0:00:00.882,0:00:03.482
Just after Christmas last year,

0:00:03.482,0:00:07.320
132 kids in California got the measles

0:00:07.320,0:00:09.333
by either visiting Disneyland

0:00:09.333,0:00:12.282
or being exposed to someone[br]who'd been there.

0:00:12.282,0:00:15.486
The virus then hopped the Canadian border,

0:00:15.486,0:00:18.922
infecting more than[br]100 children in Quebec.

0:00:18.922,0:00:21.871
One of the tragic things[br]about this outbreak

0:00:21.871,0:00:27.490
is that measles, which can be fatal[br]to a child with a weakened immune system,

0:00:27.490,0:00:31.275
is one of the most easily[br]preventable diseases in the world.

0:00:31.275,0:00:33.272
An effective vaccine against it

0:00:33.272,0:00:36.638
has been available for more[br]than half a century,

0:00:36.638,0:00:39.912
but many of the kids involved[br]in the Disneyland outbreak

0:00:39.912,0:00:41.886
had not been vaccinated

0:00:41.886,0:00:44.138
because their parents were afraid

0:00:44.138,0:00:47.157
of something allegedly even worse:

0:00:47.157,0:00:48.875
autism.

0:00:48.875,0:00:52.658
But wait -- wasn't the paper[br]that sparked the controversy

0:00:52.658,0:00:54.981
about autism and vaccines

0:00:54.981,0:00:56.978
debunked, retracted,

0:00:56.978,0:00:59.450
and branded a deliberate fraud

0:00:59.450,0:01:01.158
by the British Medical Journal?

0:01:01.158,0:01:03.201
Don't most science-savvy people

0:01:03.201,0:01:07.520
know that the theory[br]that vaccines cause autism is B.S.?

0:01:07.520,0:01:09.377
I think most of you do,

0:01:09.377,0:01:11.955
but millions of parents worldwide

0:01:11.955,0:01:16.573
continue to fear that vaccines[br]put their kids at risk for autism.

0:01:16.923,0:01:18.047
Why?

0:01:18.827,0:01:20.290
Here's why.

0:01:20.290,0:01:25.375
This is a graph of autism[br]prevalence estimates rising over time.

0:01:25.375,0:01:27.488
For most of the 20th century,

0:01:27.488,0:01:31.180
autism was considered[br]an incredibly rare condition.

0:01:31.180,0:01:34.500
The few psychologists and pediatricians[br]who'd even heard of it

0:01:34.500,0:01:37.217
figured they would get through[br]their entire careers

0:01:37.217,0:01:39.724
without seeing a single case.

0:01:40.364,0:01:43.602
For decades, the prevalence estimates[br]remained stable

0:01:43.602,0:01:46.853
at just three or four children in 10,000.

0:01:46.853,0:01:48.919
But then, in the 1990s,

0:01:48.919,0:01:51.380
the numbers started to skyrocket.

0:01:51.380,0:01:54.608
Fundraising organizations[br]like Autism Speaks

0:01:54.608,0:01:57.696
routinely refer to autism as an epidemic,

0:01:57.696,0:02:01.365
as if you could catch it[br]from another kid at Disneyland.

0:02:01.365,0:02:02.967
So what's going on?

0:02:02.967,0:02:06.194
If it isn't vaccines, what is it?

0:02:06.194,0:02:10.165
If you ask the folks down at[br]the Centers for Disease Control in Atlanta

0:02:10.165,0:02:11.860
what's going on,

0:02:11.860,0:02:16.370
they tend to rely on phrases like[br]"broadened diagnostic criteria"

0:02:16.370,0:02:18.134
and "better case finding"

0:02:18.134,0:02:20.711
to explain these rising numbers.

0:02:20.711,0:02:22.731
But that kind of language

0:02:22.731,0:02:25.680
doesn't do much to allay[br]the fears of a young mother

0:02:25.680,0:02:30.324
who is searching her[br]two-year-old's face for eye contact.

0:02:30.324,0:02:33.319
If the diagnostic criteria[br]had to be broadened,

0:02:33.319,0:02:36.152
why were they so narrow[br]in the first place?

