Chosen over guanfacine, methylphenidate leads the plan in this MN665 Unit 1 post, which tracks tics on a named scale because a composite boy's parents expect them to worsen. Searches like "mn 665 unit 1 assignment example", "mn665 unit 1 sample" and "mn665 unit 1 example" land here.
Methylphenidate or Guanfacine for a Ten-Year-Old With ADHD and Motor Tics
MN665 · Unit 1 Discussion
Posted by [Student Name]
Composite patient written for a model post. No real child or family is described.
Initial Post
The case. He is 10, in fifth grade, and his Vanderbilt ratings from both parents and his teacher are above threshold for inattention and for hyperactivity-impulsivity. Shoulder shrugs and hard blinking began at age 7. There are no vocal tics, and his Yale Global Tic Severity Scale motor score is 14. He is at the 25th percentile for weight. His parents said, "We read that stimulants make tics worse, and we don't want him shrugging all day in front of his class."
Two reasonable directions. Methylphenidate gives the larger improvement in attention, and its effect can be judged within days of each dose change. Guanfacine extended release, approved by the FDA for ADHD in 2009, may ease tics as well, does not suppress appetite and suits a boy who is already light for his age, but it usually helps attention less and takes weeks to judge.
My choice is methylphenidate. The fear his parents raised was tested directly in a 16-week trial of 136 children with ADHD and a chronic tic disorder: tic worsening was reported by 20 percent of children on methylphenidate alone, against 22 percent on placebo, and measured tic severity fell in every active group (Tourette's Syndrome Study Group, 2002). A Cochrane review of eight trials rated the evidence for methylphenidate in children with tics as low quality but found no sign that it worsened tics in the short term (Osland et al., 2018). I would show his parents those two numbers, 20 and 22, rather than simply telling them not to worry. Titration would follow a [composite titration], with the tic score repeated at each step.
What would reverse it. If his motor tic score rises clearly above 14 over two dose steps, or if he loses weight, I would switch to guanfacine extended release and accept a smaller gain in attention.
Reply to a Classmate
Your plan for the 8-year-old girl starts medication but does not mention the classroom. The AAP guideline for children aged 6 to 11 pairs medication with parent training in behavior management and behavioral classroom supports, preferably both (Wolraich et al., 2019). Would her teacher take part in a daily report card?
References
Osland, S. T., Steeves, T. D., & Pringsheim, T. (2018). Pharmacological treatment for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders. Cochrane Database of Systematic Reviews, 2018(6), CD007990. https://doi.org/10.1002/14651858.CD007990.pub3
Tourette's Syndrome Study Group. (2002). Treatment of ADHD in children with tics: A randomized controlled trial. Neurology, 58(4), 527-536. https://doi.org/10.1212/WNL.58.4.527
Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & Subcommittee on Children and Adolescents With Attention-Deficit/Hyperactive Disorder. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528
How this MN665 Unit 1 example is structured
Ordering does deliberate work here: the decision arrives only after both options have been given their best case. Each direction is stated with its evidence, its likely burden for this boy and the outcome his parents care about most, which is whether the shrugging gets worse in class. Methylphenidate wins on the size of benefit for attention and on how quickly an effect can be judged. Guanfacine is credited for the chance of easing tics and for avoiding appetite loss in a child at the 25th percentile for weight. The parents' fear, quoted in their own words, is answered with the trial data rather than dismissed. Titration steps appear only as [composite titration]. The reply notes that a classmate's plan for a school-age child left out behavioral classroom supports, which the AAP's 2019 guideline pairs with medication at this age.
Get an MN665 Unit 1 example written to your instructions
Which case did your MN665 section's opening board ask for: one supplied by the instructor, or one you choose? Share it, or the prompt, with the rubric. A first custom post costs nothing and comes back within 24-48h, taking a side between two defensible plans and stating the finding that would switch it. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
MN665 Unit 1 questions, answered
Can a board post choose a medication for a child?
It can, framed as coursework reasoning about a composite case. Name the options, state the evidence for each in this age group, and commit to one with the condition that would change it. Keep amounts bracketed, cite pediatric sources, and include the non-drug supports guidelines pair with medication, because a plan built only on a prescription reads as incomplete for a school-age child.
How much evidence should a board post cite?
Usually two or three sources that bear directly on the decision, such as a trial, a systematic review and a guideline, each with its year. More citations rarely help if they only restate background. What earns credit is using the evidence to separate the options, so say what each source found and how it tipped the choice for this particular patient.
Should the post address the family's concerns?
Yes, whenever the case gives them, because a plan the family rejects will not be followed. Quote the concern, treat it as reasonable where it has a basis, and answer it with evidence rather than reassurance. Where the concern cannot be fully answered, say so and describe how the plan would detect the feared outcome early.