Tulsa World Special Report: Adverse Childhood Experiences

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A special publication of the Tulsa World | July 2019

SPECIAL REPORT

BREAKING THE CYCLE Oklahoma leads the nation in childhood trauma. How are the scars we leave on our children affecting our state, and what can we do about it? In an eight-part series, The Tulsa World examines the science behind Adverse Childhood Experiences, takes a look at some of those suffering from the long-term effects of ACEs and look at ways to address the problem. Find stories from all eight parts in this special publication, and find the entire series at bit.ly/ACESproject.  Mike Simons/Tulsa World file

Adverse effects of Oklahoma ACE scores

No. 1

in female incarceration rates and

No. 2 in male incarceration

rates, according to the U.S. Department of Justice.

T

Oklahoma ranks high for several social ills that have been linked to high Adverse Childhood Experiences (ACE) scores. A few examples:

No. 1

in the nation in incarceration rates when other factors such as the juvenile and jail populations are included, according to a 2018 study.*

No. 1 No. 5 in cancer deaths per capita,

in heart-disease mortality and

according to the U.S. Centers for Disease Control and Prevention.

No. 9

per capita in substantiated child abuse cases, according to the U.S. Department of Health and Human Services. In Tulsa County, confirmed child abuse cases have more than doubled since 2010. In 2018, the number of confirmed child abuse cases statewide rose to levels not seen since 1999.

No. 5 in the nation in teen

smoking, according to CDC data. An estimated 12.5% of teens in Oklahoma smoke.

*by the nonprofit organization Prison Policy Initiative

By CURTIS KILLMAN • Tulsa World

he science is well established and should come as no surprise: children who suffer rough childhoods have a greater likelihood of being adversely affected later in life. Studies have shown that children who incur adverse experiences are more likely to develop mental health issues, suffer chronic health problems and/or take part in risky behaviors such as smoking or drug abuse. Oklahoma children are not immune from this phenomena. In fact we are No. 1, according to various nationwide surveys.

A 2017 National Survey of Children’s Health conducted by the U.S. Census Bureau found that 30.4% of Oklahoma children had incurred two or more adverse experiences, ranking it No. 1 among other states. Earlier surveys have found Oklahoma children ranked No. 1 in the percentage of children who had suffered four or more adverse experiences. So what’s the big deal? Well, studies have found that adults exposed to four or more adverse experiences in childhood were: • 7.4 times more likely than someone with no adverse childhood experiences to suffer from alcoholism. • 4.7 times more likely than someone with no adverse childhood experiences to abuse drugs

• 4.6 times more likely than someone with no adverse childhood experiences to suffer from depression. • 12 times more likely to attempt suicide. • 3 times more likely to have had 50 or more sexual intercourse partners • Twice as likely to smoke, be in poor health, suffer a stroke or have heart disease, or not graduate high school Having an incarcerated parent is an example of an adverse childhood experience. And with Oklahoma ranking No. 1 in female incarceration rate and No. 2 in male incarceration rate, it should be again no surprise that there are estimates that 26,000

According to a national survey, nearly 1 out of every 3 Oklahoma children have incurred two or more adverse childhood experiences. MATT BARNARD/Tulsa World

children have a parent in Oklahoma Department of Corrections custody, according to a 2017 report from the Oklahoma Children of Incarcerated Parents Advisory Committee. For those 26,000 children, they are 70% more likely than other children to end up incarcerated themselves, according to the committee. For children with incarcerated parents, 45.4% of them experienced

mental health problems after their mother was sent to prison, according to research by retired University of Oklahoma sociology professor Susan Sharp. Overall, a 2016-17 government study ranked Oklahoma 15th among states for adults who had reported suffering from serious mental illness in the past year, or about 5% of the state population.

PRODUCING LOCAL JOURNALISM THAT MATTERS Oklahoma leads the nation in childhood trauma.

We spent a year investigating this serious issue and asking what can be done to fix it.

The Tulsa World believes local journalism can make a difference in our community, and we strive every day to keep you informed and involved with what’s happening around you. To that end, we will continue to devote our resources to breaking news and to deeper, longer pieces like this project to get you the best information we can online and in print. You can support this kind of local journalism in Tulsa by subscribing to the Tulsa World at tulsaworld.com/subscribe. Help us make a difference in our community, and get unlimited access to the news you need to know.


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TULSA WORLD

BREAKING THE CYCLE | PART 1

WHAT ARE ACES, AND WHY DO THEY MATTER?

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dverse Childhood Experiences — ACEs — are linked to a wide range of physical and psychological problems, from obesity and drug addition to cancer rates and domestic violence. Your ACE score starts with a simple test listing 10 of the most common adverse childhood experiences. A single point is scored for each one a

THE TYPES OF ACES ABUSE Emotional abuse: A parent or other adult in your home ever swore at you, insulted you, or put you down.

As the number of ACEs increases, so does the risk for these outcomes. A few examples from the data from the original ACEs study are below. The percentage represents the portion of each group with a specific number of ACEs who reported they:

6.8% 7.9%

1

0

10.3%

4+

3

2

HAVE ATTEMPTED SUICIDE

2.4%

1.2%

2

1

0

Number of ACEs reported

4.3%

3

50.7%

36.2%

21.4%

1

0

Physical neglect: You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you, or parents were too drunk or high to take care of you or take you to the doctor if you needed it?

THE ACE TEST Take the test below to find out your ACE score. For each “Yes” answer, score one point. As your ACE score increases, so does the risk of disease and social and emotional problems. An ACE score of 3 or more is considered high. ent often or very often pushed, grabbed, slapped, or had something thrown at him/her, or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard, or ever repeatedly hit over at least a few minutes or threatened with a gun or knife by a domestic partner?

5. Before you were 18, did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes and had no one to protect you, or were your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

3. Before you were 18, did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way, or attempt or actually have oral, anal or vaginal intercourse with you?

3

2

Emotional neglect: You felt that no one in your family loved you or thought you were important or special, or that your family didn’t look out for each other, feel close to each other or support each other.

2. Before you were 18, did a parent or other adult in the household often or very often push, grab, slap, or throw something at you, or ever hit you so hard that you had marks or were injured?

4+

31.5%

Incarcerated household member: A household member went to prison.

1. Before you were 18, did a parent 4. Before you were 18, did you often or other adult in the household or very often feel that no one in often or very often swear at your family loved you or thought you, insult you, put you down, or you were important or special, humiliate you, or act in a way that or your family didn’t look out for made you afraid that you might each other, feel close to each be physically hurt? other or support each other?

Number of ACEs reported

HAVE EXPERIENCED TWO OR MORE WEEKS OF DEPRESSION IN THE PAST YEAR

14.2%

4+

Mental illness in the household: A household member was depressed or mentally ill or a household member attempted suicide.

NEGLECT

18.3%

9.5%

Substance abuse in the household: A household member was a problem drinker or alcoholic or used street drugs or abused prescription medications.

Parental separation or divorce: Parents were ever separated or divorced.

Sexual abuse: An adult or person at least 5 years older ever touched you in a sexual way, or tried to make you touch their body in a sexual way, or attempted to have sex with you.

EXAMINING THE RISK

16.5%

Intimate partner violence: Parents or adults in home ever slapped, hit, kicked, punched or beat each other up.

Physical abuse: A parent or other adult in your home ever hit, beat, kicked or physically hurt you.

a person’s risk of facing a lifetime of issues. Oklahoma’s children have the highest ACE scores in the country. Not coincidentally, the state tops the country in many of those physical and psychological problems, too. Follow the graphics below to find out your ACE score, the consequences, the risks and the mitigating factors that can reverse some of the damage.

ARE CURRENT SMOKERS 13.9%

HOUSEHOLD CHALLENGES

8. Before you were 18, did you live with anyone who was a problem drinker or alcoholic, or who used street drugs? 9. Before you were 18, was a household member depressed or mentally ill, or did a household member attempt suicide?

6. Before you were 18, were your parents ever separated or divorced?

10. Before you were 18, did a household member go to prison?

7. Before you were 18, was a par-

Need to talk? If you need immediate help, call COPES at 918-744-4800. Or call 211 for referrals to many social service agencies.

OUTCOMES OF ACES

Number of ACEs reported

BEHAVIOR

19.2% HAVE EVER USED ILLICIT 6.4% DRUGS

4+

11.4%

0

28.4%

21.5%

3

2

Lack of physical activity

1

Smoking

Alcoholism

Drug use

Missed work

PHYSICAL AND MENTAL HEALTH Number of ACEs reported

CONSIDERS THEMSELVES TO BE AN ALCOHOLIC 10.3% 11.3% 2.9% 5.7%

0

1

2

3

16.1%

4+

Number of ACEs reported

SUFFER SEVERE OBESITY 5.4%

0

7.0%

1

9.5%

10.3%

2

3

12.0%

Severe obesity

Diabetes

Depression

Suicide attempts

STDs

Heart disease

Cancer

Stroke

COPD

Broken bones

4+

Number of ACEs reported

Source: “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults,” American Journal of Preventive Medicine, May 1998

THE ACE PYRAMID How ACEs influence health and well-being throughout life DEATH

The ACE pyramid depicts the unproven but theorized progression from conception to death of how Adverse Childhood Experiences influence a person’s health and ability to function. The two foundational layers are based on research that indicates trauma may have roots in family histories or local socioeconomic conditions and can be passed

PROTECTIVE AND COMPENSATORY EXPERIENCES PACEs — Protective and Compensatory Experiences — are known to healing. A person with an ACE score of 4 who had no PACEs may have a

EARLY DEATH

loving grandmother, teacher or coach.

DISEASE, DISABILITY AND SOCIAL PROBLEMS

SCIENTIFIC GAPS

The most prominent PACE is the unconditional love of a parent or mentor. Others include:

ADOPTION OF HEALTH RISK BEHAVIOR

ACEs themselves disrupt a brain’s development, with immediate and lasting consequences.

SOCIAL, EMOTIONAL AND COGNITIVE IMPAIRMENT DISRUPTED NEURODEVELOPMENT CONCEPTION

growth gives rise to social, emotional and cognitive dysfunction. To cope with their trauma, a person self-soothes by engaging in unhealthy or risky behaviors. Those behaviors increase health risks — disease, disability and social problems — that accumulate and become chronic. Poor health and disease con-

MITIGATING ACES

ADVERSE CHILDHOOD EXPERIENCES SOCIAL CONDITIONS / LOCAL CONTEXT GENERATIONAL EMBODIMENT / HISTORICAL TRAUMA

tribute to early death. Gaps in scientific understanding exist between each of the con-

nected layers up to the adoption of unhealthy behavior. Source: Centers for Disease Control

Having at least one best friend

Mindfulness

Exercise or physical activity

Hobbies or clubs

Source: Amanda Morris and Jennifer Hays-Grudo, Oklahoma State University researchers and professors

A school that provided resources

Graphics by JAMES ROYAL/Tulsa World


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BREAKING THE CYCLE | PART 1

‘I’ve been there. I know.’

Theron Ogedengbe went into foster care at 9 and bounced around until aging out of the system. “I’m going to be the kind of therapist I wish I had had,” he says. “Because there are lot of their therapists out there who don’t really understand what it’s like. But I’ve been there. I know.” IAN MAULE/Tulsa World

Oklahoma’s children top the nation in trauma suffered, and one survivor is doing his part to stop it

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By Michael Overall • Tulsa World

he boys were jumping on the motel room bed and having a lot of fun but also making a lot of noise and getting on her nerves. Theron Ogedengbe’s stepmother yelled at them to stop. He was 9 years old and should have been going to the third grade, but they kept hopping from motel to motel and she never bothered to send him to school. She wasn’t really even his stepmom. Not exactly. His dad had broken up with her, and she had a new boyfriend now. But his dad was in jail and his biological mother was somewhere in California, no doubt strung out on drugs. Ogedengbe couldn’t remember what she looked like. This woman who was yelling at him to stop jumping on the bed was the closest thing he had to a parent. And he did what he was told. He stopped jumping. But his brother — a half brother, a year or two younger — didn’t. “Make him stop,” the woman yelled. “I can’t make him stop,” Ogedengbe said, raising his voice in irritation. “He’s your kid. You make him stop.” She had hit him before. Broke his nose once. And now, she came swinging at him again. Ogedengbe fought back. His older brother — a full biological brother and a teenager — had told him: If somebody is trying to hurt you, it’s OK to defend yourself. But she was bigger and stronger, and Ogedengbe was probably going to end up in the emergency room again if his older brother didn’t intervene. “We’re leaving,” his brother said. They walked to a nearby QuikTrip, where they sat on the curb for the rest of the night until the police came in the morning. And Ogedengbe would spend the rest of his childhood in foster care, bouncing from place to place, family to family. That’s when the real trouble started.

