One mother’s journey…adoption and psychiatric medication

Ward FamilyEditor’s note: We originally published this post from one of our readers (Janet Ward) on Mother’s Day weekend two years ago. Given the proximity of Mother’s Day to Children’s Mental Health Day/Week, I thought her post would be of interest to many of our new friends who have begun following the blog over the last two years.

Janet’s article captures the passion demonstrated by mothers who need to advocate  for for their children every day. She speaks with the acquired wisdom of a mom who has walked the walk and talked the talk and has valuable insights to share. Thanks to the folks at Adoption Today who graciously gave us permission to share…

Psychotropic Medications some pros and cons 

By Janet Ward

Driving our minivan up a scenic mountain road during a summer vacation, listening to my enraged 6-year-old daughter tantrum from the backseat, screaming about wanting to get another fairy doll at the country fair we had just left, my daughter becoming angrier with each passing second.

I concentrated intently on driving, hoping to safely and quickly make it back to the condo where we were staying. Suddenly, something struck me on the back of my head. She had taken off her shoe and had thrown it at me. I yelled at her to stop. She responded by throwing the next easily reachable projectile, which happened to be a book.

Much to my horror, I then heard the click of her seatbelt unbuckling. In the blink of an eye, my daughter charged me from the back of the minivan, pushing and hitting me on my head, right shoulder and arm as I struggled to keep the car under control.

That was it. That incident was the final straw that led to our decision to start my daughter on an antipsychotic medication. I didn’t know it that day, but during the next eight years, we would try 14 different psychotropic medications with her, all in an attempt to manage her wide array of symptoms related to anxiety, mood and attention.

During those years, I learned a lot about this hotly debated topic of medication for kids. I learned there are no easy answers. I learned that those who claim to have all the answers most assuredly do not. And I learned the answer that is right for one child and one family is not necessarily right for another.

In our fast-paced society, people often look for quick, easy fixes. Contrary to what many believe, putting a child on psychotropic medication is neither quick, nor easy, nor a fix. It is a serious decision with potentially serious consequences.

While there are times when medication is inarguably the best course of action, there are other times when arguably it is not. Either way, putting a child on psychotropic medication should be undertaken only after careful thought and with full awareness of the risks and costs of doing so. Here are some points for your consideration:

• Much needed relief: By the time parents consider psychotropic medications, especially the more potent antipsychotics, usually every single member of a family is suffering, not only the child. Medication can ease severe symptoms that hinder a child’s ability to function in his or her world, symptoms such as inattention, hyperactivity, anxiety, mood issues and more. By reducing, not necessarily eliminating, the intensity of symptoms, medications can stabilize a child, stabilize a family’s home life, and make concurrent therapies and/or interventions more effective. At their best, medications are essential to preventing or minimizing some kind of crisis, as in our case when safety and the ability to function in daily life were so severely compromised. When medication works as intended, the relief it provides both to the child and the entire family can range from immensely helpful to invaluable.

• Trial-and-error: Like much in life, there is no “one-size fits-all” answer to medication. Finding the right medication — or combination of medications — for any given child is a blend between art and science. No two children’s brains are the same; therefore, no two children react exactly the same to the same drug given at the same dosage, at the same time of day. Often, treatments require experimentation with dosage, time of day of administration, even the specific drugs themselves. Additionally, because children’s bodies change and grow, at times rapidly, even stable medication regimens need to be periodically re-evaluated and adjusted.

• Side effects; take ‘em seriously: We’ve all seen the small print at the bottom of magazine ads— usually so tiny it requires a magnifying glass to read. And we all tend to ignore it, thinking that such things only happen to other people. But my experience is that side effects with psychotropic medications are real, are common, and are not to be taken lightly. At various times, with various medications, my daughter experienced weight gain, weight loss, sleeplessness, excessive sleepiness, anxiety and some bizarre behaviors, such as constant coughing or smacking herself on the forehead with the palm of her hand. These side effects were pronounced, problematic enough that they had to be addressed.

Often with side effects, parents find themselves simply trading one set of behaviors to manage such as problems completing homework due to inattention for another such as having to ensure a child with zero appetite eats enough food to sustain him or herself throughout the day.

Side effects are so prevalent, there’s even a phenomenon called “symptom chasing,” in which another medication is added to the child’s regimen in order to address symptoms caused by a previous medication. When my 40-pound daughter gained a staggering 20 pounds after starting an antipsychotic, a stimulant was prescribed to reduce her appetite and help with attention. Her insatiable hunger did ease up, but the stimulant also had the side effect of increasing anxiety, which then led to the possibility of starting her on an anti-anxiety drug. We decided not to do that, but the lesson here is what started out as one psychotropic medication could easily have led to three, the second two being the result of managing side effects of the first.

Sometimes side effects are so troublesome as to warrant discontinuation of a medication, regardless of how well that medication is working. For example, after six years on a certain medication, my daughter developed side effects that threatened the health of her heart. She had to stop taking that drug, and its discontinuation was no easy task.

• Long-term consequences: As advanced as medical science is, long-term consequences of psychotropic medications on a child’s still developing brain are unknown. Medical science does know, however, that the human brain develops well into a person’s 20’s, so this is as much concern for an otherwise fully-grown teenager as it is for a younger child.

Adoption TodayWhat’s the exit strategy?

Politicians talk about having an exit strategy, a plan about how to leave a situation, either once an objective has been achieved or to minimize failure. Similarly, psychotropic medications require an exit strategy. Medication in and of itself is not a permanent solution. Medication simply squelches symptoms; it doesn’t fix anything. Your child will not magically outgrow his or her condition while on medication. Unless your idea is to have your child take medication into ripe old age,which really isn’t feasible, you need a plan. The ultimate goal is to enable your child to navigate the world successfully, on his or her own, without medication. This means that medication should be only one of several tools in your toolbox, a tool to be used in the short-term while you explore other options to effect permanent changes in the long-term.

