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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 factormany 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 ADHD88% 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 butthe 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 functionscognitive 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
- 7. Key executive functions: Behavioral inhibition Verbal working memory Non-verbal working memory Emotional self-regulation Reconstitution Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114
- 8. How might ADHD affect ones spiritual life? Behavioral inhibition: sitting through a worship service Nonverbal working memory: remembering my Bible when its 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 homeworks 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 thats 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 shouldnt 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 Theyll learn and retain more in 1:1, small group situations Ministry resources need to be sent directly to parentsrole 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 theyre 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
- 20. Questions?
- 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 Church4EveryChildKey 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: Church4EveryChildSteves 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 35): 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 1318): 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.