The Hidden Challenge: How ADHD Can Impact Religious Observance

For those raising or educating a child with Attention Deficit Hyperactivity Disorder (ADHD), the child’s difficulty in adjusting to structured environments and rules is clear. This can manifest as an inability to focus on what needs concentration, adjusting organization and order to effective ways of working, restraining oneself, and even calming one's body when high energy is inappropriate. ADHD is a condition of boundaries - the rounded internal world struggles to fit into the square frame of defined rules. Naturally, this struggle can also affect adherence to the framework of Jewish law.

Is There Evidence?

This area of study has only started gaining traction in recent years. Research conducted on religious Jewish adolescents indicates that ADHD is linked to difficulties in adhering to commandments. Moreover, a very high percentage of teenagers who drop out of Torah education systems have ADHD.

Does ADHD Necessarily Mean Lapses in Observance?

Not necessarily. It’s not black and white: not all individuals with ADHD find it difficult to keep all commandments, but generally, individuals with ADHD might struggle more with consistently following rules. It also depends on whether the disorder is being managed. Many studies indicate that individuals with ADHD are more likely to break laws - for instance, they are at a higher risk of receiving traffic tickets. However, this doesn’t mean that everyone with ADHD will break laws...

What Shouldn't Be Done?

Often, parents might think their child’s spiritual struggle comes from a lack of reverence, treating them as if they are indifferent to Torah. The child himself may be confused about why he finds it hard to adhere to commandments. When a parent perceives the child as lacking reverence, the child may internalize this negative message, becoming "evil in his own eyes" and losing hope and motivation for improvement. The truth is, ADHD is a trait you’re born with, affecting the brain's behavior, making it difficult for someone to conform to frameworks and rules. The brain is like a "machine" - it doesn’t know whether the rules are written in the Shulchan Aruch or a driving code...

What Should Be Done?

Diagnosis – Being aware of one's weaknesses makes coping easier. Some fear that naming it might give them an excuse, but the opposite is true. Knowing that one has boundary issues doesn’t absolve responsibility; it increases it - one knows there's a valid reason to work on oneself. Someone with ADHD isn’t "foolish" and bears full responsibility for their actions (even if their decision point is different, even with mitigating circumstances considered).

Treating Through the Body – Treatment through the body may include various aspects for each person, not detailed here. One of the most effective treatments is medication, upon a doctor's recommendation. Medication helps activate brain parts aiding in maintaining boundaries. Research shows that even though individuals with ADHD are at higher risk for law violations, medication reduces the risk by about thirty percent in men and forty percent in women!

Treating Through the Mind – A person is a unity of body and soul, so the mind can’t be ignored. According to leading global medical recommendations, attention should also be given to mental and emotional aspects. Viewing ADHD as a brain-only issue is a grave mistake. The body is only part of the "person". The tendency not to conform manifests in the brain but is also part of an individual's character, an aspect that can be self-worked on.

Self-work involves three parts (Mila): What – An accurate understanding of the challenge; Why – Finding personal meaning, emotional support, and enhancing motivation in the challenge; How – Searching and refining methods that work for the individual to adjust to frameworks and rules without losing their uniqueness.

This time, we’ll address the "what" part. ADHD has four main components: concentration, organization, restraint, and calmness. The manifestation of ADHD differs among individuals. Each person has their own blend of components and specific areas of difficulty. For instance, one might struggle with restraint, concentration, and calmness but not organization. Two people might struggle with organization, but for one, it could mean time management, and for another, organizing objects. Let's go over the four components of ADHD and see how each can impact religious observance.

Concentration – Difficulty concentrating over time, ignoring distractions, paying attention to detail, and learning systematically and organized. This issue can affect essential knowledge required for observance, whether related to halachot or beliefs. A child who doesn’t study might lack basic knowledge of commandments or Judaism, which could lessen their commitment to observance. Additionally, this can affect a student's connection to Torah study, and when they don’t feel "belonging" to such a central practice, their motivation to behave according to halacha might wane. For example, people with ADHD often think "roundly," generally being impressed by study, engaging in "talks of study," getting excited by specific ideas in a topic, but might lack "square" thinking - orderly, systematic, and organized - they lack the "structure of the subject." As a result, many feel that they "gain nothing from study," they experience confusion and disorder, and they feel lost within a yeshiva framework. When a young man spends most of his day bored, feeling empty and without meaning, his connection to Torah may weaken. 

Organization – Difficulty organizing effectively, keeping objects orderly, time management, planning and adhering to schedules. Many commandments are time-dependent, like Shema, prayer, Shabbat. When there's difficulty in keeping time, a person might want to adhere to the commandment but repeatedly fails. For example, they plan to pray in an orderly place, but remember last minute and miss praying in public. Another example, struggling to organize bedtime leading to missing Shema. Over the years, one might develop a sense of failure and lose hope in success. One might even give themselves explanations and "excuses" to justify the situation. Additionally, individuals with ADHD struggle with realistic time perception, and when doing tasks that don’t particularly excite them, they might feel like "time never ends," thus losing patience. This can lead them to avoid commitments. For instance, prayer, birkat hamazon, Shabbat meals, learning in "Avot Ubanim," and similar activities might seem unending to them.

Restraint – Difficulty in delaying gratification, waiting, low patience, low frustration tolerance, emotional outbursts, and impulse behavior. All of these share a common trait: preferring the present over the future, manifesting as self-control issues and an inability to delay gratification. In other words, the condition leads to a tendency to do what one "wants" over what "needs" to be done. Thus, individuals might struggle more with commandments such as stopping to bless before eating, waiting between meat and milk, waiting for Kiddush, maintaining composure when angry, avoiding forbidden actions or speech, or performing commandments when there is no desire. Furthermore, when untreated, emotional and social difficulties may arise. Emotional struggles weaken the strength to restrain and do what "needs" to be done. Social struggles weaken the sense of belonging and commitment to the community, thereby losing a crucial supportive factor - since community connection aids one in observing halachic boundaries.

Calmness – Lack of calmness can manifest as excessive activity mentally, verbally, or physically. Too much talk or thought. Excessive movement, frequent position changes, fiddling with objects. Excessive running, dancing, or climbing. Difficulty sitting still for long, sometimes prolonged sitting "tires" a person. Studying Torah and prayer often require the ability to remain in one place for extended periods. Additionally, community expectations require children to sit calmly during prayer, maintain silence, and not engage in other activities. Furthermore, it is common for those with the disorder to experience fluctuations; sometimes their body is overly active - making falling asleep hard, and at times too calm - making it hard to hurry for morning prayers or studies.

In summary: ADHD can impact religious observance, and medical treatment and guidance can help. The first step is awareness and understanding of specific ways the disorder can affect the willingness and ability to observe commandments.

Chaim Dayan is a clinical social worker and doctoral candidate, chair of the Institute for Attention.