Postscript: My daughter is now a teenager and has been medication-free for the past 18 months. She is happier and healthier than ever before, both emotionally and physically, thanks to an extreme amount of hard work and specialized treatment. For my family, psychotropic medication provided a critical tool on the road to get her to where she is today, at a time when we desperately needed it, but it was neither a simple nor problem-free tool to use. If you are contemplating psychotropic medication for your child, my advice is to make an informed decision about medication, as well as other alternatives. In this way, you can choose what is best for your child and for your entire family.

What to Do When Your Child Needs Medication

As a loving parent who wants what’s best for your child, you can be your child’s greatest ally. Here are a few tips to help you navigate through your child’s medication journey:

Find a good doctor: Prescribing psychotropic medication — wisely— is a most complicated affair. Work with the best doctor you can find, one who is highly trained in prescribing these medications, experienced with it, and who takes into account your input and concerns when making decisions.

Compliance is critical: Inconsistency in giving your child his or her medication can lead to further issues for both your child and family. Adequate dosage, timing and consistency are key to obtaining optimal results. Make sure your child takes medication exactly how and when it is prescribed. Aim for 100 percent compliance, and if you miss your mark by just a little bit, you’ll still be doing well.

Keep copious notes: One of the things about life that never changes is that life is always changing. Medication dosage, time of administration, the medication itself, even doctors — all change over time. Don’t trust these important details to your memory or to medical staff. Keep an up-to-date notebook containing all this information. Every time medication is started or adjusted, put on your Sherlock Holmes hat and keenly observe your child’s behavior. Record your observations about behavioral changes, both positive and negative, as well as notes about concurrent changes or stressors in your child’s life. Your notebook can become an invaluable tool to you and your doctor for making informed, intelligent decisions.

Be your child’s advocate: You’re an all-important link between the doctor and your child. You are the one providing most of the information that the doctor will use to make decisions. So communicate well. Describe your child’s behaviors, changes in behaviors, medication side effects, and anything else of significance.

Ask questions: If you are concerned you might forget something during an appointment, write down notes in advance. By taking an active, collaborative role during appointments, you can maximize the chance for the best possible decisions to be reached.

Janet B. Ward is the mother of three children, biological twin boys and a daughter adopted from Russia as an infant. A product of trauma while in Russia, her daughter has received 15 mental health diagnoses in 14 years.

Posted in Adoption, Advocacy, Controversies, Families, Mental Health, Stories | Tagged , , , , , , | 1 Comment

Seven reasons church attendance is difficult when kids have mental illness…

depressed teenWe as the church do a lousy job of welcoming and including families of children and teens with mental illness or trauma histories. I’d argue that a major reason why we struggle is the absence of an agreed-upon model for a mental health inclusion ministry for kids.

I’ve come to the conclusion that our team at Key Ministry needs to, at the very least, put forth a conceptual model for a mental health/trauma inclusion ministry that could be implemented by churches of all sizes, denominations and organizational styles. This model would be continually tested and refined through the experiences of ministry partners everywhere seeking to include kids and teens with ADHD, anxiety, attachment issues, mood disorders, post-traumatic stress and difficulties with social communication and interaction. Today, we’ll start by identifying seven reasons church attendance/participation is difficult for families of kids with mental illness.

Barrier #1. Social isolation

Families of kids with many of the common mental health conditions described above are less likely to have as many opportunities for interaction with other families/children that produce invitations to church.

Barrier #2. Social communication

Churches are intensely social places. Consider the challenges that a child or teen faces in an environment surrounded by same-age peers who has difficulty processing body language/body space, tone/inflection of speech, common rules of social behavior or  struggles to effectively use words to express thoughts or feelings in unfamiliar or stressful situations!

Barrier #3. The child/teen’s capacity for impulse control and emotional self-regulation

shutterstock_86980295_2Kids with common mental disorders frequently experience difficulties with impulse control, problem-solving, learning from experience, managing time, delaying gratification and self-regulating emotions…all of which are common expectations in the environments in which we do much of our children’s and youth ministry. See this post that further explains the importance of executive functioning.

Barrier #4. Sensory processing

Sensory processing differences are common among children with autism spectrum disorders, ADHD and anxiety disorders. Many respond differently to sound, light, touch and taste than their same-age peers, and ministry environments that some kids find engaging may be experienced as noxious by children with heightened sensitivity to sensory stimulation.

Barrier #5. Stigma in the church

As we discussed this past winter, many prominent pastors and church leaders have characterized common mental health conditions in children and teens as either an indication of sin or poor parenting. Others question whether commonly diagnosed conditions such as ADHD really exist.

Barrier #6. The fear of being singled out

shutterstock_15545299Kids and teens with the conditions we’re discussing often express their desperation at wanting to “belong.” Older children and teens are often very reluctant to accept any help that might result in their peers viewing them as “different” in any way. The vast majority of kids I serve in my practice would be horrified by the prospect of having to be part of a “special needs ministry.”

Barrier #7. Parents with mental illness

The apple doesn’t fall far from the tree. Many common mental illnesses are highly heritable. Kids generally don’t drive themselves to church. Any effective strategy to include kids with mental illness or trauma histories at church needs to take into consideration the barriers that have excluded their parents or caregivers from church.

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KM Logo UpdatedKey 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!

Posted in ADHD, Hidden Disabilities, Inclusion, Key Ministry, Mental Health | Tagged , , , , , , , , , | 6 Comments

Welcome Ryan Wolfe to our Key Ministry team…

Ryan Wolfe ColorOn behalf of the Board and staff of Key Ministry, we’re delighted to announce that Ryan Wolfe has joined our ministry team as a church consultant.

Ryan will continue to serve full-time in the position he has held since 2010 as Developmental Disabilities Pastor at First Christian Church in Canton, Ohio. At First Christian, Ryan has developed a faith-based day program & employment program for adults with developmental disabilities. First Christian Church also hosts respite events, an annual prom, Sunday morning ministries for both children & adults, a volunteer guardianship program, and more to support persons with disabilities.

In addition to his church duties, Ryan is very active in his community, serving on the boards of ARC (Autism Resource Center) of Ohio and Canton Challenger Baseball. He has been honored for his community service by the Cleveland Indians – Honorable Mention for Mentor of the Year 2014 and the Arc of Ohio – Stark County Volunteer of the Year 2012. He also raised the funds to build a baseball field for the local Special Olympics Teams and Challenger Baseball in 2011 on the campus of First Christian.

When Key Ministry’s leadership team met to “reimagine” how we might serve churches in the future, we were in agreement on two important issues… First, we were unanimous in affirming a future in which our team continues to provide direct service to churches, and second, we were of a single mind in affirming that we will offer churches relationships along with resources. Ryan (along with Shannon Dingle) is available through our FREE Consultation Service to come alongside churches of all sizes when they have a child or family impacted by disability they’re called to serve. If you’re looking for advice on launching a disability ministry program or outreach, want to bounce ideas off an experienced disability ministry leader or are struggling with how to include a child or teen with especially challenging needs, Ryan and Shannon are available to help you and your church take the next step.

The best way to access Ryan’s services is to submit our “Contact Us” form either through the consultation page on our website or directly through this link.

We’re blessed to be able to offer Ryan as a resource to the disability and special needs ministry community. Please join us in welcoming him to the team!

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shutterstock_24510829Key Ministry is pleased to make available our FREE consultation service to pastors, church leaders and ministry volunteers. Got questions about launching a ministry that you can’t answer…here we are! Have a kid you’re struggling to serve? Contact us! Want to kick around a problem with someone who’s “been there and done that?” Click here to submit a request!

Posted in Inclusion, Key Ministry, Resources | Tagged , , , , , | 2 Comments

Church, what if we think _______ diagnosis isn’t a real thing?

shutterstock_149729270May 3rd-9th is Children’s Mental Health Week. Today, Shannon speaks out about the propensity of others to question the legitimacy of a child’s psychiatric diagnosis.

Everybody has that nowadays.

Isn’t that just a checklist thing? I mean, it’s not a real diagnosis, right?

That’s just an excuse for bad behaviors.

That’s so overdiagnosed.

When I was growing up, we didn’t label kids like that, and we did just fine.

I hear these comments often, usually about ADHD,  Asperger’s Disorder and childhood trauma. I’d love to address them, first as a special educator, then as a ministry leader, and finally as a mom.

In this post, I’m going to focus specifically on ADHD, but please keep in mind that these are CERTAINLY not limited to that areas of diagnosis. In my city and at my church, I’ve noticed that people only make such comments with boldness about ADHD. When they make comments like this about other special needs, they usually used more hushed tones…or they just think the comment instead of saying it.

As a trained special education teacher with my MAEd in the field, I’m no stranger to ADHD in the classroom setting. Is ADHD prevalent nowadays? Yes. It possible that some ADHD diagnoses aren’t legit? Yes. Is it a real disorder? Yes. Can you or I conclusively pass judgment on whether or not a specific individual has a legit diagnosis? Nope.

As a special needs ministry leader, is it be wise or profitable for you or I to try to pass judgment on whether or not an individual has a legit diagnosis? No. If you want to debate the issue from a diagnostic or theoretical perspective, particularly if you work in a field related to special education, go for it. Just don’t bring that into your ministry.

shutterstock_68372575As a mom, my daughter’s diagnosis of cerebral palsy is easier at church than the behavioral concerns I have for my son who will probably end up with a diagnosis of ADHD, Asperger’s, or sensory processing disorder. Why? Because I know no one is going to question her wheelchair and inability to walk in the way they might question his sensory meltdown or difficulty sitting through a church service designed for adults rather than kids. Others view my daughter’s disability objectively but my son’s subjectively (that is, assuming I’m right about the diagnosis to come for him).

Whenever you are tempted to pass judgment on the legitimacy of someone’s diagnosis, stop. Remember that God is all-knowing and you are not. He knows the ins and outs of each person’s life; you only know the tiny sliver of interaction that you have each week or month with that individual.

I don’t see Christ analyzing whether or not the woman who was hemorrhaging had sought adequate care first or bled enough to warrant healing. No, instead He noticed her desperate touch on His robe and called her daughter. I don’t hear Jesus suggesting that we place bouncers at the door of a Luke 14 banquet to ensure that folks are crippled enough, lame enough, or blind enough. No, He says, “But when you give a banquet, invite the poor, the crippled, the lame, the blind, and you will be blessed. Although they cannot repay you, you will be repaid at the resurrection of the righteous.” I don’t read about Christ ignoring the pain of His friends when Lazarus died, even though He knows that the death won’t stick because healing will be provided. No, He cares enough and feels enough to weep.

The comments I shared at the beginning remind me of comments I often hear about people who are homeless or poor. Well, we shouldn’t help them because they could be making a lot of money panhandling. They could be abusing my kindness. They might even {gasp!} buy alcohol with my money. And so those attitudes provide an excuse not to help others, not to care about them. Could those statements be true? Sure. But can you know with certainly whether or not they are? No.

Why are we so afraid of helping someone who might not be “worthy” (according to our own assumptions, that is)? Could it be that we have somehow deluded ourselves into thinking that we have made ourselves worthy in some way instead of acknowledging that not one of us is deserving of grace? God is the only one who knows without a doubt if a person was rightly diagnosed with a disorder or if a person really needs food. And He is the only one who can take a proficient sinner like me and turn her messy life into a masterpiece worthy of reflecting His glory.

What if we became less concerned about trying to be God – which is what we’re doing when we try to decide who is and isn’t worthy – and became more concerned about loving and serving others?

ShannonShannon Dingle provides consultation, training and support to pastors, ministry staff and volunteers from churches requesting assistance from Key Ministry. In addition, Shannon regularly blogs for Key Ministry on topics related to adoption and foster care, and serves on the Program Committee for Inclusion Fusion, Key Ministry’s Disability Ministry Web Summit. Shannon and her husband (Lee) serve as coordinators of the Access Ministry, the Special Needs Ministry of Providence Baptist Church in Raleigh, NC.

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KM Logo UpdatedKey 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!

Posted in ADHD, Advocacy, Hidden Disabilities, Inclusion, Key Ministry, Mental Health | Tagged , , , , , , , , | 5 Comments

Mental health inclusion…taking the first step

shutterstock_131292623May 2015 is Mental Health Month. In recognition, Key Ministry will be presenting a series of blog posts… Ten Strategies for Promoting Mental Health Inclusion at Church. By the end of the series, we will have created a template for churches to follow in pursuing families impacted by mental illness or trauma. We begin today with a discussion of how churches can take the first step in launching an intentional process of mental health inclusion.

Mental health inclusion will likely be a process as opposed to a program. The challenges each person or each family encounters to church attendance and spiritual growth will be far too diverse to be addressed by any program…and programs that result in kids or families being singled out for “special” treatment are likely not to fly for reasons we’ve discussed earlier on this blog. We’re looking to establish a mindset for doing mental health ministry that may impact how your church approaches other areas of ministry.

I’d suggest the first step in a mental health inclusion initiative would be to involve everyone serving in a leadership position over an identified area of ministry in your church  in the process. Mental health inclusion is truly a family ministry. When Mom or Dad struggle with a mental condition that interferes with church attendance or engagement, their kids aren’t going to connect with your children’s or youth programming.

TampaChanelsideSilosAug08Churches that are organized in what leaders refer to as “silo ministries”…systems or departments that operate in isolation from one another-may be at a distinct disadvantage in developing synergy for inclusion efforts. We’re familiar with churches that launched adoption initiatives without including their disability ministry staff despite the proliferation of data suggesting that the children being adopted are more likely to experience conditions that may impact church participation. I know of one congregation that offered groups for families of kids with special needs as part of their online church initiative without any involvement from their special needs ministry team.

RowingThe strategies we’ll be sharing as the series progresses will require the input and expertise of every department or ministry in the church. It only makes sense that ministry will be more impactful when everyone on the team is pulling toward a common goal.

All of the strategies we’ll share will fall under one of these general categories…

  • How do the environments in which we do ministry create real barriers to engagement for kids with mental illnesses and their families?
  • How does a church most effectively communicate their desire to welcome persons impacted by mental illness or trauma and their families?
  • What can each area of your ministry do to connect relationally with families impacted by mental illness both inside and outside your church?
  • How can your church better serve persons with mental illness?
  • How can you help the people of your church to assume ownership of mental health ministry?

One more suggestion…I think it would be wise to consider including a spiritually mature member of your church with firsthand experience of mental illness as part of your mental health inclusion team as well as the parent of a child or teen affected by mental illness or trauma. Research tells us that families impacted by mental illness very much value the support of their local church and no one will be able to provide a more beneficial perspective than someone who is part of your Christian community while living with the challenges presented by a mental health condition or trauma.

Inclusion isn’t a program…it’s a mindset for doing ministry.

Editor’s Note: This series is intended to hash out ideas to be presented in a book for church leaders on mental health inclusion we hope to publish later this year. We don’t have all the answers yet and very much desire the collective wisdom of pastors, church staff, lay leaders and families with firsthand experience of mental illness. As we did with our last series, we’ll be assembling a private, online Facebook group to discuss the topics to be presented. If you’d like to be part of the group, send me a message on Facebook (or a friend request with a message if we’re not already Facebook friends) and I’ll add you to the group.

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KM Logo UpdatedKey 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!

Posted in Inclusion, Key Ministry, Mental Health, Strategies | Tagged , , , , , , | 1 Comment

But what if we don’t have any children with disabilities in our church?

shutterstock_94233817This is a good question. It’s a logical one. It’s one that often comes up when a church first begins discussing special needs ministry.

It’s just not the right question.

Here are some better questions:

1) If you had no children’s ministry – no nursery for babies, nothing taught in an age-appropriate way for preschoolers, and so on – do you think families with children would feel welcome in your church?

Another way of wording that: if you were starting a church but had no children in the first few families, would you include a children’s ministry, or would you say, “No, we won’t concern ourselves with that until kids show up. Then maybe we’ll consider it” or something like that?

I’m not saying your plans need to be complex and cover any and every eventuality. But a special needs family will come to your church, and you need to know what you’ll say and do then. A welcoming plan can be as simple as this: “We’ll tell families, We’re not sure what this looks like, but we’re committed to working with you so your child can be included” and then we’ll follow through to make that happen.”

2) Do you have people with disabilities in your community?

I can already tell you that the answer to that is yes. According to the U.S. Census Bureau in 2010, more than 12% of Americans have a severe disability impacting their daily life. To provide some context, that means the number of people in the US living with severe disabilities – 38.3 million people – is the same as the total population of California. If more than 1 in 10 people are living with a substantial special need and your church doesn’t have any, are you effectively reaching your community?

Maybe you’re thinking the number must be lower for your area. It’s probably not, but if you want to know the exact percentages and breakdowns by disability area for public school students in your area, search for “child count” on your schools district’s website or call the special education department and ask for that information. For funding purposes, every district is required to track and support the count of students with disabilities, and this information is part of public record. Those numbers won’t include children who are in homeschools or private schools, nor does it include children too young or not yet diagnosed. It is a good place to start, though.

3) Do you want to share the Gospel with everyone in your community, or do you want to limit who has access to your body of believers?

Some churches communicate this to their members: “Please invite your friends to join us next week. (And as a note of clarification, by ‘friends’ we mean friends that would fit well and easily in our facilities and current programs. If you would like a complete list of who to invite and who to exclude, please see one of our ushers in the back after the service.)” 

Okay, maybe the last bit is a stretch. I don’t know any churches that would communicate that outright. But if your members don’t see kids with disabilities being included, then they’re not likely to invite that mom from the playground whose son has autism to your church. In other words, even if the clarifying note above isn’t the message you want to send, it might be the one you’re sending.

Throw out the initial question. Answer the other three instead.

ShannonShannon Dingle provides consultation, training and support to pastors, ministry staff and volunteers from churches requesting assistance from Key Ministry. In addition, Shannon regularly blogs for Key Ministry on topics related to adoption and foster care, and serves on the Program Committee for Inclusion Fusion, Key Ministry’s Disability Ministry Web Summit. Shannon and her husband (Lee) serve as coordinators of the Access Ministry, the Special Needs Ministry of Providence Baptist Church in Raleigh, NC.

Say hello to Shannon if you’re planning to attend the Christian Alliance for Orphans Summit this coming Thursday and Friday (April 30-May 1) in Hendersonville, TN.

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2000x770 S DINGLE CHRCH4EVCHILD 2Check out Shannon Dingle’s blog series on adoption, disability and the church. In the series, Shannon looked at the four different kinds of special needs in adoptive and foster families and shared five ways churches can love their adoptive and foster families. Shannon’s series is a must-read for any church considering adoption or foster care initiatives. Shannon’s series is available here.

Posted in Advocacy, Inclusion, Key Ministry | Tagged , , , , , , | 2 Comments

Five reasons churches shouldn’t have vaccine policies

Preparing_a_measles_vaccine_in_EthiopiaVaccines are a hot topic. Before I go into my thoughts about vaccines at church, I think it’s only fair to share my personal stances: I am pro-vaccine for my family. I have read mounds of research, and I’m fully convinced of their effectiveness and role in advancing modern public health. Our family also has several members who are immune deficient – one by HIV (my child), one by taking immune-suppressing drugs for an autoimmune condition (that’s me), and a few due to asthma (me and some kiddos). I believe research proves that herd immunity is a real thing, so I’m thankful when those around us are vaccinated.

All that said, I don’t think churches should have vaccine policies (which Steve recommended in this post). Here’s why:

  1. Enforcing a vaccine policy at church would be a mess.

Do visitors gets to come a certain number of weeks before they have to produce records? How do we decide who gets a legit pass for not being able to have vaccines and who doesn’t because we decide their reasons are more of a choice than a need? Which alternative schedules are okay with us and which aren’t? What about the flu shot? How about children who have recently received live vaccines and might shed the virus to others; will they be excluded from church too, and if so, for how long?

Is this really the cross on which we want to hang our identity as a children’s ministry?

  1. We don’t ask for medical records about anything else.

Our school system’s kindergarten physical form includes a question about other health conditions present in our home, and I’m the snarky mama who writes, “Any medical diagnoses in other members of our family are completely irrelevant to this child’s education, and I find this question to be inappropriate.” I’m pretty sure asking parents for vaccine records before entering children’s ministry will have some parents lose their religion for a moment and say something like “%$*# you” as they pivot toward the exit. Honestly, even though I have those records for each of my kids, I might feel the same way because I loathe paperwork and have to produce enough of it elsewhere. Church is a safe place from that for me.

  1. Creative ministry can figure out other ways to protect kids who might be at risk.

In cases in which a child – for example, a cancer patient – cannot be around unvaccinated children, more thoughtful policies can create separate spaces/classes to accommodate that child in a group of kids who are vaccinated. When done well, all children could be included with both protection for the child who needs it and permissiveness for other parental choices.

For example, we had a separate Sunday school class for a while for a little guy whose mitochondrial disorder meant his immune system couldn’t function properly, so other kids were risky for him. Is that our norm? No. But we did it because it was necessary for him and his family to come to church.

  1. Vaccine injuries are real, albeit rare.

One reason I rarely join in the vaccine fights online is my friend Melissa. Her son Christian passed away two years ago from a brain tumor, but he also had autism and some other complications. His doctors believed some of his neurological issues were due to a rare, severe vaccine reaction. Do I think these reactions are common? No. Does Melissa’s experience and my love for her son Christian make me change my mind about vaccinating my own children? No. But does it make me pause and consider how unloving and hurtful my pro-vaccine stances might feel to families like hers? Yes.

A recent blog post called out Focus on the Family for a pro-vax article in their magazine. That post (which I think was poorly researched, so I won’t link to it here) argued that negative vaccine reactions aren’t rare because of the money doled out for vaccine injuries, but if you look at the number of individual cases rather than the dollar amounts, you could just as easily use those numbers to prove the point that such injuries are uncommon. But as the church, should that matter to us? Why not say that it doesn’t matter if vaccine injuries are rare because we should care about those families too, even if they aren’t the common cases?

  1. We’d be turning people away from church.

When I entered disability ministry, I didn’t have a child with any special needs diagnosis. I didn’t have a personal stake, not in the same way I do now. But I saw families being turned away from church, and I just couldn’t stand for that. Exclusion isn’t part of God’s design for the church or true to the gospel we say we believe is good news for all.

Is safety a major issue for the church? Yes. Do we occasionally turn people away from the church due to safety? Yes, in rare cases like individuals on the sex offender registry, for example (though churches work to creatively engage them in ways that also respect local laws). But excluding unvaccinated or undervaccinated children would mean turning away a significant group of families.

In a world in which the church is often identified more by what we oppose than by the Christ we love, I’m not interested in joining another fight in which we draw lines of unwelcomeness.

ShannonShannon Dingle provides consultation, training and support to pastors, ministry staff and volunteers from churches requesting assistance from Key Ministry. In addition, Shannon regularly blogs for Key Ministry on topics related to adoption and foster care, and serves on the Program Committee for Inclusion Fusion, Key Ministry’s Disability Ministry Web Summit. Shannon and her husband (Lee) serve as coordinators of the Access Ministry, the Special Needs Ministry of Providence Baptist Church in Raleigh, NC.

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2000x770 S DINGLE CHRCH4EVCHILD 2Check out Shannon Dingle’s blog series on adoption, disability and the church. In the series, Shannon looked at the four different kinds of special needs in adoptive and foster families and shared five ways churches can love their adoptive and foster families. Shannon’s series is a must-read for any church considering adoption or foster care initiatives. Shannon’s series is available here.

Posted in Advocacy, Autism, Controversies, Families, Key Ministry | Tagged , , , , , , | 2 Comments

Autism, vaccines and the need to keep our kids safe

shutterstock_161622521An excellent study was published on Tuesday in the Journal of the American Medical Association that should permanently lay to rest the oft-repeated claims of links between autism and the MMR vaccine given to children to protect against measles, mumps and rubella. I’ll share the abstract here…

Importance Despite research showing no link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders (ASD), beliefs that the vaccine causes autism persist, leading to lower vaccination levels. Parents who already have a child with ASD may be especially wary of vaccinations.

Objective To report ASD occurrence by MMR vaccine status in a large sample of US children who have older siblings with and without ASD.

Design, Setting, and Participants A retrospective cohort study using an administrative claims database associated with a large commercial health plan. Participants included children continuously enrolled in the health plan from birth to at least 5 years of age during 2001-2012 who also had an older sibling continuously enrolled for at least 6 months between 1997 and 2012.

Exposures MMR vaccine receipt (0, 1, 2 doses) between birth and 5 years of age.

Main Outcomes and Measures ASD status defined as 2 claims with a diagnosis code in any position for autistic disorder or other specified pervasive developmental disorder (PDD) including Asperger syndrome, or unspecified PDD (International Classification of Diseases, Ninth Revision, Clinical Modification 299.0x, 299.8x, 299.9x).

Results Of 95 727 children with older siblings, 994 (1.04%) were diagnosed with ASD and 1929 (2.01%) had an older sibling with ASD. Of those with older siblings with ASD, 134 (6.9%) had ASD, vs 860 (0.9%) children with unaffected siblings (P < .001). MMR vaccination rates (≥1 dose) were 84% (n = 78 564) at age 2 years and 92% (n = 86 063) at age 5 years for children with unaffected older siblings, vs 73% (n = 1409) at age 2 years and 86% (n = 1660) at age 5 years for children with affected siblings. MMR vaccine receipt was not associated with an increased risk of ASD at any age. For children with older siblings with ASD, at age 2, the adjusted relative risk (RR) of ASD for 1 dose of MMR vaccine vs no vaccine was 0.76 (95% CI, 0.49-1.18; P = .22), and at age 5, the RR of ASD for 2 doses compared with no vaccine was 0.56 (95% CI, 0.31-1.01; P = .052). For children whose older siblings did not have ASD, at age 2, the adjusted RR of ASD for 1 dose was 0.91 (95% CI, 0.67-1.20; P = .50) and at age 5, the RR of ASD for 2 doses was 1.12 (95% CI, 0.78-1.59; P = .55).

Conclusions and Relevance In this large sample of privately insured children with older siblings, receipt of the MMR vaccine was not associated with increased risk of ASD, regardless of whether older siblings had ASD. These findings indicate no harmful association between MMR vaccine receipt and ASD even among children already at higher risk for ASD.

A brief explanation of the data…a relative risk ratio less than 1.00 suggests that the risk of autism is lower than what would be expected by random chance, while relative risk >1.00 suggests a greater than expected risk. In this study, the statistics suggest that in kids with older siblings with autism who received both recommended doses of the MMR vaccine, rates of autism approached the statistical threshold of being significantly lower than the rate in siblings who were unvaccinated. The authors had some interesting observations about this finding that were discussed at some length in the paper.

So…why bring this up here? Because what church leaders communicate to their congregations really matters, and the medical consequences of measles are potentially very serious for the young children we minister to.

ManWearingTinFoilHatWe just finished a blog series about attitudes regarding mental illness and the church and it’s pretty obvious that skepticism in large pockets of the church about recommendations from the medical community run pretty deep…and from where I sit, some of that skepticism…especially when people in the medical and scientific community operate from a very different worldview…is well-deserved. But there’s a point at which blind rejection of good science jeopardizes our ability to credibly communicate our witness to the world outside our Christian cocoon. We become as easy to dismiss as people who wear tinfoil hats and reinforce the perception among outsiders that one needs to check their brain at the door in order to come to church.

There’s a real possibility that you have kids in your church with a chronic medical condition that precludes them from getting the MMR vaccine. Kids who are being treated for cancer, kids who are HIV-positive (3.2 million children worldwide, according to the Kaiser Family Foundation) and kids receiving high doses of oral steroids are unable to take the vaccine. They depend upon “herd” immunity from infections that are potentially fatal for those with compromised immune systems. When large numbers of families forego immunization, vulnerability to outbreaks increases.

One such outbreak occurred at Eagle Mountain International Church in Texas in 2013. In that church, 21 people contracted measles, 16 of whom had never been vaccinated, including all of the children who developed measles. The story received national scrutiny from major media, including Fox News, NPR, USA Today, the Washington Post and ABC News. From the Fox News story

Although church officials were quick to act after the outbreak — including hosting clinics in August where 220 people received immunization shots — and have denied they are against medical care or vaccinations, people familiar with the ministry say there is a pervasive culture that believers should rely on God, not modern medicine, to keep them well.

