Can disabilities be disabling in some places, but not others?

A recent article in the New York Times critical of the trend of more children and teenagers receiving medication for ADHD spurred my thinking about our conceptualization of disability, the interface between disabilities and environment, and my frustration at the lack of progress we’ve made in helping churches welcome and include kids with mental illness, experiences of trauma and developmental disabilities.

One reason that we’re seeing so many more kids diagnosed with ADHD now compared to 20 years ago is that the external demands imposed within school and work environments upon kids and adults with ADHD have radically changed. The light bulb went on for me a few years ago when our youngest daughter (then in the first grade) was bringing home about the same volume of work I had when I was in middle school in what was at the time one of the top school districts in our state. I’ve had first graders in my office who are required to carry planners. I don’t think our kids are necessarily different than we were. I do think that the demands for work product placed upon them in school and the number of activities and commitments they have to juggle are radically different than what my generation faced. Kids with genetic traits resulting in more inattentiveness and disorganization than peers and more difficulty delaying gratification (shutting off the X-Box to do homework) struggle more as the demands of the environment shift.

Another phenomena I see among kids with ADHD are grades that are highly dependent upon their level of interest in a subject or the entertainment value of their teacher. In middle school and high school, they struggle mightily in required classes they perceive to have little to no relevance for their future, but thrive in classes when they find a subject interesting. For many of these kids, I can tell their parents with some confidence that once they identify an engaging major in college or a career with demands that fit the way their child processes information, there’s a good possibility they may no longer need accommodations or medication on a regular basis. They have traits that are lumped together and characterized as disabilities that are no longer disabling when in a more friendly environment.

Many of the conditions I treat on a daily basis fall into this same category…they represent clusters of traits that may be adaptive in some environments but very maladaptive in others.

Kids with social anxiety are often respectful of their parents and very conscientious students, but struggle mightily if they’re dropped off for the first time at a church youth group, or need to approach a teacher with a question. Adults with Asperger’s Disorder may be highly proficient in certain technical capacities, but avoid like the plague signing up for a small group Bible Study. Their problems are different than those of children and adults who fit into the traditional mental model of disability ministry or special needs ministry, but face obstacles not unlike those faced by persons with physical or intellectual disabilities when mismatched with the demands they face in church environments.

Many of our non-medical interventions for kids with ADHD involve environmental accommodations…a seating location in the room with the fewest possible distractions, allowing them to take tests in a quiet, distraction-free room, helping them to organize their bookbag and homework at their locker five minutes before their peers pour out into the hallways, rushing to their school bus.

What do we do when folks need accommodations in order to consistently attend church and participate in activities that facilitate spiritual growth but function relatively well at home, at work or in school?

Updated December 22, 2013


IMG_0209-2Can you help us to help churches pursue kids with disabilities and their families? For this year’s Key Ministry Online Campaign, we’re asking our friends not for money, but to share our ministry’s Facebook page with others who share interest in our mission. We’re over halfway to our goal of 5,000 “likes”! Forward this post to your friends, ask them to “like” our Facebook page, and share it with others who wish to see more families of kids with mental illness, trauma or developmental disabilities welcomed and included at church.

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
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2 Responses to Can disabilities be disabling in some places, but not others?

  1. Pam says:

    My son has combined type ADHD and Social Anxiety. He wants to be baptized, but the church leadership is struggling with the idea of his baptism being done only in front of a small group of friends and family, instead of the whole congregation. I have explained repeatedly my son’s diagnoses and challenges, but they continue to question us. So what is the answer to your question above: “What do we do when folks need accommodations in order to consistently attend church and participate in activities that facilitate spiritual growth but function relatively well at home, at work or in school?”


  2. drgrcevich says:

    Hi Pam,

    Thanks for your interest in the blog…

    I’ve been to churches where kids and adults being baptized have shared their testimonies through very powerful prerecorded videos. Children or adults who are apprehensive about speaking in front of others have the opportunity to rehearse and reshoot their video if anxiety gets the best of them. It seems to me that the important thing here is your son’s desire to publicly identify himself with Jesus’ death and resurrection through baptism.

    Our staff has had some experience working with pastors and church staff around issues related to baptism in kids with disabilities. We’d be happy to speak to the folks at your church and brainstorm ideas for your son’s baptism consistent with your church’s teaching and traditions.

    Please contact Rebecca Hamilton at or Katie Wetherbee at if we can be of help.


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