CE/CME

Child Trafficking and Exploitation: Screening, Intervention and Prevention

Welcome to the training on Child Trafficking and Exploitation: Screening, Intervention and Prevention provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit Hours: 1.00 CE

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Goal

The goal of this module is to equip Texas Health Steps providers and other pediatric health care professionals to recognize risk factors and signs of child trafficking and exploitation and to take appropriate steps to protect vulnerable children and adolescents.

Target Audience

Texas Health Steps providers and other interested health care professionals.

Specific Learning Objectives

After completing the activities of this module, you will be able to:

  1. Assess risk factors and possible indicators of child trafficking and exploitation as part of routine clinical care.
  2. Formulate trauma-informed, culturally sensitive practices to identify and respond to children and adolescents who have experienced or are at risk for trafficking and exploitation.
  3. Determine appropriate referrals and resources that support and provide ongoing care to children and adolescents who have experienced trafficking and exploitation. 

Notes on Nomenclature

This module focuses on sex and labor trafficking and exploitation of individuals under the age of 18 years. The terms “health care provider” and “provider” to denote clinicians who are educated, trained and licensed to deliver health care. In addition, the term “caregiver” refers to parents, legal guardians, family members and others who may be responsible for a child’s health care. 

Please note this module expires on 8/14/2026.

This module was released on 8/14/2023.

Featured

American Academy of Pediatrics. (2023). Trauma-Informed Care.

American Academy of Pediatrics. (2021). Supporting Children Who Have Experienced Trauma.

American Academy of Pediatrics. (2014). The Medical Home Approach to Identifying and Responding to Exposure to Trauma.

American Academy of Pediatrics and PATTeR. (2021). Moving beyond ACE Scores: AAP Infographic.

American Hospital Association/ (2018). ICD-10-CM Coding for Human Trafficking.

Canadian Public Health Association. (2021). Trauma-Informed Physical Examinations and STBBI Testing: A guide for service providers.

Centers for Disease Control and Prevention. (2022). The Social-Ecological Model: A Framework for Prevention.

Chang, K. S. G., Tsang, S., & Chisolm-Straker, M. (2022). Child trafficking and exploitation: Historical roots, preventive policies, and the Pediatrician’s role. Current Problems in Pediatric and Adolescent Health Care, 52(3), [101167].

Fehrenbach, T., Ford J., Olafson E., Kisiel, C., Chang, R., Kerig, P., Khumalo, M., Walsh, C., Ocampo, A., Pickens, I., Miller, A., Rains, M., McCullough, A.D., Spady, L., & Pauter, S. (2022). A Trauma-Informed Guide for Working with Youth Involved in Multiple Systems.. Los Angeles, CA, and Durham, NC: The National Center for Child Traumatic Stress.

Greenbaum, J., & Bodrick, N; AAP Committee on Child Abuse and Neglect, AAP Section on International Child Health. (2017). Global Human Trafficking and Child Victimization. Pediatrics, 140(6):e20173138. (2017).

Greenbaum, J., Kaplan, D., Young, J., et al.; AAP Council on Child Abuse and Neglect, AAP Council on Immigrant Child and Family Health. (2023). Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients. Pediatrics, 151(1):e2022060416.

International Centre for Missing and Exploited Children. (2021). Documenting IDC Codes and Other Sensitive Information in Electronic Health Records: Guidelines For Healthcare Professionals Who Encounter Patients With A History Of Human Trafficking Or Other Forms Of Violence.

Texas Health and Human Services Commission. Medical Transportation Program MTP.

The National Child Trauma Stress Network. (2023). About Child Trauma: What Is a Traumatic Event?

Polaris. (2023). Part 2-The Narrative Arc: Understanding Human Trafficking.

Polaris. (2022). Polaris Analysis of 2021 Data from the National Human Trafficking Hotline.

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884.

Texas Children’s Commission. Definition of Human Trafficking.

Texas Health and Human Services Commission. Texas Medicaid and Children’s Health Insurance Program (CHIP).

Texas Health and Human Services Commission. (2023). Health Care Practitioner Human Trafficking Training.

Texas Health and Human Services Commission. (2023). Texas Human Trafficking Resource Center.

