took a construct from our pediatrician friends,

Osnovu smo uzeli

od naših kolega pedijatara

the concept of growth charts --

u vidu grafikona rasta.

you know, when you take a child to the pediatrician,

Znate, kada odvedete dete kod pedijatra

and you have physical height and weight.

i izmere mu visinu i težinu.

Well, we decided we were going to create growth charts

Mi smo rešili da napravimo grafikone rasta

socijalne interakcije.

of social engagement.

We sought children from the time they're born.

I ispitivali smo decu od vremena kada su rođena,

What you see here on the x-axis

a na X-osi vidite dva, tri, četiri,

is two, three, four, five, six months and nine,

pet, šest, devet meseci, sve do starosti od 24 meseca,

until about the age of 24 months.

This is the percent of their viewing time

a ovo je procenat vremena koje provedu gledajući,

that they're focusing on people's eyes,

i to gledajući oči ljudi,

and this is their growth chart.

a ovo je grafikon rasta.

They start over here -- they love people's eyes --

Ovde počinje, obožavaju oči drugih ljudi

and it remains quite stable.

i situacija je prilično stabilna.

It sort of goes up a little bit in those initial months.

Možda se malo poveća u prvim mesecima.

Now, let's see what's happening with babies who became autistic.

Da vidimo sad šta se dešava sa decom

koja dobiju autizam.

It's something very different.

Potpuno drugačija situacija.

Počinje ovako visoko, ali onda samo opada.

It starts way up here, but then it's a free fall.

It's very much like they brought into this world the reflex

Kao da su na svet došli s refleksom

that orients them to people, but it has no traction.

koji ih orijentiše prema ljudima, ali nema trenja.

It's almost as if that stimulus -- you --

Kao da stimulus, vi,

you're not exerting influence on what happens

nema nikakvog dejstva na to što se događa

as they navigate their daily lives.

dok se oni kreću kroz svakodnevni život.

Now, we thought those data were so powerful, in a way,

Zaključili smo da su ovi podaci veoma značajni,

that we wanted to see what happened in the first six months of life,

pa smo hteli da vidimo šta će se desiti

u prvih šest meseci života, pošto, ako biste pokušali da uspostavite kontakt

because if you interact with a two- and a three-month-old,

sa bebom starom dva ili tri meseca,

you'd be surprised by how social those babies are.

iznenadili biste se koliko su bebe društvene.

And what we see in the first six months of life

Uočili smo da se u prvih šest meseci

is that those two groups can be segregated very easily.

te dve grupe mogu vrlo jednostavno razgraničiti.

And using these kinds of measures and many others,

Korišćenjem ovakvih i mnogih drugih postupaka

what we found out is that our science could, in fact,

otkrili smo da bi se pomoću naših naučnih saznanja

identify this condition early on.

ovo oboljenje moglo primetiti u ranom stadijumu.

We didn't have to wait for the behaviors of autism

Nije bilo potrebe da čekamo da se autističko ponašanje

to emerge in the second year of life.

pojavi u drugoj godini života.

If we measured things that are, evolutionarily, highly conserved,

Ako bismo merili stvari koje su, evolucionarno,

teško dostupne, a u razvoju se pojavljuju vrlo rano,

and developmentally very early-emerging --

stvari koje se javljaju u prvim nedeljama života,

things that are online from the first weeks of life --

we could push the detection of autism

pomerili bismo otkrivanje autizma

all the way to those first months,

na prve mesece

and that's what we are doing now.

i upravo to sada radimo.

Now, we can create the very best technologies

Čak i da stvorimo najbolju tehnologiju

and the very best methods to identify the children,

i najbolje metode za prepoznavanje obolele dece,

but this would be for naught if we didn't have an impact

ne bismo dobili rezultate ako ne bi bilo uticaja

on what happens in their reality in the community.

na ono što se zaista događa u zajednici.

