0:00:01.571,0:00:03.880 Host: We're going to move along[br]with our content, 0:00:03.913,0:00:05.547 providing it for you as we go on, 0:00:05.595,0:00:08.095 our next presenter today[br]is doctor Ami Klin. 0:00:08.125,0:00:12.537 He refers to himself as a walking[br]laboratory of social engagement. 0:00:12.546,0:00:16.251 And I'll tell you, the man just[br]minding his own business at Yale, 0:00:17.363,0:00:19.974 and Home Depot co-founder,[br]Bernie Marcus, 0:00:19.999,0:00:23.061 went up there and persuaded him[br]to come down south, 0:00:23.109,0:00:26.894 where he is now the new director[br]of the Marcus Autism Center. 0:00:26.919,0:00:29.267 He is here today to share with us[br]some viewpoints 0:00:29.292,0:00:32.609 on how early targeted[br]social engagement with autistic children 0:00:32.665,0:00:35.394 can be an investment[br]in their future productivity. 0:00:35.807,0:00:37.855 I'd like you to join me in welcoming him, 0:00:37.910,0:00:39.505 to share an idea worth sharing - 0:00:39.553,0:00:43.878 autism, disruptions is early human[br]social adaptation mechanisms. 0:00:44.276,0:00:45.577 Welcoming doctor Ami Klin. 0:00:45.633,0:00:51.386 (Applause) 0:01:00.244,0:01:03.844 Ami Klin: For me,[br]autism has been a personal journey. 0:01:06.149,0:01:07.482 As I was introduced, 0:01:07.600,0:01:12.232 I always wanted to become[br]a walking laboratory of social engagement: 0:01:13.513,0:01:17.922 to resonate other people's feelings,[br]thoughts, intentions, motivations, 0:01:18.107,0:01:19.768 in the act of being with them. 0:01:21.399,0:01:25.928 As a scientist, I always wanted[br]to measure that resonance, 0:01:27.176,0:01:29.794 that sense of the other[br]that happens so quickly, 0:01:29.818,0:01:31.125 in the blink of an eye. 0:01:32.082,0:01:34.408 We intuit other people's feelings; 0:01:34.432,0:01:37.575 we know the meaning of their actions[br]even before they happen. 0:01:38.359,0:01:40.105 We're always in this stance 0:01:40.129,0:01:43.211 of being the object[br]of somebody else's subjectivity. 0:01:43.235,0:01:45.975 We do that all the time.[br]We just can't shake it off. 0:01:46.425,0:01:50.124 It's so important that the very tools[br]we use to understand ourselves, 0:01:50.148,0:01:51.975 to understand the world around us, 0:01:51.999,0:01:53.605 are shaped by that stance. 0:01:54.626,0:01:56.677 We are social to the core. 0:01:57.972,0:02:00.423 So my journey in autism really started 0:02:00.447,0:02:04.053 when I lived in a residential unit[br]for adults with autism. 0:02:04.468,0:02:07.559 Most of those individuals[br]had spent most of their lives 0:02:07.583,0:02:09.068 in long-stay hospitals. 0:02:09.092,0:02:10.556 This is a long time ago. 0:02:11.421,0:02:14.948 And for them, autism was devastating. 0:02:15.795,0:02:18.438 They had profound[br]intellectual disabilities. 0:02:18.958,0:02:20.192 They didn't talk. 0:02:20.710,0:02:22.029 But most of all, 0:02:22.617,0:02:27.546 they were extraordinarily isolated[br]from the world around them, 0:02:27.570,0:02:29.407 from their environment 0:02:29.431,0:02:31.304 and from the people. 0:02:31.792,0:02:34.619 In fact, at the time,[br]if you walked into a school 0:02:34.643,0:02:36.431 for individuals with autism, 0:02:36.455,0:02:38.768 you'd hear a lot of noise, 0:02:38.792,0:02:42.865 plenty of commotion, actions,[br]people doing things. 0:02:44.130,0:02:46.615 But they're always doing[br]things by themselves. 0:02:47.805,0:02:51.286 So they may be looking[br]at a light in the ceiling, 0:02:51.927,0:02:54.709 or they may be isolated in the corner, 0:02:55.336,0:02:58.871 or they might be engaged[br]in these repetitive movements, 0:02:58.895,0:03:02.314 in self-stimulatory movements[br]that led them nowhere. 