We’re going to plunge headfirst into a topic that I’ve never seen addressed anywhere in books, articles or seminars on working with families of kids with ADHD…the use of medication for the specific purpose of helping kids function better during church-based programs and activities.
There are several reasons why today’s discussion is a “taboo topic.” Parents of kids with ADHD who make their way to church are often very uncomfortable sharing information about their child’s diagnosis or treatment. Church staff and volunteers should avoid speculation about a child’s diagnosis or judgments regarding a child’s treatment needs. Physicians and other professionals involved with treating kids with ADHD are likely too uncomfortable broaching the need for medication at church or too oblivious to the reality that some parents would desire treatment in support of activities central to their child’s spiritual development.
First, my two cents: If your child’s experience at church is as important as their experience at school, the need for effective treatment at church is as great as their need for treatment at school.
Why would a parent not give their child medication on the weekend that would help them have a better experience at church? Here’s one reason…the side effects many kids experience from commonly prescribed ADHD medications.
Here’s data from a study I presented a number of years ago at the American Academy of Child and Adolescent Psychiatry looking at prescription fill rates for children and adults with ADHD:
Parents of the “average” kid with ADHD fill between four and five 30 day prescriptions per year…the number for adults is 3.1. 27% fill seven or more 30 day prescriptions per year. As a result, the “average” kid with ADHD who has been prescribed medication isn’t on their medication on any given day. My interpretation is that kids and adults take medication when they really need it and avoid taking it whenever they can.
Appetite suppression is the most common side effect in kids. Some kids have more difficulty sleeping on medication. Kids with ADHD who also have anxiety disorders (30%) often experience worsening of anxiety symptoms accompanied by moodiness and irritability on stimulants. Parents administer medicine because, in many instances, their kids just wouldn’t make it through school without it or their behavior would just be too disruptive to family life and peer relationships.
Parents haven’t been conditioned to think about the impact of ADHD on their child or family’s church participation because I doubt most clinicians ask about it. In the last fifteen years, I can count on the fingers of one hand the number of times I can recall a parent spontaneously volunteering that they were concerned about their family’s inability to do church because of their child’s ADHD before I raised the question. Talk about don’t ask, don’t tell!
Tweens and teens frequently take themselves off medication between the ages of 10-14. I hear kids tell me their medicine results in feedback from friends telling them they’re too “serious,” or they don’t feel like themselves or experience more self-consciousness in social situations. The middle schooler on a retreat may be more concerned about having fun with their friends than being able to absorb the content of the group discussions on the trip. Parents may choose not to provide medication for overnight retreats or mission trips because of concerns the knowledge their child takes medication may not remain confidential.
Finally, some church activities are scheduled at times of day when administration of ADHD medication is inconvenient or becomes problematic because of side effects. For example, if your church offers AWANA and has a relatively high population of kids with ADHD, starting your programming at 7:00 PM on a weeknight probably isn’t a great idea. The three most commonly prescribed ADHD medications, Adderall XR, Concerta and Vyvanse typically last (at the most) 10-13 hours. If kids are getting medication before school, the effects will typically be wearing off around dinnertime. The only time I’ve ever had to have a parent sign a release of information for me to talk to my wife involved a situation when she was serving as AWANA group leader. One of my patients with ADHD got into a fight with another kid who probably should have been one of my patients. Having an understanding of this boy’s issues at a time of night when others wouldn’t have considered his need for treatment led to a medication adjustment and a successful year in AWANA.
My hope would be that parents would become as comfortable addressing the need for medication at church with their child’s physician as they would discussing the impact of their child’s ADHD in school or at home, and physicians would routinely ask about the impact of ADHD on the child’s church participation and spiritual development. We’ve got a long way to go before those conversations become routine.
Key Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!