Now we want those devices, of course,

Želimo da te uređaje

to be deployed by those who are in the trenches --

razdelimo pravim borcima,

our colleagues, the primary care physicians, who see every child --

našim kolegama, lekarima primarne zdravstvene zaštite,

koji pregledaju svako dete,

and we need to transform those technologies

a tu tehnologiju moramo preobraziti

into something that is going to add value to their practice,

u nešto što povećava vrednost njihove prakse,

because they have to see so many children.

jer moraju da pregledaju toliko dece.

And we want to do that universally so that we don't miss any child.

Želimo da ti pregledi budu univerzalni

da ne bismo propustili nijedno dete,

But this would be immoral

ali bi to bilo amoralno

if we also did not have an infrastructure for intervention, for treatment.

ako ne bismo imali infrastrukturu za intervenciju,

za lečenje.

We need to be able to work with the families, support the families,

Moramo biti u mogućnosti da sarađujemo sa porodicama,

da podržavamo porodice, upravljamo prvim godinama života zajedno s njima.

to manage those first years with them.

We need to be able to really go

Moramo biti u mogućnosti

da sa univerzalnih pregleda pređemo na univerzalan pristup lečenju,

from universal screening to universal access to treatment,

because those treatments are going to change

jer će to lečenje promeniti

these children's and those families' lives.

živote te dece i njihovih porodica.

Now, when we think about what we [can] do in those first years,

Kad razmišljamo o tome šta možemo učiniti

u prvim godinama,

I can tell you, having been in this field for so long,

znate šta,

posle ovoliko vremena u ovoj oblasti,

one feels really rejuvenated.

osećam se podmlađeno.

There is a sense that the science that one worked on

Imam utisak da nauka na kojoj smo radili

can actually have an impact on realities,

može zaista da utiče na stvarnost,

preventing, in fact, those experiences

odnosno da spreči iskustva

that I really started in my journey in this field.

kojim je započeo moj put kroz ovu oblast.

I thought at the time that this was an intractable condition.

Tada sam mislio da je ovo neizlečiva bolest.

No longer. We can do a great deal of things.

Više nije tako. Možemo mnogo da promenimo.

And the idea is not to cure autism.

Ne nameravamo da izlečimo autizam.

That's not the idea.

Nije nam to cilj.

What we want is to make sure

Želimo da se postaramo

that those individuals with autism can be free

da osobe sa autizmom mogu da budu oslobođene

from the devastating consequences that come with it at times,

razarajućih posledica koje ta bolest ponekad donosi,

the profound intellectual disabilities, the lack of language,

teškog intelektualnog zaostatka, nemogućnosti govora,

the profound, profound isolation.

veoma duboke izolovanosti.

We feel that individuals with autism, in fact,

Zapravo mislimo da osobe sa autizmom

have a very special perspective on the world,

imaju poseban pogled na svet,

and we need diversity.

pri tom nam je raznovrsnost potrebna, a oni odlično funkcionišu

And they can work extremely well in some areas of strength:

u pojedinim oblastima:

predictable situations, situations that can be defined.

u predvidivim situacijama, situacijama koje se mogu definisati.

Because after all, they learn about the world

Oni o svetu i uče skoro kao da se radi o nečem

almost, like, about it,

odvojenom, umesto da uče kako da funkcionišu unutar njega.

rather than learning how to function in it.

But this is a strength if you're working, for example, in technology.

Međutim, to je pozitivno ako se, recimo, bavite tehnologijom.

And there are those individuals who have incredible artistic abilities.

Postoje i osobe sa izvanrednim umetničkim darom.

We want them to be free to do that.

Želimo da ih oslobodimo.

We want that the next generations of individuals with autism

Želimo da naredne generacije osoba sa autizmom

will be able not only to express their strengths,

budu u stanju da iskažu svoje veštine,

but to fulfill their promise.

ali i da ispune obećanja.

Well, thank you for listening to me.

Hvala vam što ste me saslušali.

(Applause)

(Aplauz)