That might explain why the state also ranks high for a long list of disparate social problems, from obesity and drug addiction to cancer rates and domestic violence. Oklahoma, for example, ranks No. 1 in female incarceration rates and No. 2 in male incarceration rates, according to the U.S. Department of Justice. That leaves a lot of Oklahoma children answering “yes” when the ACE test asks if a close family member has ever gone to prison, and that experience in turn makes the child statistically more likely to go to prison someday, according to ACE studies. Likewise, Oklahoma ranks No. 3 in teen birth rates, No. 1 in heart-disease mortality and No. 5 in cancer deaths per capita, according to the U.S. Centers for Disease Control and Prevention. The state also ranks high in child abuse cases, divorce, teen smoking and grandchildren living with grandparents instead of parents, all of which can be linked to high ACE scores.

‘A number’

Theron Ogedengbe has an ACE score of 8, which statistically predicts a bleak life for him. He’s supposed to be at a higher risk to abuse drugs, commit crimes, become homeless and suffer multiple health problems before dying early. “That’s not my story,” he says. IAN MAULE/Tulsa World

ACEs Vincent Felitti, head of Kaiser Permanente’s Department of Preventive Medicine in San Diego, ran an experimental weight-loss program in the 1980s, when he discovered that a majority of the participants had suffered sexual abuse during childhood. Perhaps overeating was a coping mechanism for deepseated psychological trauma, Felitti thought. And maybe other types of destructive behavior could be traced back to childhood experiences, too. In the mid-’90s, Kaiser Permanente teamed up with the Centers for Disease Control and Prevention to test the theory with an extensive survey of more then 17,000 people, concluding that “adverse childhood experiences” could be correlated with a remarkably wide range of problems later in life, from weight gain and heart disease to addiction and imprisonment.

The researchers devised a simple test listing 10 of the most common adverse childhood experiences and awarding a single point for each one that a person has suffered. Even a score of 2 or 3 can increase a person’s risk of facing a wide range of physical and psychological problems, the researchers concluded, with the level of risk increasing along with the ACE score. For an individual, of course, simply having a high ACE score doesn’t make a troubled life inevitable. But when researchers look at a large population of people with “elevated” scores, the correlation seems clear. And Oklahoma children have some of the highest ACE scores in the country. The state ranks No. 1 in percentage of children with an ACE score of 2 or more, according to multiple surveys. And some experts believe Oklahoma ranks first in children with a score of 4 or more.

The day before his 16th birthday, Ogedengbe’s latest foster mother offered to take him to a park with her biological daughter and some other teenage boys. And Ogedengbe asked to stop at Walmart, where he bought himself Band-Aids and Neosporin. Going to high school in Okmulgee, he knew a gang initiation when he saw one. The boys needed to “jump” somebody, and his foster mom was making Ogedengbe available. After it was over, he had to ride home, bloodied and bruised, with his attackers. The next morning, he woke up not to find birthday gifts but to see all his belongings stuffed into trash bags. “You don’t live here anymore,” his foster mom said. By then, Ogedengbe had gone through several foster families, some better than others. In one home, a boy tried to put his hand down Ogedengbe’s pants. And when Ogedengbe reported it, the foster parents protected the abuser and told police that Ogedengbe had threatened to kill himself, which resulted in Ogedengbe being sent to a mental hospital. After Okmulgee, childwelfare officials seemed to run out of places to send him. So Ogedengbe came to Youth Services of Tulsa, which runs a group home east of down-

town. It was only temporary, his caseworker assured him, but Ogedengbe spent two years there and “aged out of the system.” Youth Services, however, gave him something he never had. More than one thing, in fact. Stability. Routine. And discipline, administered consistently, but not brutally. He knew the rules and the consequences for breaking them, but he didn’t have to live in fear. One rule that shelter workers let him break with impunity: bedtime. Ogedengbe stayed up late to finish homework, taking AP classes and earning a Gates Scholarship to college. Recently turning 27, Ogedengbe now has two bachelor’s degrees — one in biology from the University of California, Berkeley, and one in psychology from Northeastern State University in Tahlequah. And in May, he received a master’s from the University of Oklahoma-Tulsa, with plans to become a therapist for children in foster care. “I’m going to be the kind of therapist I wish I had had,” he says. “Because there are lot of their therapists out there who don’t really understand what it’s like. But I’ve been there. I know.” Ogedengbe has an ACE score of 8, which statistically predicts a bleak life for him. He’s supposed to be at a higher risk to abuse drugs, commit crimes, become homeless, sink into debt, abuse his own children and suffer multiple health problems before dying early. But his life doesn’t have to be that way. “An ACE score is correlation, not causation,” Ogedengbe says. “I don’t want to be a number on an ACE score. That’s not the narrative I choose to write. That’s not my story.” He can’t change what happened to him as a child, but he’s in control of what he’s doing now, Ogedengbe says. An ACE score measures risk. It doesn’t determine destiny. Not for him. And not for the state of Oklahoma. This week, the Tulsa World will publish a series of stories examining the state’s high ACE scores, what they mean and, perhaps most importantly, what can be done about them. Michael Overall 918-581-8383 michael.overall @tulsaworld.com Twitter: @MichaelOverall2


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BREAKING THE CYCLE | PART 2

Soda, cigarettes and trauma

MRI tech Bill Alden gets a 12-year-old girl ready for her MRI as part of the Adolescent Brain Cognitive Development study that has nearly 12,000 children participating nationwide.   MIKE SIMONS/Tulsa World

How Adverse Childhood Experiences alter brain chemistry, cultivate unhealthy habits and prompt premature death

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By Corey Jones • Tulsa World

atients would carry soda into Dr. Gerard Clancy’s office, with cigarettes tucked away for after therapy. Often victims of abuse or violent crime, they would seek soothing but risky behaviors to cope. Overweight. Chronic pain. Chronic obstructive pulmonary disease. Type II diabetes. His former patients will die younger than they should, he said. Clancy conducted therapy sessions until he became president of the University of Tulsa in 2016. At his psychiatry clinic, he saw firsthand how a lifetime of unhealthy habits wear on a person suffering post-traumatic stress disorder after a serious threat to his or her well-being. “It dates back as much as anything to their behaviors and how they live their lives daily,” said Clancy, who remains a prominent leader in Tulsa’s mental-health network. “They walk in with the biggest QuikTrip thing of sugary Coca-Cola as possible. And as soon as they’re done seeing me, they go outside and smoke. “Part of that is how their brain has been wired.” Tulsa is at the forefront of revolutionary research to unlock a deeper knowledge of how social, behavioral, physical and environmental factors may affect brain development and health. Oklahoma is No. 1 in the nation in youths up to age 17 who have experienced two or more Adverse Childhood Experiences, according to the 2017 National Survey of Children’s Health conducted by the U.S. Census Bureau. Trauma at a young age can negatively alter or stunt cognitive development, creating undesirable genetic changes that may even be passed onto future generations, some studies show. Referred to as Adverse

The brain of a 12-year-old girl is projected on a computer screen while she gets an MRI as part of the Adolescent Brain Cognitive Development Study at Laureate Institute for Brain Research.  MIKE SIMONS/Tulsa World

Childhood Experiences, ACEs include household dysfunction, neglect, abuse, poverty, crime, substance abuse and mental illness. Research is showing ACEs to be strong predictors of cognitive, behavioral and physical health, and mental wellness problems. The initial question no longer is a superficial and judgmental, “What’s wrong with this kid?” Trauma-informed experts are nuanced, mining for answers by posing the more enlightening query, “What’s happened to him or her?” ACEs are the common thread underlying behaviors that, from a logical standpoint, don’t make sense because they are knowingly harmful to the person, said Jennifer Hays-Grudo, director for the Center for Integrative Research on Childhood Adversity in Tulsa. Things like smoking. Drinking to excess. Drugs. “At the time, these behaviors were solutions to a larger problem,” Hays-Grudo said. “The larger problem is the fact that either you are a child being abused or neglected and feeling hopeless, or you’re an adult who didn’t develop the ability to soothe and regulate your emotions when you’re stressed. “And in fact, your body didn’t develop the ability to

help you do that. You might want to do that, but your body is programmed to get upset and stay upset because life is dangerous. That’s what your body learned as a child.” Examples of long-term ramifications include premature death in adults, according to a study published in 2009 in the American Journal of Preventative Medicine. Participants were questioned in 1996 and 1997 about potential ACEs under eight categories. People with an ACE score of 6 or higher were found to have died nearly 20 years earlier on average than those with no ACEs. As transformative as germ theory was more than a century ago, ACEs appear poised to have a global effect. Hays-Grudo noted how germ theory prompted wholesale changes in hospital policies and procedures to block the transmission of germs. Doctors no longer simply used the same instruments from patient to patient like during the Civil War. The ongoing paradigm shift in how trauma affects developing brains has reverberated through scientific circles for two decades and now is beginning to filter more into public consciousness and practice. Hence the more nuanced and illuminating question,

“What’s happened to him or her?”

Suffering adolescents pursue risky but soothing behaviors Children raised in traumatic environments grow up chasing instant and soothing behaviors. Think smoking or drinking or sex. Depicted in an eight-stack pyramid, the unproven but promising theory describes how Adverse Childhood Experiences influence a person’s functioning and well-being from conception to death. The pyramid’s base is generational embodiment or historical trauma, followed by social conditions and local context. ACEs disrupt neurodevelopment, which then leads to social, emotional and cognitive impairment. In turn, health-risk behaviors are adopted and cultivate disease, disability and social problems. Early death tops the pyramid. Clancy, who also serves on the Laureate Institute for Brain Research advisory board, said the best interruption points to stop harmful programming of the brain are at home. But often those environments are chaotic. So the next best option is schools, which must be a neighborhood’s anchor and safe place, Clancy said. Kristin Atchley, former executive director of counseling at the Oklahoma Department of Education, said educators often have viewed in-school suspension and other punishment as appropriate ways to correct “bad” or “difficult” kids. Actually, the “problem” students need wraparound services to help them cope and heal — not overly punitive measures, she said. For example, Atchley said educators must be mindful of a kindergartner who is caught stealing from another student. Schools can’t punish young children who learn to steal as a survival mechanism, she said. And that mindset must extend to other adverse behaviors that arise from ACEs to truly help struggling children. “If our policies and procedures are saying the day a kid comes to school high they are out, we are not being restorative,” Atchley said. “And we are not getting that kid the actual services they need.”

PACEs Carrying a high ACE score doesn’t mean that a dire trajectory is set in stone. Scientists already know how to counteract harm imparted by ACEs, which is especially critical early on because rewiring the brain becomes increasingly difficult as time passes. PACEs — protective and compensatory experiences — are known to act as buffers or insulators against trauma, as well as promote healing. Most prominent is the unconditional love of a parent or mentor. Other mitigating factors for trauma are strong friendships, mindfulness, exercise or physical activity, and hobbies or clubs. Think sports, band, 4-H, scouts, church, a coach or teacher. PACEs provide opportunities to build the brain architecture that allows a person’s body to calm physiologically and learn positive habits and behaviors in the present and carry them into the future, said Hays-Grudo, of Tulsa’s Center for Integrative Research on Childhood Adversity. “Children with high ACEs and no PACEs have a very difficult time in life because they don’t have the opportunity to develop the skills and the competencies — the psychological skills, the social skills and even the cognitive learning skills — to compensate for the abuse and neglect that has compromised how their brains develop,” she said. “ACEs are not a death sentence. I know many people with high levels of ACEs who live very happy and productive and good lives. “And that’s generally because they also had many other good things going on in their lives.”

