ADHD of the Christian Kind - Response to "Christian Home" Article

ADHD in Our Christian Home - A Response

I read Dr. James Thomas' article, ADHD in the Christian Home back in 1997. As I read his article, emotions surfaced that I had yet to identify. Among them were despair and frustration. No one understood what I was dealing with. I read book after book on biblical child training, applying the methods prescribed. My children still exhibited underlying ADHD behaviors no matter what I did. Was I a failure as a parent? Was my faith flawed? As the years have passed and I have lived with ADHD and other co-morbidities, I have come to identify the cause of my intense emotions: denial. How dare someone deny what I am living and claim that it was just sin.

I will attempt to address Dr. Thomas' arguments one by one. Since his article is nearly 10 years old, he may have changed his position. I will address what was written in the 1995 article above because I believe these positions are still held among Christian pastors, counselors, and teachers. I will provide a different point of view, one that has grown from my own walk with the Lord and my experiences with my own ADHD and that of my children.

Dr. Thomas breaks his arguments against the clinical existence of a medical and biological ADHD diagnosis into four parts:

"Non-Biblical Presuppositions"
"The Leading 'Experts' Don't Agree"
"The 'Medical' Diagnosis is Made Using Behavior Symptoms"
"The Behavioral 'Symptoms' Are Biblical Issues"

Let us look at each of his arguments and think about them from a logical point of view. Let us reason together.

"Non-Biblical Presuppositions"

Dr. Thomas' first argument against the existence of ADHD as a biological disorder is because "The basis for the diagnosis ADHD is the presupposition 'that some children who cannot sit still and pay attention in school have a biologically based behavior disorder,'"citing Dr. Martin Baren's article, "ADHD: Do We Finally Have It Right?" 1994, Contemporary Pediatrics. Consequently, Dr. Thomas believes that with an ADHD diagnosis, these children will not be held accountable for their behavior. Further, the Bible and its teachings will then be considered irrelevant and harmful to children.

In a nutshell, Dr. Thomas is claiming that the existence of a biological or neurological disorder called ADHD is in opposition to biblical teaching and beliefs. The following is what I believe Dr. Thomas is saying: The Bible's teachings and tenets do not allow for the existence of a biological disorder, ADHD.

How does he make these corrolations? Are they relevant arguments against the existence of ADHD? Are Dr. Thomas' assumptions true? Do clinicians diagnose a child with ADHD, give him some pills, then never expect his parents and teachers to hold that child accountable for his behavior? Are parents always told that the Bible is irrelevant and harmful to an ADHD child's upbringing?

There are Christian psychologists and psychiatrists who acknowledge the existence of ADHD as a biological or neurological disorder. These professionals also acknowledge and declare that the Bible is the inerrant, living Word of God, and is useful for teaching, exhorting and correcting. [2 Timothy 3:16-17] Although I do admit that the standard secular mental health practices do not support the use of biblical chastisement, I do not believe this is a valid argument against the existence of true mental health disorders of neurological or biological origin. For example, the American Association of Pediatrics does not support the use of chastisement as a valid child training method either. Does this mean that any medical disorders they identify and treat are then not existent? You can see the flaw in Dr. Thomas' inference.
"The Leading 'Experts' Don't Agree"

Dr. Thomas claims that because "Experts" do not agree on how to diagnose and treat ADHD, it must not be a valid biological disorder.

Back in the 1800's, it was believed that malaria was caused by gases from swampy areas. The medical profession disagreed on cause for decades. In the late 1800's the mosquito was identified as the carrier of the protozoa that causes malaria and there are now a multitude of successful treatments available. Does this disagreement among "Experts" prove that malaria is not a biological disorder? Before the protozoa were identified in the blood of an adult, the cause of malaria was unknown. There were only symptoms to indicate the existence of this disease. I know it seems a far stretch to apply the same logic to what has been considered a behavioral disorder, but it does apply. Just because the knowledge and research necessary to test for ADHD is not available today does not mean that it won't be in the future.

In the last 10 years, great strides have been made in identifying the neurological basis of ADHD. PET scans have identified areas of the brain that appear to receive less blood flow and exhibit less activity in diagnosed ADHD patients when compared to PET scans of normal brains. When given a dose of a stimulant, these sleepy areas of the brain come to life. This would indicate a biological basis in the ADHD diagnosis.

Below are links to interesting articles on what brain scans have provided researchers in the search for a biological cause for ADHD:

- Brain Scans Reveal ADHD Differences: Some Children with ADHD May Have Different Levels of Brain Chemicals
- Test Predicts ADHD Response to Ritalin: Brain Scan IDs Adults With ADHD Likely to Benefit From Stimulants
- Why Would You Give A Stimulant To Someone Who Is Already Hyperactive? - Shows brain scans of normal adult as compared to an ADHD adult as well as an ADHD boy without medication and then again after taking a stimulant.

We all agree that the study of the brain is new territory. Physicians do not agree on treatment of epilepsy, narcolepsy, Tourette's Syndrome, Autism, and many other disorders that seem neurological in nature. This does not make them invalid diagnoses.
"The 'Medical' Diagnosis is Made Using Behavior Symptoms"

Let's address Dr. Thomas' argument that because ADHD is diagnosed using a behavioral checklist, it cannot be a biological disorder. There are many medical conditions that are diagnosed using a symptoms checklist. These include fibromyalgia, epilepsy, and other disorders that are not detected using blood tests or other clinical tests.