0:03:02.958,0:03:05.557 Extremely, extremely isolated. 0:03:07.025,0:03:12.605 Well, now we know that autism[br]is this disruption, 0:03:12.629,0:03:16.146 the disruption of this resonance[br]that I am telling you about. 0:03:16.170,0:03:18.104 These are survival skills. 0:03:18.128,0:03:20.255 These are survival skills[br]that we inherited 0:03:21.038,0:03:24.419 over many, many hundreds[br]of thousands of years of evolution. 0:03:25.245,0:03:29.913 You see, babies are born[br]in a state of utter fragility. 0:03:30.432,0:03:32.561 Without the caregiver,[br]they wouldn't survive, 0:03:32.585,0:03:35.091 so it stands to reason[br]that nature would endow them 0:03:35.115,0:03:36.892 with these mechanisms of survival. 0:03:38.569,0:03:40.512 They orient to the caregiver. 0:03:40.925,0:03:43.777 From the first days and weeks of life, 0:03:44.340,0:03:47.074 babies prefer to hear human sounds, 0:03:47.098,0:03:49.222 rather than just sounds[br]in the environment. 0:03:49.246,0:03:51.723 They prefer to look at people[br]rather than at things, 0:03:51.747,0:03:55.088 and even as they're looking at people,[br]they look at people's eyes, 0:03:56.147,0:04:00.355 because the eye is the window[br]to the other person's experiences, 0:04:00.379,0:04:02.837 so much so that they even prefer[br]to look at people 0:04:02.861,0:04:06.100 who are looking at them[br]rather than people who are looking away. 0:04:06.925,0:04:09.507 Well, they orient to the caregiver. 0:04:09.531,0:04:11.164 The caregiver seeks the baby. 0:04:11.672,0:04:14.920 And it's out of this mutually[br]reinforcing choreography 0:04:15.485,0:04:19.279 that a lot that is of importance[br]to the emergence of mind -- 0:04:19.303,0:04:22.828 the social mind, the social[br]brain -- depends on. 0:04:23.987,0:04:27.059 We always think about autism 0:04:27.083,0:04:31.723 as something that happens[br]later on in life. 0:04:31.747,0:04:35.152 It doesn't; it begins[br]with the beginning of life. 0:04:37.301,0:04:42.896 As babies engage with caregivers,[br]they soon realize that, well, 0:04:42.920,0:04:47.042 there is something between the ears[br]that is very important -- 0:04:47.066,0:04:50.481 it's invisible, you can't see it,[br]but it's really critical. 0:04:51.249,0:04:53.176 And that thing is called attention. 0:04:53.200,0:04:54.533 And they learn soon enough, 0:04:54.557,0:04:57.145 even before they can utter one word, 0:04:57.169,0:05:00.052 that they can take that attention[br]and move somewhere 0:05:00.673,0:05:02.471 in order to get things they want. 0:05:03.955,0:05:07.055 They also learn to follow[br]other people's gazes, 0:05:07.079,0:05:11.064 because whatever people are looking at[br]is what they are thinking about. 0:05:13.104,0:05:16.750 And soon enough, they start to learn[br]about the meaning of things, 0:05:16.774,0:05:19.147 because when somebody[br]is looking at something 0:05:19.171,0:05:21.389 or somebody is pointing at something, 0:05:21.413,0:05:23.586 they're not just getting[br]a directional cue. 0:05:24.152,0:05:27.835 They are getting the other[br]person's meaning of that thing, 0:05:27.859,0:05:29.069 the attitude. 0:05:29.093,0:05:33.864 And soon enough, they start[br]building this body of meanings, 0:05:33.888,0:05:37.740 but meanings that were acquired[br]within the realm of social interaction. 0:05:38.510,0:05:40.425 Those are meanings that are acquired 0:05:40.449,0:05:43.081 as part of their shared[br]experiences with others. 0:05:44.486,0:05:50.302 Well, this is a 15-month-old little girl, 0:05:51.912,0:05:53.559 and she has autism. 