Strong predictors of behavioral, health problems Strengthening the science supporting the ACE pyramid is paramount for researchers. And Tulsa is an important outpost in this endeavor, garnering national recognition. Amanda Morris, a regents professor of human development at OSU-Tulsa, said the ACE test is a better predictor of health and behavioral outcomes than almost any other method. The power is derived


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BREAKING THE CYCLE | PART 2 from looking at myriad early stressors encompassed by household dysfunction and maltreatment. “Those 10 items predict not only health but mental health outcomes,” Morris said. “And the rates at which they are predicting are better than many other simple measures and methods looking at one factor.” Morris also is a researcher involved in the landmark Adolescent Brain Cognitive Development study. The Laureate Institute for Brain Research in Tulsa is one of 21 sites across the United States charting social, behavioral, physical and environmental factors that may affect brain development and health. Nearly 12,000 subjects ages 9 or 10 were enrolled in the ABCD study, with 742 in Tulsa. Entry closed in October, with researchers set to track the participants for 10 years. “So many studies are just one time point,” Morris said. “Sort of the chicken and the egg: what’s causing what? This allows us to look at cause and effect and change over time.” Researchers regularly conduct intensive surveys, neurocognitive assessments and brain imaging to try to answer questions about influences in a more robust manner, she said. The study doesn’t directly collect ACEs. But it does seek insights into stressors that would be categorized as ACEs.

What’s happening within brain Consider the legs of a child who suffered from polio. Even when cured of the crippling disease, the developmental opportunity or period for those muscles was lost, HaysGrudo said. So polio survivors had to use leg braces for the rest of their lives, despite the absence of the disease. “We see some of the same effects in the brain,” Hays-Grudo said. “There are sensitive periods where if the brain does not get the kind of stimulation it’s expecting as a human being — as a species, we expect certain things to happen in development — if it doesn’t happen,

Research assistant Peyton Jennings watches as Destiny Locke, 12, collects a saliva sample as part of the landmark Adolescent Brain Cognitive Development study at Laureate Institute for Brain Research. Researchers regularly conduct intensive surveys, neurocognitive assessments and brain imaging to try to answer questions about influences on brain health and development. The landmark study tracks many children — some who have experienced trauma and some who have not.  MIKE SIMONS/Tulsa World

it’s much more difficult later on. “It can happen. The brain can make up for it later, but there’s a lot of difficulty.” Therein lies the importance of early childhood development. Stress is a natural response to help keep a person alive in an emergency. The body pumps out cortisol and adrenaline, placing a person in a heightened state to achieve feats not usually within his or her ability. But Hays-Grudo said the chemicals over a long time become corrosive. The chemicals are meant as a short-term response to protect the body or help it cope. The levels are supposed to decrease and normalize once the threat subsides. But if the stressors are consistent, a person may stay in a hypervigilant state. Wear and tear develops on the body and can result in auto-immune or heart diseases, as well as cancer, HaysGrudo said. “If this is happening in developing systems, it has a

much worse effect and more enduring effect than if it happens to adults,” Hays-Grudo said. “Because now the brain is expecting this, and the brain is not getting exposed to other experiences that would allow other parts of the brain to develop.” Scientists are learning how deep these alterations can go through “inherited epigenetics.” Hays-Grudo described epigenetics as the chemicals that sit on top of our DNA and attach to its strands. Epigenetics essentially act as on-off or dimmer switches that make it more or less likely for DNA to be replicated to create cells, Hays-Grudo said. “When you turn off that process, you turn off some of the production of chemicals needed, for example, for brain cell regeneration — new neurons,” Hays-Grudo said. “It also may turn off receptors for all of the cortisol that you’re pumping out when you’re stressed, and then the cortisol doesn’t leave the body. You just stay stressed. “So these epigenetic changes

to certain DNA structures have given us a clue why some of these experiences last all the time. Why they literally change the body’s DNA blueprint for how to react to stress, and these changes can be passed across generations.”

Generational costs of trauma Researchers repeatedly subjected adult male mice to mild foot shocks after introduction of an odor — fear conditioning. The conditioned males were mated with unconditioned females. The Emory University scientists were examining offspring inheritance of a parent’s exposure to trauma. Or, simply put, trauma that transverses generations. They found that two successive generations (children and grandchildren) exhibited behavioral sensitivity to the odor, with an enhanced representation of the odorant receptor’s pathway. The offspring weren’t conditioned to fear the odor, nor did they learn the behavior from the conditioned male parent

because they were separated. Evidence indicated the odor fear was passed biologically, with epigenetic marks that might be the basis for the inheritance. The study was published in 2013 in Nature America. Similar links are beginning to be established in humans. A team of researchers studied 32 Holocaust survivors — interned in a concentration camp, witnessed or experienced torture, or had to flee or hide during World War II — and their adult children for biological effects of stress. The scientists compared them against demographically similar control subjects who lived outside of Europe during the war, meaning they weren’t exposed to trauma from the Holocaust. They found genetic alterations associated with Holocaust trauma present in both parents and their children that couldn’t be attributed to the offspring’s own traumatic experiences or psychopathology. Morris, the OSU-Tulsa regents professor involved with the ABCD study, described ACEs as more of a social problem. A person can’t “catch them” like a sickness by talking about them, she said. Openly dealing with ACEs rather than repressing trauma is a means to heal and recover. A public health and prevention approach, along with policy changes, are keys to halt the spread of ACEs, she said. “So the science is really an important part of the story here. Why? Because it predicts these health and behavioral outcomes better than almost any other measure we have,” Morris said. “And the root of it is family dysfunction and things that we know — it’s difficult — but we know how to target and help families. Through resources. Through building good parenting skills and relationships. “It’s not like a communicable disease. It’s a thing we can fix.” Corey Jones 918-581-8359 corey.jones@tulsaworld.com Twitter: @JonesingToWrite

Turning counseling into an art form PACES

By Guerin Emig • Tulsa World

Jessica Orvis is telling you about her work with children, her efforts to blunt their trauma, when you notice her tattoos. Is she making a statement? No. She is providing an outlet to connect with these children. “A lot of times with kids, you have to build rapport and you have to have buy-in,” she says, peering at a design on her forearm that looks like a science class diagram. She can tell the kids affected by trauma, the ones with high ACE (adverse childhood experience) scores, about their brain cells and neurotransmitters. But it is better to show them. She’ll use her tattoos and explain: “These are pathways. You lose your temper and go straight to fighting; your aggression and testosterone and adrenaline ones will be fatter. Right here. We’re going to put that one on a diet and get another one healthier. We’re going to exercise it and use it. Next time you’re mad, we’re going to do this instead. If you do it enough times, it’ll get fat, and the fat one will get skinny. “These colors are serotonin and oxytocin and dopamine. Those are the things that get you addicted and get you happy or depressed. What are the ones we need to get fat, healthier? What are the ones you need to muscle up? We want less of the colors like the depression. We want more serotonin. In your brain, this is what’s happening. “They can see what I mean,” Orvis said. “They can make sense of it.” Three years ago, Orvis made her first visit to Kendall-Whittier Elementary as part of the Healing Hearts Club, the Tristesse Grief Center’s six-week program for area public school students who have encoun-

PACEs — Protective and Compensatory Experiences — are known to act as buffers or insulators against trauma, as well as promote healing. Most prominent is the unconditional love of a parent or mentor — like a coach. Other therapies include strengthening relationships, mindfulness, exercise or physical activity, and hobbies or clubs. Throughout this special section, we introduce you to one person in the community who is a difference maker in a child’s life and offer information on how you can get involved.

Jessica Orvis celebrates making a basket while playing with her son, Brax, 8, and stepson, Zane Ferguson, 13, at their home in Broken Arrow­. IAN MAULE/Tulsa World

Jessica Orvis shows off her tattoos, which can help kids see what’s going on in their brains. “These colors are serotonin and oxytocin and dopamine,” she tells them. “Those are the things that get you addicted and get you happy or depressed.” IAN MAULE/Tulsa World

tered trauma. “They were haywire,” Orvis says of the children she first encountered. “I thought, ‘Oh my god, I don’t want to work with kids.’ I went back the next week, and they said, ‘We were hoping you would come back.’

“I said, ‘You were? You guys didn’t listen to anything.’ “‘You were so nice and you asked us questions about us and you let us talk.’ “I was like, ‘OK.’ I didn’t realize what I had done. I had no idea.

“By the third week, they asked me, ‘How many more times do you get to come?’ They were telling me things. ‘Do all moms do this? How come my dad does this?’ They had a grown-up for a whole hour who would talk to them and hear them. They were my little angels in disguise. “Now, I can’t ever walk away from them.” Orvis goes into schools throughout Tulsa. She goes to Union, Jenks and Bixby. Occasionally, she goes to Muskogee. She has been called to go to Stillwater and as far away as Missouri. As an outreach therapist for the Grief Center, she sees students who have lost loved ones or had classmates commit suicide. She lets them ask questions and tell her things, like at Kendall-Whittier. She helps. “Wednesday, I went to three different schools,” Orvis said. “They pull out the kids; we sit

for an hour. Some are teenagers. We process and work with coping skills. Then it’s on to another school with first- and second-graders, and we color and do activities. Then I might go and do a continuing education unit where I educate a community on how to work with kids that have been through it.” This is what resilience looks like. A child experiencing trauma has it in her to cope or power through. Sometimes, all it takes is a triggering mechanism, like a caring, stabilizing adult. Sometimes, it takes a therapist with really cool tattoos. “If anybody is going to be resilient, it’s a kid,” Orvis said. “There are days I hear things and my mind is just blown. What these kids have seen or have been told ... “Then that same kid will give me a fist bump on their way out of a session or ask for my card when their friends aren’t around. They’re starving for somebody, and if they can find that person — there’s a lot of us out there — it can help tremendously.” Guerin Emig 918-629-6229 guerin.emig@tulsaworld.com Twitter: @GuerinEmig


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TULSA WORLD

BREAKING THE CYCLE | PART 3

‘All I ever knew’

Tara Peterson plays with her daughters at McClure Park. By the time she was in her mid-20s, Peterson had been arrested a dozen times, mostly for drug possession and writing bad checks, and she had lost custody of her daughter. It took two years and court-ordered rehab to gain permission just to see her again. IAN MAULE/Tulsa World

Drugs. Alcohol. Jail. Oklahoma’s children repeat the patterns of their parents

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By Michael Overall • Tulsa World

t was Christmas Eve, and 13-year-old Tara Peterson had a house full of uncles and aunts and cousins. The adults started drinking, and once they started, they usually didn’t stop until they were falling down drunk. “It was normal behavior,” Peterson remembers. “It’s just what people did.” Feeling grown up, she joined them. And that’s how her drinking problem began. Not sneaking around and hiding it but right in front of her closest relatives. With them. Marijuana came next, then harder substances. “When I started experimenting with drugs,” she says, “I never really got in trouble or punished for it, either. Everybody just acted like it was normal, too, and I guess for my family it was.” By the time she was in her mid-20s, Peterson had been arrested a dozen times, mostly for drug possession and writing bad checks, and she had lost custody of her daughter. It took two years and courtordered rehab to gain permission just to see her again. Waiting for the first afternoon play date to begin, Peterson sat in a therapist’s office and fidgeted nervously. Would her now 5-year-old daughter still call her Mom? Would she want a hug? Would she even remember Peterson at all? More importantly, in the long term, would her daughter follow the family’s same destructive path? Would she face drug and alcoholic abuse? Endure violent, abusive relationships? Go in and out of jail? “I wanted a better life for my daughter,” Peterson says. “But somehow, I had to get a better life for myself first.”

‘Struggle and fall’ The theory behind ACE scores is that social problems become generational. If a parent, for example, goes to prison, it becomes an “adverse childhood experience” for the kids and makes them more

likely to struggle in school, have unwanted pregnancies, abuse drugs and alcohol and go to jail themselves someday, according to ACE studies. Oklahoma incarcerates more women per capita than any other state, with roughly 400 women a month booked into the Tulsa County jail alone. And 80% of those women have children, which makes losing a mother to prison one of the most common adverse childhood experiences in the state. And it partly explains why Oklahoma children have some of the highest ACE scores in the country. The Women in Recovery program, operated since 2009 by Family & Children’s Services in partnership with the George Kaiser Family Foundation, is trying to break the ACEs cycle by keeping mothers out of prison, offering counseling and rehabilitation instead of incarceration. Tulsa judges divert a small percentage of defendants into the program, sometimes with a prosecutor’s recommendation, sometimes against it. In exchange, the women have to follow a strict regimen, living in WIR apartments while spending 40 hours a week at the WIR offices in downtown Tulsa to take part in a carefully blended mix of group therapy, one-on-one counseling and parenting classes. “It was the hardest thing I ever did,” says Shelby Caudle, who was facing 10 years in prison if she hadn’t been redirected to the program. “There are a lot of rules. Be here at a certain time. Be back at your apartment at a certain time. Do this; do that. It was not the kind of mindset I was used to.” Caudle lost custody of a 2-year-old after passing out drunk in a car and waking up to realize the boy was missing. Police found him 45 minutes later at home by himself, and Caudle was arrested for felony child neglect. Alone, that probably wouldn’t have meant serious time in prison, but she was already on probation for burglary, DUI and hit and run. Women in Recovery, however, offered Caudle another chance, not so much for her own sake, but for her son’s.

