This document discusses barriers to spiritual development for children with ADHD, anxiety disorders, and Asperger's disorder. It outlines challenges they may face participating in church and growing in faith. Strategies are provided for churches to be more inclusive as well as gifts these conditions may provide. The impact of each condition is described for children and teenagers.

1. The Impact of the Three A’s (ADHD, Anxiety and
Asperger’s Disorder) upon Spiritual Development in Kids
Stephen Grcevich, MD
President, Key Ministry Foundation
Assistant Professor of Psychiatry
Northeastern Ohio Universities College of Medicine
Senior Clinical Instructor, Child and Adolescent Psychiatry
Case Western Reserve University School of Medicine
Presented at 2011 Children’s Ministry Telesummit
April, 2011
Key Ministry, 8401 Chagrin Road, Suite 14B, Chagrin Falls, OH 44023
Stephen Grcevich, MD, President (440) 543-3400,steve@keyministry.org
Web: www.keyministry.org

2. What barriers keep kids withhidden disabilitiesfrom
coming to Christ or growing in faith?

3. Learning objectives:
 Outline challenges to church participation and spiritual
growth in persons with ADHD, anxiety disorders
andAsperger’s disorder
 Discuss interventions with children, teens and adults
with common hidden disabilities in church settings to
facilitate spiritual growth
 Identify gifts and talents often associated with ADHD,
anxiety disorders andAsperger’sDisorder that may be
channeled for Kingdom purposes

4. 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

5. Executive functioning as the
fundamentaldifferencein persons with
ADHD?
 Executive functions describe a set of cognitive
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

6. How might ADHD affect one’s spiritual life?
Children/teens: Adults:
 Inhibition: sitting through a  Can I use the computer without
worship service viewing pornography?
 Nonverbal working memory:  Forgetting to register my kids for
remembering my Bible when it’s the weekend retreat
time to leave for church  The ability to memorize and
 Verbal working memory: the meditate quietly upon Scripture
ability to pray silently  I scream and yell at my spouse
 Emotional self-regulation: and my kids, overreact when
immediately react negatively to imposing discipline
demands from authority  Difficulty applying Biblical truths,
 Planning, problem-solving: I’m wisdom in daily life
not going to youth group on
Sunday night because my
homework’s not done.

7. Problems with internalization of
faith arising from ADHD:
 Persons with ADHD will have more difficulty
maintaining a spiritually disciplined life, even when
they desire to do so to honor God
 Likely to have more difficulty meditating quietly upon
God
 More prone to give up on studying the Bible when it
becomes tedious
 More difficulty delaying immediate gratification for very
long-term spiritual outcomes
Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114

8. Problems with stability of spiritual
growth arising from ADHD:
 Less effective self-regulation results in greater vulnerability
to negative environmental influences
 More likely to have intense spiritual experiences at VBS,
camp, mission trips that fade when spiritual context is gone
 More prone to “roller-coaster” spirituality
 Miss out on volunteer, service opportunities if perceived as
undisciplined, disorganized
 Drawn to religious contexts that are more participatory,
action-oriented, relational
Hathaway WL, Barkley RA. J Psychol Christianity 2003, 22(2) 101-114

9. Challenges presented to the
church by persons with ADHD:
 Style of worshipneeds tobe engaging, but not
overstimulating
 Kids (and some adults) find worship experiences
unpleasant
 Children’s 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 encourage
discontinuation of effective medication on weekends
 Many activities occur when medication has worn off or
rebound is occurring
Key Ministry

10. Ministry strategies for persons with ADHD:
Environments
Children/teens: Adults:
 Registration/sign-in needs to  Is signage, direction clear?
be orderly  Use of music, technology
 Staffing for transition times  Physical environment
before/after services shouldn’t become a
 Use of color, lighting distraction
 Engaging, not overwhelming  Flexibility in dress code
 Communication strategies…  Simplicity in communication
reinforce key point(s)
 Use of touch, nonverbal cues
 Family worship experiences
geared to kids?

11. Ministry strategies for persons with ADHD:
Discipleship
Children/teens: Adults:
 Church and parents as  Connecting them with others
partners in teaching kids in the church especially
about God important
 They’ll learn and retain more  Break Scripture into smaller,
in 1:1, small group situations manageable parts
 Ministry resources need to be  Small groups offer multiple
sent directly to parents accountability partners
 Where can they be involved  Where can they be involved
in meaningful service? in meaningful service?
 You have to remind them if
you want them to come

12. What can I do to help someone I love
with ADHD come to faith, grow in faith?
My child: My spouse, sibling, friend:
 Spend time with your child  Invite them to church (or
one on one or as a family remind them to come)
praying together, studying the  Go with them to a church
Bible together where they’re more likely to
 Make Jesus, Scripture have a positive experience
interesting by sharing from  Pray, study the Bible, serve
your experiences with them
 Seek opportunities for your  Connect them to others in the
child to serve in ways that fit church who will accept them,
their talents, gifts follow up with them
 Attend church regularly

13. 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 may help in sharing the
Gospel
 Good at scanning environment for trends
 Is ADHD over-represented among senior pastors?