0:05:55.094,0:06:00.882 And I am coming so close to her[br]that I am maybe two inches from her face, 0:06:00.906,0:06:02.741 and she's quite oblivious to me. 0:06:02.765,0:06:06.193 Imagine if I did that to you,[br]came two inches from your face. 0:06:06.217,0:06:08.422 You'd do probably[br]two things, wouldn't you? 0:06:08.446,0:06:11.044 You would recoil.[br]You would call the police. 0:06:11.068,0:06:12.242 (Laughter) 0:06:12.266,0:06:13.419 You would do something, 0:06:13.443,0:06:17.501 because it's literally impossible[br]to penetrate somebody's physical space 0:06:17.525,0:06:18.928 and not get that reaction. 0:06:18.952,0:06:22.407 We do so, remember,[br]intuitively, effortlessly. 0:06:22.431,0:06:23.596 This is our body wisdom; 0:06:23.620,0:06:25.818 it's not something mediated[br]by our language. 0:06:25.842,0:06:28.273 Our body just knows that. 0:06:28.769,0:06:31.137 And we've known that for a long time. 0:06:31.161,0:06:34.076 And this is not something[br]that happens to humans only. 0:06:34.100,0:06:37.300 It happens to some[br]of our phyletic cousins, 0:06:37.324,0:06:41.390 because if you're a monkey,[br]and you look at another monkey, 0:06:41.413,0:06:45.407 and that monkey has a higher[br]hierarchy position than you, 0:06:45.432,0:06:48.961 and that is considered[br]to be a signal or threat, 0:06:48.985,0:06:51.379 well, you are not going[br]to be alive for long. 0:06:51.865,0:06:56.697 So something that in other species[br]are survival mechanisms, 0:06:56.721,0:06:59.828 without which they[br]wouldn't basically live, 0:06:59.852,0:07:02.383 we bring into the context of human beings, 0:07:02.407,0:07:06.124 and this is what we need[br]to simply act, socially. 0:07:06.680,0:07:09.449 Now, she is oblivious to me[br]and I'm so close to her, 0:07:09.473,0:07:11.447 and you think, maybe she can see you, 0:07:11.471,0:07:12.982 maybe she can hear you. 0:07:13.006,0:07:14.628 Well, a few minutes later, 0:07:14.652,0:07:16.593 she goes to the corner of the room, 0:07:16.617,0:07:20.367 and she finds a tiny little piece[br]of candy, an M&M. 0:07:21.359,0:07:25.876 So I could not attract her attention, 0:07:25.900,0:07:27.771 but something -- a thing -- did. 0:07:28.430,0:07:30.947 Now, most of us make a big dichotomy 0:07:30.971,0:07:33.851 between the world of things[br]and the world of people. 0:07:35.382,0:07:39.873 Now, for this girl,[br]that division line is not so clear, 0:07:39.897,0:07:43.003 and the world of people[br]is not attracting her 0:07:43.027,0:07:44.486 as much as we would like. 0:07:44.510,0:07:48.197 Now, remember that we learn a great deal[br]by sharing experiences. 0:07:48.945,0:07:54.806 What she is doing right now[br]is that her path of learning is diverging, 0:07:54.830,0:07:56.571 moment by moment, 0:07:56.595,0:07:59.815 as she is isolating herself[br]further and further. 0:08:00.413,0:08:03.355 So we feel sometimes[br]that the brain is deterministic, 0:08:03.379,0:08:05.556 the brain determines[br]who we're going to be. 0:08:05.929,0:08:08.717 But, in fact, the brain[br]also becomes who we are, 0:08:08.741,0:08:12.730 and at the same time[br]that her behaviors are taking away 0:08:12.754,0:08:14.916 from the realm of social interaction, 0:08:14.940,0:08:16.965 this is what's happening with her mind, 0:08:16.989,0:08:19.405 and this is what's happening[br]with her brain. 0:08:21.643,0:08:26.843 Well, autism is the most strongly[br]genetic condition 0:08:26.867,0:08:28.739 of all developmental disorders. 0:08:30.961,0:08:32.619 And it's a brain disorder. 