In this presentation, Dr. Steve Grcevich reviews our current medical understanding of the functional impairment seen in persons with ADHD, explore how ministry environments represent obstacles to church participation and spiritual growth in children and adults with ADHD, outlines strategies for promoting spiritual growth in persons with ADHD and identifies gifts and talents often associated with ADHD that may be channeled for Kingdom purposes.
English - The Story of Ahikar, Grand Vizier of Assyria.pdf
Helping kids with ADHD to grow spiritually
1. Stephen Grcevich, MD
Director of Strategic Initiatives, Key Ministry
Awana 2014 Ministry Conference
First Baptist Church, Oxford, MS
August 23, 2014
Helping Kids With ADHD to Grow Spiritually
2. Learning objectives:
Review our current medical understanding of the
causes of functional impairment seen in persons with
ADHD
Explore how our ministry environments represent
obstacles to church participation and spiritual growth
in children and adults with ADHD
Discuss strategies for promoting spiritual growth in
persons with ADHD
Identify gifts and talents often associated with ADHD
that may be channeled for Kingdom purposes
3. What is ADHD?:
ADHD is a neurodevelopmental disorder
characterized by an age-inappropriate degree of
inattentiveness and disorganization, and in some, but
not all instances, impulsivity and hyperactivity
4. What causes ADHD?:
Genetics is primary factor…many genes appear to
make minor contributions
Environmental toxins (lead)
In-utero environmental toxins (drugs, alcohol,
cigarettes)
Trauma
Prematurity
Technology?
5. ADHD facts and figures:
11% of U.S. kids ages 4-17 have been diagnosed
with ADHD…88% continue to carry the diagnosis
14% of kids in Mississippi have ever been
diagnosed with ADHD, 10.9% currently diagnosed
Highest prevalence in southeastern U.S.
69% are currently being prescribed medication
but…the majority do not take medication on a daily
basis
42% increase in parent-reported prevalence since
2003
Many have “comorbid” mental health conditions
U.S. Centers for Disease Control
6. Executive functioning as the fundamental
difference in persons with ADHD?
Executive functions…cognitive abilities involved in
controlling and regulating other abilities and behaviors
Necessary in initiating goal-directed behavior, regulating
emotions, delaying gratification, planning future
behavior
Children with weaknesses in executive functioning have
more difficulty foreseeing outcomes of behavior,
adapting to new situations.
Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114
8. How might ADHD affect one’s spiritual life?
Behavioral inhibition: sitting through a
worship service
Nonverbal working memory:
remembering my Bible when it’s time
to leave for church
Verbal working memory: the ability to
pray silently
Emotional self-regulation:
immediately react negatively to
demands from authority
Reconstitution: Managing time,
priorities… Skipping AWANA
because homework’s not done.
Can I use the computer without
viewing pornography?
Forgetting to register my kids for
the weekend retreat
The ability to memorize and
meditate quietly upon Scripture
I scream and yell at my spouse
and my kids, overreact when
imposing discipline
Difficulty applying Biblical truths,
wisdom in daily life
Children/teens: Adults:
9. Problems with internalization of
faith arising from ADHD:
Kids struggle to maintain a spiritually disciplined life
More difficulty meditating quietly upon God
May give up on Bible study when it becomes tedious
Difficulty delaying immediate gratification for long-term
spiritual outcomes
Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114
10. Problems with stability of spiritual
growth arising from ADHD:
Poor self-regulation increases vulnerability to negative
environmental influences
Tend to have intense spiritual experiences at VBS, camp,
mission trips that fade when spiritual context is gone
More prone to “roller-coaster” spirituality
Shunned for volunteer, leadership opportunities if perceived
as undisciplined, disorganized
Drawn to religious contexts that are more participatory,
action-oriented, relational (better doing than talking)
Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114
11. Challenges presented to the
church by persons with ADHD:
Balancing worship that’s engaging, but not overstimulating
Pastors, ministry leaders lack training, experience in
working with kids with ADHD
Church environments less structured than school
Parents choose not to use, or physicians discourage use
of effective medication on weekends
Many activities occur when medication has worn off or
rebound is occurring
12. Ministry strategies for persons with ADHD:
ADHD-friendly environments
Registration/sign-in needs to be
orderly
Staffing for transition times
before/after services
Use of color, lighting
Engaging, not overwhelming
Communication strategies…
reinforce key point(s)
Use of touch, nonverbal cues
Family worship experiences
geared to kids?
Is signage, direction clear?
Use of music, technology
Physical environment shouldn’t
become a distraction
Flexibility in dress code
Simplicity in communication
Children/teens: Adults:
16. Ministry strategies for persons with ADHD:
Discipleship
Church and parents as
partners in teaching kids
about God
They’ll learn and retain more
in 1:1, small group situations
Ministry resources need to be
sent directly to parents…role
for technology?
Where can they be involved
in meaningful service?
Connecting them with others in
the church especially important
Break Scripture into smaller,
manageable parts
Study guide format for sermon
notes
Small groups offer multiple
accountability partners
Where can they be involved in
meaningful service?
You have to remind them if you
want them to come
Children/teens: Adults:
17. What can I do to help someone I love
with ADHD come to faith, grow in faith?
