Arab and Jewish Mothers' Decisions Regarding Treatment of their Children with Attention-Deficit/ Hyperactivity Disorder: A Qualitative Study

Background: The use of medication for attention deficit hyperactivity disorder (ADHD) differs globally, depending on ethnic group. In Israel, the prevalence of stimulant prescriptions for ADHD among Jewish children is four times higher than among Arab children. Ethnical differences may affect parents’ perceptions and attitudes towards diagnosing and treating ADHD. Therefore, it is important to identify differences in attitudes and beliefs towards diagnosis and treatment of ADHD among Arab and Jewish mothers and teachers, in order to understand what affects the mothers’ decision whether to medicate their child diagnosed with ADHD.Methods: A qualitative study including 23 in-depth interviews with mothers of children diagnosed with ADHD and 12 teachers (Arabs and Jews) from elementary schools in Northern Israel. The interviews were analyzed using thematic analysis.Results: Data analysis revealed four themes, emphasizing the way mothers and teachers perceive ADHD differently in the two ethnic groups: (1) The degree of ADHD medicalization differed between the ethnic groups. Jewish mothers and teachers tended to perceive ADHD more as a medical problem, while Arab mothers and teachers perceived it more as a childhood social behavior; (2) Arab mothers reported guilt feelings in relation to ADHD diagnosis and treatment, whereas Jewish mothers felt sympathy and understanding towards their child; (3) Among Arab mothers, the social environment is a stronger influence than among Jewish mothers; and (4) Stigmatization was reported only by Arab mothers. Conclusions: Our study suggests that there are ethnical differences in the perception of ADHD that may explain the differences in its prevalence and treatment.