Church4EveryChild

Communication Breakdown…Doing Ministry Together Without Diagnostic Labels

drgrcevich — Thu, 26 Jan 2012 05:01:20 +0000

This is the third post of a four part series: No Labels…Should Diagnosis Matter at Church? Today, we look at how church staff and volunteers in disability ministry can communicate with one another and effectively serve kids and families without depending upon diagnostic labels.

When we began this series of posts last Sunday, we examined the importance of diagnostic criteria for facilitating communication between clinicians and for helping them organize their thoughts in the service of developing a plan to “treat” the patient/client. This process is very necessary in treating diseases or disorders, but seems very much out of place when it comes to welcoming kids and families into communities of faith, sharing Christ’s love with them, and including them in activities and practices to help them grow to be more like Christ.

Using diagnostic language works in hospitals, clinics and physician offices, where nearly all the staff involved with direct service has been through rigorous professional training and a licensure process that ensures that everyone knows the common language. When professional people with experience in caring for persons with disabilities volunteer at church (this includes medical and mental health personnel, but also teachers with experience in special education) they can easily slip into the language they use at work. It’s easy to see the problem such language could create at church…everyone at work may know what they’re talking about when they use the words “bipolar disorder,” dyslexia or Tourette’s syndrome, but not everyone volunteering in a church will understand those terms.

If we decide not to use a medical-based model as a common language around which to serve kids and families in churches, we need a common language for communication with one another that can be readily understood by every staff person and every volunteer at church. I’ll argue that it’s best to to use everyday language while guided by a set of communication principles.

My Key Ministry colleague Katie Wetherbee (pictured with kids) is in the middle of an outstanding series on confidentiality and communication at church. I’m going to encourage you to check out her posts on a thought process to guide written and verbal communication at church, strategies for maintaining confidentiality, and describing behavior in a non-judgmental manner. In addition to Katie’s excellent resources, I’d encourage church staff and volunteers to be intentional in using “people-first language.“

None of this is to say that there isn’t an incredibly vital role for trained clinicians in your church’s inclusion ministry. If you’re fortunate to have physicians, psychologists, speech and language pathologists or special education teachers available to you who can borrow from their training and experience in ways that inform the rest of the team how to more effectively administer to kids and families, by all means, take advantage of their expertise!

On several occasions, I’ve done observations and assessments of individual kids presenting challenges to churches served by Key Ministry. When I’ve been asked to do this, I’ve made it clear to parents that we’re not performing a clinical service, although I will call the child’s pediatrician or treating clinician at the parents’ request to share my observations. A consultation is unlikely to be effective if I’m unable to communicate my thoughts and ideas to the ministry team in clear and practical language.

Coming Sunday: Tying it All Together

Filed under: Controversies, Inclusion, Key Ministry, Strategies Tagged: communication, diagnosis, Disability Ministry, Katie Wetherbee, Key Ministry, labels, people-first language, Stephen Grcevich MD

Do We Put People in Boxes?

drgrcevich — Tue, 24 Jan 2012 05:01:52 +0000

This is the second post of a four part series: No Labels…Should Diagnosis Matter at Church? Today, we look at the propensity of church members to make judgments based upon diagnostic labels and the risks of creating ministry programs for people who fit specific diagnostic categories.

I’ve seen two practices in the church that cause me to worry about emphasizing clinical diagnoses among those doing ministry with families of kids with disabilities…

Don’t get me wrong…It’s great that there are thousands of churches in the U.S. and beyond launching special needs ministries. Our team at Key Ministry is helping to promote the trend. But something bothers me about some of the ministries we see taking root.

As imperfect people, Christians are all too often quick to judge other people. We make lots of value judgments, including judgments about the causes of the disabilities experienced by kids who come (but are all too often missing) from our churches. We have “good” disabilities and bad disabilities!