Shelby Caudle grew up dealing with a series of traumas. “Addiction and abuse is all I know,” she says. With help from Women in Recovery, she’s regained custody of her son.   IAN MAULE/Tulsa World

ABOVE: Tara Peterson carries her daughter while running errands recently. “I wanted a better life for my daughter,” Peterson says. “But somehow I had to get a better life for myself first.” LEFT: Shelby Caudle plays with her son in their home. She’s still involved in Women in Recovery alumni activities.   IAN MAULE/Tulsa World


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BREAKING THE CYCLE | PART 3

Women in Recovery offered Shelby Caudle another chance, not so much for her own sake, but for her son’s. Sending her to prison would have added another point to his already high ACE score.  IAN MAULE/Tulsa World

Sending her to prison would have added another point to his already high ACE score. After therapy, Caudle understands the effects her childhood experiences had on her as an adult. “Growing up sexually abused, physically abused, my parents in addiction, all I ever knew, and still know, is that pain is love. Addiction and abuse is all I know. That’s all I know. That’s what I expect and what I crave for.” With WIR’s help, however, she has been sober for two years and has regained custody of her son. And now, she is involved in WIR alumni activities, which offer support indefinitely for women who have graduated from the program. “They say the two-year mark is where a lot of people struggle and fall back,” she says. “So I have to be vigilant. I can’t slack off now.”

‘Generation after generation’ Like Caudle, Peterson saw the Women in Recovery program as a chance to break her family’s long, multigenerational cycle of addiction and incarceration. She hadn’t seen

Tara Peterson was nervous about seeing her daughter for the first time after two years. Then she heard her 5-year-old yell “Mom!” and run across the room. “I knew it was going to be OK eventually,” she says.  IAN MAULE/Tulsa World

her 5-year-old daughter in two years when, thanks to making progress in rehab, a judge let her have a play date at the Women in Recovery offices. As soon as Peterson’s daughter came into the room, she yelled “Mom!” and ran to

throw her arms around her mother. Peterson could breathe again. “That’s when I knew everything was going to be OK,” she says. “I mean, it wasn’t like everything was suddenly

fine again. It was still going to take a lot of time to repair the damage I had done. But when she hugged me, I knew it was going to be OK eventually.” Having completed the Women in Recovery program, she has regained partial

custody and currently works as a family advocate for Tulsa BEST, an anti-poverty program funded through the George Kaiser Family Foundation. But her daughter still worries about Mom “disappearing” again. The little girl already has an ACE score of 2: one point for her mother’s addiction, one for her mother’s time in jail. But Peterson gave birth to a second child just weeks before this spring’s Women in Recovery graduation. And that child has a chance to grow up with an ACE score of zero. One child will have at least faint memories of her mother as a drug addict, and it remains to be seen how those memories will affect her later in life. The other child, however, will never know that kind of environment, Peterson promises. “My family has faced these kinds of problems with addiction for generation after generation,” she says. “It stops with me.” Michael Overall 918-581-8383 michael.overall @tulsaworld.com Twitter: @MichaelOverall2

Advocacy leads to 20-year bond Be a CASA volunteer

By Guerin Emig • Tulsa World

Maura Guten didn’t encounter much adversity growing up, but others in her life did. Her parents were impoverished in Ireland. Her University of Tulsa roommate experienced abuse and neglect as a child. Guten’s parents emigrated to the U.S., made a family and modeled service to their children. Guten’s roommate tore through TU classes during the week and Tulsa police reserve training on weekends. That made an impression on Guten. When her TU sorority partnered with Court Appointed Special Advocates (CASA), a program that champions traumatized or neglected children caught up in the court system, she seized the opportunity. “I was almost 22 when I went through the training,” said Guten, now president of Tulsa’s Child Abuse Network. “I remember being scared. ‘Gosh, I don’t know if I can do this. I’ve never had kids.’ They encouraged me and said, ‘Listen, these kids just by virtue of having an advocate assigned to them will have better odds in life than any kid who doesn’t have a CASA volunteer.’ ”

Tulsa CASA Inc., 700 Boston Ave., Suite 230, 918-584-2272

Court-appointed special advocates (CASA) are appointed by a judge to advocate for an abused or neglected child in court. Volunteers help judges get a better understanding of each child’s situation, which makes for a more well-informed decision for each child. Training: Volunteers receive 30 hours of training and an additional 12 hours a year of in-service train-

Maura Guten, president and CEO of the Child Abuse Network, was a CASA volunteer when she met two sisters with whom she’d have a 20-year relationship. MIKE SIMONS/Tulsa World

Guten completed the program and took her first case. “Thirteen- and 14-year-old sisters,” she said “They were street smart. They did not have parents around, and the 14-year-old had a 6-week-old baby when I became their advocate … “The girls had lived in a filthy hotel room for a time. Their mom was manufacturing drugs. There were some seedy people there. Some men were trying to get one of the girls to drink alcohol and take her clothes off and things. She said she was go-

ing to use the restroom and took the phone in there. She can still describe the phone call to me. “She pulled this phone with a really long cord into the bathroom and called her dad, who wasn’t around. She remembered his number and said, ‘Dad, I’m scared. Will you come get me?’ He said, ‘I’m sorry honey, I can’t come right now, but I promise as soon as I get time I’ll come visit you.’ ” Guten heard stories like that, trashed any notions of fear and pledged she would

be there. She was there, all right. “In Tulsa, they ask CASA advocates people to stay on for at least a year,” she said. “A lot of cases in Tulsa County last about two years. Some of them are longer, some are shorter.” The 13- and 14-year-old girls Guten encountered when she completed training are now 33 and 34. They are both doing well, Guten reported, kept busy by marriages, children, jobs and the ups and down of everyday life. They still see their CASA advocate. “Maybe seven or eight years ago, the older sister, she and I were speaking at an event,” Guten said. “When she got up on stage, it was the first time I heard her speak publicly

ing. Time commitment: Volunteers make a 1-year commitment to their case and typically spend 10-15 hours per month working on their case. Qualifications: Must be 21 years old with no felony convictions. No experience required. If you suspect child abuse, call the Oklahoma Child Abuse Hotline at 1-800-522-3511.

about her experience having an advocate. She said, ‘Maura was always there.’ “It wasn’t something that I did actively. It was something I just did by virtue of being there. That was the key. Always being there. In fact, I’m going to Arkansas Monday to see her. Something came up at work, and I’ll have to ask to have that rescheduled. “I thought this morning, ‘Oh, she’s an adult. She’ll understand.’ Then I was like, ‘No, I was always there. I promised her I’d always be there.’ I still need to always be there for her.” Guerin Emig 918-629-6229 guerin.emig @tulsaworld.com Twitter: @GuerinEmig


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BREAKING THE CYCLE | PART 4

‘It’s up to me’

Donavon Ramsey was homeless before he found Walker Hall, a transitional living home in Tulsa run by the Mental Health Association Oklahoma. “It’s by the grace of God. That’s all I can say,” Ramsey says. IAN MAULE/Tulsa World

How do you know if childhood trauma is affecting your life? ••Complete the Adverse Childhood Experiences test. ••How are your current relationships? Are they positive and supportive? ••Do you dwell on the past, unable to be in the present or think about goals? ••Do you react negatively to others when your needs/wants are not met? ••Do you have health-related issues? (smoking, drinking, IV drug use, STDs, teen pregnancy, heart disease, lung disease, liver disease) ••Do you have any current mental health issues? (depression, anxiety, attempted suicide) ••Is it difficult for you to trust anyone, including those who want to help? ••Are you in crisis situations most of the time? ••Do you engage with people who take advantage of you? ••Did you have positive attachments with caregivers when you were growing up? ••Do you have past abuse (physical, emotional, sexual) or current abuse? ••Did you experience domestic violence or a relationship with someone who is in control of you?

Source: “The Relationship of Adverse Childhood Experiences to Adult Health Status,” Kaiser Permanente and the Centers for Disease Control, Vincent J. Felitti, M.D., & Robert F. Anda, 1995-1997

How can you recognize mental health issues in your own life?

••Emotions so difficult to manage that they affect daily functioning (work, school, ability to care for family if a parent) ••Others recognize a change in your mood/behavior ••Feelings of hopelessness ••Fears that others may be watching you (paranoia) ••Multiple stressors that are affecting your ability to make dayto-day decisions ••Isolation from others ••Difficulty staying asleep, oversleeping or not wanting to get out of bed ••Changes/neglect in hygiene (for example, going from showering daily to once a week) ••Using substances to cope with daily stressors ••Nervous more than usual; inability to stay on task; feeling like your heart is going to “jump out of your chest” or like you cannot catch your breath ••Mood shifting (happy one moment followed by anger or sadness)

Source: Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), basic criteria of symptoms for diagnosing clinical syndromes

For many trauma survivors, the key is breaking down what happened to them

A

By Tim Stanley • Tulsa World

s a high school senior in Alabama, Donavon Ramsey got used to not having a permanent place to

sleep. If it was a friend’s couch one night, it could be his truck the next. But never in that time did Ramsey think of himself as homeless. That wouldn’t come until last year, when he returned to Tulsa. “It sucked,” said the former Union Public Schools student, describing what it was like to rely on shelters for meals and a bed. “You’re just — it’s like you have the word ‘homeless’ stamped across your forehead. I didn’t like how that felt.” Ramsey, 19, was thankful, though, for the services available. Places such as the John 3:16 Mission and The Salvation Army kept him going, he said. Finally, he found Walker Hall, a transitional home run by the Mental Health Association of Tulsa. “It’s by the grace of God. That’s all I can say,” Ramsey said. As is the case with many young people in Oklahoma, Ramsey’s transition from troubled adolescent to independent adult wasn’t easy. He recently took an adverse childhood experiences — or ACEs — test and scored 6 on the 1-10 scale. Anything over 4 is considered very high. Among the consequences for him have been depression and anxiety, for which he’s being treated. The idea that traumatic childhood experiences may play a large part in future mental health problems is not a new one. But recent advances strongly suggest that it’s the primary factor. Ramsey’s experience doesn’t surprise Lucinda Morte, a clinical coordinator with the Mental Health Association. In a previous job, Morte counseled criminal offenders with mental health issues through Tulsa County’s Mental Health Court. Most, if not all, she said, had traumatic experiences as children.

ers accept that “I’m just a criminal.” They don’t get that “what happened to you growing up” plays a big part, she added. On that point, Morte speaks with extra conviction. Her own family history — the complex depths of which she’s still just beginning to plumb — strongly backs it up.

Living with ‘a crazy person’

Donavon Ramsey looks through photos from his childhood, a tumultuous time in his life that saw him moving around frequently. Ramsey recently scored 6 out of 10 on an adverse childhood experiences test.  IAN MAULE/Tulsa World

Lucinda Morte, a counselor with Mental Health Association Oklahoma, learned to draw from her own childhood trauma in working with patients. “I sat down and read those ACE questions for what they really were,” she said. “It was very emotional for me.” IAN MAULE/Tulsa World

Donavon Ramsey bounced around before finding Walker Hall, where a strict set of rules helped him succeed. It’s something he still craves. “I want a routine,” he says now. “I’m tired of surprises in life.”  IAN MAULE/Tulsa World

“When I was in direct care, working daily with clients, the amount of trauma that was shared in my office — it’s

things that I will take to my grave,” Morte said. Lacking true understanding of themselves, too many suffer-

As a young girl growing up in California, it never occurred to Morte to ask. She hung out all the time at her friends’ homes. Why didn’t they ever come over to hers? Years later, after she began to dig into her past, Morte finally learned the truth: “Their parents would not allow them to go to my house,” she said. As they put it, “I was living with ‘a crazy person.’ ” Today, as a mental health professional, Morte is better able to understand the role adverse childhood experiences play for those with mental health challenges because of her own background, she believes. It took her a long time, though, to acknowledge that the emotional and sometimes physical abuse she once suffered was just that — abuse. “I thought it was normal — that was how families were,” Morte said, adding that the troubles began after her parents divorced and an alcoholic stepfather entered her life. In fact, when Morte first took an ACEs test about three years ago, she scored a 2, not associating her experiences with what the test questions described. The truth began to dawn on her shortly after that, as she did some serious reflection and talked to childhood friends and family members. She took the test again more than a year later. This time, she scored a 5. “I sat down and read those ACE questions for what they really were,” she said. “It was very emotional for me.” And concerning professionally. How could she go on treating sufferers, Morte wondered, when she had so much baggage of her own? But this growing understanding of herself would work in the therapist’s favor. In the end, understanding her background actually made her better at the job. “I was able to turn my experience into a way of healing others,” she said. It’s gratifying “to know that I was able to, for at least a


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BREAKING THE CYCLE | PART 4 small part of their life, give them a glimmer of hope that things can and will be different,” Morte said, adding that she still attends mental health court graduations to show her support. For many, she said, the key is “breaking down ‘what happened to you growing up?’ Because they didn’t become criminals overnight.”

