Charlie is an 8-year-old boy who is having difficulty making friends and sitting still in class. When he goes to school, his teacher complains that he can’t sit still. He will sit for 3 minutes, but soon afterwards, he starts bouncing his legs, and then he begins tapping his pencil. Shortly thereafter, he starts rapping lyrics under his breath. He is performing well in school, but his behavior is distracting to others.

Charlie isn’t hyperactive like this at home, but his mother is concerned. His mother wants you to prescribe him Xanax for anxiety and Adderall for Attention deficit hyperactivity disorder (ADHD). After you do an extensive interview with Charlie, you realize that he is just bored in his U.S. History class and would rather be playing basketball in P.E. However, Charlie’s mother insists that you write a few prescriptions. Research suggests that medical professionals (Doctors, Nurse Practitioners, Physician Assistants, etc.) are often pressured to write prescriptions even when they don’t believe that it is the best thing to do for the patient.

Your investigation has led you to believe that Charlie just needs more physical exercise. But his mother continues to insist that Charlie needs medication. How would you explain to his mother what you plan to do? Use your investigation skills and present your facts to her.

Struggling with where to start this assignment? Follow this guide to tackle your assignment easily!

Step 1: Identify the Core Issue in the Case

Begin by clearly stating the main concern. In this scenario, the issue is whether medication is an appropriate intervention for Charlie’s classroom behavior. Clarify that although Charlie displays restlessness at school, he performs well academically and does not exhibit the same behaviors at home.

Step 2: Apply Clinical Investigation and Assessment Skills

Explain that a thorough assessment was conducted, including:

Behavioral observation
Parent and teacher reports
Environmental and situational factors

Highlight that Charlie’s behavior appears situational (boredom and lack of physical activity) rather than consistent across settings, which is critical when considering diagnoses such as ADHD or anxiety disorders.

Step 3: Present Evidence-Based Facts to the Parent

Clearly and respectfully explain to Charlie’s mother that:

ADHD symptoms must be present in multiple settings (home and school) to meet diagnostic criteria
Xanax is not recommended for children and carries risks of dependency
Prescribing medication without a clear diagnosis may cause unnecessary harm

Use professional language and avoid dismissing her concerns.

Step 4: Explain Ethical and Professional Responsibilities

Emphasize that as a healthcare professional, your responsibility is to:

Act in the best interest of the child
Avoid unnecessary or potentially harmful medications
Follow evidence-based practice and clinical guidelines

Explain that prescribing medication without medical necessity would be unethical and unsafe.

Step 5: Propose a Non-Pharmacological Plan

Describe your plan clearly and confidently, such as:

Increasing structured physical activity
Coordinating with the school to allow movement breaks
Encouraging participation in sports like basketball
Monitoring behavior over time before reconsidering medical intervention

Explain how physical exercise has been shown to improve focus, self-regulation, and classroom behavior in children.

Step 6: Communicate Empathy and Partnership

Reassure Charlie’s mother that her concerns are valid and that:

You are not dismissing her worries
You will continue to monitor Charlie’s progress
Medication can be reconsidered if evidence supports it later

This builds trust and reduces conflict.

Step 7: Conclude With a Clear, Professional Explanation

End by summarizing that:

Current evidence does not support medication at this time
The proposed plan prioritizes Charlie’s safety and development
Collaboration between healthcare provider, parent, and school offers the best outcome

Maintain a calm, confident, and professional tone throughout.

🔗 Credible Academic & Professional Resources

You may use the following links to support your discussion:

American Academy of Pediatrics – ADHD Guidelines:
https://www.aap.org/en/patient-care/adhd/
Centers for Disease Control and Prevention (CDC) – ADHD in Children:
https://www.cdc.gov/adhd/index.html
National Institute of Mental Health – Child Mental Health:
https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health
Mayo Clinic – ADHD Diagnosis and Treatment:
https://www.mayoclinic.org/diseases-conditions/adhd
Ethical Principles in Healthcare (AMA):
https://www.ama-assn.org/delivering-care/ethics

Managing Classroom Behavior Without Medication: A Case-Based Ethical Approach