Elaina sits down and talks with Lisa Jamieson from Walk Right In Ministries about family caregivers, the holidays, and ways the church can better support them.
The training, content, gatherings and experiences that we’ve created for pastors, church staff and ministry volunteers produced with the assistance of like-minded colleagues serving in disability ministry have become our principal service. So much of what we’re able do to help churches welcome and support families, we accomplish by bringing together experts from other ministry organizations.
November is Caregiver Awareness Month. As someone who became one of my dad’s caregivers before I started school, I grew up thinking everyone in the world was aware of caregivers and caregiving. As a young adult my husband and I cared for a son born with a life-threatening medical condition, and his typical sibling. As members of the sandwich generation, my brother, sister, and I cared for our mother for 15 years after she was diagnosed with dementia. This explains why, when I first heard that November is Caregiver Awareness Month, I was incredulous, and I still am.
In this episode, Lauren Hickman shares her personal journey and calling to disability ministry, describing how God has guided her every step of the way to serve families impacted by disability.
In today’s episode, Sandra talks about the challenges small to normative-sized churches face in disability ministry and shares how the churches she’s been a part of have overcome these challenges.
We're delighted to share that the team at Harper Collins Christian Publishing and their associates at Zondervan (which, along with Thomas Nelson is one of their two foundational publishing groups) has recognized the same need and has extended a contract to work together with us in making the book a reality.
A new study suggests the media implicates mental illness as a cause of violence with increasing frequency and in doing so, is complicit in increasing the stigma experienced by persons with mental illness and their families.
If you think mental health ministry is something your church should consider, just start the conversation. If your church is like most, the pastors and staff are already aware of mental health needs in your faith community. Prayerfully consider if Jesus isn’t asking you to step up and reach out to the ones who can’t reach out for themselves.
Most kids with gender dysphoria become comfortable with their biological sex as they progress through childhood. For those who continue to experience significant gender discordance as adolescents, far too many will have experienced trauma, mental illness, social isolation, self-injury and suicidal thoughts.
Families in which someone was struggling with a mental illness were very desirous of support from their local churches, but members not exposed to mental health issues were basically oblivious to their needs and the presence of mental illness appears to be an impediment to church attendance and regular prayer.
Editor’s note: Out of the 700+ blog posts featured here since the middle of 2010, the post I’ve printed out and shared most frequently with parents coming through our office is this post on the differences in kids with ADHD. Here’s an updated version taking into account research developments since the original was written in 2010…
ADHD is among the most commonly identified mental disorders in children and teens in the U.S. According to a 2011 study, 11% of youth between the ages of 4-17 have received a diagnosis of ADHD, and over 6% are actively being treated for the condition with prescription medication. Given the sheer number of kids affected by the disorder, the need for the local church to serve, welcome and include them (and their families) has become too great a problem to ignore.
We need to understand the nature of the disability associated with ADHD if we’re to appreciate the challenges the condition presents for the church and for parents invested in their child’s spiritual development.
According to the DSM-5 criteria, children, teens and adults with ADHD have a developmentally inappropriate degree of inattentiveness, poor impulse control and in some (but not all) instances, hyperactivity.
Russell Barkley, Ph.D. is one of the world’s foremost experts in researching brain mechanisms in children and adults associated with ADHD. I had the honor of being his co-presenter at a day-long symposium on ADHD a number of years ago and was surprised to discover that he’d co-authored a paper with Dr. William Hathaway from Regent University entitledSelf-Regulation, ADHD and Child Religiousness(Journal of Psychology and Christianity, 2003; 22(2):101-114). Here’s a fascinating lecture on the nature, causes and treatment of ADHD that Dr. Barkley gave on February 13, 2008 at the U.C. Davis MIND Institute.
Dr. Barkley’s theories suggest that ADHD is a disorder not only of attention, but of executive functioning as well. 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. We’ll describe in more detail the consequences of delays in the development of these functions.
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. Kids in whom the development of this capacity is delayed will be unable to suppress the publicly observable aspects of behavior.
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 who experience delays in developing this capacity will have more difficulty remembering multi-step directions, more difficulty completing tasks (especially tasks that take a long time to complete), and will tend to underestimate the amount of time necessary to complete assigned tasks.
Verbal 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 a thought in their mind without having to actually say what they’re thinking. A classic example is the inability of little kids to pray silently.Kids with delays in development of verbal working memory would tend to talk excessively compared to peers, have more difficulty organizing and communicating thoughts, struggle more with use of proper grammar and experience more challenges in following rules and directions.
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 who experience delays in acquiring this capacity will likely appear to overreact in response to minor provocation, have more difficulty appreciating the impact of their actions upon others, and have more difficulty summoning the drive or emotional states to overcome obstacles or complete goal-directed behaviors. Their response to initial frustration is usually to quit the activity or task.
