In this presentation, Dr. Steve Grcevich looks at specific challenges associated with church attendance and spiritual growth for the two most common mental health conditions seen in kids and teenagers…ADHD and anxiety disorders...and a third condition presenting unique inclusion challenges that often encompasses issues with both anxiety and ADHD...kids with Asperger’s Disorder.

1. Stephen Grcevich, MD
Director of Strategic Initiatives, Key Ministry
Presented at An Inclusive Children’s Ministry Conference
Christ Church
Louisville, Kentucky
November 7, 2015
Helping Kids With the “3A’s” - ADHD, Anxiety
and Asperger’s Disorder to Thrive at Church

2. Learning Objectives:
 Identify obstacles to spiritual growth for kids with
common mental health disorders…ADHD,
anxiety disorders and Asperger’s Disorder
 Explore ideas for promoting inclusion of kids
and teens with mental illness and their families
at church
 Discuss strategies for parents/caregivers to
promote spiritual growth at home when kids
struggle with mental illness

3. The barriers to church participation are different for
kids with mental illnesses and their families!

4. Do our strategies for helping kids grow spiritually work
if they have mental illness?
An individual with a disability is
defined as a person who has a
mental or physical impairment that
substantially limits one or more
major life activities, a record of
such impairment, or is regarded as
having such an impairment.
Americans With Disabilities Act (1990)
If a mental or physical impairment
substantially limits a person’s
ability to pursue spiritual growth
and participate in a local church, is
that person “disabled?”

5. Barriers to including kids with mental illness
at church…
Church… Where does she fit in?
 Social isolation
 Fear/anxiety
 Social communication
 Capacity for self-regulation
 Sensory processing
 Reluctance to self-identify
 Stigma
 Parents with mental illness

6. 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

7. Executive functioning as the fundamental
difference in persons with ADHD
 Executive functions…cognitive abilities involved
in controlling and regulating other abilities and
behaviors.
 Necessary to initiate goal-directed behavior,
regulate emotions, delay gratification, plan
future behavior.
 Kids with executive functioning weakness
struggle to foresee outcomes of behavior, adapt
to new situations.
Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114

8. Key executive functions in ADHD
 Behavioral inhibition
 Verbal working memory
 Non-verbal working
memory
 Emotional self-regulation
 Reconstitution
Poor executive functioning
leads to behavior we call “sin”

9. How might ADHD affect one’s spiritual life?
 Inhibition: sitting still 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: often
demonstrate immediate negative
reaction to authority
 Struggles with time management,
prioritizing: I can’t go to youth group
on Sunday night because my
homework’s not done.
 Avoiding pornography on the
computer
 Forget to register their kids for
VBS or the weekend retreat
 Struggle to memorize and
meditate upon Scripture,
remember devotionals with their
kids
 Scream, yell at spouse and kids,
overreact when imposing
discipline
 Difficulty applying Biblical truths,
wisdom in daily life
Children/teens: Adults:

10. How does ADHD present challenges
to internalizing faith:
 May have more
difficulty maintaining a
spiritually disciplined life
 May have more
difficulty meditating
quietly upon God
 May give up on Bible
study when it becomes
tedious
 More difficulty delaying
immediate gratification
for long-term spiritual
outcomes
Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114

11. Unique challenges presented to the
church by kids with ADHD:
 Church environments less structured than school
 Church staff lack training, experience with kids
with ADHD (unlike the schools that they attend all
week)
 Parents choose not to use, or physicians
encourage discontinuation of effective medication
on weekends
 Many church activities occur when medication
has worn off or rebound is occurring
 Dichotomous thinking…Can they or can’t they
control it?

12. Child/Teen Possible Solutions
Large group
activities
(worship,
education)
Small groups
Church activities
Parental
challenges in
promoting
spiritual growth
ADHD: Challenges, solutions in our most
common ministry environments

13. Strategies for promoting church involvement,
spiritual formation for kids with ADHD:
 Ministry environments designed to be engaging,
not overwhelming
 Group leaders, mentors offer accountability,
encourage use of gifts, passions for Kingdom
purposes
 Active learners may do better talking while doing
 Share your stories!
 Resource parents for 1:1 conversations

14. What advantages might ADHD provide
a follower of Christ?
 Willingness to take chances for God
 Often energized by ministry activities
that capture their imagination
 Effective in ministry teams when
others have complimentary
organizational skills
 Good at scanning environment for
trends
 Over-represented among senior
pastors? (clearly over-represented
among student pastors!)