Look at the focus of many of our “special needs” ministries…kids with wheelchairs, kids with Down’s Syndrome, kids with cerebral palsy and kids with autism…as long as they have severe challenges with communication and significant intellectual disability. The kids served by our “special needs” ministries are almost exclusively those with disabilities for which there is nearly universal agreement that parents bear no culpability.

Most people “get” what autism is about because of some fabulous public education initiatives. But way too many people think that ADHD is caused by poor discipline at home, anxiety is produced by a lack of faith and that depression persists because the person afflicted doesn’t pray enough. If we get hung up on diagnoses, the value judgments of too many people in our churches becomes an impediment to creating welcoming ministry environments for all kids and families.

The second practice I’m concerned about is the propensity of churches to address the need by starting programs led by people who develop expertise in “special needs” ministry that aren’t fully integrated into the most vital ministries of the church. After all, churches have lots of “silo” ministries…men’s ministries, women’s ministries, singles ministries, children’s ministries, youth ministries, family ministries and sports ministries. It may seem easier to train a team of people to serve kids and families with a defined range of disabilities than to create a culture of inclusion across all ministries that becomes part of a church’s DNA. The challenge is that no two people meeting criteria for a specific disability have the exact same gifts, talents or needs. If you’ve seen one kid with autism, you’ve seen one kid with autism.

I’ve been in psychiatry for 26 years, with a primary focus in child and adolescent psychiatry for 23 years. Figuring out what to do for individual kids and families is getting harder as I get older. I develop an increased appreciation on a daily basis of the complexity of the problems my patients and their families struggle with. The National Institute of Mental Health has a strategic plan focusing on research to make possible personalized medicine in treating people with neuropsychiatric disorders. We need personalized ministry at least as much as we need personalized treatment.

Inclusion ministry is ultimately about sharing the love of Christ with people who were created to be unique. It’s not about putting people into programs…it’s about offering the love of Christ in response to need. Assigning people to diagnostic categories at church doesn’t help us make progress toward that goal.

Addendum: Our friend and colleague Shannon Dingle posted on the topic of how much does a special needs diagnosis matter at church. She expressed what I was thinking as well or better than I did. Check out her post.

Thursday: Communication Breakdown…How Do We Talk to One Another Without Discussing Diagnostic Labels?

Filed under: Controversies, Inclusion Tagged: churches, diagnosis, Inclusion, Key Ministry, No Labels, putting people into boxes, Stephen Grcevich MD

The Purpose of Diagnostic Criteria

drgrcevich — Sun, 22 Jan 2012 15:35:27 +0000

This post begins a four part series: No Labels…Should Diagnosis Matter at Church? Today, we look at the purpose of diagnostic criteria…and whether they serve the purpose of the church.

Dr. Fred Volkmar, chief of Child and Adolescent Psychiatry at Yale-New Haven Children’s Hospital and Chair of the Yale Child Study Center created quite a stir within the special needs community this past week when he presented findings from a study demonstrating that 55% of persons currently diagnosed with autism (and 75% of persons with Asperger’s Disorder) will no longer meet the revised criteria for the diagnosis proposed in the DSM-5, the manual used to diagnose mental disorders.

From time to time, leading researchers and clinicians in the mental health field come together to review the appropriateness of the diagnostic criteria we use, consider the evidence for including additional conditions in the DSM-5 and eliminate others, in a process that often generates great controversy. There are three primary purposes served by establishing common criteria…

Common criteria help ensure that our diagnoses are both accurate and consistent. They’re essential for communication between clinicians throughout the world. If one of my patients with ADHD moves to Paris, the physician assuming responsibility for their care needs to be working from the same understanding of the criteria for ADHD that I do.

Common criteria that are consistent and reliable are essential for meaningful research into the underlying causes and risk factors for psychiatric disorders, determination of the incidence and prevalence of specific disorders and the comparative effectiveness of different treatments.

The process of establishing a clinical diagnosis and case formulation helps us to organize our thoughts about how to best treat our patients. When we have residents and medical students rotating through our practice, one of my admonitions to them is “I don’t care what you call it, as long as you know what to do about it.”