A stint in jail Ramsey has done his best to stay out of trouble since moving into Walker Hall. If he ever needs motivation, he just thinks back to last year and the eight days he spent in jail. It happened after his vehicle broke down near Atoka. Ramsey, who was trying to get to Tulsa from Texas, found himself stranded on the side of the road. Frustrated at his luck — he’d recently put money into auto repairs — “I had a gram of weed, and I rolled me up a blunt,” he said. He’d just taken a puff when he saw the police cars pulling up behind him. Hauled off to jail, Ramsey eventually worked out a plea deal. He then caught the next Greyhound bus to Tulsa. His plan had been to move in with a relative and then find work. But that relative, he discovered, was heavily into methamphetamine. The drug held no appeal for Ramsey, who was turned off by “the way people looked when they were on it.” He knew he couldn’t live there. And that was how Ramsey suddenly found himself homeless.

The next Chef Ramsey It wasn’t just the fact of being homeless that he hated. There was also the label that went with it. After eight months of feeling hopeless and living in shelters, he found the Mental Health Association. Now — and maybe for the first time in his life — Ramsey has good reason to believe the future is bright. Still a resident of Walker Hall, he’s enrolled in culinary school and is working toward becoming a chef. “We call Donavon the ‘unofficial kitchen manager,’ ” said Lacey Howell, Walker Hall team lead, describing how Ramsey enjoys sharing what he’s learning at Platt College’s Culinary Arts School. In addition to cooking for the group once a week — a requirement for all Walker Hall residents — “He takes the new guys under his wing,” Howell said, teaching them everything

Donavon Ramsey, who was homeless for a while before he moved into Walker Hall, a transitional home run by Mental Health Association Oklahoma, is preparing to graduate from culinary school. His goal is to become a chef. IAN MAULE/Tulsa World

Donavon Ramsey looks through things from his childhood in his room at the Mental Health Association’s Walker Hall. Since moving into Walker Hall last year, Ramsey has begun treatment for depression and anxiety, and he is learning how difficult experiences from his youth continue to affect him.  IAN MAULE/Tulsa World

from how to sanitize kitchen items to the proper thawing of meat. Ramsey showed a couple of residents on special diets how to work within their restrictions, including how to make a turkey burger. Ramsey grew to like cooking as a child, when he used to help his mother in the kitchen, he said. Now it’s a real career possibility. Since arriving at Walker Hall, Ramsey has also begun to learn more about himself. That growing self-knowledge includes how events from his past continue to shape him. The strikes against Ramsey, which contribute to his ACE score, start with a lack of sta-

bility. A native of New Orleans, as a boy Ramsey moved back and forth frequently among Louisiana, Florida and Oklahoma, staying with relatives while his mother battled serious illness. When he was 14, his mother died, he said. He continued to bounce around and eventually landed in Geneva, Alabama. He moved in with a family member there. But it didn’t last, and Ramsey ended up spending his last few months of high school sleeping on friends’ couches, in his truck and in a space that a church provided for him. Given his prospects at the time, Ramsey can’t help but feel grateful at where he is today.

“I tell people I’m going to be the next Chef Ramsey,” he said — a riff on TV chef Gordon Ramsey. But while he now has direction in life, many questions are still ahead. After graduation from Platt, he hopes to find work and then get a place of his own and a car. “I want a routine. I’m tired of surprises in life,” he said. He added, “I want a routine but while still having fun.” For any other young people facing circumstances like his, Ramsey offers encouragement. “One of the things that kept me going,” he said, is knowing that “it’s up to me to make my life” better. “If I give up now — give up and let life have its way with me — that’s worse to me than struggling.” Liberation
Meanwhile, Morte’s personal journey to healing — the one she so long deferred — continues. For years, “I just stuffed it. That’s what mental health professionals do. We’re about helping other people,” she added, noting that it’s easy to neglect your own “emotional and spiritual health.” Thinking back on her youth, Morte can identify things that served to counteract, at least partly, the negativity at home. There were supportive teachers along the way and other caring people who helped. School itself became a “coping outlet,” she said, adding that she focused on her studies and made straight A’s.

Her experience is consistent with what scientists have learned about counteracting the harm done by ACEs. “Protective and Compensatory Experiences” — or PACEs, as they are known — have been shown to act as buffers or insulators against trauma and even to promote healing. Most effective seems to be the unconditional love of a parent or mentor, but PACEs also include exercise or physical activity and hobbies or clubs. In the end, the factor that most likely saved Morte was a complete change in environment. She was able to escape the home life and stepfather she’d grown to hate. When she was 13, her biological father was granted full custody of her. She remembers how liberating it felt. A final, symbolic act of liberation would come many years later. Morte had kept a secret journal of the things that were happening at home. It was used in court in helping the judge make his custody decision. Before she moved to Oklahoma in 2011, “I burned it,” she said of the journal. “I put it in the fireplace.” “It was the best feeling,” she added. “A release. There was a lot of emotion.” Tim Stanley 918-581-8385 tim.stanley@tulsaworld.com Twitter: @timstanleyTW

‘We need to create a relationship’ By Guerin Emig • Tulsa World

It is the end of another challenging day at McClure, a Tulsa public elementary school tucked into a neighborhood where residents worry about low income and high crime. Physical education teacher Mike McShane spots one of his students walking through the gymnasium. “Thanks for that letter you wrote me. It meant a lot to me, dude,” McShane tells the little boy. “Your future is very bright. I love you. I’ll see you tomorrow!” “What we see in homes where there’s trauma is there’s no language,” McShane says as the child departs. “There are no conversations that maybe you and I took for granted and got to have with our parents and extended family about the future and about education and about life. “Then a lot of the behavior challenges that we see is because of the trauma that’s been experienced. The way we negate that is by building relationships.” McShane is in his fifth year at McClure. When he started, he might have considered a more rigid “you’d better listen” approach. “There’s still some value in that, but we need more than just discipline,” he says. “There

Physical education teacher and coach Mike McShane talks with a student in the hallway at McClure Elementary School. MIKE SIMONS/Tulsa World

are so many different experiences and developmental issues going on in an elementary school. We need to create a relationship with these children and let them start to become a more active participant in the conversation about their life.” McShane has those conversations with his students in

front of a gym wall decorated with pictures of Muhammad Ali, Harriet Tubman, Martin Luther King Jr., Serena Williams and Simone Biles, among many others. He works his way down to another display titled “Path to College,” then to another about nutrition. “From the wall, we medi-

tate. That’s a huge tool for us. We practice yoga. We play,” McShane says. “Humans, and especially children, are designed for play.” McShane is encouraged by McClure Principal Katy Jimenez, by her perspective. “We have mandatory meetings every Monday after school. Once a month, we do

diversity chats where we’re learning about the trauma some of our students are going through,” he says. “We’re kind of on the ground level with a lot of young people, so we have a huge opportunity to connect with them and bridge.” McShane revels in the fact that as a PE teacher he sees the entire student body. That enhances the effect he can have as an adult influence. How does he know he is making an impact? “I don’t know. I hope,” he says. “I can show you a note I just got where a kid wrote it out. ‘Hey, coach, the conversations we’re having, I wouldn’t have passed my assessments if it wasn’t for you talking to me about the challenges of stress and how it affects us and affects our performance.’ Every once in a while you’ll have a student come back and say, ‘Hey, you’re helping.’ “At the same time, every once in a while you’ll see students in the seventh or eighth grade that you wish you could have helped more. Some of that stuff is out of our hands. You just keep showing up and doing your best.” Guerin Emig 918-629-6229 guerin.emig @tulsaworld.com Twitter: @GuerinEmig


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TULSA WORLD

BREAKING THE CYCLE | PART 5

LEADING THE WAY One school district is leading the state and nation in approach to serving students grappling with adverse childhood events By Andrea Eger • Tulsa World

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ORMAN — A rapidly changing student population combined with two high-profile sexual assault cases involving students forced school district leaders here to find a new approach to educating kids. “We saw a need in all of our schools. We realized a lot of our students were suffering from adverse childhood events, and we wanted to set up a framework in all schools to help all students,” said Sharon Heatly, director of guidance and counseling. Norman Public Schools set out to become “traumainformed” from top to bottom, and now district and school site leaders say there’s no going back from the culture of respect and support they’re creating for all kids. “This is an issue rooted in inclusiveness and equity — kids who need a boost. And to help, we have to think about student behavior in a different way,” said Jason Sanders, an assistant principal helping lead the change across Norman Public Schools and within his own school community at Whittier Middle School. Being a “trauma-informed” school requires the adults working in schools to be trained to recognize and respond to the signs of traumatic stress in children, which research has shown can hinder learning and negatively affect a person’s health throughout life. The goal is not only to provide kids with new coping tools to better manage behavior but also to improve overall school safety and educational outcomes. “We don’t want their past experiences to define their future. We want them to be able to move forward,” Heatly said.

Norman Police Sgt. Joel Formby waits with his Wednesday Warriors students as they prepare to get their hair cut at The Mane Man hair salon. The Wednesday Warriors is a therapeutic support group led by Formby and Norman’s Whittier Middle School Assistant Principal Jason Sanders. IAN MAULE/Tulsa World

she said. “The more we educate students about adverse childhood experiences and the need for mental health, the more they will seek help.” Saying that “we want school to be a safe place — many students get here as early as they possibly can,” Hollingsworth added, “I think kids are in a space here where they know they have resources, and they’re utilizing them.”

Needs have never been greater

Practical realities Every principal, teacher and school resource officer assigned to Norman Public Schools by the city’s Police Department has extensive, ongoing training in trauma and resilience training, as well as suicide prevention. And every school has a dedicated trauma team with two to three teachers, a counselor and one administrator who can respond to students in crisis, be it with behavioral issues, sexual assault or harassment, neglect, loss, suicidal thoughts or violence. “Sometimes I just wonder: How can this child get up and go to school each day?” Heatly said. “It has been overwhelmingly sad but also compelling in the way we can help students.” Change had already come for this once-sleepy college town when the reported bullying of three sexual assault victims at Norman High School erupted into community protests that made national headlines in November 2014. Then, in January 2016, a 16-year-old and a 12-yearold reported being sexually assaulted by teammates on a bus as the junior varsity wrestling team from Norman North High School returned from a tournament. But Norman Public Schools was already beginning to grapple with the challenges presented by its significant uptick in student poverty levels, Superintendent Nick Migliorino said. During the past two decades, Norman’s rate of students qualifying for free or reduced-rate school lunches based on household income had climbed from 17% to 20% to more than 50%. Migliorino describes the use of trauma-informed practices in schools as a recogni-

Sharon Heatly, Norman Public Schools’ director of guidance and counseling, says educators don’t want students’ “past experiences to define their future.” IAN MAULE/Tulsa World

tion of the practical realities of Oklahoma’s nation-leading rates of adverse childhood experiences, or ACEs. “Seeing the changes in our society, it’s disheartening — it’s scary. It’s our job to put systems in place to address those,” Migliorino said. “We’ve been responsive, been able to adapt as things have evolved.”

