What does “executive functioning” have to do with kids and church?

ADHD pencil noseIn our fourth segment of our Winter 2014 blog series Including Kids and Teens With Mental Illness at Church, we’ll help our readers better understand the concept of executive functioning, and explore challenges kids and teens with executive functioning weaknesses experience in becoming and staying involved at church.

Executive functioning describes a set of cognitive abilities involved in controlling and regulating other abilities and behaviors. Such functions are necessary in initiating goal-directed behavior, suppressing impulses arising from lower brain centers, and planning future behavior.

There are five key executive functions: Behavioral inhibition (critical to development of the other functions), non-verbal working memory, verbal working memory, emotional self-regulation and reconstitution. 

Difficulties with executive functioning are associated with many different mental health conditions. Weaknesses in executive functioning have been speculated by many to represent the core deficit in persons with ADHD. Many of my patients with autism spectrum disorders of average to high intelligence struggle with executive functioning. Individuals with schizophrenia are impacted, and executive functioning is frequently impaired during episodes of depression or mania. Executive functions are exquisitely vulnerable to the effects of prenatal tobacco, alcohol, and drug exposure, and may represent the final common pathway of prenatal substance exposure.

Behavioral inhibition involves the ability to delay one’s response to an event (allowing time to think), interrupt a chain of responses to an event and the capacity to keep competing events from interfering with the initial response. Without this ability a person would be entirely focused on the immediate consequences of any action or behavior and would be unable to develop the capacity for self-control. This capacity is foundational to the other executive functions.

Kids or teens with weaknesses in behavioral inhibition would be more prone to the following struggles at church…

  • They are more vulnerable to impulsive or aggressive behavior as the level of sensory stimulation in their environment increases.
  • They have more difficulty sitting or standing for an extended period of time, especially when the content of the worship service, class or activity is uninteresting.
  • They may lash out to leaders or authority figures…or text…or post to Instagram before they’ve thought through their actions.

Non-verbal working memory involves the capacity to maintain a picture of events in one’s mind. The ability to analyze situations for recurring patterns in order to predict future events is critical in anticipating consequences of behavior, managing relationships and planning complex, goal-directed behavior. Moral conduct and social cooperation are contingent upon this capacity as well the retention of events in sequence that allows one to estimate the time required to perform a task.

Kids, teens and adults with weaknesses in non-verbal working memory might have to cope with challenges like these in attending church…

  • Getting to church on time. Kids and adults who struggle with non-verbal working memory tend to underestimate the amount of time required to complete routine tasks.
  • Finding where they’re supposed to go at church. They have difficulty visualizing or repeating directions. They need good signage!
  • Kids might become frustrated by their inability to master the hand gestures that accompany the worship music in a children’s service.
  • They lose lots of things, especially in busy or unfamiliar environments. They’re the kids who forget their Bibles at home and forget their permission slips for going on the youth ministry retreat.

Child negative labels schoolVerbal working memory involves the capacity to think in words. Internalization of speech allows kids to internalize social norms and rules, facilitating moral development. As kids develop this capacity, they’re able to hold thoughts in their mind without having to actually say what they’re thinking. A classic example is the capacity to pray silently.

Kids who have difficulty with verbal working memory might experience embarrassment at church from the following  challenges…

  • Memorizing Scripture. Kids who struggle with verbal working memory generally aren’t winning prizes at AWANA.
  • Applying Scripture in their daily lives. They might have difficulty taking knowledge they have learned in one church setting and applying it in another…i.e., resolving conflict with a peer in their youth group.
  • Organizing/expressing their thoughts in a small group or Bible Study. They may ramble, or have difficulty getting to the main point they wish to communicate. They may aggravate teachers, group leaders and peers by talking too much.

Emotional self-regulation involves the ability to keep private one’s initial emotional response to an event or situation. This allows a child to modify their response to an event as well as the emotions that accompany the response. Capacity to sustain motivation for future-directed behavior is contingent on this ability.

Kids and youth who struggle with this capacity…

  • May be prone to conflict with peers and adults at church.
  • Are more likely to have difficulty tolerating frustration with some aspect of church.
  • Are more likely than their peers to struggle with keeping commitments.
  • Are more likely to experience difficulty delaying gratification. They want what they want when they want it even when what they want isn’t in their best interests. This propensity often leads to patterns of self-destructive behavior during the teen years that we in the church refer to as “sin.”

Reconstitution involves the ability to use private visual imagery and language to represent language and actions. This allows us to mentally rehearse possible solutions to problems when attempting to overcome obstacles in order to complete a task or achieve a goal without physically having to carry out each and every solution. This is the capacity that allows us to problem solve.

A child or teen struggling with reconstitution might…

  • Experience more difficulty resolving conflict with a peer or a group leader.
  • Resolving scheduling conflicts between school and church commitments.
  • Approaching a pastor, staff member or volunteer in order to have a need met.

In contrast to the first two barriers to church attendance we discussed in this series…an absence of relationships with Christians and difficulty with social communication, we might predict kids and teens who struggle with executive functioning would have less difficulty with the initial experience of attending church but more difficulty staying involved with church.

Wild kidExecutive functioning weaknesses represent a manifestation of disability that overlaps with our current conceptualization of “special needs ministry.” Executive functioning weaknesses are especially common among children and teens with developmental disabilities. Much of what our crew at Key Ministry is asked to do in support of existing special needs ministries involves helping church staff and volunteers address the challenges presented by kids who struggle with behavioral inhibition. Through identifying the other challenges executive functioning weaknesses present to a person’s ability to maintain an ongoing pattern of involvement with a local church, we hope to assist leaders in designing ministry environments and developing supports to welcome kids and families who were “unsuccessful” in previous experiences of church and strengthen their connection to the local church once they become attenders.

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ADHD Series LogoKey Ministry has assembled a helpful resource page for church leaders and parents addressing the topic of ADHD and spiritual development. This page includes our blog series on the topic and links to helpful videos and resources for pastors, church staff, volunteers and parents. Access the resource page here.

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, www.church4everychild.org was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
This entry was posted in ADHD, Autism, Bipolar Disorder, Depression, Hidden Disabilities, Inclusion, Intellectual Disabilities, Key Ministry and tagged , , , , , , , , , , , . Bookmark the permalink.

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