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Day 1: Breaking the cycle

The 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 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.


Local
Day 1: ACES: breaking the cycle: 'I've been there. I know.' Oklahoma's children top the nation in trauma suffered, and one survivor is doing his part to stop it

The 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.

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 deep-seated 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.

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’

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, child-welfare 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 downtown. 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.


Take the test

Before your 18th birthday:

1. Did a parent or other adult in the household often or very often ...

Swear at you, insult you, put you down or humiliate you?

or

Act in a way that made you afraid you might be physically hurt?

2. 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?

3. 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 to actually have oral, anal or vaginal intercourse with you?

4. Did you often or very often feel that ...

No one in your family loved you or thought you were important or special?

or 

Your family didn't look out for each other, feel close to each other or support each other?

5. 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 

Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

6. Was a biological parent ever lost to you through divorce, abandonment or other reason?

7. Was a parent:

Often or very often pushed, grabbed, slapped or had something thrown at him or her by a domestic partner?

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?

8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

9. Was a household member depressed or mentally ill or did a household member attempt suicide?

10. Did a household member go to prison?

Add up your "yes" answers. This is your ACE score.