‘What happened to them?’ Norman leaders say they believe they’re the first school district in the U.S. to employ student advocates, who are mental health counselors who advocate for kids even when that means asking a teacher for special accommodations or asking a principal to deviate from rules or regulations when need be. The first two advocacy counselors were charged with primarily attending to sexual assault and sexual harassment issues in Norman’s two high schools, and then the district won a federal grant to fund similar positions for two middle schools, as well as outside mental health service providers to work with students during the school day. “Trauma-informed means changing the mindset in the whole building from ‘What’s wrong with them?’ to ‘What happened to them?’” said

Norman North High School Student Advocacy Coordinator Lori Hollingsworth. Hollingsworth said there is no such thing as a “typical” day in her line of work. “I never know what my day is going to look like,” she said. “My job is to just be available to kids.” That means furnishing basic necessities to students who know to come to her if those resources aren’t available at home. She stocks up on bottled water so kids can pop in and get a cool drink when what they’re really after is a place to cool off emotionally. Some kids need help processing a family crisis from the night before or guidance in how to deal with a dating relationship issue. The toughest cases are victims of abuse or other crimes, and those kids get immediate attention, plus contact with school resource officers for crime reports and referrals for outside mental health services when necessary. Hollingsworth has seen her caseload grow, and she thinks that’s not only an indication of a growing need but also of growing awareness about the availability of help. “Kids talk. I get a lot of my referrals from friends of students I’ve already served,”

While trauma-informed training is now standard procedure from top to bottom in the Norman district, individual school sites there have been able to adopt unique strategies and programs. At Whittier Middle School, just west of the University of Oklahoma campus, Assistant Principal Sanders and Sgt. Joel Formby, a school resource officer with the Norman Police Department, lead a therapeutic support group for boys called Wednesday Warriors in a nod to the school mascot. They started out with sixthgraders with two or more serious behavior infractions. But since then, they have expanded to 30 students, including seventh- and eighth-graders, and students who have had trouble making friends or other difficulties identified by their teachers. The Warriors meet each week in groups of 10 not only to review their grades and reflect on their behavior from the previous week but also to eat a lot of pizza and bond during special learning activities such as fishing and basic car mechanics. For Sanders and Formby, it all boils down to ensuring that every child has the opportunity to build relationships in their school community. They’ve even shared with the students about their own adverse childhood experiences, and that has made it easier for the students to open up with one another. “It comes down to an equity issue for me,” Sanders said. “Every single boy in all three grade levels (in the program) comes from divorce — the largest single adverse childhood experience. Many are being raised by grandparents. A lot of kids don’t have the knowledge of how to navigate school. “It’s a mindset shift we have to have for a lot of our teachers. If you haven’t lived those experiences yourself, you can’t appreciate what some kids are going through.”

They’ve seen improvements in everything from the Wednesday Warriors’ grades and classroom behavior to their relationships with teachers. Along the way, they’ve also helped students navigate obstacles and challenges great and small, from homelessness and the incarceration of one child’s father to the need for regular haircuts. “We were having this constant battle with one boy wearing his hoodie — there’s a rule that says you’ve got to remove your hood,” Formby said. “Instead of a simple punishment, I found out he felt embarrassed about his hair, so I found a local barber shop to provide free haircuts. That hood came right off. You could tell he felt better about himself, and pretty soon more kids started asking for haircuts.” Jonathan Atchley, principal at Norman’s Irving Middle School, recently recruited a master teacher with extensive experience as a foster parent to help transform his school’s in-school suspension classroom. Instead of a kind of holding cell, the Irving Restoration Program requires students to complete self-reflection assignments, community service within the school and a lesson specific to their particular infraction. “Before, we spent most of those teachable moments trying to get people to understand what we have to say instead of, ‘What’s the story?’” Atchley said. “It’s us asking ourselves: How can we help that child make different decisions instead of us just telling them to make different decisions? You have to do something different with each one of those kids instead of the same approach all of the time.” From August through February, the school of 850 students posted 51 lost instructional days for students, compared to 84 during the same period the previous academic year. Atchley used the all-toocommon discipline issue of physical fights among preteens and teens as an example. In trying to understand each kid’s story, educators can help students become more self-aware of their issues and how better to deal with them. “In the past, we would have said, ‘Don’t hit people.’ Now, instead, it is, ‘What are your triggers? What got you into that situation? What is the story of your life that has


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BREAKING THE CYCLE | PART 5 taught you that fighting is the only way out of those situations?’” Atchley said educators have been quick to embrace the idea of being traumainformed because, as a rule, they’re drawn to the profession out of a desire to truly help kids. “We have so many societal issues we have come to accept as normal that we are not addressing in school or as a society — that we are not addressing how simple or how profound it impacts a kid’s life,” he said.

‘Healing to Learn’ State Superintendent Joy Hofmeister has been working to raise awareness among educators and parents about the need for trauma-informed approaches and the employ-

ment of more counselors in schools. And Oklahoma’s new first lady, Sarah Stitt, has even taken up support for the cause, appearing at the most recent childhood trauma summit hosted by the Oklahoma State Department of Education. “The current movement toward trauma-sensitive schools and trauma-informed instruction comes at a time when more than ever Oklahoma students are in need of this mindset shift among the adults in charge of their learning, care and well-being during the school day,” Hofmeister said. She has issued a call for new state funding to significantly increase the number of counselors working in Oklahoma’s public schools. She also points to Norman’s example in encouraging schools to

consider the trauma-informed approach while molding it “to meet the unique needs of their students, faculty and community.” “Norman Public Schools has increased the sense of safety and security within its buildings for all students, with the understanding that traumainformed practices work for every student, not just those who have experienced a traumatic event,” she said. The ideas are beginning to be embraced in a host of ways in communities across Oklahoma. Tulsa school leaders held book clubs and pursued professional development training on the topic throughout 2018-19 and are incorporating the ideas into discussions with community mental health providers who work in schools, said Ebony Johnson,

executive director of student and family support at Tulsa Public Schools. In Bartlesville, a new “alternative learning environment” for elementary school students in trouble is set to open this fall. Called ATLAS, which stands for Academic Therapeutic Learning Alternative School, the program will serve 12 early childhood and 12 upper elementary students at a time in a half-day program on the campus of Ranch Heights Elementary School. Superintendent Chuck McCauley said school districts that are large enough typically have alternative settings for secondary school students. But his district’s teachers have expressed growing concerns about issues they’re seeing in younger students. “We wanted to do some-

thing completely different for our elementary kids to help get them back on track,” McCauley said. A teacher and teacher’s assistant from Bartlesville Public Schools and a mental health therapist and behavior health coach furnished by Grand Lake Mental Health Center will work together to help ATLAS students “gain the social-emotional and academic skills they need to be successful.” “Our motto is ‘Healing to Learn,’” McCauley said. “The goal is for the students to return to transition back to the regular classroom as they are ready.” Andrea Eger 918-581-8470 andrea.eger @tulsaworld.com Twitter: @AndreaEger

‘Waking up was miserable’ After seven of her students died in a tornado at a Moore elementary school, a counselor is helping Oklahoma schools become trauma-informed By Andrea Eger • Tulsa World

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he kids at Plaza Towers Elementary School in Moore changed Kristin Atchley as an education professional. Tragedy there changed her as a person. Today, Atchley uses what she learned and lived through to teach others about the impact of chronic stressors on growing kids and how trauma rewires our brains. “I had a fully-developed brain as a 30-year-old. I knew I could get help and get through. Kids don’t always understand that,” she said. Atchley didn’t have the personal or professional experience to understand the struggles and obstacles so many Oklahoma school children come to school with each day before she went to work as the school counselor at Plaza Towers, which serves a high concentration of students living in poverty. “I had traumatic events happen in my life, but I didn’t have chronic trauma,” she said. Then, shortly before afternoon dismissal time May 20, 2013, an EF-5 tornado razed the school full of children and faculty. Seven of her students died. In the weeks after the tornado, Atchley found herself one evening paralyzed to leave her house to buy milk for her small children. And she cringes as she tells the story of an emotional meltdown she had when she tried to replace her favorite sandals — the ones she wore and had destroyed on the day of the tornado — only to learn that the manufacturer had stopped making them. “I struggled with anxiety from the loss of control I had experienced. I would get tingly; my heart and mind would be racing,” Atchley said. Even after extensive therapy, Atchley still has disturbing gaps in her memory from the hours after the tornado. And all of these years later, images of tornadoes and the sound of a helicopter passing overhead like so many news helicopters at the time can still trigger sudden, emotional responses of fear and anxiety within her. It crystallized her understanding of how high levels of chronic stress from experiencing or witnessing abuse, growing up with a parent with mental illness, suffering significant losses and other breakdowns in family life, can literally change a person’s brain chemistry and leave emotional scars for life. “When you are in the middle of trauma, you don’t think through consequences. Kids in chronic stress are often just reacting out of

Kristin Atchley lost seven students at a Moore elementary school that was ravaged by a tornado. Now she’s helping create trauma-informed schools in Oklahoma. IAN MAULE/Tulsa World

An emergency responder stands in the rubble of Plaza Towers Elementary School in Moore on May 21, 2013, a day after the school was leveled, killing seven children. MIKE SIMONS/Tulsa World file

adrenaline,” she said. “My trauma was out there for the whole world to see on the news. The majority of our kids, their trauma happens behind closed doors. But even the things we don’t know affect a kid’s life.” She sought help and quietly tried to move on with her career, accepting a newly created counseling position at Norman High School to work even more closely with students in trauma or with other extraordinary challenges and needs. Her charge by Norman’s then-Superintendent Joe Siano was this: “I don’t want you to do what’s right for this school. I want you to make sure the school is doing what’s right for the kid in front of you.” She said his expectation for her and the other newly hired “student advocacy counselor” in the district included doing uncomfortable things, such as standing up to principals on behalf of kids needing special accommodations and creating channels for victims of sexual assault or harassment to get the help they need from law enforcement and mental health care. “We had to push ourselves,” she said. “What I found worked best was ask more

questions when you talk — instead of telling kids what to do. Some schools don’t want you to go down that road and find out what might be going on with a kid. Norman allowed us to ask those questions.” In response to so many students suffering the effects on their well-being and behavior from adverse childhood experiences, such as abuse, neglect and other forms of household dysfunction, Norman set up a framework in all schools to better identify and serve those in need. It trained every teacher, counselor and school administrator in “trauma-informed” instruction. Then, two years ago, Atchley was tapped by State Superintendent Joy Hofmeister to share with educators and parents all over the state what she had learned about the brain science behind the trauma-informed school model and how trauma-informed schools can provide kids with new coping tools to better manage behavior, improve overall school safety and educational outcomes. “You don’t have to know how many kids in your building have a four-plus ACE score. All you have to do is look at the local, state

and national data for the 10 (categories of ) ACEs,” Atchley said. The role she was cast into was not unlike that of a traveling preacher. And to carry the message, Atchley decided to share her story to help other adults understand what she witnessed among the students she served at Plaza Towers and at Norman High and what she lived after the most traumatic experience of her life. You could hear a pin drop in classrooms holding three times their capacity in teachers and school leaders attending annual conferences for educators and in ballrooms full of people at two statewide summits on traumainformed instruction. “There is a difference between acute trauma and chronic trauma, but one common thread is the loss of power and control in your life,” Atchley said. “And every day, waking up was miserable because I was waking up to reality. It taught me that mornings can be the hardest time for some of our kids.” Today, Atchley still laments the impact of her experience on her two children. “The mom they had on May 19 is not the mom they had on May 20 and the rest of their lives,” she said. Atchley and her husband are expecting their third child, so she recently took a new position with the MidDel School District in the Oklahoma City area that will still allow her to engage in work she’s passionate about without having to travel away from home. As director of student services, Atchley is overseeing an initiative to train employees districtwide in becoming trauma-informed. “Teachers — more than anything else — want to be

able to do their jobs,” said Rick Cobb, superintendent at Mid-Del. “They’re hungry for strategies to help students and not send them away from the learning environment and make them feel unwanted. There have always been those stories, but we may not have paid much attention to them because they were outliers. We saw them as a disruption. Now, we have higher concentrations of poverty and social problems in general. Also, we have more teachers from a relatable background.” Cobb said Atchley’s message is so effective because it’s relatable — she’s done the work of serving students and teachers in schools. And she’s making the information relatable for adults. “When Kristin is speaking to packed rooms of educators, she’s not shaming anyone for the things we’ve done in classrooms for 50 years or longer, but she’s talking about her story, about her students’ stories, to help people understand we can do things in a better way.” For educators and parents interested in “trauma-informed” or “trauma-sensitive” instruction, Atchley said strategies must be implemented from the top-down and from the bottom-up. She said it also requires a fundamental goal among educators of serving the whole child. “You have to have a leader who believes in it. And we have teachers who have been doing these types of things for years,” Atchley said. “You have to address trust and a child’s lack of safety first — before education.” Andrea Eger 918-581-8470 andrea.eger @tulsaworld.com Twitter: @AndreaEger