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. Kids with delays in acquiring this capacity will experience much more difficulty generating solutions to problems when they get frustrated or stuck.
The theory described above applies only to kids with the classic, combined type ADHD in which kids have difficulty with impulse control and hyperactivity. In general, they know what they should do, but lack the self control to do what they know is right. They also are challenged to generate work product, be it schoolwork or completion of chores at home. Kids with the inattentive subtype of ADHD have problems with focus, concentration and information retrieval. They are more likely to complete their work, but make careless mistakes in doing so.
The potential effects of trauma and abuse on the developing brain and nervous system are powerful and incredibly complex.
Healthy brain development is highly contingent upon a number of highly interrelated neuroregulatory systems that are highly sensitive to the effects of environment and experience. In some instances, environmental factors influence the expression of genes responsible for proteins affecting neurotransmitter sensitivity and function. In other instances, circulating hormones affect development of critical brain regions associated with learning, memory, impulse control, mood and emotional self-regulation.
The neuroregulatory systems that help us to manage stress throughout life are extremely malleable during the prenatal period and early childhood. Toxic levels of stress during this period affect the development of these neuroregulatory systems in ways that cause those systems to become overly responsive to shut down in response to a wide range of stressors in later life.
Let’s look at how toxic stress affects the development of different systems and structures in the brain…
The hypothalamic-pituitary axis (HPA): The HPA plays a critical role in the body’s response to stress. The hypothalamus produces corticotropin-releasing hormone (CRH) which stimulates the pituitary gland to produce adrenocorticotropic hormone (ACTH). ACTH acts on the adrenal gland to increase levels of cortisol (see diagram at top of page). Cortisol is a steroid hormone produced in response to a wide variety of stressors. Cortisol mobilizes energy stores and suppresses immune response. Surgeons prefer to operate early in the morning when cortisol levels tend to be at their highest. Long-term elevation of cortisol levels in children (as seen in kids exposed to high levels of acute or chronic stress/abuse) can turn off the glucocorticoid receptor gene (involved with regulation of the long-term stress response of the brain to cortisol) and the myelin basic protein gene, producing the “insulation” of nerve cells that allows for efficient nerve signal transmission. Elevated cortisol levels also cause damage to the hippocampus (below).
The hippocampus: The hippocampus is a structure that plays a key role in learning by consolidating information from short-term to long-term memory. The hippocampus is capable of growing new neurons in adulthood. Damage to the hippocampus from elevated cortisol levels in childhood leads to impairments in learning and memory.
The locus coeruleus/noradrenergic brain systems: The locus coeruleus is a region located in the brainstem where the cell bodies of most noradrenergic neurons are located. This system is involved with regulating the overall level of arousal in the central nervous system. Exposure to stress/trauma early in life have been associated with lifelong increases in noradrenergic reactivity.
The noradrenergic system (along with the dopaminergic system) is the primary system associated with executive functioning. Tracts of neurons originating in the locus coeruleus project to the posterior attention center in the parietal cortex (responsible for scanning the environment for relevant stimuli) and the anterior fronto-striatal system, which is more involved with executive control and focusing attention. The posterior center is primarily under noradrenergic control, while the anterior center receives both dopaminergic and noradrenergic projections. Difficulties associated with weaknesses in executive functioning include poor impulse control, diminished capacity for emotional self-regulation, delaying gratification and problems with working memory. Editor’s note: This may help to explain the increased prevalence of ADHD among kids who have been traumatized or abused along with the observation they are frequently less responsive to medication than kids with ADHD lacking such exposure.
Dopaminergic systems: Numbing, decreased interest in pleasurable activities and difficulties with ability to maintain focus upon a task are associated with pathways mediated by dopamine. Dopamine pathways originating in the midbrain projecting to the medial prefrontal cortex may be especially vulnerable to the effects of acute and chronic stress. These pathways also play a role in selective information processing, working memory, and applying previously learned information to new experiences. Pathways from the medial prefrontal cortex to the amygdala are thought to play a role in mediating the response to fear.
Serotonergic/GABA systems: Alterations in these systems in response to stress/trauma contribute to difficultiess in social attachment and regulation of mood and affect following early stress.
Here’s a diagram from an article in Child and Adolescent Psychiatric Clinics of North America that shows the interrelationship of the different neural circuits involved in childhood PTSD…
Bottom line…The neuroendocrine changes that occur in response to trauma in children are widespread, long-lasting, and impact mood, learning, arousal, impulse control, memory, emotional self-regulation, and contribute greatly to future response to stress.
Updated March 4, 2016
