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

いつも思っていました

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

社会につながる活動を 実地に研究し

in the act of being with them.

人々に寄り添い その感情や思考-

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

意思 欲求に共感したいと

that sense of the other that happens so quickly,

科学者としては ずっと その共感を測定したいと願っていました

in the blink of an eye.

｢他者と共にいる」という－

We intuit other people's feelings;

瞬時に生まれる感覚

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

人の気持ちは直感でわかります

We're always in this stance

人の行為の意味は

of being the object of somebody else's subjectivity.

あらかじめ わかってしまいます

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

我々は常に

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

他者の主観の対象という立場に置かれています

to understand the world around us,

途切れることなく 避けることもできません

are shaped by that stance.

大変重要なことで

We are social to the core.

自分や周りの世界を－

So my journey in autism really started

理解する手段はまさにその立場から形づくられます

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

人は 骨の髄まで 社会的です

Most of those individuals had spent most of their lives

自閉症の探求の出発点は

in long-stay hospitals.

成人の自閉症者用の施設でした

This is a long time ago.

昔の事ですが そこの人達は

And for them, autism was devastating.

人生の大半を 病院で過ごしてきた人ばかり

They had profound intellectual disabilities.

彼らにとって 自閉症は 災いでした

They didn't talk.

深刻な知的障害を持ち

But most of all,

口も利けない でも最悪なのは－

they were extraordinarily isolated from the world around them,

極めて孤立していたこと

from their environment

自分たちを取り巻く 世界や環境や

and from the people.

人から孤立しているのです

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

当時の自閉症者の学校は

for individuals with autism,

騒がしく 落ち着きがなくて

you'd hear a lot of noise,

何かしている人がいても その人達は決まって

plenty of commotion, actions, people doing things.

独りぼっちでした

But they're always doing things by themselves.

天井の照明を見つめたり

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

部屋の隅に引きこもったり

or they may be isolated in the corner,

何の意味もない 自己刺激運動を

or they might be engaged in these repetitive movements,

延々と繰り返すのに 夢中だったり

in self-stimulatory movements that led them nowhere.

非常に根の深い孤立です

Extremely, extremely isolated.

自閉症とは このように

Well, now we know that autism is this disruption,

他者への共感が 断絶した状態だと

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

今は分かっています

These are survival skills.

共感は 数十万年の

These are survival skills that we inherited

進化の歴史の中で

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

人類が受け継いできた

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

生存の為の知恵です

Without the caregiver, they wouldn't survive,

赤ん坊は無力なので 生き延びるには 誰かに－

so it stands to reason that nature would endow them

世話をしてもらいます

with these mechanisms of survival.

彼らに共感能力が

They orient to the caregiver.

あるのは自然な事なのです

From the first days and weeks of life,

赤ん坊は世話をする人の方を向きます

babies prefer to hear human sounds,

産まれた日や最初の数週間から

rather than just sounds in the environment.

ただの物音より 人の立てる音を

They prefer to look at people rather than at things,

好むのです

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

彼らは物よりも

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

人を見るのを好み

so much so that they even prefer to look at people

特に人の目を見つめます

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

目は 他人の経験に通じる 窓だからです

Well, they orient to the caregiver.

だから 彼らは

The caregiver seeks the baby.

自分を見ている人の事を 見るのです

And it's out of this mutually reinforcing choreography

世話をする人を

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

その逆も言えます

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

互いに与えあう このダンスこそ

We always think about autism

社会的な精神 頭脳が

as something that happens later on in life.

誕生するのに 極めて重要な事なのです

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

自閉症は

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

もっと大きくなってから発症するものと 考えられてきましたが

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

それは間違いです 生まれつきのものなのです

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

世話をする人と交流し 赤ん坊は気付く

And that thing is called attention.

「両耳の間には何かがあるな」

And they learn soon enough,

重要なもの

even before they can utter one word,

目には見えないが とても大事なもの

that they can take that attention and move somewhere

｢注目｣です

in order to get things they want.

赤ん坊はたちどころに学びます

They also learn to follow other people's gazes,

言葉を話す前から

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

欲しいものを得るには この｢注目｣をとらえて動かせばいいのです

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

人の視線を追う事も学ぶ

because when somebody is looking at something

人が見る物 それは

or somebody is pointing at something,

頭に思い浮かべている物ですから

they're not just getting a directional cue.