0:02:36.152,0:02:39.147
Why were cases of autism[br]so hard to find

0:02:39.147,0:02:41.437
before the 1990s?

0:02:41.437,0:02:47.172
Five years ago, I decided to try[br]to uncover the answers to these questions.

0:02:47.172,0:02:49.216
I learned that what happened

0:02:49.216,0:02:53.116
has less to do with the slow and cautious[br]progress of science

0:02:53.116,0:02:56.354
than it does with the seductive[br]power of storytelling.

0:02:56.544,0:02:58.750
For most of the 20th century,

0:02:58.750,0:03:01.211
clinicians told one story

0:03:01.211,0:03:04.763
about what autism is[br]and how it was discovered,

0:03:04.763,0:03:07.573
but that story turned out to be wrong,

0:03:07.573,0:03:09.384
and the consequences of it

0:03:09.384,0:03:13.285
are having a devastating impact[br]on global public health.

0:03:13.285,0:03:16.814
There was a second,[br]more accurate story of autism

0:03:16.814,0:03:19.430
which had been lost and forgotten

0:03:19.430,0:03:22.410
in obscure corners[br]of the clinical literature.

0:03:22.410,0:03:26.427
This second story tells us everything[br]about how we got here

0:03:26.427,0:03:29.032
and where we need to go next.

0:03:29.352,0:03:33.996
The first story starts with a child[br]psychiatrist at Johns Hopkins Hospital

0:03:33.996,0:03:35.946
named Leo Kanner.

0:03:35.946,0:03:39.499
In 1943, Kanner published a paper

0:03:39.499,0:03:44.212
describing 11 young patients[br]who seemed to inhabit private worlds,

0:03:44.212,0:03:46.302
ignoring the people around them,

0:03:46.302,0:03:48.462
even their own parents.

0:03:48.462,0:03:50.737
They could amuse themselves for hours

0:03:50.737,0:03:53.384
by flapping their hands[br]in front of their faces,

0:03:53.384,0:03:55.358
but they were panicked by little things

0:03:55.358,0:03:58.970
like their favorite toy[br]being moved from its usual place

0:03:58.970,0:04:00.977
without their knowledge.

0:04:00.977,0:04:03.693
Based on the patients[br]who were brought to his clinic,

0:04:03.693,0:04:07.269
Kanner speculated[br]that autism is very rare.

0:04:07.269,0:04:11.727
By the 1950s, as the world's[br]leading authority on the subject,

0:04:11.727,0:04:17.300
he declared that he had seen[br]less than 150 true cases of his syndrome

0:04:17.300,0:04:21.363
while fielding referrals from[br]as far away as South Africa.

0:04:21.363,0:04:23.754
That's actually not surprising,

0:04:23.754,0:04:27.130
because Kanner's criteria[br]for diagnosing autism

0:04:27.130,0:04:29.443
were incredibly selective.

0:04:29.443,0:04:34.621
For example, he discouraged giving[br]the diagnosis to children who had seizures

0:04:34.621,0:04:38.382
but now we know that epilepsy[br]is very common in autism.

0:04:38.382,0:04:41.424
He once bragged that he had turned[br]nine out of 10 kids

0:04:41.424,0:04:45.255
referred to his office as autistic[br]by other clinicians

0:04:45.255,0:04:47.883
without giving them an autism diagnosis.

0:04:48.503,0:04:50.944
Kanner was a smart guy,

0:04:50.944,0:04:53.113
but a number of his theories[br]didn't pan out.

0:04:53.113,0:04:56.888
He classified autism as a form[br]of infantile psychosis

0:04:56.888,0:05:00.858
caused by cold and unaffectionate parents.

0:05:00.858,0:05:02.995
These children, he said,

0:05:02.995,0:05:07.313
had been kept neatly[br]in a refrigerator that didn't defrost.

0:05:07.313,0:05:09.264
At the same time, however,

0:05:09.264,0:05:12.189
Kanner noticed that some[br]of his young patients

0:05:12.189,0:05:15.602
had special abilities[br]that clustered in certain areas

0:05:15.602,0:05:18.853
like music, math and memory.