Texas Medicaid & Healthcare Partnership (TMHP). Online Provider Lookup.

Texas Children’s Commission. Texas Penal Code § 20A.01.

Texas Children’s Commission. Texas Penal Code § 20A.02(b).

Toney-Butler, T. J., Ladd, M., & Mittel, O. (2023). Human Trafficking. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

United Nations Human Rights Office of the High Commissioner. Protocol to Prevent, Suppress and Punish Trafficking in Persons Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime (Adopted November 15, 2000).

United Nations Office on Drugs and Crime. (2023). Trafficking: The Crime.

H.R. 767 115th Congress (2017-2018). Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2018.

U.S. Department of State. (2023). About Human Trafficking.

U.S. Department of State. (2021). The National Action Plan To Combat Human Trafficking.

U.S. Department of State. (2022). Understanding Human Trafficking.

The U.S. Department of Justice. Key Human Trafficking Legislation.

Westcoast Children’s Clinic. Commercial Sexual Exploitation – Identification Tool (CSE-IT).

World Population Review. (2022).Human Trafficking Statistics by State (Updated August 2022).

Youth.gov. Trafficking Prevention.

Medical Definitions

The medical definitions in this module were obtained or adapted from the Substance Abuse and Mental Health Services Administration.

Continuing Medical Education

This activity has been planned and implemented with the accreditation requirements and policies of the Texas Medical Association (TMA) through the joint providership of the Texas Department of State Health Services Continuing Education Service and Texas Council of Community Centers. The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Nursing Education.

Social Workers

The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Social Work Education.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.00 hour(s) for attendance.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

  1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
    • Create a Texas Health Steps account.
    • Complete on-line registration process.
    • Thoroughly read the content of the module.
    • Complete the on-line examination.
    • Complete the evaluation.
  2. Commercial Support.
    The THSTEPS Web-based Continuing Education Series has received no commercial support.
  3. Disclosure of Relevant Financial Relationships.
    The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
  4. Non-Endorsement Statement.
    Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
  5. Off-Label Use.
    Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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Resources for Providers

Children’s Advocacy Centers™of Texas

Canadian Public Health Association. (2021). Trauma-Informed Physical Examinations and STBBI Testing: A guide for service providers.

International Centre for Missing and Exploited Children. (2021). Documenting ICD Codes and Other Sensitive Information in Electronic Health Records: Guidelines For Healthcare Professionals Who Encounter Patients With A History Of Human Trafficking Or Other Forms Of Violence.

Murphy, Laura T. (2016). Labor and Sex Trafficking Among Homeless Youth: A Ten-City Study Full Report. Loyola University New Orleans and the Modern Slavery Research Project.

National Children’s Alliance.

National Human Trafficking hotline website. Contact the hotline 24 hours a day at 1-888-373-7888 or by texting 233733, “BeFree”.

Office of the Texas Governor. Child Sex Trafficking Team.

Office of the Texas Governor The Sexual Assault Survivors’ Task Force (SASTF). Resources for Sexual Assault Survivors.

Polaris Project, the nonprofit organization that operates the National Human Trafficking hotline.

US Department of Health and Human Services Office on Trafficking In Persons. SOAR to Health and Wellness Training.

Texas Health and Human Services Commission. Find Your Local Mental Health or Behavioral Health Authority.

Texas Health and Human Services Commission. (2020). Provider Guidebook: Services for Victims of Human Trafficking in Texas.

U.S. Department of Homeland Security Blue Campaign. (DHS, 2022). Myths and Misconceptions.

Screening Tools

Westcoast Children’s Clinic. Commercial Sexual Exploitation – Identification Tool (CSE-IT).

Pediatric ACEs and Related Life Events Screener (PEARLS): TEEN (Self-Report)

Schnurr, P., Vielhauer, M., Weathers, F., & Findler, M. National Center for Posttraumatic Stress Disorder (1999). Brief Trauma Questionnaire (BTQ) [Measurement instrument].

Children’s Healthcare of Atlanta. Short Screen for Child Sex Trafficking (CST) for the Healthcare Setting.

Vera Institute for Justice. Out of the Shadows: Trafficking Victim Identification Tool and Manual.