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Table 3 Selected quotes

From: Does the education system serve as a persuasion agent for recommending ADHD diagnosis and medication uptake? A qualitative case study to identify and characterize the persuasion strategies of Israeli teachers and school counselors

The education system’s strategies in convincing parents to have their children diagnosed for ADHD
The necessity of diagnosis Parents’ reports of strategy Teachers and school counselors’ reports of strategy
   “We explain to the parents that we just want a diagnosis, that it is important and necessary to know what the child has and how we can help him, especially because there are a lot of benefits and easements for children with ADHD, and the whole matter of medication does not interest us and we’re not talking about it right now” (teacher from the Arab sector)
“Diagnosis is an important step towards identifying the child’s difficulty and does not require medication. Let’s at least identify the problem. You decide for yourself. I’m not telling you to take a pill [...] I’m just asking you to get a diagnosis so at least we’ll know what the trouble is and how to help the child” (a teacher from the Jewish sector)
The child’s best interest “They said listen, your son needs Ritalin. You have to help him. It is ultimately for his own good. Consult doctors. Doctors usually recommend pills” (a mother from the Jewish sector)
“When the teacher told me you have to give your son the medicine because that is how you can help him, it will help him concentrate in class and be a better student, I agreed” (a mother from the Jewish sector)
“You show them and explain to them that it is for the child’s own good, to see where the problem is so we can treat it, to provide a solution to his needs, because there are things we don’t know and he needs to get treated for it, maybe more hours and things like that, we need to understand what the problem is so we can help him” (a teacher from the Jewish sector).
  “When the teacher told me ‘you need to give the boy the medicine because it will help your son, it will help him concentrate in class, be a better student,’ I agreed.” (Mother from the Arab sector).  
Analogies and examples that illustrate ADHD “She explained that it’s something neurological, a short circuit in the brain, the neurons don’t connect, what that pill does is to connect the neurons and cause a better flow, it allows the brain better absorption.” (a mother from the Jewish sector) “So I start explaining what it means to have ADHD. And I illustrate, I do a kind of illustration with them. Let’s say you’re holding a weight for a few minutes, then for a few hours and then for a few days, can you hold onto it so long? No, so you drop it. That’s what happens to the kid. He drops his attention. He comes wanting to hold the weight, he comes in the morning wanting to succeed, I believe everybody wants to succeed, but there’s something here that gets in the way and makes it difficult for him.” (school counselor from the Jewish sector)
“Unfortunately we have to find techniques and methods to convince parents to get a diagnosis and medicate, even though we know it is not our job and it is a medical matter [...] I explain to the parents that these difficulties are out of the child’s control and it’s not because your son wants to behave that way or he doesn’t want to concentrate, but there is something in your son’s brain, something that holds him back and prevents him from using his abilities.” (school counselor from the Arab sector).
The education system’s strategies in convincing parents to medicate their children
Improving achievements and academic success “It is not quiet I’m looking for. I’m interested in my child’s achievements in school. Focus, focusing on the question, willingness to learn, the availability to learn improves fivefold. I tell parents this is my experience. I say to the mother, send him to a test without Ritalin and see the result, instead of 100 he might get 50. It’s something that makes the child focused.” (teacher from the Jewish sector)
“The teacher and counselor told me that if I gave my son medication he could get higher grades on the tests, which would help prevent him from flunking, especially because he had bad grades.” (a mother from the Arab sector)
Improving the child’s functioning socially and behaviorally, improving their self-image and providing an experience of success. Socially: “Children with ADHD are usually perceived in the class as nuisances. They disrupt the class and label themselves in such a way that the class perceives them as disrupting learning. They interrupt a lot and have hyperactive behaviors that antagonize the other children who are not tolerant of this and do not know how to tolerate hyperactivity, chatter, impulsiveness, and therefore they shun that kid” (school counselor from the Jewish sector)
Behaviorally: “Very soon he will go to middle school and high school. Here he is still among little kids. In high school there are kids who are bigger than him. He will be exposed to smoking and drugs and you will not be able to control him. Let him become ready to move from here to high school. Give him the tools he needs to take care of himself and not go near such things. Hyperactivity influences behavior and everything in life. If you treat it with medicine the child will calm down and be restrained in his behavior too. The medicine definitely does not only influence school achievements.” (A homeroom teacher from the Arab sector)
Improving self image. “Ritalin helps the child concentrate better, his grades go up, the child starts to feel better. When he sees that he understands what the teacher is explaining and the teacher praises him, after all of the frustration he went through before the treatment, his classmates except him more, his grades go up, it all improves his self-image and he starts working harder and even taking initiative.” (guidance counselor from the Arab sector)
Experience of success for the child: “I say that relative to what he has experienced until now, failed grades, failed behavior, I say this is what we are trying to produce. We want to give the child an experience of success now, not in 10 years, because the moment he experiences success, belief in himself is the first thing.” (a teacher from the Jewish sector)