0:08:33.195,0:08:36.424 It's a disorder that begins[br]much prior to the time 0:08:36.448,0:08:37.763 that the child is born. 0:08:38.717,0:08:42.698 We now know that there is a very[br]broad spectrum of autism. 0:08:42.722,0:08:46.191 There are those individuals[br]who are profoundly intellectually disabled 0:08:46.215,0:08:48.172 but there are those that are gifted. 0:08:48.196,0:08:50.590 There are those individuals[br]who don't talk at all; 0:08:50.614,0:08:53.002 there are those individuals[br]who talk too much. 0:08:53.026,0:08:56.523 There are those individuals[br]that if you observe them in their school, 0:08:56.547,0:09:00.217 you see them running the periphery fence[br]all the school day if you let them, 0:09:00.241,0:09:02.602 to those individuals[br]who cannot stop coming to you 0:09:02.626,0:09:05.479 and trying to engage you[br]repeatedly, relentlessly, 0:09:05.591,0:09:07.860 but often in an awkward fashion, 0:09:08.732,0:09:11.389 without that immediate resonance. 0:09:12.312,0:09:16.058 Well, this is much more prevalent[br]than we thought at the time. 0:09:16.082,0:09:17.493 When I started in this field, 0:09:17.517,0:09:20.605 we thought there were four individuals[br]with autism per 10,000 -- 0:09:20.629,0:09:21.900 a very rare condition. 0:09:22.361,0:09:26.015 Well, now we know it's more[br]like one in 100. 0:09:26.457,0:09:29.745 There are millions of individuals[br]with autism all around us. 0:09:31.716,0:09:34.969 The societal cost[br]of this condition is huge, 0:09:35.085,0:09:38.033 in the US alone,[br]maybe 35 to 80 billion dollars. 0:09:38.057,0:09:39.245 And you know what? 0:09:39.269,0:09:43.906 Most of those funds are associated[br]with adolescents and particularly adults 0:09:43.930,0:09:45.681 who are severely disabled, 0:09:45.705,0:09:47.866 individuals who need[br]wraparound services -- 0:09:47.890,0:09:50.146 services that are very, very intensive. 0:09:50.170,0:09:54.256 And those services can cost in excess[br]of 60,000 to 80,000 dollars a year. 0:09:55.036,0:09:58.260 Those are individuals who did not[br]benefit from early treatment, 0:09:58.974,0:10:03.112 because now we know[br]that autism creates itself 0:10:03.136,0:10:07.288 as individuals diverge in that pathway[br]of learning that I mentioned to you. 0:10:07.700,0:10:10.273 Were we to be able[br]to identify this condition 0:10:10.297,0:10:13.047 at an earlier point,[br]and intervene and treat -- 0:10:14.312,0:10:18.366 I can tell you, this has been probably[br]something that has changed my life 0:10:18.390,0:10:19.686 in the past 10 years, 0:10:19.710,0:10:23.964 this notion that we can absolutely[br]attenuate this condition. 0:10:25.422,0:10:27.777 Also, we have a window of opportunity, 0:10:27.801,0:10:30.421 because the brain[br]is malleable for just so long, 0:10:30.937,0:10:34.450 and that window of opportunity[br]happens in the first three years of life. 0:10:34.474,0:10:37.185 It's not that that window[br]closes; it doesn't. 0:10:38.121,0:10:40.634 But it diminishes considerably. 0:10:41.399,0:10:44.497 And yet, the median age[br]of diagnosis in this country 0:10:44.521,0:10:46.433 is still about five years, 0:10:46.457,0:10:48.552 and in disadvantaged populations, 0:10:48.576,0:10:51.705 the populations that don't have[br]access to clinical services, 0:10:51.729,0:10:54.142 rural populations, minorities, 0:10:54.838,0:10:57.547 the age of diagnosis is later still, 0:10:57.571,0:10:59.596 which is almost as if I were to tell you 0:10:59.620,0:11:03.387 that we are condemning those communities[br]to have individuals with autism 0:11:03.411,0:11:05.734 whose condition is going[br]to be more severe. 