Changes in our diagnostic criteria are a big deal because the criteria are used for a multitude of other reasons other than those for which they were originally intended. Consider a few of the ways in which the criteria are used…

Practitioners and hospitals use diagnoses on the claim forms they submit in order to be paid for their services. Insurance companies and pharmacy benefit managers all too often use diagnostic codes to avoid having to pay for specific treatments.
Pharmaceutical companies need to conduct research trials demonstrating the effectiveness of their products for specific psychiatric diagnoses in order to market their products legally in the U.S. and receive payment from government-funded health care programs. As you might imagine, changes in diagnostic criteria producing increases or decreases in the pool of potential customers is of great interest to the pharmaceutical industry.
Diagnoses are required by law for children with disabilities to receive accommodations in public education, and help determine eligibility for special education services.
Diagnoses are used in determination of eligibility for disability benefits.
The presence of a diagnosis often contributes significantly to the identity of persons with disabilities. Many “Aspies” (as they refer to themselves) have vociferously protested the proposed elimination of Asperger’s Disorder from the DSM-5 in favor of inclusion into a broader classification of autism spectrum disorders.

Think about this…Diagnosis is ultimately used as a tool to facilitate the treatment of patients/clients with identifiable medical/psychiatric disorders.

Does the church treat kids with disabilities? Or do we disciple them?

Tuesday: Do We Put People in Boxes?

Filed under: Autism, Controversies, Key Ministry Tagged: Autism, church, diagnosis, Dr. Fred Volkmar, dsm-5, Key Ministry, Stephen Grcevich MD

Mini-Series: No Labels…Should Diagnosis Matter at Church?

drgrcevich — Sun, 22 Jan 2012 04:33:39 +0000

At this week’s Key Ministry planning meeting (Rebecca, Katie, Harmony, and myself), one of our tasks involved assigning content for our blogs in the coming year. One of my assigned topics is to discuss the importance (or unimportance) of diagnoses for churches seeking to connect with and minister to families of kids with disabilities.

This past Friday, news reports surfaced of a chart review study suggesting that proposed changes to the diagnostic criteria for autism would result in a 55% reduction in the number of children and adults who would qualify for the disorder.

Given the interest in the special needs community about the impact of changes in the criteria for autism, along with proposed changes in diagnostic criteria for ADHD and mood disorders in children, there seemed to be no better time than the present to examine the topic of diagnosis in serving families touched by disability.

This coming week, we’ll take a closer look at the topic No Labels…Should Diagnosis Matter at Church? Here’s a preview:

Sunday, January 22: The Purpose of Diagnostic Criteria

Tuesday, January 24: Do We Put People in Boxes?

Thursday, January 26: Communication Breakdown?

Sunday, January 29th: Tying it All Together

Filed under: Announcements, Resources Tagged: Asperger's Disorder, Autism, church, diagnosis, Key Ministry, No Labels, Stephen Grcevich MD

Klout…What’s a Good Christian to Do?

drgrcevich — Thu, 19 Jan 2012 05:21:38 +0000

When Jesus noticed that all who had come to the dinner were trying to sit in the seats of honor near the head of the table, he gave them this advice: “When you are invited to a wedding feast, don’t sit in the seat of honor. What if someone who is more distinguished than you has also been invited? The host will come and say, ‘Give this person your seat.’ Then you will be embarrassed, and you will have to take whatever seat is left at the foot of the table! “Instead, take the lowest place at the foot of the table. Then when your host sees you, he will come and say, ‘Friend, we have a better place for you!’ Then you will be honored in front of all the other guests. For those who exalt themselves will be humbled, and those who humble themselves will be exalted.”

Luke 14:7-11 (NLT)

Is there any encouragement from belonging to Christ? Any comfort from his love? Any fellowship together in the Spirit? Are your hearts tender and compassionate? Then make me truly happy by agreeing wholeheartedly with each other, loving one another, and working together with one mind and purpose. Don’t be selfish; don’t try to impress others. Be humble, thinking of others as better than yourselves. Don’t look out only for your own interests, but take an interest in others, too.

