Battle Hymn of the Tiger Mother and Section 504 Accommodations


So what’s the latest buzz on the street about parenting as related to raising children who are “successful”?  Many optometric physicians, particularly those who see significant numbers of children with vision based learning problems, are familiar with parents who request Section 504 Accommodations for their children. To make a long story short, Section 504 is  part of the Rehabilitation Act of 1973 that prohibits discrimination based upon disability, and extends to accommodations made for students with learning disabilities explained in exquisite detail here.

Enter Battle Hymn of the Tiger Mother, a brilliant new publishing tour de force by Amy Chua.  As she describes in her book , when Amy originally began to write this work she fancied herself as the author of an epic novel centered on tough love Chinese child-rearing, but was scooped by Maxine Hong Kingston, Amy Tan, and Jung Chang by the time she got her act together.  So she set out on a different path, one that frankly has positioned her squarely in the center of a maelstrom about child rearing practices.  Ms. Chua, a Yale University Law Professor, seems to have taken the role of provocateur, and you can view an enjoyable clip of her back-pedaling a bit on her tough love Eastern vs. Western parenting stance on the Stephen Colbert show last night here.

Optometric recommendations for Section 504 Accommodations revolve around those requests that would relate to visual impairment, but not necessarily the way you’d classically think about visual impairment.  In the field, we define this as reduced BVA in the better eye(s) to the level of 20/70 or poorer, and a constriction of peripheral vision to within a 20 degree angle.  This imparts a false sense of security that anyone who does not meed these criteria cannot be impaired, or have a disability that would impede learning, or at least performance on standardized testing.  This notion was first blown out of the water by my former student, friend and colleague, Dr. David Damari, noting in a seminal book chapter how documentable, abnormal findings in ocular motility and binocular vision, for example,  can and should qualify under the ADA act that would extend to Section 504 Accommodations.

Which made me wonder while reading Ms. Chua’s Battle Hymn:  What would she think of an optometric examination that resulted in an accommodations request based on optometric guidelines?  One of Amy’s father’s bedrock principles was,  “Never complain or make excuses.  If something seems unfair at school, just prove yourself by working twice as hard and being twice as good.”  So are we and their parents being too soft on these kids who present themselves on the surface as underachievers?

Far from being just a blah-blah-blah issue, this concept of Western Society allegedly lowering the bar on expectations for learning and mastery pierces the heart of the accommodations controversy.  So what accounts for all the attention to Amy Chua and the Battle Hymn’s contents and discontents?  I side with Nancy Gibbs’ conclusion in her back essay of this week’s Time Magazine:

“But maybe the real appeal is her tone of certainty in discussing something so confounding as child rearing – as if it’s a puzzle to be solved rather than a picture to be painted, and there’s no way to know what it will look like until it’s done.”

- Leonard J. Press, O.D., FCOVD, FAAO

12 thoughts on “Battle Hymn of the Tiger Mother and Section 504 Accommodations

  1. Three cheers for Dr. Damari! I’ve been building a case in my own life story for the ADA to include stereo blindness and a mandate for support of vision therapy. Thrilled to find someone is way ahead of me!

    The best analogy I have of my stereo blindness is dull scissors that still have some sharpness on either side of the part of the blades most frequently used. I can cut anything if I adapt and compensate around the dull (stereo blind) area, but don’t expect me to be as fast as I could be if that “fusional area” was sharp!

    I am all for achievement; giving it 100%, in myself and in others. But achievement at any cost can have a price: did I teach myself to supress my left eye in order to make the top reading group in the first grade? … I wonder …

    I did make the top reading group as a one-eyed reader and slid under the disability radar as a result. Sheer fear of failure made me average in gym class. Since I was average or above with my dull scissors, I have flown under that radar all my life … until reading Fixing My Gaze and speaking out.

    I read Amy Chua’s essays in the WSJ … I shudder to think that, if she was unaware of the scope of the human eye-brain connection and one of her daughters had my problem, that “tiger” could have needlessly unleashed punishment over a “B” that was her daughter’s very best!

    Our fervent hope is to eradicate ignorance, so that those like Amy Chua can be sure of the power of their zeal to encourage and build up the very best in their kids by including vision therapy when needed.

    • Sigh … the chapter Dr. Damari published rightly focuses on reading disabilities and asks for academic accommodation. Strabismics who suppress in order to read well still fly under the “disability” radar.

      • Right on, Lynda. Keep pushing us as professionals to see things through your eyes. Note my comments to Dr. Damari. There are certainly anecdotal reports from strabismics about difficulty with reading that improves with print size, beyond what one can account for based on visual acuity needs. Seems like devices that provide easy reading enlargement will make that observation more commonplace. See for example: http://www.eyesapart.com/2010/07/03/i-discovered-reading-again/

        I want to support what Dr. Damari said, that when addressing request for academic accommodations, too often we see requests where the disability could have been treated effectively through optometric vision therapy, but the individual was never given the benefit of that option. It is reprehensible to see indivdiuals left to struggle through the lifespan with report after report indicating that no treatment was needed because the patient is either “too old”, or some value judgment that they simply need to try harder or obtain accommodations.

