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The Many Impacts of ADHD Upon Spiritual Development

  1. The Many Impacts of ADHD Upon Spiritual Development Stephen Grcevich, MD President and Founder, Key Ministry Wonderfully Made Conference Overland Park, KS October 24, 2019
  2. Our objectives today… • Discuss differences in brain functioning seen in persons with ADHD • Explore how ADHD impacts participation in worship services, Christian education and other common church activities and useful strategies for including them in the full range of ministry environments • Identify common pitfalls to spiritual development for children, teens and adults with ADHD • Introduce practical ideas family members can use to promote spiritual growth in their child, spouse or loved one with ADHD.
  3. What is ADHD? • A neurodevelopmental disorder characterized by an age- inappropriate degree of… • Inattentiveness/disorganization • Impulsivity • Hyperactivity • Hyperactivity goes away first as children age, impulse control improves next • Adults struggle with time management, task completion, organization, prioritization
  4. ADHD facts and figures: • 11% of U.S. kids ages 4-17 have been diagnosed with ADHD…88% continue to carry the diagnosis • Highest prevalence in southeastern U.S. • 69% are currently prescribed medication but…the majority don’t take medication on an ongoing basis • 42% increase in parent-reported prevalence since 2003 • Many have “comorbid” mental health conditions Source: U.S. Centers for Disease Control
  5. 35 25 29 28 33 21 8 11 11 66 32 15 0 10 20 30 40 50 60 70 % Comorbidity in Pediatric ADHD Lifetime Prevalence of Comorbid Conditions in Pediatric Population With ADHD Biederman J. J Clin Psychiatry. 2004;65(suppl 3):3-7. Boys (N = 140) Girls (N = 140) ODD Enuresis Major Depression Multiple (>2) Anxiety Conduct Disorder Bipolar Disorder
  6. Preschool School-age Adolescence College-age Adult  Disruptive behavior  Academic failure  Poor socialization  Self-esteem issues  Injuries  Low self-esteem  Smoking  Substance use  Crime  Car accidents  Academic failure  Occupational failure  Substance abuse  Relationship failures  Poor work history  Chronic substance abuse and dependence  Incarceration ADHD impairment across the lifespan… Slide courtesy ofJoseph Biederman, MD.
  7. What Causes ADHD? • Genetics - primary factor • 70-80% of risk • many genes appear to make minor contributions • Trauma • Environmental toxins • drugs, alcohol, cigarettes • environmental toxins (lead) • Prematurity • Technology? • Birthday influences diagnosis in younger kids
  8. Catecholamine Mechanisms in ADHD Posterior Parietal Cortex Prefrontal Cortex Striatum Sensory input Cerebellum Locus Coeruleus VTA Substantia Nigra NE enhances relevant signal NE enhances relevant signal DA suppresses irrelevant signal Posner MI, et al. Images of Mind. 1st ed. New York, NY: Scientific American Library; 1997.
  9. Executive functioning as the fundamental difference in persons with ADHD • Cognitive abilities involved in controlling and regulating other abilities and behaviors. • Necessary for • initiating goal-directed behavior, • regulating emotions • delaying gratification • learning from one’s mistakes • planning future behavior. • Struggle to adapt to new situations and foresee outcomes of their behavior.
  10. Five Key Executive Functions • Behavioral inhibition • Verbal working memory • Non-verbal working memory • Emotional self-regulation • Reconstitution
  11. Whitehead AL. J ScientificStudy Religion 2018;57(2)377-395.
  12. How might having ADHD impact church participation? • Difficulty sitting through adult worship service, • Struggles keeping hands to self at children’s worship/Sunday School • Prone to immediate, negative reactions to authority figures • Teens may struggle with time management, prioritizing church activity • Misses youth group when homework is unfinished
  13. The more stimulation they have to process, the less capacity they have for self-control
  14. Unique challenges presented to the church by kids with ADHD: • Church environments are generally less structured than school • Churches rely upon ministry volunteers who lack training as educators • Parents, physicians often withhold effective ADHD medication for weekends • Many church activities occur when ADHD medication has worn off
  15. How does ADHD present challenges to internalizing faith? • More difficulty living a spiritually disciplined life • More difficulty with quiet reflection, meditation • Difficulty sustaining Bible study, worship, spiritual practices that becomes tedious • More difficulty delaying immediate gratification for long- term spiritual outcomes
  16. How instability of spiritual growth might arise from ADHD • Vulnerable to negative peer, environmental influences • Effects of intense spiritual experiences (VBS, retreats, mission trips) fade when context is gone • “Roller-coaster” spirituality • Shunned for volunteer, leadership opportunities if perceived as undisciplined, disorganized • Drawn to more participatory, action- oriented, relational religious contexts
  17. Seven strategies for promoting mental health inclusion (TEACHER) • Assemble your inclusion team • Create welcoming ministry environments. • Focus on ministry activities most essential to spiritual growth • Communicate effectively • Help families with their most heartfelt needs • Offer education and support • Empower the people of your church to assume responsibility for ministry
  18. ADHD inclusion strategies (children/youth) • 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 personal stories, experiences • System for getting helps, resources to parents • Family worship experiences geared to kids?
  19. ADHD inclusion strategies (adults) • Clear signage, direction • Use of music, technology • Remove distraction in worship, adult education spaces • Flexibility in dress code • Simple communication • Disproportionately found in AA, substance abuse ministries
  20. Discipleship strategies for children, youth with ADHD • Church, parents as partners in teaching kids about God • 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? • Better loading trucks at food bank vs. sitting in a circle
  21. Discipleship strategies for adults with ADHD • Connections with others in the church especially important • Small groups offer multiple accountability partners • Break Scripture into smaller, manageable parts • Study guide format for sermon notes • They’re doers as opposed to listeners • You have to remind them if you want them to come
  22. How can I help my child with ADHD 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 how you’ve applied what you’ve learned • Seek opportunities for your child to serve using their talents, gifts • Attend church regularly!
  23. What can I do to help my spouse, sibling or friend with ADHD to come to faith, grow in faith? • 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
  24. What advantages might ADHD provide a follower of Christ? • Willing to take chances for God • Energized by ministry activities that capture their imagination • Effective on ministry teams when others have complimentary organizational skills • Good at identifying trends • Overrepresented among senior pastors, student pastors?
  25. Key Ministry promotes meaningful connection between churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. Free training, consultation, support and resources What Does Key Ministry Do?
  26. Help from Key Ministry • Training • Conferences • Video training • Roundtables • Consultation to church teams • Resources • Networking with other ministries • Social media, sermon videos, research to support your ministry • Someone to come alongside your ministry!
  27. Connect with Key Ministry Catherine Boyle –Director of Mental Health Ministry • • Twitter: @KeyMinistry • • • •