0:05:18.853,0:05:20.734
One boy in his clinic

0:05:20.734,0:05:25.328
could distinguish between 18 symphonies[br]before he turned two.

0:05:25.796,0:05:28.443
When his mother put on[br]one of his favorite records,

0:05:28.443,0:05:31.809
he would correctly declare,[br]"Beethoven!"

0:05:31.809,0:05:34.665
But Kanner took a dim view[br]of these abilities,

0:05:34.665,0:05:38.242
claiming that the kids[br]were just regurgitating things

0:05:38.242,0:05:40.865
they'd heard their pompous parents say,

0:05:40.865,0:05:43.465
desperate to earn their approval.

0:05:43.465,0:05:48.829
As a result, autism became[br]a source of shame and stigma for families,

0:05:48.829,0:05:51.406
and two generations of autistic children

0:05:51.406,0:05:54.889
were shipped off to institutions[br]for their own good,

0:05:54.889,0:05:58.163
becoming invisible to the world at large.

0:05:58.163,0:06:02.400
Amazingly, it wasn't until the 1970s

0:06:02.400,0:06:07.567
that researchers began to test[br]Kanner's theory that autism was rare.

0:06:07.567,0:06:11.305
Lorna Wing was a cognitive[br]psychologist in London

0:06:11.305,0:06:14.509
who thought that Kanner's theory[br]of refrigerator parenting

0:06:14.509,0:06:17.528
were "bloody stupid," as she told me.

0:06:17.528,0:06:21.707
She and her husband John were warm[br]and affectionate people,

0:06:21.707,0:06:24.520
and they had a profoundly[br]autistic daughter named Susie.

0:06:25.110,0:06:29.822
Lorna and John knew how hard it was[br]to raise a child like Susie

0:06:29.822,0:06:31.784
without support services,

0:06:31.784,0:06:33.386
special education,

0:06:33.386,0:06:37.635
and the other resources that are[br]out of reach without a diagnosis.

0:06:37.635,0:06:40.259
To make the case[br]to the National Health Service

0:06:40.259,0:06:45.507
that more resources were needed[br]for autistic children and their families,

0:06:45.507,0:06:47.643
Lorna and her colleague Judith Gould

0:06:47.643,0:06:52.193
decided to do something that should[br]have been done 30 years earlier.

0:06:52.193,0:06:57.139
They undertook a study of autism[br]prevalence in the general population.

0:06:57.139,0:07:01.435
They pounded the pavement[br]in a London suburb called Camberwell

0:07:01.435,0:07:05.100
to try to find autistic children[br]in the community.

0:07:05.100,0:07:09.767
What they saw made clear[br]that Kanner's model was way too narrow,

0:07:09.767,0:07:14.293
while the reality of autism[br]was much more colorful and diverse.

0:07:14.663,0:07:16.806
Some kids couldn't talk at all,

0:07:16.806,0:07:21.542
while others waxed on at length[br]about their fascination with astrophysics,

0:07:21.542,0:07:25.486
dinosaurs or the genealogy of royalty.

0:07:25.486,0:07:30.176
In other words, these children[br]didn't fit into nice, neat boxes,

0:07:30.176,0:07:31.871
as Judith put it,

0:07:31.871,0:07:33.752
and they saw lots of them,

0:07:33.752,0:07:37.537
way more than Kanner's monolithic model[br]would have predicted.

0:07:37.537,0:07:41.252
At first, they were at a loss[br]to make sense of their data.

0:07:41.252,0:07:44.380
How had no one noticed[br]these children before?

0:07:44.380,0:07:47.899
But then Lorna came upon a reference[br]to a paper that had been published

0:07:47.899,0:07:50.554
in German in 1944,

0:07:50.554,0:07:52.899
the year after Kanner's paper,

0:07:52.899,0:07:54.617
and then forgotten,

0:07:54.617,0:07:57.194
buried with the ashes of a terrible time

0:07:57.194,0:08:00.445
that no one wanted to remember[br]or think about.