Philippians 2:1-4 (NLT)

From time to time, I get messages in my Twitter account or e-mail notifying me that I’ve been “awarded a K+” on Klout by a wonderful colleague and friend of our ministry. Every time I get one of these messages, I contend with a great ambivalence about responding. I either need to be all-in or all-out. Feel free to share a little wisdom and discernment.

What’s Klout you ask? Here’s a description from the company’s Facebook page:

Klout measures influence across the social web.

Klout tracks the impact of your opinions, links and recommendations across your social graph. We collect data about the content you create, how people interact with that content and the size and composition of your network. From there, we analyze the data to find indicators of influence and then provide you with innovative tools to interact with and interpret the data.

That doesn’t sound too bad. Except that everyone is assigned a Klout “score” that is very prominently displayed when one clicks a link to their site. And the site is basically designed to promote competition and foster self-promotion. So…why bother?

Conference organizers, publishers, bloggers and other folks in old and new media are very interested in Klout scores, because leaders with high Klout scores have a demonstrable ability to influence other people to view and respond to their content.

One of the biggest surprises I encountered in the process of shifting more of my time and energy from the medical world to the ministry world was a level of narcissistic self-promotion in ministry that would shame my most competitive colleagues in medicine. Would you like an example? Enter the following terms in Google: ministry blog march madness. I came up with 2.76 million results.

I served three terms on the Program Committee for the American Academy of Child and Adolescent Psychiatry. In order to speak at the Academy’s meeting, we actually required all of our presenters to have done something of interest or significance. In most instances in ministry world, it appears you either have to be pastor of a big, cool church, have the capacity to sell lots of books or have the demonstrated ability to get the attention of lots of people in order to obtain a platform to influence others.

So here’s the dilemma…We have a fabulous team of speakers and trainers at Key Ministry and friends and colleagues in other ministries with wonderful ideas and strategies and resources that I want to get in front of as many pastors, church staff and volunteers as possible so that they can help connect families of kids with disabilities to churches. There are certain rules in place that guide who gets access to platforms of influence. I think we’re doing this for the right reason if we use resources like Klout, but…

I come back to the Scripture verses above, and many others like them. How do we serve the purposes of God without reflecting the character traits of God? The temptation for self-promotion through social media seems great. And we’re supposed to flee from temptation, right?

What’s a good Christian to do?

Filed under: Controversies, Key Ministry, Strategies Tagged: Christian, Key Ministry, Klout, social media, Stephen Grcevich MD

Some weekend reading…and a request for input

drgrcevich — Sun, 15 Jan 2012 16:29:35 +0000

This past week, our core team at Key Ministry spent a day putting together our game plan for approaching the year ahead. We discussed some potential features and series we might present during 2012. I’d like to offer you the opportunity to help choose our next series and lend some input to the content being developed for 2012. after all, our reason for doing this is to help the churches served by our readers to more effectively minister to families of kids with disabilities in the year ahead. Please take the one question poll below and feel free to leave additional suggestions there or in the comments section below…

Take Our Poll

I’ve also been working on ways to make it easier for new followers of the blog to find and reference teaching series we’ve produced in the past. We’ve put together a summary page with links to all of our blog posts from our most popular series… The Impact of ADHD on Spiritual Development. We now have a summary page with links to every post from our most popular series of 2011… Thinking “Orange”…Family Ministry Strategies When Families Have Special Needs. Feel free to share the links to friends or colleagues interested in these topics.

Let us know of other tools or resources we can develop to assist you or your church in ministering to families of kids with disabilities. We’re honored to serve.

Pajama Conference is able to support FREE ministry training and conferences such as Inclusion Fusion through selling advertising on their websites and conference recordings. Your purchase of the videos from Inclusion Fusion will help to support the costs involved with producing Inclusion Fusion, but other valuable training events including the 2012 Children’s Ministry Web Summit and Youth Ministry Web Summit. Click here to order the complete 2011 Inclusion Fusion DVD collection!

