In this presentation from the Together Conference at Mount Paran Church, Dr. Grcevich reviews: Brain functioning associated with ADHD Impacts of ADHD upon worship service attendance and involvement in Christian education and other church activities ADHD inclusion strategies across ministry environments Common pitfalls to spiritual development for children, teens and adults with ADHD Practical ideas family members can use to promote spiritual growth in their child, spouse or loved one with ADHD

1. Overcoming Challenges to
Spiritual Growth in Children and
Teens with ADHD
Stephen Grcevich, MD
President and Founder, Key Ministry
Together Special Needs Ministry Conference
Mount Paran Church, Atlanta GA
March 7, 2020

2. Our objectives today…
• Review brain functioning associated withADHD
• Explore impacts of ADHD upon:
• Worship service attendance
• Involvement in Christian education, other church activities
• Discuss ADHD inclusion strategies across 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. Kids with ADHD often have other
mental health conditions
Danielson ML et al. J Clin Child Adolesc Psychology 2018, 47:2, 199-212.

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
• Nonverbal working
memory
• Emotional self-regulation
• Reconstitution

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

12. Impacts of
ADHD on
church
participation
• Before they arrive at church…
• Getting ready & the car ride
• Showing up on time
• Sitting through adult service
• Self-control in children’s ministry
• Gravitate to peers with ADHD
• Defiance to authority figures
• Struggles in teens with time
management, prioritizing church

13. 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

14. Understanding
why “structure”
helps people with
executive
functioning deficits

15. “Structure” and kids with ADHD
• Intentionally reducing demands on cognitive function to
maximize capacity for good decision-making
• Considerations in developing a “structured” environment
• Minimize need for decision-making
• Limited number of clear rules, expectations
• Consistent accountability
• Few distractions

16. The more kids have to process, the less capacity
they have for self-control

17. Welcoming ministry
environments…
• Promote focus, attention
• Help attendees prioritize
important takeaways
• Support in processing
directions
• Supports kids in
maintaining self-control
• Reserved seating for
persons with agoraphobia

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. Common
challenges
internalizing
faith in kids
with ADHD
• Living a spiritually disciplined life
• Sustaining regular Bible study
• Worship may feel repetitive,
tedious
• Quiet reflection, meditation,
prayer
• Delaying immediate gratification
for long-term spiritual outcomes

20. How
instability of
spiritual
growth
might arise
from ADHD
• Vulnerability 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

21. Discipleship strategies for children, youth with
ADHD
•Coming alongside parents as partners
•Your story is more interesting than a lecture
•May retain more in 1:1, small group situations
•One-point messages
•Better doing than sitting
•Send discipleship resources directly to parents

22. How parents can help children 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 use their talents, gifts in
serving
• Cultivate habit of attending church regularly!

23. Discipleship strategies for adults with ADHD
• Connections with others especially important
• Small groups offer multiple accountability partners
• Break Scripture into smaller, manageable parts
• Study guide format for sermon notes
• Doers as opposed to listeners
• Need more reminders if you want them to come

24. What can I do to help
my spouse, sibling
or friend with ADHD
to 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

25. 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?

26. 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?

27. Help from Key
Ministry
• Training
• Conferences
• Video training
• Roundtables
• Consultation to churches
• Resources
• Networking with other
ministries
• Social media, sermon
videos, research
• Someone to come alongside
your ministry!

29. Connect with Key Ministry
• www.keyministry.org
• Twitter: @KeyMinistry
• www.facebook.com/keyministry
• steve@keyministry.org