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Book Review

Uniquely Human: A Different Way of Seeing Autism

Christiansen, Audrey MD

Author Information
Journal of Developmental & Behavioral Pediatrics: May 26, 2022 - Volume - Issue - 10.1097/DBP.0000000000001098
doi: 10.1097/DBP.0000000000001098
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In Uniquely Human, Dr. Prizant summarizes his philosophy on caring for children on the autism spectrum and their families. He developed his perspective throughout his career working with children with autism and their parents in various roles in research, in schools, and in private practice. His goal is to reframe how families and providers view autism and their experience working with persons on the spectrum. He uses cases and stories gathered in his work to illustrate his approach. Each case serves as a framework for illustrating a lesson learned.

Each chapter reviews an aspect of working with individuals on the spectrum and living with autism. Dr. Prizant reframes how we look at various aspects of autism, emphasizing the importance of the function of behaviors. Each discussion is focused on asking “why.” For example, in the chapter entitled “Listen,” he reframes how we view echolalia, highlighting this as a variation in communication strategies. He provides many case examples of children who used echolalia to communicate illness, anxiety, or stress. In each case, caregivers and teachers were only able to ascertain the meaning of the child's speech by asking why.

In the chapter entitled “The Long View,” Dr. Prizant presents his thoughts on prognosis and outcomes. In particular, he confronts the idea of “recovering from autism.” He reframes the conversation by shifting perspectives. His reflections again highlight cases and parent perspectives. He emphasizes that every child is different, and there is no one-size-fits-all therapeutic plan for autistic children. He uses 4 longitudinal cases to illustrate how each child progressed, faced challenges, and thrived in their own way. In this chapter, instead of detailing learning points from each case, he allows the reader to draw their own conclusion based on each child and family.

Overall, the book presents a unified viewpoint on how to understand autism. His overarching philosophy is that autism is not an illness, merely “a different way of being human,” and to help children with autism, “we don't need to change them or fix them.” Instead, we need to work to understand them and then change what we do as providers and caregivers to appreciate and support them. He does acknowledge behavioral difficulties, e.g., self-injurious behaviors, but he reframes these behaviors and emphasizes that we cannot merely extinguish them without first understanding their “why.”

Dr. Prizant confronts head on several controversial and debated topics, including removing Asperger syndrome from the DSM, extinguishing self-stimulatory behaviors, and what therapeutic approaches to use. He does not provide his own opinion on the Asperger diagnosis but instead focuses on the conversation around “high” and “low” functioning. He again emphasizes a strength-based approach and steers clinicians away from such language, which could limit a child.

Dr. Prizant also includes a brief reflection regarding person-first and identity-first language in his introduction. He uses person-first language throughout the book. In light of current dialog surrounding this language, a more thorough discussion would have been beneficial in framing the context of this book.

Dr. Prizant's philosophies align with developmental-behavioral pediatrics' perception of parents as experts on their children and its emphasis on strength-based models of autism spectrum disorder. The emphasis on case examples, which include parents and self-advocates' stories and perspectives, makes this a great book for parents, caregivers, educators, clinicians, and self-advocates.

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