Filed under: Families, Key Ministry, Resources Tagged: ADHD, Church4EveryChild, Family Ministry, Key Ministry, Special Needs Ministry, spiritual development, Stephen Grcevich MD

New Tool: ADHD Resource Page

drgrcevich — Tue, 10 Jan 2012 17:43:35 +0000

We’ve made lots of new friends through this blog since we launched in September of 2010. When analyzing the utilization of the blog, we found that our most-viewed teaching series of 2011 was our series from 2010 on ADHD and Spiritual Development.

In order to make it easy for new friends to find what appears to have been a useful resource for blog readers, we’ve created a page containing links to the entire blog series along with two very useful resources for ministry leaders and parents…links to the American Academy of Child and Adolescent Psychiatry’s ADHD Resource Center and a video by Dr. Russell Barkley, one of the world’s leading experts in the area of brain functioning and ADHD.

Check out our new resource page on ADHD and Spiritual Development!

Filed under: ADHD, Key Ministry, Parents, Resources, Spiritual Development Tagged: ADHD, American Academy of Child and Adolescent Psychiatry, Key Ministry, Russell Barkley, Russell Barkley Ph.D., spiritual development, Stephen Grcevich MD

Kids With Aggressive Behavior…Is it Ever OK for a Church to Say No?

drgrcevich — Mon, 09 Jan 2012 00:21:39 +0000

This is the tenth post in our Fall series Beyond Zero Tolerance: When Kids Become Aggressive at Church. Today, we’ll look at the question of whether it’s ever appropriate for ministry leaders to encourage parents not to bring their child or teen to worship services or church activities because of their history of aggressive behavior.

Where in the Great Commission or the New Testament does it say anything about a requirement that all followers of Christ keep the Sabbath by being physically present inside an identified church building for worship or instruction?

In my humble opinion, no children’s ministry or youth ministry is going to be able to successfully include 100% of kids with disabilities 100% of the time. Our team at Key Ministry would certainly encourage churches to attempt to include as many kids and teens with as broad a range of disabilities as possible into as much of their age and developmentally appropriate worship and church programming as they possibly can. But there will be kids who will have times when participation in activities at church doesn’t represent the “least restrictive environment” for that child to grow as a follower of Christ. Kids with a history of severe aggressive behavior may fall into this category.

So when should kids at risk for severe aggression be asked to stay home? Schools have guidelines for parents about when they should keep children home to prevent other kids from getting sick. When are other kids, church staff and volunteers at risk of being harmed by kids prone to aggression?

If the parent(s) can’t manage the child’s behavior safely at home
When a foreseeable event has transpired at home (changes/lapses in medication used to control aggressive behavior, marked escalation of behavior while transitioning/preparing to leave for church) or at church (changes from the norm in environment/availability of appropriately trained staff or volunteers familiar to the child) increasing the child’s risk of aggressive behavior.

The church isn’t off the hook for its’ responsibility to help the child and their family to come to faith or grow in faith. What can (and should) the congregation do to support the rest of the family in attending church and participating in activities vital to spiritual growth?

Could the church provide relational respite in the child’s home to allow the adults in the family to attend worship or participate in other activities? If the child’s needs are severe enough, what about paying for specially trained, in-home child care providers?
Could the church schedule activities (small groups, Bible studies, service opportunities) during times of day/seasons of the year when the needs of the child at risk of severe aggression are being met through the educational system?
Can the church arrange for transportation for the other children in the home to attend age-appropriate programming on Sunday…and during the week?
Can the church become a resource provider to parents of tools to support them in their role as primary faith trainer of their children…with and without special needs?
Can the church be intentional about creating ministry environments that support the child at risk of aggressive behavior in participating in as many activities as possible as often as possible?

