Domain Independence: Origin Story

Domain independent: understanding situations outside the context in which you learn them
-Nassim Nicholas Taleb

Domain independent thinking has enabled me to examine how the complexities I encounter in my practice are transferable to different areas of my life.

Last week, I received a text from a colleague about a student of mine from 4 years ago.

When he came to my school, he was non-verbal, diagnosis of Autism.

First principle: If you know one student with autism, you know one student with autism. Treat the child, not the disorder.

He was a sweet kid, endearing and engaging.
I could tell from my first visit that there was much more to him.

His comprehension was outstanding. He was responsive. He would point, smile, nod his head and laugh.

At lunch, I watched him eat.

Watching someone eat is a window into their anatomy and physiology.

I noticed he had black rings around his eyes, his tongue thrusted out as he barely chewed what the menu referred to as ‘cheese sticks’.

He was an obligatory mouth breather, which means he sounded like he was snoring while he was awake. 

When he would drink his milk, he would take tiny sips and then gasp for air. It was as though he was drowning every time, he took a sip.

I felt two golf balls under his throat, by his jaw muscle. He gagged when I rested the tongue depressor on the tip of his tongue. I wasn’t surprised when I shined the flashlight in his mouth and revealed the two massive swollen tonsils that were taking up the real estate of the back of his throat.

“We need to get those out of there buster.”

He giggled.

“Nuh do da.” (Don’t do that) He replied.

It’s my job to comprehend what a person says by how they speak. If I cannot understand them, then most likely, no one else will.

It was clinically clear that the tonsils were obstructing his air way, affecting his breathing, chewing and sleeping. Since he snored while he was away, my hypothesis was that when I asked Mom and Dad if he snored at night, they would give a resounding yes!

I called his parents and asked about his snoring. Since he is one of 4, soon to be 5, Mom and Dad were quite… exhausted. Dad said he “snores like a lion” but the doctor at the hospital said he is okay.

There are many roadblocks in working in a title 1 area. Lack of appropriate medical care is one of them. I gently suggested they get a second opinion from an ENT (ear nose and throat doctor).

ENTs are like gold. Find a good one and befriend them. They can do wonders for your breathing, chewing and sleeping.

It took about 6 months before he had his tonsils removed. Within that time frame, he worked up from exchanging pictures, to discriminating pictures, to using a dynamic display device to communicate his wants and needs. He would giggle, say “goo doo wuh” (do your work) and wag his finger.

This was how he called you out for slacking. “Do your work!” was a running joke. He would say it to everyone he saw, especially his classmates. He used this phrase appropriately and with tact.

I work with this student for two years. He made tremendous progress before and especially after his surgery.

You learn to accept the fact that one day a student can vanish off your caseload. They move or go to different programs; this is simply what happens in life.

When he did suddenly move, I was glad to know that he would be at a site where I knew the therapists.

Miracles are inherently rare. But I know them when I see them. I am not claiming that there is a magic solution to most of what ails us, but with a proper understanding of breathing, chewing and sleeping, I was able to change the course of this kid’s life.

The text I got from my colleague was a picture of him competing in a spelling B. Something that would not have been imaginable at first glance of this kid 4 years ago.

There are many lessons here. Domain independent thinking is what enables me to share these insights with you as they directly relate to your life. It is a matter of understanding the things we do every day, without thinking about them: breathing, chewing and sleeping.

This had a direct impact on my life when we noticed the same disruption in my son's chewing, breathing and sleeping. Because I knew what to expect we didn't hesitate in taking out his tonsils. Now he is exponentially better off. 

This is why I do this. To share everything I know so that it may serve you and yours.

Matthew CriscuolaComment