そしてすぐ 物の意味を

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

学び始めます 何故なら 人は－

the attitude.

何かを見たり指差す時

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

ただ方向を示すだけでなく

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

その物が持つ意味を

Those are meanings that are acquired

他人に対して示しているからです

as part of their shared experiences with others.

赤ん坊はすぐ この意味のシステムを築き始めます

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

でも 交流なしには

and she has autism.

｢意味｣を学ぶことはできません

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

体験を共有して

and she's quite oblivious to me.

初めて 物の｢意味｣を 学ぶ事ができるのです

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

この小さな女の子は 1歳3カ月で

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

自閉症です

You would recoil. You would call the police.

顔から5センチまで 近づいても

(Laughter)

全然私に気付いていません

You would do something,

もし5センチまで

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

顔を近づけられたらどうします？

and not get that reaction.

たぶん 二つに一つ

We do so, remember, intuitively, effortlessly.

後ずさりするか 警察を呼ぶか (笑)

This is our body wisdom;

何かはするでしょう

it's not something mediated by our language.

領域を侵されると 人は

Our body just knows that.

必ず反応するのです

And we've known that for a long time.

本能的に 自然に そうするのです

And this is not something that happens to humans only.

これは体の働き

It happens to some of our phyletic cousins,

言葉に関係なく 体はそう動くものです

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

ずっと昔からそうなのです

and that monkey has a higher hierarchy position than you,

人間だけではありません

and that is considered to be a signal or threat,

人間に近い動物たちもです

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

あなたが猿で

So something that in other species are survival mechanisms,

他の猿を見ていて

without which they wouldn't basically live,

その猿があなたより 地位が高ければ

we bring into the context of human beings,

合図 または威嚇とみなされ

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

あなたの命はそこまでです

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

他の動物にとっては不可欠の－

and you think, maybe she can see you,

生き残る為の知恵ですが

maybe she can hear you.

人間にとっては単に

Well, a few minutes later,

社会的活動に必要な事 というだけです

she goes to the corner of the room,

こんな近くにいれば

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

私が見えたり

So I could not attract her attention,

声が聞こえたりすると思います

but something -- a thing -- did.

数分後 この子は

Now, most of us make a big dichotomy

部屋の隅に行き ちっちゃなキャンディを見つけます

between the world of things and the world of people.

彼女の「注意」は私には向かなくても

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

何か物には向くのです

and the world of people is not attracting her

ほとんどの人にとって

as much as we would like.

｢物の世界｣と｢人の世界」があります

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

この子にとって その境界は 定かでなく

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

人の世界に対する興味は 期待されるほど

moment by moment,

強くありません

as she is isolating herself further and further.

｢体験の共有」を通じて

So we feel sometimes that the brain is deterministic,

人は多くを学ぶことを思い出してください

the brain determines who we're going to be.

彼女が今のように 自分の中に

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

閉じこもれば閉じこもるほど

and at the same time that her behaviors are taking away

学びの道からどんどん 外れていくのです

from the realm of social interaction,

脳の将来の姿は決まっていて

this is what's happening with her mind,

その脳がどんな人になるか決めると思いがちです

and this is what's happening with her brain.

実は脳も私達自身になる

Well, autism is the most strongly genetic condition

この子の行動が 社会的交流から

of all developmental disorders.

切り離される時 精神や脳にも

And it's a brain disorder.

そういう事が起こっているのです

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

自閉症は あらゆる発達障害の中で 一番強く

that the child is born.

遺伝的条件に支配されるものであり

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

脳の障害なのです

There are those individuals who are profoundly intellectually disabled

子供が生まれるより

but there are those that are gifted.

ずっと前から始まっています

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

自閉症スペクトラムは 幅広く

there are those individuals who talk too much.

重い知的障害の人も

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

才能のある人もいます

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

全く口を利かない人

to those individuals who cannot stop coming to you

しゃべりすぎる人も

and trying to engage you repeatedly, relentlessly,

止められなければ

but often in an awkward fashion,

学校のフェンス沿いに一日中

without that immediate resonance.

走っている人もいます

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

人のところに来て

When I started in this field,

繰り返し 執拗に

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

気を惹こうとするけれど

a very rare condition.

他人の心をはかり知ることができない人も います

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

かつて思われたよりも症状を持つ人は ずっとたくさんいました

There are millions of individuals with autism all around us.