0:08:00.445,0:08:03.115
Kanner knew about this competing paper,

0:08:03.115,0:08:07.860
but scrupulously avoided[br]mentioning it in his own work.

0:08:07.860,0:08:10.322
It had never even[br]been translated into English,

0:08:10.322,0:08:13.285
but luckily, Lorna's husband spoke German,

0:08:13.285,0:08:15.932
and he translated it for her.

0:08:15.932,0:08:19.624
The paper offered[br]an alternate story of autism.

0:08:19.624,0:08:22.317
Its author was a man named Hans Asperger,

0:08:22.317,0:08:25.591
who ran a combination clinic[br]and residential school

0:08:25.591,0:08:28.331
in Vienna in the 1930s.

0:08:28.331,0:08:32.302
Asperger's ideas about teaching children[br]with learning differences

0:08:32.302,0:08:35.436
were progressive even[br]by contemporary standards.

0:08:35.436,0:08:39.848
Mornings at his clinic began[br]with exercise classes set to music,

0:08:39.848,0:08:43.354
and the children put on plays[br]on Sunday afternoons.

0:08:43.354,0:08:46.349
Instead of blaming parents[br]for causing autism,

0:08:46.349,0:08:51.202
Asperger framed it as a lifelong,[br]polygenetic disability

0:08:51.202,0:08:55.103
that requires compassionate forms[br]of support and accommodations

0:08:55.103,0:08:58.510
over the course of one's whole life.

0:08:58.510,0:09:01.395
Rather than treating the kids[br]in his clinic like patients,

0:09:01.395,0:09:04.460
Asperger called them[br]his little professors,

0:09:04.460,0:09:08.245
and enlisted their help in developing[br]methods of education

0:09:08.245,0:09:10.729
that were particularly suited to them.

0:09:10.729,0:09:16.460
Crucially, Asperger viewed autism[br]as a diverse continuum

0:09:16.460,0:09:21.114
that spans an astonishing range[br]of giftedness and disability.

0:09:21.584,0:09:25.116
He believed that autism[br]and autistic traits are common

0:09:25.116,0:09:26.982
and always have been,

0:09:26.982,0:09:32.276
seeing aspects of this continuum[br]in familiar archetypes from pop culture

0:09:32.276,0:09:34.612
like the socially awkward scientist

0:09:34.612,0:09:37.306
and the absent-minded professor.

0:09:37.306,0:09:39.419
He went so far as to say,

0:09:39.419,0:09:42.646
it seems that for success[br]in science and art,

0:09:42.646,0:09:45.592
a dash of autism is essential.

0:09:46.292,0:09:51.214
Lorna and Judith realized that Kanner[br]had been as wrong about autism being rare

0:09:51.214,0:09:53.907
as he had been about parents causing it.

0:09:53.907,0:09:55.951
Over the next several years,

0:09:55.951,0:09:59.364
they quietly worked with[br]the American Psychiatric Association

0:09:59.364,0:10:01.964
to broaden the criteria for diagnosis

0:10:01.964,0:10:05.981
to reflect the diversity of what[br]they called "the autism spectrum."

0:10:05.981,0:10:08.559
In the late '80s and early 1990s,

0:10:08.559,0:10:10.857
their changes went into effect,

0:10:10.857,0:10:13.226
swapping out Kanner's narrow model

0:10:13.226,0:10:16.801
for Asperger's broad and inclusive one.

0:10:16.801,0:10:19.472
These changes weren't[br]happening in a vacuum.

0:10:19.472,0:10:23.326
By coincidence, as Lorna and Judith[br]worked behind the scenes

0:10:23.326,0:10:25.160
to reform the criteria,

0:10:25.160,0:10:30.176
people all over the world were seeing[br]an autistic adult for the first time.

0:10:30.176,0:10:33.550
Before "Rain Man" came out in 1988,

0:10:33.550,0:10:38.209
only a tiny, ingrown circle of experts[br]knew what autism looked like,

0:10:38.209,0:10:42.969
but after Dustin Hoffman's unforgettable[br]performance as Raymond Babbitt

0:10:42.969,0:10:46.104
earned "Rain Man" four Academy Awards,

0:10:46.104,0:10:48.844
pediatricians, psychologists,

0:10:48.844,0:10:53.534
teachers and parents all over the world[br]knew what autism looked like.