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BREAKING THE CYCLE | PART 6

‘It’s amazing’

Linda Vincent, a foster parent to three children, works in the kitchen with the children at their home in Tulsa. MATT BARNARD/Tulsa World

Tulsa foster mom helps kids with high ACE scores realize they aren’t defined by them

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By Guerin Emig • Tulsa World

inda Vincent lets you know straight away: Being a foster parent can be terrifying. “Ter-ri-fy-ing,” she says for emphasis. “My kids come into my home and I see behaviors that would blow other people’s minds. They call them ‘trauma rages’ sometimes.” Foster children tend to have encountered trauma. They tend to have high ACE scores. They typically haven’t encountered stabilizers in their lives. Then they come into the lives of foster parents. They come into lives like Vincent’s. “I’ve watched my children go from name-calling that I’ve never heard from a grown-up to months later my children coming and sitting down in front of me saying, ‘Mama Linda, my heart’s hurting right now. I just need to talk about it,’ ” Vincent says. “Or, ‘I need a hug.’ ” Vincent, a Tulsa real estate

Linda Vincent is “Mama Linda” to three foster children. “It is the most rewarding and value-building thing I’ve ever done in my entire life,” she says.  MATT BARNARD/Tulsa World

agent when she isn’t fostering her 8-, 5- and 4-year-old children, offers a perspective that sounds straight out of a parenting class. “When a child feels completely overwhelmed and overstimulated and they’ve never been shown healthy regulation ... It’s tough,” she

says. “What they’re really trying to say is, ‘I’m hurting and I don’t know how to tell you that. And I’m scared to tell you that because you might hurt me or make fun of me.’ But they can’t say that so they call you really bad words.” This is where adult stabilizers come in. Teachers, counselors or mentors give children affected by adversity attention and empathy for periods beyond a moment, and it opens paths. The children have a sympathetic figure, someone they did not have before, and what can result is dialogue, understanding and some healing. Vincent presents that figure as a foster mom. “No one gets to see this kind of progress in human spirit quite like a foster parent. It’s an incredible thing to watch,” she says. “It’s exhausting. But it is the most rewarding and value-building thing I’ve ever done in my entire life.” Vincent has been drawn to children since she was a nanny in college. She consid-

No one gets to see this kind of progress in human spirit quite like a foster parent.” Linda Vincent On experiencing her foster children’s emotional growth ered teaching until realizing something: “You would find me having a snuggle session with my kids in a big circle, completely disregarding the ‘letter of the day.’ ” Vincent wound up volunteering at the Laura Dester Children’s Center for a few years. There, she discovered the sheer number of area foster kids in need of care. She considered fostering herself, only to talk herself out of the proposition because she felt she needed to have her own children first. “Eventually, I just said, ‘This is kind of silly. I can do this right now. And I’m needed right now. I have space in my house and a pretty flexible

schedule,’ ” she says. “I did it, and let me tell you, it’s amazing ... “I started my certification process in October of 2017. In January of ’18, I signed my contracts to become a foster parent. Jan. 19, they dropped the most adorable little kid I’ve ever seen in my life on my front porch. I’ve had kids in my house ever since. I got the three kids I’m fostering now the beginning of January.” Their trauma can still be frightening, but it is absolutely not defining. “Their ACE score would paint a scary picture for a lot of people from the outside. But what’s amazing is to watch them say, ‘That’s not who I am,’ ” Vincent says. “ ‘I have all these amazing attributes, and if you give me time and space to explore them, watch me show you what I’m good at, watch me show you how loving I can be...’ “They have zero reason to trust an adult, and yet they do it. It’s incredible. I feel sorry for anybody who doesn’t get to watch that up close and personally.” Guerin Emig 918-629-6229 guerin.emig @tulsaworld.com Twitter: @GuerinEmig

Become a cheerleader As our children encounter alarming adversity, adult caregivers in their lives play an indispensable role in coping By Guerin Emig • Tulsa World

Teachers and coaches, counselors and mentors, foster parents and Big Brothers Big Sisters make considerable differences in the lives of children. Society acknowledges this, typically, because people are conditioned to do so. It can be surface-level appreciation. To dig beneath the surface is to realize a few things: • Oklahoma children encounter more trauma and adversity than those in any other state, according to Joe Dor-

man, CEO of the Oklahoma Institute for Child Advocacy. • Professionals in the children’s mental health field increasingly turn to children’s ACE (adverse childhood experiences) scores to get a psychological grip on kids’ trauma. “It is really changing a way of thinking,” said Amanda Morris, a regents professor of human development at OSUTulsa. “Not ‘What’s wrong with you?’ but ‘What happened to you?’ ” • As the ACEs approach to childhood trauma is more widely embraced, so is the psychological approach to buffering that trauma. In 2014, Morris and OSU colleague Jennifer Hays-Grudo developed a framework to better understand factors that promote resilience in children with high ACE scores. They

did so through a questionnaire evaluating the presence of protective and compensatory experiences, or PACEs, that could buffer kids’ trauma. Two significant questions from Morris’ and HaysGrudo’s framework: “Did you have someone who loved you unconditionally (you did not doubt that they cared about you)?” and “Did you have an adult (not a parent) you trusted and could count on when you needed help or advice?” PACEs provide opportunities to build the brain architecture — or neuro connections — that allow a person’s body to calm down and carry forward with positive habits. “Children with high ACEs and no PACEs have a very difficult time in life because they don’t have the opportunity to develop the skills and the

competencies — the psychological skills, the social skills and even the cognitive, learning skills — to compensate for the abuse and neglect that has compromised how their brains develop,” Hays-Grudo said. “ACEs are not a death sentence. I know many people with high levels of ACEs who live very happy and productive and good lives. “And that’s generally because they also had many other good things going on in their lives.” That makes something Child Protection Coalition Executive Director Nellie Kelly said at a recent Tulsa children’s mental health forum read like gospel: “Become involved with a child and become that stabilizing adult who cares for them and becomes a cheerleader. There are

kids who literally have never had an adult come to a school event and clap for them. Nobody at home tells them to brush their teeth, let alone that they’re proud of them and they do a good job at something. That’s what we can do on a very personal level.” Fortunately, there are stabilizing adults across the city who are involved. They work in classrooms. They advocate in courtrooms. They open their homes. They volunteer at parks. “What seems to be really important is that somebody is believing in you,” said OSU’s Morris. “Somebody has your back.” Guerin Emig 918-629-6229 guerin.emig @tulsaworld.com Twitter: @GuerinEmig


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BREAKING THE CYCLE | PART 7

Counselor and coach

Central High School head football coach Kip Shaw talks to a student while his team lifts weights during off-season workouts. “You help one find his way, and you know the next young man is coming and you’re going to have to put your work into him,” he says. “I love it, though. This has been the most rewarding experience of my life.” IAN MAULE/Tulsa World

Central coach calls strenuous work with at-risk students ‘the most rewarding experience of my life’

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By Guerin Emig • Tulsa World

ip Shaw was once an unwavering college football assistant. Now he coaches at Central High School, where he estimates 80% of his players have encountered alarming degrees of adversity. “I bend and I’m flexible and I say, ‘Let’s have a conversation,’ ” he says. “I sit him down and say, ‘This is what I’m trying to do. What are you trying to do?’ Once they come in and you ask them that and you have that conversation as opposed to, ‘F you, I don’t wanna hear that,’ then you know you’re starting to make progress. Then you know you have a chance to make an impression on them. “Any coach worth his salt is trying to do that.” Coaches can have an enormous impact on kids who have faced personal trauma. They can be adult role models

Football coach Kip Shaw talks to his players during a conditioning session at an off-season workout. IAN MAULE/Tulsa World

who do more than bark out: “On my whistle!” Just one person — perhaps a coach, a teacher or a relative — can make a huge

difference in helping a young person overcome a high adverse childhood experiences — or ACEs — score, studies show. Shaw tries to be that

person for his players. “I have a kid who is going to be a senior,” Shaw says. “His mom died a few years ago. Dad has had a challenge in raising him. The kid has anger issues. “Yesterday, we had a conversation about going to college. It wasn’t about, ‘Hey, Coach, why am I not getting scholarship offers?’ It was, ‘Hey, Coach, what am I gonna do when I’m on my own? How am I gonna handle buying groceries? How am I gonna wash my clothes?’ ” From there, Shaw can try to assure him, “It’s going to be all right,” and then get into the particulars of how and why. But first, he must gain the youngster’s trust. If he does that, it enhances the possibility for a conversation, then other conversations and ultimately meaningful impact. This can be a task. “My master’s was in positive psychology. I learned a lot of techniques. Some days, I want to throw that book out the window,” Shaw says. “Some days, I’m like, ‘Man, there ain’t no way in the world I can be positive with him. Let me go find my next college job.’ ” He hangs in, though, and his kids typically try to hang in with him. “The one I told you about?

It’s to the point now where this kid has texted me a couple times and said, ‘Coach, I just need you to know I love you,’ ” Shaw says. “This is something last year or two years ago wouldn’t have happened. We still have to deal with the anger issues, but at least we’ve made progress. “Before it was, ‘What’s wrong with you?’ ‘Nothin.’ And just storm out of here. So you see the progress you’ve made.” Central, like so many of Tulsa’s public schools, is besieged by adversity. “It’s not just athletes,” Shaw says. “Some of the stories I’ve heard here, I’m like, ‘How in the hell do you come to school every day, son?’ ” They come, though. They have the resilience to do so, to try to manage their adversity and trauma with the help of guidance and stability. That’s where adults like Shaw come in. “You help one find his way, and you know the next young man is coming and you’re going to have to put your work into him,” he says. “I love it, though. This has been the most rewarding experience of my life.” Guerin Emig 918-629-6229 guerin.emig @tulsaworld.com Twitter: @GuerinEmig

Tulsa Big Brother shows the power of being there for a child ‘He knows I’ll be back,’ he says of the 12-year-old boy he mentors By Guerin Emig • Tulsa World

Ryan McDaniel’s first experience in Big Brothers Big Sisters was with an 11-year-old boy from south Dallas named Sherman. “He was poor. His father was incarcerated. His mother was in and out of different issues relative to drugs,” McDaniel said. “He couldn’t read, and he was getting pushed through the public school system down there. On top of that, he had been shot, supposedly on accident, when he was 4 years old.” On their first outing, McDaniel took Sherman bowling. Sherman bowled one frame and spent the rest of the day watching bigger kids play video games, oblivious to his Big Brother. McDaniel was irritated,

then hurt, figuring he had blown his chance at mentoring this child. Then, on his drive home, McDaniel had what he called “an epiphany.” “Sherman really had no expectation of me ever coming back or he was ever going to see me again. So why would he devote an ounce of time to getting to know me?” McDaniel said. “What difference does it make if I’m there or not? I won’t be there tomorrow.” The experience taught McDaniel the value of two tenets related to Big Brothers Big Sisters: One, it takes patience and commitment to influence a child faced with adversity and trauma. Two? “All of them have some defense mechanism that protects them from whatever trauma happened,” McDaniel said. “You don’t really know what the magic code is to help that facade go away. That’s kind of the point of the program. You’re not here to fix the problem.

Become a Big Brother or Sister Want to become a mentor with Big Brothers Big Sisters of Oklahoma? Go to bbbsok.org and complete an application — be ready with three references. An interview and background check are the next steps.

