double down…

For anyone unfamiliar with the game of Blackjack, “doubling down represents a move in the card game where the player can double their bets at certain points in the hand, while awaiting the outcome.  The idea behind doubling down is to double your bet when you have the best opportunity of beating the dealer. Most of the time, this is when the dealer’s hand is at BlackJack6their weakest. This happens when the dealer shows an up card, which can possibly cause them to bust.  The risk is high, but if successful, the reward can be even higher.

As much as the “double down” theory may entice gambling fanatics, it is not often a term – or method, for that matter – associated with children’s education.  So you might imagine my surprise yesterday when the mother of a prospective VT patient began an impromptu conversation by offering “we don’t know whether to have our son repeat Kindergarten, or double down with him in first grade, hoping VT can turn his academics around.  What do you think?”.  Her son is six years old, and completely struggled through Kindergarten.  He doesn’t know his alphabet, or his numbers, and has a very hard time sitting still – but then again, he’s only six.  Although his mother suspected something to be amiss, his teachers assured mom for most of the year that her son was on pace to begin first grade.  It wasn’t until the last week of the school year that mom received a telephone call from the principal asking that she and her husband consider having her son repeat Kindergarten.  Once they were able to set their anger aside for the what they perceived to be a massive misrepresentation of their son’s progress through most of the school year, they were left to ponder their next move.  They are still undecided, and school begins Monday.

Does it make more sense repeating Kindergarten to remediate the same in curriculum with a different teacher while possibly damaging his already fragile self esteem?  If they choose this option and VT is successful, by the middle of the school year, their son may begin to excel, and they would then face the regrets of holding him back.


Does it make more sense to allow him to progress to first grade hoping that VT, maturity and private tutoring close the gap by the end of first grade.  This option also risks colossal failure if their chosen combination of services are not the answer. Their son would struggle through first grade, his self esteem would plummet, and he’d have to repeat anyway.

Suddenly that Blackjack gamble doesn’t seem like such a big deal, does it?

sad_boy Gambling with your child’s future is a quandary no parent should ever find themselves in. Let’s just face facts, it would suck.  The stakes are high, and the reward is not guaranteed. Nonetheless, the position is common, and calling a timeout to consider it all is not really an option. A decision needs to be made, and quickly.  Do we play it safe, or gamble everything?

My best answer for this mom’s question: “I don’t know”.  Certainly there is risk and reward in both arguments, and while I am confident VT will have a positive impact, I just cannot guarantee the impact will be great enough, or soon enough to show immediate success in first grade. As a character trait, I tend to err towards the side of caution, especially when it comes to patients. Making promises to mom that her son would be highly successful in first grade was just not fair, to either of us.  I hope it happens, and all evidence points towards a positive outcome, but I do not own a crystal ball.  Neither does she.

As our conversation ended, I deferred to my doctor’s judgement and told mom I would share her concerns.  Trying to reassure her, I reminded her that there really is no wrong decision.  As long as you remain vigilant, and adjust accordingly in the best interests of your son, you cannot be faulted for either decision. After all, kids don’t come with a user’s manual.


Posted on August 14, 2013, in From My Perspective.... Bookmark the permalink. 4 Comments.

  1. Excellent thoughts, Robert. And to continue the metaphor, this is a double-edge sword for the doctor to handle. We may be experts in learning, in the sense that vision is a learned process as well as vision therapy itself setting conditions to guide learning. But learning decisions aren’t synonymous with educational decisions, and placement is a slippery slope to comment on. Most of us are not educators. (Ironically many instructors of record in healthcare graduate schools do not have degrees in edcuation.) Point being, elementary school education is a distinct field and I would therefore be cautious in making a recommendation as to whether or not a child should repeat a grade. My suggestion is to have an “off-the-record” conversation with the parent, more as a fellow parent than as a doctor, giving one’s impressions based on personal experience — and making it clear that is what it is — that if this was your son, here’s what you would be learning toward.


    • Thank you, Dr. Press. Although my doctor earned her Masters in Education simultaneous to her doctorate, she still is very cautious with these issues. Her position has always been to provide as much information as possible to the parents, without trying to influence the decision, in either direction. As a fellow parent, I can appreciate the challenges of such a decision and the need for guidance, but ultimately parental instincts seem to be the best barometer. At the end of the day, the parents need to live with the decision, and they alone should make it.


  2. Thanks Robert and Dr. P: In over 40 years (yes, I started when I was 6!!!) of being involved in Optometry, I have encountered similar situations. I have found that begining Vision therapy immediately with special consideration in terms of extended time, nearpoint glasses and VT are the way to go. We found that 90% of the time in children with similar circustances, near point glasses were necessary as was basic ocular motor vision rehab therapy. Not only will the child benifit from the VT and glasses but it gives us an opportunity to build the ego in terms of being successful. Sometimes, the praise has to be quite simple, e.g., “Wow, I really like the shirt you are wearing today”, or “I noticed how quickly you got out your glasses and I’m so proud that you are remembering to put them on”. etc. etc. One has to be creative in this as kids can spot fakes very quickly. Discussion with the parents is critical, and communication with the school is of utmost importance.


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