15. How are kids with anxiety disorders
different from their peers?
 They misperceive the level of threat, danger in
their environment
 They think too much…often to the point that
academics, family functioning, friendships,
extracurricular activities are compromised
 Prone to rumination, perseveration,
indecisiveness, perfectionism

16. How anxiety manifests in children,
teens
Note: Kids may experience different manifestations of anxiety as
they progress through developmental stages
 Separation Anxiety Disorder
 Specific Phobia
 Generalized Anxiety Disorder
 Social Anxiety Disorder
 Panic Disorder
 Selective Mutism
 Obsessive-Compulsive Disorder (OCD)is closely related to
the anxiety disorders, but was placed in its’ own category in
DSM-5
J Am Acad Child Adolesc Psychiatry, 2007;46(2):267-283

17. Spiritual challenges for kids and adults
with anxiety
 Propensity to misperceive God’s character, intentions
 They frequently need to be “in control.”
 Predisposed to focus on their performance for, as
opposed to their relationship with God
 As rule followers, may be drawn to legalism
 Often susceptible to questioning their faith, salvation
 Spiritual concerns not infrequently become fodder for
obsessive thinking, compulsive behavior
But… for some, God may use anxiety to draw them into a
deeper relationship with Him

18. When is anxiety most likely to cause
problems with church participation?
 When parents are dropping
off kids at age-appropriate
programming
 If they find themselves the
focus of attention
 Activities not part of the
weekly routine (mission
trips, retreats)
 Transitions between age-
group ministry environments
(elementary-middle school,
middle school-high school
ministry)
 Small groups with
expectation for self-
disclosure

19. Child/Teen Possible Solutions
Large group
activities
(worship,
education)
Small groups
Church activities
Parental
challenges in
promoting
spiritual growth
Anxiety Disorders: Challenges, solutions in
our most common ministry environments

20. Strategies for promoting church involvement,
spiritual formation for kids with anxiety…
 Preparing kids for new
experiences (includes
pictures, video)
 Anticipate response to
anxiety-provoking
situations
 Familiar people help
transitions to new
experiences, activities
 Anxiety as a signal to draw
closer to God?
 Parents with partners in
reinforcing lessons learned
at church

21. How are kids and teens with Asperger’s
Disorder different?
 Difficulties with reciprocal social interactions and
restricted patterns of interests or activities
 Verbal language development is typical (in contrast to
other kids with autism)
 Sensory processing issues
 Average to high intelligence
 High rates of ADHD, Obsessive-Compulsive Disorder
(OCD)
 Many are desperately lonely and desire friends, but they
also frequently prefer their own company

22. Issues seen in kids with Asperger’s
Disorder:
 Intense preoccupation with
topics, objects, activities
 May struggle with motor skills,
coordination
 Difficulty with pragmatic
language, differences in
intonation, pace, volume, pitch
(monotonal)…difficulty with
implied meaning, figurative
speech, will struggle to find
right words in unfamiliar
situations
 Difficulties identifying with
experiences of others
(empathy)

23. Spiritual challenges common to persons
with Asperger’s…
 May focus on mechanics instead of meaning when
asked to “invite Jesus into your heart.”
 May experience more difficulty grasping empathy…
“putting themselves into someone else’s shoes”
 Vulnerable to faith becoming excessively ritualized,
manual
 May be resistant to trying new spiritual disciplines,
experiences
 May have more difficulty moving on from hurts
 Hypocrisy from Christians too often hardens hearts
against Christianity

24. Child/Teen Possible Solutions
Large group
activities
(worship,
education)
Small groups
Church activities
Parental
challenges in
promoting
spiritual growth
Asperger’s Disorder: Challenges, solutions in
our most common ministry environments

25. Strategies for promoting church involvement,
spiritual growth for kids with Asperger’s
 Provide opportunities to
rehearse social skills for new
situations, environments
 Evaluate sensory stimulation in
ministry environments
 Bullying education, disability
awareness especially important
for peers in student ministry
 May do better serving alongside
adults
 Placement
 Tap into areas of potential
giftedness

26. Defining the “win”
 Whenever a child with a disability or any
family member experiences meaningful
interaction with a local church

27. Takeaway points…
 Kids with ADHD benefit from environments designed to
optimize capacity for self-control and relevant, engaging
teaching on the most essential truths of our faith
 Kids with anxiety can have excellent church experiences with
appropriate preparation, gradual exposure to threatening
situations and sensitivity to their need to not become a focus
of attention.
 Kids with Asperger’s Disorder need sensory-friendly
environments, authentic relationships with accepting peers
and adults and individualized support of spiritual growth.
 Kids with mental illness and their families represent one of
your church’s greatest outreach opportunities.
 No church can do everything, but every church can do
something!

28. Additional Resources:
 Resource page on ADHD and spiritual development
(includes video from Dr. Russ Barkley)
http://drgrcevich.wordpress.com/teaching-series-adhd-
and-spiritual-development/
 Resource page on anxiety and spiritual development
http://drgrcevich.wordpress.com/resource-page-anxiety-
and-spiritual-development/
 Resource page on Asperger’s Disorder and spiritual
development (includes video of 2012 Children’s Ministry
Web Summit presentation)
http://drgrcevich.wordpress.com/resource-page-anxiety-
and-spiritual-development/

29. Questions?

30. 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?

31. Stay in Touch!
Key Ministry Website: http://www.keyministry.org
Church4EveryChild…Key Ministry Blog: http://www.church4everychild.org
www
http://www.facebook.com/keyministry
http://www.pinterest.com/keyministry/
http://twitter.com/#!/drgrcevich
http://twitter.com/#!/KeyMinistry

32. Additional Slides

33. Ministry strategies for persons with ADHD:
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:

34. 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
 Where can they be involved
in meaningful service?
 Connecting them with others in
the church especially important
 Break Scripture into smaller,
manageable parts
 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:

35. 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: