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

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.

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

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

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

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.

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

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.

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.

Five Key Executive Functions
• Behavioral inhibition
• Verbal working memory
• Non-verbal working memory
• Emotional self-regulation
• Reconstitution

Whitehead AL. J ScientificStudy Religion 2018;57(2)377-395.

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

The more stimulation they have to process, the less
capacity they have for self-control

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

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

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

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

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?

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

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

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

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!

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

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?

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?

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!

Connect with Key Ministry
Catherine Boyle –Director of Mental Health Ministry
• www.keyministry.org
• Twitter: @KeyMinistry
• www.facebook.com/keyministry
• www.keyministry.org/contact/
• steve@keyministry.org
• catherine@keyministry.org