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

15. Specific Anxiety Disorders in Children,
Adolescents:
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
 Obsessive-Compulsive Disorder
 Selective Mutism
J Am Acad Child Adolesc Psychiatry, 2007;46(2):267-283

16. Impact of Mental Health Conditions on
Spiritual Development:
Anxiety Disorders:
Child Teenager
Weekend In adult worship with parent Reluctant to attend without friends
Worship: Difficulties with separation Uncomfortable with attention of group
Visiting church challenging Transitions from children’s, middle school
ministry difficult
Church Reluctant to read Scripture out Disclosure in small groupschallenging
Activities: loud, participate actively, avoid New, unfamiliar places, experiences may
plays, performances be threatening…retreats, mission trips
Spiritual Prone to misperceive who God More prone to ritualism
Disciplines is… Common obsessions- doubting salvation,
Prayer, process of confession sinning against one’s will
in some traditions challenging Group disciplines more challenging
Growing in Parents can model faith, Parents can sensitively expose teens to
faith at practicing disciplines as a new service opportunities, encourage
home: positive coping strategy spiritual relationships outside home

17. Tips for church staff and volunteers:
Kids with anxiety
 Look for kids from established families in adult worship with
parents
 Greeters can watch for problems when “drop-offs” occur
 Have a quiet place to meet with kids/parents in distress
 Monitor sensory stimulation level of kids’ ministry
environments
 Leaders can watch for kids who are alone
 Offer to meet with parents when a child’s anxiety appears to
interfere with ministry participation
 Explain that anxiety will decrease with experience, time
(exposure)
 Possible areas of giftedness: Administration, organization,
sensitivity to others
Key Ministry

18. How are kids with Asperger’s Disorder
different?
 Kids with Asperger’s Disorder have difficulties
with reciprocal social interactions and restricted
patterns of interests or activities
 Normal language development (in contrast to
other kids with autism)
 Typically, average to high intelligence
Key Ministry

19. Impact of Mental Health Conditions on
Spiritual Development:
Asperger’s Disorder:
Child Teenager
Weekend Sensory integration may be More difficulty navigating social aspects
Worship: problematic…bright lights, of worship, less likely to have friends,
loud music can cause distress social networks to be invited to church
Church Difficulties with transitions, Difficulty picking up on social cues
Activities: understanding expectations in difficult in small groups, very sensitive to
church environments, may be teasing, rejection by peers, negative
easily irritated by peers perceptions of church difficult to change
Spiritual May be less sensitive to Reluctant to experiment with new
Disciplines needs of others, prone to very spiritual practices, disciplines, prone to
mechanical spirituality legalism, avoidant of group disciplines
Growing in Parents may struggle to Less likely to engage in family service
faith at home: engage child in faith issues if experiences involving social interaction,
not an area of interest church attendance following negative
experiences may cause conflict at home

20. Tips for church staff and volunteers:
Kids with Asperger’s Disorder
 Be aware of impact of sensory stimulation in
ministry environments
 Partial inclusion an option
 May do better socially by serving alongside
adults
 Opportunities to rehearse new situations,
environments
 Disability awareness important in student
ministry
 Areas of potential giftedness: Often dedicated
students of the Bible, may become immersed in
areas of ministry that stimulate interest
Key Ministry

21. Conclusions:
 Kids with ADHD, anxiety disorders, Asperger’s
Disorder and other hidden disabilities can be
welcomed into church activities without having to
establish stand-alone programs or “buddy systems”
 The way we do church may inadvertently produce
impediments tospiritual growth in kids with hidden
disabilities
 Families of kids with conditions including ADHD,
anxiety and autism spectrum disorders may represent
the ultimate “low-hanging fruit” from an evangelism
and outreach perspective

22. Provides FREE training,
consultation, resources and
support to help churches serve,
welcome and include families of
kids with hidden disabilities

23. Stay in Touch!
Church4EveryChild…Steve’s Key Ministry Blog:
http://drgrcevich.wordpress.com
Diving For Pearls…Katie Wetherbee’s Key Ministry Blog
http://katiewetherbee.wordpress.com
http://www.facebook.com/drgrcevich
http://www.facebook.com/pages/Key-Ministry/116940088329098
http://twitter.com/#!/drgrcevich
http://twitter.com/#!/KeyMinistry
http://cmconnect.org/profile/StephenGrcevichMD

24. Questions?

25. Additional Resources:
Church4EveryChild…Steve’s Key Ministry Blog:
http://drgrcevich.wordpress.com
Key Ministry
http://www.keyministry.org
AACAP Resource Centers:
Anxiety Disorders
http://www.aacap.org/cs/AnxietyDisorders.ResourceCenter
ADHD
http://www.aacap.org/cs/ADHD.ResourceCenter
Autism/Asperger’s Disorder
http://www.aacap.org/cs/Autism.ResourceCenter