“We use the phrase ‘defenders of potential.’ You let them know you’re on their team to help them achieve whatever they’re capable of achieving in their own mind.” Seven years later, McDaniel has relocated. He is a commercial banker in Tulsa, not Dallas. He is still a Big Brother, applying what he learned from that first experience with Sherman. He mentors a 12-year-old boy named Sam. Sam’s adversity is different from Sherman’s — his father died when he was 6 — but his need for a

stabilizing adult presence is just as critical. The two of them began 3½ years ago with Legos and board games at Sam’s elementary school. Then it was cheering at Sam’s baseball games and promoting the boy’s interest in ballet. Eventually it was conversations about class work, then about the value of school and about feelings about Sam’s late father. The conversations don’t always finish where McDaniel wants. They aren’t always wrapped up in one visit. But it is the effort, the patience and the commitment that counts. “I’m not Sam’s friend he plays ‘Fortnite’ with. I’m not necessarily his teacher, his coach or his parent. I’m an adult figure that enjoys spending time with him,” McDaniel said. “It’s not perfect. It’s taken a while to see those things. But those moments are really rewarding. “The four years we’ve spent

together have created some comfort where awkward silences aren’t as awkward anymore. I’m not as worried about trying to please him. If we don’t have a really good time, he knows I’ll be back in the next week or so.” McDaniel went back to see Sherman when he lived in Dallas. A relationship blossomed. Now he goes back to see Sam. “It used to be I’d ask questions and get one-word answers. Now it’s questions and a story,” McDaniel said. “Now there’s trust. “Me and him are going to be connected as long as it takes, whether he wants to be done at 18 or 30. That’s the impact of being a mentor and showing up every week.” Guerin Emig 918-629-6229 guerin.emig @tulsaworld.com Twitter: @GuerinEmig


tulsaworld.com

14 | SPECIAL PUBLICATION

TULSA WORLD

BREAKING THE CYCLE | PART 8 ACEs project team

Oklahoma leads the nation in childhood trauma. What can we do to change that?

What the leading voices for change say Oklahoma needs to reduce chronic childhood traumas  MIKE SIMONS/Tulsa World file

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By Andrea Eger • Tulsa World

ew people have been in a position to bear greater witness to Oklahoma’s extraordinary rates of childhood trauma than Doris Fransein, who recently retired as Tulsa County’s longtime chief judge over juvenile cases. In nearly two decades of handling 30 to 40 cases a day, she has had to confront every kind of heartbreak and horror a child could suffer. “My largest frustration is the fact that we need public awareness and the proper resources to address it — more medical and appropriate mental health care,” Fransein said. “I get so frustrated that we don’t get out of our little neighborhoods. It was just so sad — what people who live here experience. There’s such a large part of our population that has just gone through so much and is hurting so much, and so many people aren’t even aware.” Leaders from government, education, and mental health and social services say there is a growing consensus to attack the root causes of Oklahoma’s extraordinary rates of incarceration, divorce, child abuse, heart disease and cancer deaths. “If Gov. Stitt wants to be a top-10 state, it starts with our kiddos,” said Rep. Carol Bush, R-Tulsa. Oklahoma has the highest percentage of children who suffer multiple adverse childhood experiences (ACEs), which studies have linked to a wide range of health problems and social ills. And to address those high ACE scores, Bush helped create the state Legislature’s Task Force on Trauma-Informed Care, which is one year into its three-year study that will lead to making recommendations to the Legislature. The first report from the 17-member panel is due out in November and its final plan by December 2020, which would allow lawmakers to consider reforms in early 2021. Bush said there’s a national movement, with grants and federal dollars available for Oklahoma to try to tap once it comes up with a statewide approach. Annette Jacobi, co-chair of the task force and director of the Oklahoma Commission on Children and Youth, said Oklahoma needs to take stock of current efforts and to identify potential strategies to address gaps in its services. She said that is particularly critical in underserved rural areas and after nearly a decade of budget cuts and service eliminations in child abuse and neglect prevention programs. But Jacobi senses momentum building within the state and feels positive progress is being achieved. “It’s not a state government problem — all of us are in this,” she said. “Everyone has a role to play.”

‘This is a crisis’ In the last year, State Superintendent Joy Hofmeister has

convened two state summits for educators on childhood trauma and healing. She cited research that has shown children exposed to trauma often exhibit learning difficulties, depression and poor decision-making in the classroom, plus higher rates of absences, decreased reading abilities and lower graduation rates when compared to their peers. “Teachers and education leaders must address the needs of our students where they are, or we will shortchange the future of kids who suffer maltreatment, abuse and neglect,” Hofmeister told the Tulsa World. “Thankfully, our state has begun to face the facts about our most vulnerable children, and momentum is building for a new, more promising approach within schools and community.” Oklahoma’s new first lady, Sarah Stitt, spoke at the most recent summit, sharing her personal story about the lasting effects of childhood trauma from growing up in a household with two parents suffering from mental illness. “This is a crisis,” Stitt told thousands of educators who attended the February event. “All of us have known or have a family member who struggles with mental illness, abuse or drug addiction. These are the things we have to change in our state if we want to give our children hope. I am living proof that there is hope and a future for everyone.” Hofmeister recently issued a call for $58 million in new state funding to build a school counselor corps with more licensed professional counselors and academic school counselors in Oklahoma schools for two purposes. “These important professionals are needed for our students, but also for our teachers who seek coaching and training to meet the needs of children with adverse childhood experiences,” she said. Next up will be a push for the use of restorative practices — as opposed to punitive practices — in more classrooms and schools across the state. In a nutshell, being “trauma-informed” means educators and others working with children must ask themselves what happened to a child rather than “What’s wrong with them.” New examples of community support for that approach are popping up in the form of new partnerships with outside mental health providers and even local police departments, including Oklahoma City and Norman, where police officers contact schools with a three-word heads-up that a child has suffered a potentially traumatic event at home, such as the loss of a family member or witnessing a crime or the arrest of a parent. The simple, cautionary message passed along? “Handle with care.” “For students to thrive, we must all recognize that the world outside the classroom impacts the world inside the classroom,” Hofmeister said. “This is why community partnerships with programs such as ‘Handle with Care’ are so

effective in supporting kids.”

A problem crossing generations Hofmeister’s work in public schools should serve as an example for other state agencies to follow in making ACEs a priority, said Joe Dorman, a former state representative who now serves as CEO of the Oklahoma Institute for Child Advocacy. Every state official who comes into contact with troubled children, from police officers to welfare caseworkers, need to know how to recognize the signs of emotional trauma, Dorman said. And the effort needs to be statewide, not concentrated only in Tulsa and Oklahoma City, he said. “Because rural areas are experiencing the same traumas,” Dorman said. “Maybe even at a higher percentage.” High rates of social ills go back several generations, he said, so Oklahoma urgently needs to expand parentingskills training. “Often times, the parents have experienced the same kind of trauma,” Dorman said. “And the parents may not even realize how they are passing those experiences on to their children.” Whatever the costs, he said it won’t be nearly as expensive as building more prisons. “If we don’t deal with these kids in the early years,” Dorman said, “we’ll have to deal with them as adults in the correctional system.” One local program, Women in Recovery, is proving that intervention with parents can make a difference. But its reach is limited. About 400 women a month enter the Tulsa County jail, and 80% of them have children. A court liaison works with attorneys, judges and prosecutors to identify candidates for Women in Recovery’s counseling and rehab program as an alternative to prison sentences “based on individual risks and needs assessment,” according to Mimi Tarrasch, the program director. “Our efforts break the cycle of multi-generational incarceration,” Tarrasch said. “We know with every grad, the next generation’s score will be improved.” The program, which is funded largely through the George Kaiser Family Foundation, can take only a small percentage of women who are facing prison time, and only women from Tulsa County. Tarrash said Women in Recovery would welcome the chance to expand, but that would take a massive increase in funding.

‘We have to come at it on every level’ Michael Brose, chief empowerment officer at Mental Health Association Oklahoma, said to truly alter Oklahoma’s current trajectory, everyone in the state must be aware of and understand adverse childhood experiences and how they have a real stake in finding solutions — because nonprofits and state agencies can’t do it alone. “We need a real, statewide campaign to raise awareness and develop ways to address

the issues. And it needs to come from the very top levels — from the governor’s office, the Legislature, down to the state agencies and then out into the community,” Brose said. “If we’re really serious, we have to come at it on every level. Then, it has to be sustained. It can’t be a flavor of the month.” Both Brose and Fransein, the retired Tulsa County District Court’s juvenile division chief judge, said one necessary solution isn’t as simple as more mental health services being funded immediately, because they said the mental health profession has its own work to do when it comes to addressing childhood traumas. “There’s a false assumption that all mental health professionals get this,” Brose said, “but too often, we treat the symptom right in front of us instead of exploring what happened to someone and what insight that might give. It’s a time-consuming process, but it can be critically rewarding.” Fransein said court workers from all over the state have undergone awareness training in recognizing childhood trauma, and Tulsa County received national recognition for its trauma-informed practices to better serve children and parents caught in the judicial process. “The majority of parents that come to us, particularly in neglect cases, suffer horrifically from their own experiences,” she said. “We saw very disregulated behaviors in the courtroom — a lot of substance abuse, a lot of domestic abuse. Any time we did extensive psychological evaluation or I was fortunate enough to have a good DHS caseworker involved in the case who asked good questions, they would relate some extremely traumatic experiences very early in their childhood.” Fransein said Tulsa County is fortunate to be able to collaborate with top-notch community mental health providers, but she said more “appropriate” mental health services are needed and such services need to be made available to more people. “Trauma puts up tremendous barriers and walls. When someone’s ready, because so much of that is about the willingness of the client to delve deep into their past, and you have a good therapist, it works,” Fransein said. “I saw miracles when that was done well. The parent would come to us and say: ‘Thank you for helping me. I didn’t realize this. I feel better. I am able to understand.’ That needs to occur on a regular basis with all of our cases.” The bottom line, according to Brose, is: “We’ve got a problem here in Oklahoma. Once again we’re at the top of the bad list.” And short of a serious statewide campaign, he said, “we could talk this to death for the rest of our lives and not make a dent.” Andrea Eger 918-581-8470 andrea.eger @tulsaworld.com Twitter: @AndreaEger Staff writers Corey Jones, Michael Overall and Tim Stanley contributed to this report.

Andrea Eger is a projects reporter, examining key education topics and other local issues. Since joining the Tulsa World in 1999, she has been a three-time winner of Oklahoma’s top award for investigative reporting by an individual. In 2017, she was first runner-up for the honor of the nation’s best education beat reporter at a medium-sized outlet and she won the Inland Press Association’s top honors for investigative reporting and community leadership. Guerin Emig joined the Tulsa World in 2004. He lived in Norman and covered the Oklahoma Sooners until 2016, when he became a sports columnist and relocated to Tulsa. He and his wife have two children. All four Emigs are University of Kansas graduates or students. Corey Jones joined the Tulsa World in 2014. He predominantly covers criminal justice, public safety and public health, along with whatever the city editor throws at him. His work has been honored by the Great Plains Journalism Awards, Inland Press Association, Heart of America Awards and several state contests. Curtis Killman is a member of the Projects Team with an emphasis on database analysis. He also covers federal court news, maintains the Tulsa World database page and develops online interactive graphics. Ian Maule has worked for the Tulsa World since 2015 as a staff photographer. He graduated from Western Kentucky University with a degree in photojournalism, and his work has been featured in the New York Times, LA Times and by The Associated Press. Michael Overall has worked for the Tulsa World since 1996. He covers a wide variety of issues and writes a weekly news column. He’s been honored by the National Headliner Awards, Great Plains Journalism Awards, SNPA, and many state competitions. Tim Stanley is a staff writer and columnist. His award-winning projects include the World War II Veterans Remember series and book; the Camp Scott Girl Scout Murders 40th anniversary series; and Still Missing, a series on the “Missing Welch Girls” case. James Royal is the Tulsa World’s chief designer. He has won numerous design awards from state and national competitions. He joined the World in 2005 and previously served as assistant sports editor. Ashley Parrish has worked for the Tulsa World in positions ranging from copy clerk as a teenager to deputy managing editor today. She edits projects and Tulsa World Magazine, which has been honored as the Great Plains Magazine of the Year.

ACES advisory board A group of Tulsa’s leading experts on childhood trauma served as advisers to the Tulsa World’s reporting team. Kristin Atchley, former executive director of counseling at the State Department of Education Dr. Gerard Clancy, University of Tulsa president, psychiatrist Joe Dorman, former legislator and CEO of the Oklahoma Institute for Child Advocacy Judge Doris Fransein, retired District Court chief juvenile judge Deidra Kirtley, Resonance Center for Women executive director Gail Lapidus, CEO of Family & Children’s Services Suzann Stewart, Family Safety Center executive director Julie Summers, director of outreach and prevention at Mental Health Association Oklahoma