0:11:06.662,0:11:09.206 So I feel that we have[br]a bioethical imperative. 0:11:09.668,0:11:11.397 The science is there. 0:11:12.525,0:11:14.645 But no science is of relevance 0:11:14.669,0:11:17.598 if it doesn't have an impact[br]on the community. 0:11:18.227,0:11:21.181 And we just can't afford[br]that missed opportunity, 0:11:21.205,0:11:24.150 because children with autism[br]become adults with autism. 0:11:24.912,0:11:28.916 And we feel that those things we can do 0:11:28.940,0:11:31.318 for these children,[br]for those families, early on, 0:11:31.342,0:11:33.519 will have lifetime consequences -- 0:11:33.543,0:11:37.551 for the child, for the family,[br]and for the community at large. 0:11:37.575,0:11:40.148 So this is our view of autism. 0:11:40.645,0:11:43.967 There are over a hundred genes[br]that are associated with autism. 0:11:43.991,0:11:45.950 In fact, we believe there are going to be 0:11:45.974,0:11:49.779 something between 300 and 600[br]genes associated with autism, 0:11:49.803,0:11:53.106 and genetic anomalies,[br]much more than just genes. 0:11:53.960,0:11:57.279 And we actually have[br]a bit of a question here, 0:11:58.144,0:12:01.429 because if there are so many[br]different causes of autism, 0:12:01.453,0:12:05.721 how do you go from those liabilities[br]to the actual syndrome? 0:12:05.745,0:12:07.296 Because people like myself, 0:12:08.030,0:12:10.267 when we walk into a playroom, 0:12:10.291,0:12:12.649 we recognize a child as having autism. 0:12:13.335,0:12:15.563 So how do you go from multiple causes 0:12:15.587,0:12:17.915 to a syndrome that has some homogeneity? 0:12:18.991,0:12:21.682 And the answer is what lies in between, 0:12:22.253,0:12:23.685 which is development. 0:12:24.160,0:12:28.933 And in fact, we are very interested[br]in those first two years of life, 0:12:28.957,0:12:32.745 because those liabilities[br]don't necessarily convert into autism. 0:12:32.769,0:12:34.527 Autism creates itself. 0:12:35.312,0:12:39.157 Were we to be able to intervene[br]during those years of life, 0:12:40.069,0:12:45.485 we might attenuate for some, and God[br]knows, maybe even prevent for others. 0:12:46.475,0:12:47.713 So how do we do that? 0:12:48.337,0:12:51.229 How do we enter that feeling of resonance, 0:12:51.253,0:12:54.047 how do we enter another person's being? 0:12:55.637,0:12:58.752 I remember when I interacted[br]with that 15-month-old, 0:12:58.776,0:13:00.914 the thing that came to my mind was, 0:13:00.938,0:13:03.251 "How do you come into her world? 0:13:03.910,0:13:07.307 Is she thinking about me?[br]Is she thinking about others?" 0:13:08.410,0:13:11.260 Well, it's hard to do that, 0:13:11.284,0:13:13.462 so we had to create the technologies. 0:13:13.486,0:13:15.955 We had to basically step inside a body. 0:13:15.979,0:13:18.573 We had to see the world through her eyes. 0:13:19.692,0:13:22.004 And so in the past many years, 0:13:22.028,0:13:24.424 we've been building these new technologies 0:13:24.448,0:13:26.029 that are based on eye tracking. 0:13:26.053,0:13:30.969 We can see, moment by moment,[br]what children are engaging with. 0:13:32.546,0:13:34.310 This is my colleague, Warren Jones, 0:13:34.334,0:13:37.628 with whom we've been building[br]these methods, these studies, 0:13:37.652,0:13:38.981 for the past 12 years. 0:13:39.379,0:13:42.535 And you see there a happy five-month-old, 0:13:43.289,0:13:48.356 a five-month little boy[br]who is going to watch things 0:13:48.380,0:13:50.292 that are brought from his world: 0:13:51.096,0:13:53.329 his mom, the caregiver, 0:13:53.353,0:13:57.583 but also experiences that he would have[br]were he to be in his daycare. 