John Constantino | |
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Occupation(s) | Inaugural System Chief of Behavioral and Mental Health |
Awards | George Tarjan Award, American Academy of Child and Adolescent Psychiatry, 2015 |
Academic background | |
Alma mater | Cornell University; Washington University School of Medicine |
Academic work | |
Institutions | Children's Healthcare of Atlanta |
John N. Constantino is a child psychiatrist and expert on neurodevelopmental disorders,especially autism spectrum disorders (ASD). [1] Constantino is the inaugural System Chief of Behavioral and Mental Health at Children's Healthcare of Atlanta. He is a Professor of Pediatrics,Psychiatry and Behavioral Sciences and Genetics at the Emory University School of Medicine.
Constantino is best known for developing the Social Responsiveness Scale (SRS), [2] a diagnostic rating scale used to distinguish autism spectrum disorder from other child psychiatric conditions by identifying the presence and extent of social impairments. [3] The SRS,published in 2005,includes parent-,teacher-,self-,and spouse-report rating forms. It has been used to assess social-behavioral characteristics indicative of the broader autism phenotype. [4] The SRS is a widely used tool to help clinicians identify social impairments in individuals both with and without a diagnosis of ASD.
Constantino received the 2014 Irving Philips Award and the 2015 George Tarjan Award from the American Academy of Child and Adolescent Psychiatry, [5] respectively for lifetime contributions in prevention and developmental disabilities. In 2013,he received the Alumni Achievement Award from the Washington University School of Medicine. [6]
Constantino earned his B.A. at Cornell University in 1984. Constantino completed his medical degree at Washington University School of Medicine in 1988. After completing a 5-year combined residency in pediatrics,general psychiatry and child psychiatry at the Albert Einstein School of Medicine,Constantino joined the faculty of Washington University School of Medicine where he held the appointment of the Blanche F. Ittelson Chair and Chief of the Division of Child and Adolescent Psychiatry from 2009 to 2022 and co-led its Intellectual and Developmental Disabilities Research Center (IDDRC). His research program at the IDDRC was funded through numerous grants from the National Institutes of Health. [7]
Constantino was appointed the Liz and Frank Blake Chair of Behavioral and Mental Health at Children's Healthcare of Atlanta in 2024,following his move to Atlanta in 2022 to lead a large-scale effort to model system transformation and parity in child mental health there and at Emory University. [8]
Constantino's research program focuses on developmental disabilities and social development from infancy through early adulthood. [9] Some of his most influential work has used twin studies to examine the prevalence of autistic traits in the general population (also referred to as the broader autism phenotype [10] ) and in at-risk groups including individuals with attention deficit hyperactivity disorder who have heightened rates of autistic traits. [11]
As a member of the Autism Genome Project Consortium, [12] Constantino was involved in genetic linkage studies of autism risk. [13] His laboratory linked familial risk for autism to early variations in visual social engagement, [14] motor coordination [15] and activity level. [16] Other research has examined patterns of familial aggregation in multiplex autism,defined as instances where two or more individuals in the same family are affected;knowledge gained from these studies helped specify the impact of combined influences of independently-inherited traits on early childhood social development [17] [18] His work has also elucidated opportunities to resolve enduring disparities in developmental outcomes of minority children affected by autism. [19] His research contributions have also addressed environmental influences on antisocial development [20] including prospects for its prevention through parenting education [21] and the prevention of maltreatment in early childhood. [22]
Asperger syndrome (AS),also known as Asperger's syndrome or Asperger's,is a diagnosis formerly used to describe a neurodevelopmental condition characterized by significant difficulties in social interaction and nonverbal communication,along with restricted,repetitive patterns of behavior and interests. Asperger syndrome has been merged with other conditions into autism spectrum disorder (ASD) and is no longer a diagnosis in the WHO's ICD-11 or the APA's DSM-5-TR. It was considered milder than other diagnoses which were merged into ASD due to relatively unimpaired spoken language and intelligence.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that begins in early childhood,persists throughout adulthood,and is characterized by difficulties in social communication and restricted,repetitive patterns of behavior. There are many conditions comorbid to autism spectrum disorder,such as attention deficit hyperactivity disorder,anxiety disorders,and epilepsy.
The neurodiversity paradigm is a framework for understanding human brain function that recognizes the diversity within sensory processing,motor abilities,social comfort,cognition,and focus as neurobiological differences. This diversity falls on a spectrum of neurocognitive differences. The neurodiversity paradigm argues that diversity in human cognition is normal and that some conditions generally classified as disorders,such as autism,are differences and disabilities that are not necessarily pathological. Neurotypical individuals are those who fall within the average range of functioning and thinking.
High-functioning autism (HFA) was historically an autism classification to describe a person who exhibited no intellectual disability but otherwise showed autistic traits,such as difficulty in social interaction and communication,as well as repetitive,restricted patterns of behavior. The term is often applied to autistic people who are fluently verbal and of at least average intelligence. However,many in medical and autistic communities have called to stop using the term,finding it simplistic and unindicative of the difficulties some autistic people face.
Irritability is the excitatory ability that living organisms have to respond to changes in their environment. The term is used for both the physiological reaction to stimuli and for the pathological,abnormal or excessive sensitivity to stimuli.
The heritability of autism is the proportion of differences in expression of autism that can be explained by genetic variation;if the heritability of a condition is high,then the condition is considered to be primarily genetic. Autism has a strong genetic basis. Although the genetics of autism are complex,autism spectrum disorder (ASD) is explained more by multigene effects than by rare mutations with large effects.
Autism therapies include a wide variety of therapies that help people with autism,or their families. Such methods of therapy seek to aid autistic people in dealing with difficulties and increase their functional independence.
The epidemiology of autism is the study of the incidence and distribution of autism spectrum disorders (ASD). A 2022 systematic review of global prevalence of autism spectrum disorders found a median prevalence of 1% in children in studies published from 2012 to 2021,with a trend of increasing prevalence over time. However,the study's 1% figure may reflect an underestimate of prevalence in low- and middle-income countries.
Classic autism,also known as childhood autism,autistic disorder,(early) infantile autism,infantile psychosis,Kanner's autism,Kanner's syndrome,or (formerly) just autism,is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted,repetitive behaviors,activities,and interests. These symptoms first appear in early childhood and persist throughout life.
Autism or autism spectrum disorder (ASD),is a neurodevelopmental disorder characterized by repetitive,restricted,and inflexible patterns of behavior,interests,and activities,as well as persistent difficulties in social communication and interaction. Autism generally affects a person's ability to understand and connect with others,as well as their adaptability to everyday situations,with its severity and support needs varying widely across the underlying spectrum. For example,some are nonverbal,while others have proficient spoken language.
Paul T. Shattuck is an autism researcher at the A.J. Drexel Autism Institute at Drexel University,where he leads the Research Program Area on Life Course Outcomes. He was previously a faculty member at the George Warren Brown School of Social Work at Washington University in St. Louis.
Sex and gender differences in autism exist regarding prevalence,presentation,and diagnosis.
The Social Responsiveness Scale,developed by John Constantino in 2002 and expanded upon by Constantino et al. in 2003,is a quantitative measure of autistic traits in 4–18 year olds. Its correlation with behaviour problems and autism spectrum disorder symptoms has been studied. It can be assessed with an 18 question survey filled out by the child's parents or teacher.
Connie Kasari is an expert on autism spectrum disorder and a founding member of the Center for Autism Research and Treatment (CART) at the University of California,Los Angeles (UCLA). Kasari is Professor of Psychological Studies in Education at UCLA and Professor of Psychiatry at the David Geffen School of Medicine at UCLA. She is the leader of the Autism Intervention Research Network for Behavioral Health,a nine-institution research consortium.
Marian Diamond Sigman (1941–2012) was a developmental and child clinical psychologist known for her research on autism spectrum disorder (ASD). At the time of her death,she was Professor Emeritus of Psychiatry and Biobehavioral Sciences and Psychology at the University of California,Los Angeles (UCLA).
Current research indicates that autistic people have higher rates of LGBTQ identities and feelings than the general population. A variety of explanations for this have been proposed,such as prenatal hormonal exposure,which has been linked with sexual orientation,gender dysphoria and autism. Alternatively,autistic people may be less reliant on social norms and thus are more open about their orientation or gender identity. A narrative review published in 2016 stated that while various hypotheses have been proposed for an association between autism and gender dysphoria,they lack strong evidence.
The theory of the double empathy problem is a psychological and sociological theory first coined in 2012 by Damian Milton,an autistic autism researcher. This theory proposes that many of the difficulties autistic individuals face when socializing with non-autistic individuals are due,in part,to a lack of mutual understanding between the two groups,meaning that most autistic people struggle to understand and empathize with non-autistic people,whereas most non-autistic people also struggle to understand and empathize with autistic people. This lack of understanding may stem from bidirectional differences in communication style,social-cognitive characteristics,and experiences between autistic and non-autistic individuals,but not necessarily an inherent deficiency. Recent studies have shown that most autistic individuals are able to socialize,communicate effectively,empathize well or build good rapport,and display social reciprocity with most other autistic individuals. This theory and subsequent findings challenge the commonly held belief that the social skills of autistic individuals are inherently and universally impaired across contexts,as well as the theory of "mind-blindness" proposed by prominent autism researcher Simon Baron-Cohen in the mid-1990s,which suggested that empathy and theory of mind are universally impaired in autistic individuals.
The diagnosis of autism is based on a person's reported and directly observed behavior. There are no known biomarkers for autism spectrum conditions that allow for a conclusive diagnosis.
There is currently no evidence of a cure for autism. The degree of symptoms can decrease,occasionally to the extent that people lose their diagnosis of autism;this occurs sometimes after intensive treatment and sometimes not. It is not known how often this outcome happens,with reported rates in unselected samples ranging from 3% to 25%. Although core difficulties tend to persist,symptoms often become less severe with age. Acquiring language before age six,having an IQ above 50,and having a marketable skill all predict better outcomes;independent living is unlikely in autistic people with higher support needs.
Jan K. Buitelaar is a Dutch medical doctor,psychiatrist,author,and academic. He is a professor of psychiatry and child and adolescent psychiatry at Radboud University Medical Centre and former Head of Child and Adolescent Psychiatry at Karakter Child and Adolescent Psychiatry.