“To get a vaccine would have been viewed by me and my friends and my peers as an act of fear — that you doubted God would keep you safe, you doubted God would keep you healthy. We simply didn’t do it,” former church member Amy Arden told The Associated Press.

What are our “take home” points…

  • The finding that the MMR vaccine doesn’t cause autism is as close to “settled science” as we can get in modern medicine. Additional money spent researching this topic would  represent extraordinarily poor public policy and stewardship of research money better spent determining the causes of autism and studying interventions to limit the functional impact of the condition.
  • If I were a parent of a child with a vulnerable immune system, I’d be very concerned about bringing my child to church if I had concerns that many of the kids present in the children’s ministry were unvaccinated.
  • If I were a pastor or an elder at a church in an area shown to have low immunization rates or families involved with adopting orphans from Sub-Saharan Africa (where HIV-positive status is endemic), I’d have to consider a policy of asking (if not requiring) families who are regular attenders to provide vaccination information as part of the children’s/youth ministry registration process. Obviously, we don’t want to create unnecessary barriers to families attending church, but we also need to maintain safe ministry environments for the kids we serve. One alternative might be to offer kids with immune system vulnerabilities classes/activities with kids who have been vaccinated. Note: On a statewide basis, Ohio, West Virginia and Colorado currently have the lowest MMR immunization rates according to the CDC, while some neighborhoods and private schools in affluent areas of Los Angeles have immunization rates comparable to those found in South Sudan!

While it’s critical to not allow controversies to divide us (and to continue to welcome families opposed to vaccines at church) we need to maintain ministry environments that are safe for all kids. Where significant numbers of kids go unvaccinated, other kids with medical conditions that preclude vaccination are exposed to risk.

COMMENTS ARE NOW CLOSED ON THIS POST.

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Square Peg Round HoleKey Ministry has assembled a helpful resource on the topic of Asperger’s Disorder and Spiritual Development. This page includes the blog series Dr. Grcevich and Mike Woods developed for Key Ministry, links to lots of helpful resources from other like-minded organizations, and Dr. Grcevich’s presentation on the topic from the 2012 Children’s Ministry Web Summit. Click here to access the page!

Posted in Advocacy, Autism, Controversies, Key Ministry | Tagged , , , , , , , , | 25 Comments

Sin, mental illness and the church…Erring on the side of grace

shutterstock_165733445In this series, we’ve looked at the origins of some common attitudes and perceptions among church leaders regarding the causes of mental illness and the treatment approaches used by the mental health profession, approaches for addressing believers with mental illness within the reformed/evangelical tradition and research examining reactions of church attendees after seeking help for themselves or for family members with mental illness from pastors or church staff.

As the series comes to a close today, I’d like to toss out a suggestion to all in positions of leadership within the church, based on 29 years of experience interacting with families impacted by mental illness in my “day job.”

We need to treat persons with mental illness and their families with the same sensitivity and grace we would show to any vulnerable believer.

I’ll pick what seems to be a rather odd section of Scripture to support my point.

Paul shared some principles in 1 Corinthians 8 (ESV) that may be relevant to our discussion…

Now concerning food offered to idols: we know that “all of us possess knowledge.” This “knowledge” puffs up, but love builds up. If anyone imagines that he knows something, he does not yet know as he ought to know. But if anyone loves God, he is known by God.

Therefore, as to the eating of food offered to idols, we know that “an idol has no real existence,” and that “there is no God but one.” For although there may be so-called gods in heaven or on earth—as indeed there are many “gods” and many “lords”— yet for us there is one God, the Father, from whom are all things and for whom we exist, and one Lord, Jesus Christ, through whom are all things and through whom we exist.

However, not all possess this knowledge. But some, through former association with idols, eat food as really offered to an idol, and their conscience, being weak, is defiled. Food will not commend us to God. We are no worse off if we do not eat, and no better off if we do. But take care that this right of yours does not somehow become a stumbling block to the weak. For if anyone sees you who have knowledge eating in an idol’s temple, will he not be encouraged, if his conscience is weak, to eat food offered to idols? And so by your knowledge this weak person is destroyed, the brother for whom Christ died. Thus, sinning against your brothers and wounding their conscience when it is weak, you sin against Christ. Therefore, if food makes my brother stumble, I will never eat meat, lest I make my brother stumble.

As church leaders, we may recognize situations in which symptoms associated with a mental health condition may be exacerbated by patterns of thought or behavior that can be characterized as sin. We may also see evidence in those struggling with mental illness of an absence of coping strategies available to those with more mature faith. But we’re clearly guilty of a lack of sensitivity in how we communicate with and care for our brothers and sisters with mental health condition as well as parents of kids with emotional, behavioral or social challenges.

Why the need for such sensitivity?

  • Compared to others, persons impacted by a mental health condition are more likely to misperceive how they’re viewed by others in an inappropriately negative way. One reason many struggle with depression or anxiety is that they make incorrect assumptions about what others think of them. Because of these cognitive distortions or “thinking errors,” they may fear the judgment of pastors, counselors or other church leaders and demonstrate exquisite sensitivity to the words or actions of those in leadership.
  • People with mental illness who experience “cognitive rigidity” or are prone to obsessiveness or perseveration in thinking have a much more difficult time than others getting past a hurtful experience.

What good does it do for us as church to push people away through our words and actions who might have what Paul describes as a “weak conscience” from the way their brains are hard-wired who we might otherwise influence to grow in faith through relationship? Are we causing our brothers and sisters to stumble?

And as we’ve discussed previously, there’s an enormous population living within the shadows of our steeples who struggle as a result of their (or their spouse’s) experience with mental  illness or the experience of raising kids impacted by mental illness. People who need to experience the love of Christ with gifts and talents intended for use in expanding the Kingdom.