0:13:58.384,0:14:02.224 What we want is to embrace that world[br]and bring it into our laboratory, 0:14:02.248,0:14:04.282 but in order for us to do that, 0:14:04.306,0:14:08.561 we had to create[br]these very sophisticated measures, 0:14:08.585,0:14:12.066 measures of how people, how little babies, 0:14:12.090,0:14:16.604 how newborns, engage[br]with the world, moment by moment. 0:14:16.628,0:14:18.913 What is important and what is not. 0:14:19.663,0:14:22.274 Well, we created those measures, 0:14:22.298,0:14:25.659 and here, what you see[br]is what we call a funnel of attention. 0:14:26.326,0:14:27.691 You're watching a video -- 0:14:28.239,0:14:30.970 those frames are separated[br]by about a second -- 0:14:30.994,0:14:34.866 through the eyes of 35 typically[br]developing two-year-olds. 0:14:35.337,0:14:37.634 And we freeze one frame, 0:14:38.408,0:14:41.496 and this is what the typical[br]children are doing. 0:14:41.520,0:14:45.937 In this scan pass, in green here,[br]are two-year-olds with autism. 0:14:45.961,0:14:51.324 So on that frame, the children[br]who are typical are watching this, 0:14:52.539,0:14:55.064 the emotion of expression[br]of that little boy 0:14:55.088,0:14:57.814 as he's fighting a little bit[br]with the little girl. 0:14:57.838,0:14:59.875 What are the children with autism doing? 0:14:59.899,0:15:02.994 They are focusing on the revolving door, 0:15:03.804,0:15:05.225 opening and shutting. 0:15:06.042,0:15:09.391 Well, I can tell you that this divergence[br]that you're seeing here 0:15:09.415,0:15:12.227 doesn't happen only[br]in our five-minute experiment. 0:15:12.251,0:15:15.185 It happens moment by moment[br]in their real lives, 0:15:16.320,0:15:20.553 and their minds are being formed[br]and their brains are being specialized 0:15:20.577,0:15:24.600 in something other than what is happening[br]with their typical peers. 0:15:25.307,0:15:31.826 Well, we took a construct[br]from our pediatrician friends, 0:15:31.850,0:15:33.369 the concept of growth charts -- 0:15:33.393,0:15:35.870 you know, when you take[br]a child to the pediatrician, 0:15:35.894,0:15:38.976 and you have physical height and weight. 0:15:39.566,0:15:42.500 Well, we decided we were going[br]to create growth charts 0:15:42.524,0:15:43.825 of social engagement. 0:15:44.854,0:15:47.622 We sought children[br]from the time they're born. 0:15:48.074,0:15:51.449 What you see here on the x-axis 0:15:51.473,0:15:55.658 is two, three, four, five,[br]six months and nine, 0:15:55.682,0:15:57.445 until about the age of 24 months. 0:15:57.469,0:16:00.240 This is the percent of their viewing time 0:16:00.264,0:16:02.175 that they're focusing on people's eyes, 0:16:02.199,0:16:04.128 and this is their growth chart. 0:16:04.644,0:16:07.117 They start over here --[br]they love people's eyes -- 0:16:07.141,0:16:09.184 and it remains quite stable. 0:16:09.850,0:16:13.113 It sort of goes up a little bit[br]in those initial months. 0:16:13.819,0:16:17.556 Now, let's see what's happening[br]with babies who became autistic. 0:16:18.271,0:16:19.763 It's something very different. 0:16:20.504,0:16:23.434 It starts way up here,[br]but then it's a free fall. 0:16:24.299,0:16:28.170 It's very much like they brought[br]into this world the reflex 0:16:28.194,0:16:31.387 that orients them to people,[br]but it has no traction. 0:16:32.011,0:16:34.445 It's almost as if that stimulus -- you -- 0:16:35.040,0:16:38.030 you're not exerting[br]influence on what happens 0:16:38.054,0:16:40.408 as they navigate their daily lives. 