    • Love your metaphor about the scissors, Lynda. Aside from the general brilliance of Sue’s book, one of its strengths is the chapter on School Crossings. I will add more thoughts to your next comment about Dr. Damari’s position on strabismus and disability.

    • Totally agree, Jim. The right way is the way the child develops best. But to know that in advance is often untenable. It would be like knowing to look for your keys first in the spot where you ultimately found them. (Nor is the right way to look for your keys where the best streetlighting is ;)

  2. Thanks, Dr. Press, for the “shout-out,” and to Lynda for your initial excitement and then mild disappointment about my book chapter. I would ask your forgiveness, though, because the nature of the book was such that it is really about disabilities that affect academic achievement in higher education. While I agree that poor stereopsis, in and of itself, is disabling for many activities of daily living, there has never been any evidence that it is an impairment to academic achievement. I think your personal experience in first grade is somewhat typical, and part of the reason it is sometimes difficulty for eye surgeons and other medical professionals to understand the impact binocular and accommodative disorders can have on academic achievement.
    Also, the ADA cannot “mandate” any type of treatment. It is a civil rights law, which mandates equal access. Many times, Dr. Press, my other colleagues and I see individuals with these conditions who, in their current condition, are disabled under the ADA Amendments Act or Section 504 of the Rehabilitation Act but who almost certainly (95%, according to some studies by Dr. Mitchell Scheiman and co-workers) would no longer be disabled if they underwent a program of vision therapy. So what is stopping them? I think Dr. Press’s post here might offer a clue!

    • You’re welcome, Dr. Damari. There are some recent suggestive studies that support what Lynda is saying, and that we should look at more closely. The first one is from the British Journal of Ophthalmology in 2005, suggesting that patients with microstrabismus have reading difficulty: http://bjo.bmj.com/content/89/10/1324.abstract
      The second is from Investigative Ophthamlology and Vision Science in 2010, indicating that the adaptations required in suppression exacerbate the crowding effect: http://www.ncbi.nlm.nih.gov/pubmed/20207968

      Clearly when your wrote your chapter in 1998, there was no reason to think otherwise based on published studies. The point you made in your chapter is crucial, that patients with fusion and binocular instability often have greater challenges than patients with strabismus and constant suppression. But I am afraid we’ve done patients like Sue Barry and Lynda a disservice by pre-supposing what reading is like for them because, as you note in the chapter, reading is essentially a two-dimensional task.

      It is time for us tor re-analyze that position, and acknowledge that for some patients with strabismus the strabismic adaptation itself may come with tradeoffs that influence saccadics and other visual components required for reading efficiency. More research would be welcome, and perhaps we can influence optometrists in doing it. I hear a rumor that Dr. Scheiman is spending time with Dr. Ciuffreda to become spiffy at eye movement research, so one day that may be on his agenda. ;)

  3. Dr. Damari, I appreciate the correction about ADA mandates. I had forgotten that the primary focus of the law was accessibility.

    It amazes me that so many strabismics go through life with severe vision problems that make reading difficult like diplopia and nystagmus as well as a larger population that suffers convergence insufficiency, etc.

    I am all for research and advocacy for these more severe vision problems to take precedence over my kind of stereo blindness, which is free of all of the above.

    However, master suppressors like myself (with 25-30 Δ alternating esotropia) still need to get in the queue and communicate how the dull area of the scissors causes us to avoid work and play that depends on good stereopsis, and is therefore limiting, if not disabling. With the advent of 3D entertainment, and soon, 3D computer monitors (http://www.patentlyapple.com/patently-apple/2008/03/apple-working-on-3d-holographic-projection-displays.html), that list of limitations is growing.

  4. Dr. Damari, I appreciate the correction about ADA mandates. I had forgotten that the primary focus of the law was accessibility.

    It amazes me that so many strabismics go through life with severe vision problems that make reading difficult like diplopia and nystagmus as well as a larger population that suffers convergence insufficiency, etc.

    I am all for research and advocacy for these more severe vision problems to take precedence over my kind of stereo blindness, which is free of all of the above.

    However, master suppressors like myself (with 25-30 Δ alternating esotropia) still need to get in the queue and communicate how the dull area of the scissors causes us to avoid work and play that depends on good stereopsis, and is therefore limiting, if not disabling. With the advent of 3D entertainment, and soon, 3D computer monitors (http://www.patentlyapple.com/patently-apple/2008/03/apple-working-on-3d-holographic-projection-displays.html), that list of limitations is growing.

  5. Len, you write so well, regardless of the topic, but you’ve really hit the nail on the head with this piece. IMHO, while I dislike the oversimplified philosophy of parenting that Ms. Chua presents in her TIGER MOTHER treatise, I abhor the entitlement mentality that permeates the “everyone must have a disability” crowd’s approach.

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