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GA-Social-Media-StephenGrcevich-1 - Version 2Miss any of the posts in this series on Sin, Mental Illness and the Church? Here are links to  the earlier posts in the series…

The elephant in the living room…Sin, mental illness and the church. (January 16)

The evangelical understanding of mental illness…How Freud, Skinner, Rogers and Ellis led to Jay Adams. (January 25)

Jay Adams and the foundations of a movement… (January 28)

Unintended consequences…Sin, mental illness and the church (February 5)

Why many in the church don’t see ADHD as a disability… (February 11)

What if medication is a tool that helps us resist sin? (March 1)

Are you less likely to be referred to a psychiatrist if your physician is a Christian? (March 8)

Was Elijah Depressed? (March 24)

Posted in Advocacy, Families, Hidden Disabilities, Key Ministry, Mental Health | Tagged , , , , , , | Leave a comment

Hopeful, Trusting, Confident and Calm…Karen Crum

Karen Crum“Calm, assertive energy in the human –and calm, submissive energy in the dog”– that’s what Cesar Millan, the Dog Whisperer, strives to create in his work with dogs and their families. I’ve recently watched a few episodes of his Family Edition show and it’s been enlightening. Surprisingly, when Cesar is called in to “rehabilitate” a dog, a common part of his process is to train the humans in the family to relax. Dogs are masters of reading body language and other cues indicating human emotion, and they respond accordingly. Because of a dog’s social-behavioral “pack” mentality, changes in the psychological energy of the dog owners (“pack leaders”) affect their canine friends in fascinating and almost miraculous ways. A calm and assertive human almost always effects a positive change in dog behavior. I think, in a similar way, a calm and assertive parent usually brings about positive behavior in a child.

While this might seem like a blog about becoming a calm and assertive parent (which is a good goal)—it is really about growing as a hopeful and trusting parent. Let me explain. My children are young adults now, but when my oldest “pup” was young and showing signs of autism, I responded with anxiety, tenacious research, and problem solving. As time passed with misdiagnoses, limited local resources and other stressors, my anxiety increased. I soon learned that autism is not a puzzle easily solved. Helping my child was too big for me to negotiate in my own strength.

Like many parents of children with social, emotional or behavioral challenges, I looked for the perfect combinations of therapy, medication and specialized programs to give me a sense of peace and hope for my child’s future. I never completely found it there because people, systems and medicine are constantly changing and are sometimes more helpful than others. While I longed to trust that God would provide and care for my child, His provisions were not always on the time table or to the degree that I wanted. This fueled my doubt, worry and hopelessness—and led to a more intense striving for solutions and answers. By the time I learned to turn over the burden of these issues to God, I had already worked myself into a hopelessness and exhaustion that I didn’t see coming. Without hope and confidence in a rock solid foundation, it was impossible to feel internally calm.

I didn’t realize the significance at the time, but regaining hope was a key ingredient to my ability to parent with “calm, assertive energy”, as opposed to “frantic, anxious energy.” Like many of the dog owners on Cesar’s show, I was not even fully aware of my intense internal striving. One day I felt the overwhelming burden, however, and turned it over to God, dropping on my knees to pray for myself and my family. I admitted to God that the problems were too big for me, and I asked Him to take them over. Right then and there, I felt a burden lifted from my shoulders and I knew with certainty that God and I were in this together. I was not alone– and neither are you.

I wish I could honestly say that I never took those problems back as my burdens, but I have. However, now I more quickly identify my useless striving, and more quickly lean on God again. If you took an honest survey from my kids, I think they would tell you that most of the time, I exhibited the external behavior of a calm, assertive mother. I was not the yelling sort, or a complete pushover (at least not most of the time.) However, as calm as I may have looked on the outside, I was often behaving like a duck—appearing to peacefully glide upon the water while my legs were paddling crazily underneath. I know they sensed my internal state even if neither of us could explain it, and it most certainly affected our lives. When I was actively listening to God’s directions, I was able to relax and feel so much more internal confidence and peace as a parent. I learned that many things will not will work according to my plans and timing, but I know that God is in control and that I can trust and hope in Him to lead “my pack”.

You may find yourself in a similar place with your child. Your problem solving style may be different, but in all cases it is critical to learn to calmly and submissively trust our Father in Heaven. The results may be nothing short of miraculous—for the peace and calm of the entire family.

Lately, a hymn has been on my mind and part of the lyrics keep replaying themselves into my soul:

“My hope is built on nothing less than Jesus’ love and righteousness,

I dare not trust the sweetest frame but wholly lean on Jesus’ name,

On Christ the solid rock I stand,

All other ground is sinking sand, all other ground is sinking sand.”

I pray that you ask for and listen to God’s calm and assertive voice so that you might learn to trust, hope, and be confident and calm as a parent. It will make all the difference.

“You will keep in perfect peace those whose minds are steadfast because they trust in you” (Isaiah 26:3)

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Dr. Karen Crum has a doctoral degree in Public Health and Preventive Care. She promotes the health and well-being of children with autism and mental illness. She has developed and presented programs to support special-needs children, and currently focuses on educating and supporting parents as they care for their children with social, emotional or behavior challenges.

Persevering ParentKaren’s newest mission includes her work with a Christian focus. Dr. Crum is the author of Persevering Parent: Finding Strength to Raise Your Child with Social, Emotional or Behavior Challenges. This book points to God’s truths and to practical and spiritual principles that enhance hope, joy and effective special-needs parenting. Persevering Parent can be purchased online by following this link. In honor of Mothers Day, the book is 50% off the regular price during the months of April and May (use discount code 885VMZAG).

Persevering Parent Ministries is a non-profit organization and a portion of proceeds from direct website orders are donated to provide respite care for struggling families. The book is also available from Amazon and other online distributors.

Posted in Autism, Families, Hidden Disabilities, Parents, Resources, Stories | Tagged , , , , , , | 2 Comments