0:16:41.736,0:16:48.496 Now, we thought those data[br]were so powerful, in a way, 0:16:49.186,0:16:52.436 that we wanted to see what happened[br]in the first six months of life, 0:16:52.460,0:16:55.668 because if you interact[br]with a two- and a three-month-old, 0:16:55.692,0:16:58.942 you'd be surprised[br]by how social those babies are. 0:17:00.013,0:17:02.870 And what we see[br]in the first six months of life 0:17:02.894,0:17:07.771 is that those two groups[br]can be segregated very easily. 0:17:08.659,0:17:11.776 And using these kinds[br]of measures and many others, 0:17:11.800,0:17:15.453 what we found out[br]is that our science could, in fact, 0:17:15.477,0:17:17.701 identify this condition early on. 0:17:18.249,0:17:21.410 We didn't have to wait[br]for the behaviors of autism 0:17:21.434,0:17:23.512 to emerge in the second year of life. 0:17:24.656,0:17:29.183 If we measured things that are,[br]evolutionarily, highly conserved, 0:17:29.207,0:17:31.530 and developmentally very early-emerging -- 0:17:31.554,0:17:34.231 things that are online[br]from the first weeks of life -- 0:17:34.255,0:17:36.217 we could push the detection of autism 0:17:36.241,0:17:38.769 all the way to those first months, 0:17:38.793,0:17:40.777 and that's what we are doing now. 0:17:43.118,0:17:46.275 Now, we can create[br]the very best technologies 0:17:46.299,0:17:49.305 and the very best methods[br]to identify the children, 0:17:50.091,0:17:53.005 but this would be for naught[br]if we didn't have an impact 0:17:53.029,0:17:55.709 on what happens in their reality[br]in the community. 0:17:56.180,0:17:58.462 Now we want those devices, of course, 0:17:58.486,0:18:01.315 to be deployed by those[br]who are in the trenches -- 0:18:01.339,0:18:05.877 our colleagues, the primary care[br]physicians, who see every child -- 0:18:06.567,0:18:08.930 and we need to transform[br]those technologies 0:18:08.954,0:18:11.956 into something that is going[br]to add value to their practice, 0:18:11.980,0:18:14.166 because they have to see so many children. 0:18:14.190,0:18:18.267 And we want to do that universally[br]so that we don't miss any child. 0:18:18.291,0:18:19.902 But this would be immoral 0:18:21.029,0:18:26.392 if we also did not have an infrastructure[br]for intervention, for treatment. 0:18:26.987,0:18:30.879 We need to be able to work[br]with the families, support the families, 0:18:30.903,0:18:33.916 to manage those first years with them. 0:18:34.884,0:18:37.282 We need to be able to really go 0:18:37.306,0:18:41.228 from universal screening[br]to universal access to treatment, 0:18:41.252,0:18:44.241 because those treatments[br]are going to change 0:18:44.265,0:18:47.130 these children's[br]and those families' lives. 0:18:48.950,0:18:55.388 Now, when we think about what we [can][br]do in those first years, 0:18:55.412,0:18:59.982 I can tell you, having been[br]in this field for so long, 0:19:00.577,0:19:02.953 one feels really rejuvenated. 0:19:03.332,0:19:08.054 There is a sense that the science[br]that one worked on 0:19:08.078,0:19:10.847 can actually have an impact on realities, 0:19:10.871,0:19:13.851 preventing, in fact, those experiences 0:19:14.472,0:19:17.216 that I really started[br]in my journey in this field. 0:19:17.843,0:19:21.253 I thought at the time[br]that this was an intractable condition. 0:19:21.277,0:19:24.556 No longer. We can do[br]a great deal of things. 0:19:25.207,0:19:27.616 And the idea is not to cure autism. 0:19:27.640,0:19:29.140 That's not the idea. 0:19:30.291,0:19:32.365 What we want is to make sure 0:19:32.389,0:19:34.941 that those individuals[br]with autism can be free 0:19:34.965,0:19:38.580 from the devastating consequences[br]that come with it at times, 0:19:39.376,0:19:42.437 the profound intellectual disabilities,[br]the lack of language, 0:19:42.461,0:19:44.948 the profound, profound isolation. 