Filed under: Controversies, Spiritual Development Tagged: aggressive behavior at church, children, risk management, youth

Should a Parent of a Child With Special Needs Run For President?

drgrcevich — Thu, 05 Jan 2012 04:26:49 +0000

Note: Any comments or opinions expressed in this blog post reflect my personal viewpoints and do not necessarily reflect the opinions of Key Ministry or its’ Board of Directors.

I’d learned for the first time that Rick Santorum has a daughter with special needs while watching the election returns from Iowa last night. The Santorums’ three year old daughter (Bella) has Trisomy 18, a genetic disorder associated with intellectual disability in the small percentage of kids with the condition who survive for longer than a year.

When I started using Google to learn more, I came across an interview from last month with Senator Santorum. One question (around the 3:35 mark of the interview) jumped out at me…

“As a mother, I just wonder how you can keep going and justify this (running for President) with so much personal toll at home, given the polls.”

I’n my practice and in my volunteer work with Key Ministry, I’ve talked to too many mothers and fathers of kids with special emotional or behavioral needs whose parenting decisions and practices have been harshly judged by those who have never walked in their shoes or sought to understand the challenges they face.

I was serving on a church board where we considered a candidate for senior pastor who had been very open in discussing his son with autism during his preaching and teaching. The position involves lots of evening and weekend meetings and lends itself to a highly unpredictable schedule, none of which is necessarily helpful when one has a child who doesn’t respond well to changes in routine. The candidate was hired by the Board…I’d argue that the impact of his ministry has been enhanced by his experiences as a parent. All too often, I suspect that churches and other organizations make assumptions about how parents of kids with special needs should be spending their time that result in those parents missing out on opportunities for meaningful service.

I’m not expressing an opinion about Mr. Santorum’s candidacy one way or another. But he and his family deserve the respect to make decisions about how best to serve while raising a child with special needs, and we shouldn’t presume that we know what’s best for his children and his family, or any other family in which a child has a special emotional, behavioral, developmental or physical need. He deserves to be judged by the voters on the basis of his leadership ability, character, judgment and ideas and not by uninformed perceptions of how parents of kids with special needs should be spending their time.

Check out this video clip from an earlier debate…I don’t often see fathers of kids with special needs share from their experiences as openly as Senator Santorum did here…

Filed under: Controversies, Parents

Church4EveryChild…2011 in Review

drgrcevich — Tue, 03 Jan 2012 12:00:47 +0000

Some interesting stats from 2011…

Readers from at least 27 different countries accessed the blog in 2011.

Every continent was represented, except for Antarctica.

Blog traffic for the fourth quarter in 2011 was increased 377% compared to the same quarter in 2010. Thanks for your support!

The most viewed post was Special Needs and Divorce…What Does the Data Say? The page views for this post were nearly double that of the second most-viewed post.

The fourth most viewed post was actually published in 2010…Part Two of Harmony Hensley’s post on Welcoming Ministry Environments for Kids With ADHD. Easy to see why Harmony now has a position with our core ministry team, along with her own blog.

The most-viewed series originating in 2011 was our book study, Thinking Orange, in which we looked at applications of Reggie Joiner’s popular family ministry book with families of kids with disabilities. The most viewed series overall in 2011 was the 2010 series on ADHD and Spiritual Development.

Our three most popular guest bloggers were Colleen Swindoll-Thompson, Libby Peterson and Michael Woods, closely followed by Shannon Dingle.

Here were the top posts of 2011:

#1. Special Needs and Divorce…What Does the Data Say?

#2. Inclusion Fusion 2011…Speaker Handouts

#3. Inclusion Fusion 2011…Speakers and Topics

#4. Harmony Hensley: Welcoming Ministry Environments for Kids With ADHD (Part Two)

#5. The Pros and Cons of Medication for Kids

Honorable Mention: The relationship between ADHD and autism

Filed under: Resources Tagged: Church4EveryChild, Colleen Swindoll-Thompson, Harmony Hensley, Key Ministry, Libby Peterson, Mike Woods, Shannon Dingle, Special Needs and Divorce, stats, Stephen Grcevich MD