Spend time with your child
one on one or as a family
praying together, studying the
Bible together
Make Jesus, Scripture
interesting by sharing from
your experiences
Seek opportunities for your
child to serve in ways that fit
their talents, gifts
Attend church regularly
Invite them to church (or
remind them to come)
Go with them to a church
where they’re more likely to
have a positive experience
Pray, study the Bible, serve
with them
Connect them to others in the
church who will accept them,
follow up with them
My child: My spouse, sibling, friend:
18. What advantages might ADHD provide
a follower of Christ?
Willingness to take chances for God
May be very energized by topics or ministry
activities that capture the imagination
May be very effective in ministry teams when others
have complimentary organizational skills
Ability to engage others useful in sharing the
Gospel
Good at scanning environment for trends
Is ADHD overrepresented among senior pastors?
19. Conclusions:
Churches may promote spiritual growth in kids with
ADHD by…
1. designing ADHD-friendly ministry environments
2. resourcing parents for 1:1 discipleship
3. providing opportunities for meaningful service
4. demonstrating intentionality in promoting relationships
with others in the church
21. Key Ministry provides knowledge,
innovation and experience to the
worldwide church as it ministers to
and with families of children
impacted by mental illness, trauma
and developmental disabilities.
22. Stay in Touch!
Key Ministry Website: http://www.keyministry.org
Church4EveryChild…Key Ministry Blog: http://drgrcevich.wordpress.com
Key Ministry Training Channel: http://go.mediasocial.tv/keyministry
Front Door (Online Church Campus): http://go.mediasocial.tv/cbcfrontdoor
www
http://www.facebook.com/keyministry
http://www.pinterest.com/keyministry/
http://twitter.com/#!/drgrcevich
http://twitter.com/#!/KeyMinistry
23. Additional Resources on ADHD:
Church4EveryChild…Steve’s Key Ministry Blog:
http://drgrcevich.wordpress.com
ADHD and Spiritual Development Blog Series (including Barkley video):
Blog post:
http://drgrcevich.wordpress.com/2010/09/12/how-are-kids-and-teens-with-adhd-different/
Key Ministry
http://www.keyministry.org
AACAP Resource Center-ADHD
http://www.aacap.org/cs/ADHD.ResourceCenter
24. ADHD: DSM-5 Criteria for Predominantly
Hyperactive-Impulsive Type
Six or more of the following manifested often:
Impulsivity/Hyperactivity
Impulsivity
Blurts out answer before
question is finished
Difficulty awaiting turn
Interrupts or intrudes on
others
Hyperactivity
Fidgets
Unable to stay seated
Inappropriate running, climbing
(restlessness)
Difficulty in engaging in leisure
activities quietly
“On the go”
Talks excessively
American Psychiatric Association. DSM-5, 2013.
25. ADHD: DSM-5 Criteria for
Predominantly Inattentive Type
Inattention to details/
makes careless mistakes
Difficulty sustaining
attention
Seems not to listen
Fails to finish tasks
Difficulty organizing
Avoids tasks requiring
sustained attention
Loses things
Easily distracted
Forgetful
Six or more of the following manifested often:
Inattention
American Psychiatric Association. DSM-5, 2013.
26. ADHD in Preschoolers (Ages 3–5):
Motor restlessness (as if “driven by a motor”)
Difficulty completing developmental tasks (e.g., toilet training)
Decreased and/or restless sleep
Insatiable curiosity
Family difficulties (e.g., obtaining and keeping babysitters)
Vigorous and often destructive play
Demanding of parental attention, argumentative
Delays in motor or language development
Excessive temper tantrums (more severe and frequent)
Low levels of compliance (especially in boys)
Campbell et al. JAACAP 1984;23:243.
Greenhill. J Clin Psychiatry 1998;59(suppl 7):31.
Conners and Jett. ADHD in Adults and Children. Compact Clinicals;1999.
27. Easily distracted
Unable to sustain attention
Homework is disorganized, incomplete, contains careless
errors
Blurts out answers before question completed (often
disruptive in class)
Often interrupts or intrudes on others
Often out of seat, acts like the “class clown”
Perception of “immaturity” (unwilling or unable to complete
chores at home)
ADHD in School-Age Children (6-12):
Greenhill. J Clin Psychiatry 1998;59(suppl 7):31.
Conners and Jett. ADHD in Adults and Children. Compact Clinicals;1999.
28. ADHD in Adolescence (Ages 13–18):
Excessive motor activity tends to decrease
May have a sense of inner restlessness (rather than
hyperactivity)
School work disorganized and shows poor follow-through;
fails to work independently
Engaging in “risky” behaviors (speeding and driving mishaps)
Difficulty with authority figures
Poor self-esteem
Poor peer relationships
Anger, emotional lability
Greenhill. J Clin Psychiatry 1998;59(suppl 7):31.
Conners and Jett. ADHD in Adults and Children. Compact Clinicals;1999.
29. Disorganized, fails to plan ahead
Forgetful, loses things
Difficulty in initiating and finishing projects or
tasks
Misjudges available time
Makes impulsive decisions related to spending
money, travel, jobs, or social plans
Inattention/concentration problems
Poor anger control
May have job instability and marital difficulties
ADHD symptoms in adulthood:
Greenhill. J Clin Psychiatry 1998;59(suppl 7):31.
Conners and Jett. ADHD in Adults and Children. Compact Clinicals;1999.