0:10:53.534,0:10:56.459
Coincidentally, at the same time,

0:10:56.459,0:11:01.589
the first easy-to-use clinical tests[br]for diagnosing autism were introduced.

0:11:01.939,0:11:06.629
You no longer had to have a connection[br]to that tiny circle of experts

0:11:06.629,0:11:09.207
to get your child evaluated.

0:11:09.207,0:11:11.320
The combination of "Rain Man,"

0:11:11.320,0:11:15.499
the changes to the criteria,[br]and the introduction of these tests

0:11:15.499,0:11:17.774
created a network effect,

0:11:17.774,0:11:21.304
a perfect storm of autism awareness.

0:11:21.304,0:11:24.322
The number of diagnoses started to soar,

0:11:24.322,0:11:29.990
just as Lorna and Judith predicted,[br]indeed hoped, that it would,

0:11:29.990,0:11:32.106
enabling autistic people[br]and their families

0:11:32.106,0:11:35.798
to finally get the support[br]and services they deserved.

0:11:35.798,0:11:37.864
Then Andrew Wakefield came along

0:11:37.864,0:11:41.719
to blame the spike[br]in diagnoses on vaccines,

0:11:41.719,0:11:43.832
a simple, powerful,

0:11:43.832,0:11:46.618
and seductively believable story

0:11:46.618,0:11:48.986
that was as wrong as Kanner's theory

0:11:48.986,0:11:51.239
that autism was rare.

0:11:51.239,0:11:54.710
If the CDC's current estimate,

0:11:54.710,0:11:59.133
that one in 68 kids in America[br]are on the spectrum, is correct,

0:11:59.133,0:12:03.340
autistics are one of the largest[br]minority groups in the world.

0:12:03.340,0:12:07.167
In recent years, autistic people[br]have come together on the Internet

0:12:07.167,0:12:10.812
to reject the notion that they[br]are puzzles to be solved

0:12:10.812,0:12:12.995
by the next medical breakthrough,

0:12:12.995,0:12:15.456
coining the term "neurodiversity"

0:12:15.456,0:12:18.744
to celebrate the varieties[br]of human cognition.

0:12:19.264,0:12:21.655
One way to understand neurodiversity

0:12:21.655,0:12:25.324
is to think in terms[br]of human operating systems.

0:12:25.324,0:12:30.240
Just because a P.C. is not running Windows[br]doesn't mean that it's broken.

0:12:30.240,0:12:33.869
By autistic standards,[br]the normal human brain

0:12:33.869,0:12:35.889
is easily distractable,

0:12:35.889,0:12:37.677
obsessively social,

0:12:37.677,0:12:40.997
and suffers from a deficit[br]of attention to detail.

0:12:40.997,0:12:43.992
To be sure, autistic people[br]have a hard time

0:12:43.992,0:12:46.268
living in a world not built for them.

0:12:46.268,0:12:50.520
[Seventy] years later, we're still[br]catching up to Asperger,

0:12:50.520,0:12:54.603
who believed that the "cure"[br]for the most disabling aspects of autism

0:12:54.603,0:12:57.529
is to be found in understanding teachers,

0:12:57.529,0:12:59.665
accommodating employers,

0:12:59.665,0:13:01.522
supportive communities,

0:13:01.522,0:13:04.866
and parents who have faith[br]in their children's potential.

0:13:04.866,0:13:07.908
An autistic [man][br]named Zosia Zaks once said,

0:13:07.908,0:13:13.211
"We need all hands on deck[br]to right the ship of humanity."

0:13:13.211,0:13:15.764
As we sail into an uncertain future,

0:13:15.764,0:13:19.502
we need every form[br]of human intelligence on the planet

0:13:19.502,0:13:25.469
working together to tackle[br]the challenges that we face as a society.

0:13:25.469,0:13:27.791
We can't afford to waste a brain.

0:13:27.791,0:13:30.136
Thank you.

0:13:30.136,0:13:34.136
(Applause)