In the case of epilepsy, a person presents with loss of consciousness, possible incontinence, chewed tongue/cheeks, body shaking or spasming violently, and so on. There is no blood test for epilepsy. If a person exhibits these symptoms, epilepsy is suspected. If the symptoms continue, other conditions will be ruled out, then a diagnosis will be given with a treatment plan prescribed including medication to control the seizures, all without any pathological tests.

Fibromyalgia is much more difficult to diagnose, requiring at least 6 months of symptoms. Treatment usually includes sleep aids and muscle relaxers as well as daily exercise and a healthy diet. Does the reliance on a checklist of symptoms invalidate fibromyalgia as a biological condition? Absolutely not.
"The Behavioral 'Symptoms' Are Biblical Issues"

Dr. Thomas claims that the symptoms of ADHD are "problem behaviors, and often sinful behaviors which over time have become habits. They reflect a lack of the fruit of the Spirit and demonstrate undeveloped character qualities."

Dr. Thomas goes on to state that "they are also behaviors which the Bible clearly and sufficient addresses. Placing the label ADHD on a such a child robs him of hope, absolves him (and his parents and teachers) of responsibility, and negates the potential life-changing effect of the powerful Word of God (Hebrews 4:12)."

It is very difficult for me to read Dr. Thomas' words above and not spit nails. I grew up believing that I was stupid and lazy. I grew up in the same home as my sister who runs a perfect home, keeps her entire life organized and perfectly ordered. We had the same parents, the same opportunities. To make the story more interesting, I was the one child who sought God at a young age. I always thought about God and Jesus even when I was young. I was baptized when I was 10 years old because I felt a drawing and that is what you do in the Baptist Church when you feel drawn. I was not taught the ways of the Lord afterwards because discipleship was not something that was done at that time.

When I was 24 years old, I was truly born again. I was faced with the holiness of God and my own sinful nature and knew that I needed to repent and follow Jesus. I was cleansed by the blood of Jesus, bought with a high price, and justified because of Jesus' death and resurrection. I have continued to grow and be transformed into the image of God from 1984 until now. God has developed character in my life, I exhibit the fruit of the Spirit, and I love the Lord with my whole heart. I was diagnosed ADHD 14 years after I accepted the Lord. Why didn't my symptoms resolve as I grew in the Lord? Why didn't I transform into a completely organized, focused person as I knew more and more of the Word of God. I applied the Word. I confessed the Word. I submitted to discipline and began to heap condemnation on myself because there were areas of my life that seemed to remain like Paul's thorn in the flesh. When I was finally diagnosed with ADHD in 1998, a light came on and I knew that was what I was dealing with. I found hope in my diagnosis, not despair and absolution from responsibility. I am still responsible for homeschooling my children, running my home, training my children in the nurture and admonition of the Lord. I have not been relieved of these responsibilities because of my diagnosis.

My daughter suffers from a severe memory deficit. She has virtually no working memory. Other than a psychological workup, there are no definitive tests to diagnose my daughter's problem. A brain scan might indicate some damage in her brain, but there is no guarantee that the damage will show up. My daughter had two concussions when she was between the ages of 3 and 4. Does my daughter deliberately forget the steps necessary to cleaning the kitchen because of her sin nature, because she doesn't really want to clean the kitchen? You could argue that this is the case. I could punish her for being careless in her work. I could withhold privileges because she is not showing excellence in her chores. This would be cruel. Instead, I am teaching her coping skills so she can help herself learn to face the world with a faulty memory.

In our Christian home, God's standards are intact. We hold our children accountable for their behavior, whether it is symptomatic of ADHD or their sin nature. I teach my children that they are responsible for their actions no matter what the root cause. Though we make accommodations for learning times, we do expect our children to behave themselves in public with the utmost decorum. Actually, because our children tend to be more energetic and impulsive, I am probably much more vigilent than most parents. Our standards of behavior are probably higher than most Christians. We require respect for both parents, all adults and for their siblings. Unkind words are prohibited.

What I do not require from my children is that they be cookie-cutter copies of all the other children they know. Sometimes my children come across as a little strange, different or quirky. There is nothing biblically prohibiting people from being peculiar, As a matter of fact, I believe the Bible states that the Church is to be filled with a "peculiar people." We need to be careful what we call sin. An inability to focus in a boring situation is not sin.

I attempted to address what I consider faulty reasoning on Dr. Thomas' part. I do believe the Bible has an answer for every problem in our lives. But I believe sometimes these answers come in the form of doctors, psychiatrists, and other professionals who can help us identify and provide a name to our struggles.

The latest research indicates that ADHD is possibly being considered as an Autistic Spectrum Disorder. I do not believe any Christian would deny the existence of Autism, a neurological disorder that presents with social and relational difficulties, poor fine motor skills, poor muscle tone, sensitivity to environmental factors such as chemicals and food allergies, and other difficulties. Severity of this disorder is now believed to range from ADHD to Aspergers to Severe Autism.

I do believe that in the next few years, research in the field of Autism will provide the answers that parents have been demanding, praying for, and desperately awaiting. I believe ADHD will be officially added to the Autistic Spectrum. Thank you for allowing me to share my thoughts and concerns regarding the position Dr. Thomas and many other Christians take regarding ADHD. May the Lord reveal His wisdom in this area, and may families with ADHD children be embraced and ministered to with love and acceptance by God's people.

Additional Information:

The History of Mental Illness
Understanding Attention Deficit Disorder, by Dr. William Sears
Exploring Autism Now