この分野で働き始めたとき自閉症は稀で－

The societal cost of this condition is huge,

1万人中4人程度だと

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

考えられていました

And you know what?

現在の研究では 割合は100人中1人

Most of those funds are associated with adolescents and particularly adults

数百万の自閉症者がいる 計算になります

who are severely disabled,

関連する社会保障費は 莫大で

individuals who need wraparound services --

米国だけで350～800億ドル

services that are very, very intensive.

この費用の大半は

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

深刻な障害を持ち

Those are individuals who did not benefit from early treatment,

総合的で徹底的な

because now we know that autism creates itself

ケアを必要とする

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

若者や大人のための

Were we to be able to identify this condition

一年で6～8万ドルかかる ケアです

at an earlier point, and intervene and treat --

早期療育の恩恵にあずからなかった 人たちです

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

お話した通り 自閉症は 学習の道筋から

in the past 10 years,

逸れていくことで 重症化すると

this notion that we can absolutely attenuate this condition.

判明しています

Also, we have a window of opportunity,

もし 早い段階で

because the brain is malleable for just so long,

症状に気付き 療育を受けさせるとどうなるか

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

ここ10年の 私の人生に

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

影響を与えた事なのですが

But it diminishes considerably.

早期療育によって 我々は症状を－

And yet, the median age of diagnosis in this country

軽減できるのです

is still about five years,

チャンスはあります

and in disadvantaged populations,

脳が柔軟な時期は 充分長い

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

産まれてから３歳までが

rural populations, minorities,

その時期です

the age of diagnosis is later still,

その後も改善の可能性は 閉ざされません

which is almost as if I were to tell you

ただ効果は大幅に減るのです

that we are condemning those communities to have individuals with autism

米国で自閉症と診断される－

whose condition is going to be more severe.

平均年齢は5歳

So I feel that we have a bioethical imperative.

田舎に住む人や

The science is there.

マイノリティーは 医療サービスを受けにくく

But no science is of relevance

診断される年齢は更に上がります

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

こんなことを言うとまるで

And we just can't afford that missed opportunity,

そういうコミュニティーに対して

because children with autism become adults with autism.

自閉症の人がいて

And we feel that those things we can do

その症状はこれから さらに悪化すると告げているみたいです

for these children, for those families, early on,

生命倫理上 責任を感じます

will have lifetime consequences --

科学の存在は

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

社会の役に立たなければ意味がない

So this is our view of autism.

だから私達は 療育のチャンスを

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

逃してはならない

In fact, we believe there are going to be

成長しても彼らは自閉症です

something between 300 and 600 genes associated with autism,

この子達や その家族の為 もっと早くに－

and genetic anomalies, much more than just genes.

何かできたなら

And we actually have a bit of a question here,

子どもや家族や地域には

because if there are so many different causes of autism,

決定的な変化が起こるでしょう

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

これが我々の見解です

Because people like myself,

自閉症に関連する遺伝子は

when we walk into a playroom,

現在100を超え

we recognize a child as having autism.

やがてその数は 300～600になると

So how do you go from multiple causes

信じられています

to a syndrome that has some homogeneity?

ここで疑問が一つ 出てきます

And the answer is what lies in between,

自閉症の原因因子が 数多いなら

which is development.

それらの障害からどのようにして

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

実際の症候群になるのでしょうか

because those liabilities don't necessarily convert into autism.

専門家は遊び場に行けば

Autism creates itself.

自閉症の子が見分けられます

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

数ある原因因子から－

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

共通点のある症候群が発生するのはなぜか

So how do we do that?

因子と症候群を結ぶ物

How do we enter that feeling of resonance,

それは発達です

how do we enter another person's being?

因子は必ずしも自閉症へと

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

発展するわけではないので

the thing that came to my mind was,

2歳になるまでが重要なのです

"How do you come into her world?

自閉症は自己強化します

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

2歳になる前に診断・療育等 医療が介入できれば

Well, it's hard to do that,

症状を緩和したり

so we had to create the technologies.

未然に防ぐ事さえ可能かもしれません

We had to basically step inside a body.

でもどうすればよいのでしょうか

We had to see the world through her eyes.

どうすれば 彼らの感情を呼び覚まし

And so in the past many years,

他者に共感させることができるでしょうか

we've been building these new technologies

先程の15か月の女の子とふれあった時も

that are based on eye tracking.

彼女の身になって

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

考えるのは難しいことでした