0:19:46.063,0:19:48.309 We feel that individuals[br]with autism, in fact, 0:19:48.333,0:19:50.799 have a very special[br]perspective on the world, 0:19:50.823,0:19:52.169 and we need diversity. 0:19:52.940,0:19:56.566 And they can work extremely well[br]in some areas of strength: 0:19:56.590,0:19:59.969 predictable situations,[br]situations that can be defined. 0:19:59.993,0:20:02.951 Because after all,[br]they learn about the world 0:20:02.975,0:20:04.857 almost, like, about it, 0:20:04.881,0:20:07.678 rather than learning[br]how to function in it. 0:20:07.702,0:20:11.701 But this is a strength if you're working,[br]for example, in technology. 0:20:12.581,0:20:16.412 And there are those individuals[br]who have incredible artistic abilities. 0:20:16.436,0:20:18.769 We want them to be free to do that. 0:20:18.793,0:20:21.912 We want that the next generations[br]of individuals with autism 0:20:21.936,0:20:25.014 will be able not only[br]to express their strengths, 0:20:25.038,0:20:26.937 but to fulfill their promise. 0:20:27.452,0:20:29.199 Well, thank you for listening to me. 0:20:29.223,0:20:32.703 (Applause) 0:20:35.125,0:20:36.792 Host: Dr Klin, thank you. 0:20:37.427,0:20:41.077 You know, this talk is generating[br]quite a lot of talk 0:20:41.133,0:20:42.934 all over the web right now, 0:20:42.974,0:20:44.561 a lot of tweeting going on, 0:20:44.588,0:20:47.721 and obviously a lot of interest[br]around the issue of autism. 0:20:47.990,0:20:52.069 I'm curious to know whether[br]there are some new caregiving norms 0:20:52.094,0:20:55.275 that you see - you mentioned[br]that early intervention is the key, 0:20:55.315,0:20:57.212 but if there isn't early diagnoses, 0:20:57.220,0:21:00.402 is there a look that caregivers[br]should perhaps be - 0:21:00.490,0:21:03.942 evolving into new ways of caring[br]for children that might be helpful ? 0:21:04.140,0:21:08.116 Ami Klin: Well, there are ways[br]of identifying children early. 0:21:08.148,0:21:10.600 The fact that there is a slow[br]uptake of that 0:21:10.625,0:21:13.799 has something to do with the fact[br]that people need to know how bad. 0:21:14.109,0:21:17.242 That we can do a great deal[br]for these children and families. 0:21:17.331,0:21:18.982 But the interesting thing, 0:21:19.014,0:21:21.704 is that the forms of treatment[br]that are available now 0:21:21.752,0:21:25.791 are not forms of treatment[br]that would be taking place in a center. 0:21:25.838,0:21:27.771 They take place in the homes. 0:21:27.815,0:21:30.748 Basically, what those treatments[br]are doing, 0:21:30.911,0:21:33.711 is potentiating what every caregiver does. 0:21:33.919,0:21:35.474 We need to make sure 0:21:35.490,0:21:37.974 that those signals,[br]the communication signals, 0:21:37.998,0:21:39.465 the social engagement, 0:21:39.490,0:21:42.116 that that happens not[br]in a treatment session 0:21:42.188,0:21:45.228 that would take place[br]for like 30 minutes a day, 0:21:45.799,0:21:48.799 we basically need every moment[br]in these childrens' lives, 0:21:48.823,0:21:50.490 to be a treatment moment. 0:21:50.601,0:21:53.664 And for that, we need to both[br]support and train parents. 0:21:53.704,0:21:57.140 And that's the way[br]those early forms of treatment take place. 0:21:57.196,0:21:58.873 So there is plenty to do out there. 0:21:58.898,0:22:01.573 Host: Well, it looks[br]like people are interested in that. 0:22:01.598,0:22:04.111 Thank you very much, Dr Klin.[br]Pleasure to have you. 0:22:04.136,0:22:05.136 (Applause)