When Sean starts getting pressure from the school to put Toby on medication for ADD, something smells fishy, and it isn’t the caviar that was served at last week’s parents meeting. To Sean, Toby’s “issues” in school seem to be nothing more than normal behavior for an eight-year-old boy. But maybe Sean just isn’t seeing things clearly—harder to do since Toby’s new teacher, Jess, started teaching at Bradley. And the school should have Toby’s best interests at heart.

But what happens when the pressure to not just keep up, but to exceed, takes hold? When things take a tragic turn, Sean realizes that the price of this accelerated life is higher than he could ever have imagined.

2. Do you think Sean made the right decision when he decided to put Toby on medication?

3. Third grade seems to be the “sweet spot” for discovering learning disabilities, challenges and disorders. Do you think there’s too much emphasis at schools on “not letting anything fall through the cracks,” or do you think this is crucial for identifying and supporting any learning issues, even though some children and families will be falsely alarmed.

4. Has your child received an ADHD diagnosis of some sort, and have you been skeptical that the results were incorrect? How have your reservations been received? Have you felt pressure to put your child on medication? If you did decide to medicate, what do you think would have happened if you’d refused?

5. Medicating children used to carry a greater stigma than it does today, but it’s still not something parents talk about in casual conversation. Do you think that a more open dialogue among parents would help them make better decisions? Does knowing the statistics (all statistics and medications in the book are real, except for the fictional Ritalin-like Metattent and Metattent , Jr.). How does knowing how many children are being diagnosed with and medicated for ADHD impact your thinking about the disorder and the way this country views children’s development.

6. It’s hard to teach kids, especially boys, who are antsy and can’t sit still for hours on end. What are ways, beyond medicating, that might help boys learn what they need to learn in school? An article on education that ran a few years ago declared that boys were being treated like "defective girls". Do you think this statement is inflammatory, accurate, or both?

7. Do you think there’s an over-emphasis in today’s society on over-achieving? What are some pros and cons of pushing children and teens to work at such an advanced level?

8. Sean’s sister, Nicole, sends her daughter to a “Gifted and Talented” program at a New York City public school. Did you find this counterpoint to Toby’s private school experience helpful in considering what and how kids are learning today?

9. Many professional athletes have felt compelled to “juice” in order to keep up with the competition. Do you think steroid use among athletes is a fair comparison with the over-diagnosis and medication of school-aged kids in this country? Instead of leveling the playing field, do you think the prevalence of students taking ADHD medication has ratcheted up the level of competition to an unrealistic and overly stressful level?

10. How does Noah's approach to learning and education serve as a counterpoint to Bradley's philosophy?

11. Are you worried that reading this story will deter parents of children who need medication from giving it to them? Or do you think Sean and Toby's story will help parents who are on the fence make more informed decisions?