Table 2. Screening Questions for Child Trafficking2

Child Labor Trafficking
• Where do you work?
• Is the job what you expected?
• Does anyone at work scare/hurt you or threaten to hurt you/your family?
• Can you leave the place you work?
• Has anyone ever threatened you or your family if you were to leave your job?
• Do you owe your boss money?
• Have you ever worked without getting paid when you thought you would?
• How many hours a week do you work?
• Where do you live/who you live with?
• Do you go to school?
Child Sex Trafficking
• Have you ever been asked or had to have sex in exchange for something you wanted or needed or as a part of your job duties?
• Has anyone ever wanted you to have sex with someone else?
• Has anyone ever forced you to do something you did not want to do?
• Has anyone taken sexual pictures/videos of you and posted them on the internet?

Health care providers also can be susceptible to traffickers’ deception, Dr Peck said. Traffickers can look like a caring parent, soccer coach, or employer. They also typically know which health systems are less engaged and quipped to fight trafficking, she said.

Media portrayal of trafficking victims as young White girls who are bound and bruised does not match reality, Dr Peck noted. Victims are often groomed or deceived into a certain exploitation rather than being kidnapped. Trafficked pediatric patients often present as typical adolescents who won’t get off of their phone, have substance abuse problems, and are accompanied by a family member, or have injuries from a workplace, she said. 

The goals of health care interactions for potential trafficking victims are to provide care, assess risk, educate, and offer resources, Dr Hornor said. The physical examination should include documentation of any physical trauma (written or photographs), oral examination, sexual abuse/assault assessment, and mental health assessment. When assessing the child’s safety, involve other multidisciplinary team members, report the case to child protective services and law enforcement, consult with a local child advocacy center or children’s hospital child abuse program, and contact the National Human Trafficking Hotline.


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Children and adolescents who are trafficked or are at risk for trafficking should receive evidence-based, culturally-responsive, trauma-informed care from trained health care providers, Dr. Peck said.

Dr Peck emphasized the importance of evidence-based training for all health care providers on this topic, particularly to overcome implicit bias in health care on gender and race that bleeds over into human trafficking. NAPNAP offers free continuing education programs on assessing risk and responding to trafficking for health care providers and provides links to resources on trafficking. Other suggested resources include the US Department of Health and Human Services Office on Trafficking in Persons’ Core Competencies for Human Trafficking Response in Health Care and Behavioral Health Systems.

Visit Clinical Advisor’s meetings section for complete coverage of NAPNAP 2021.

References

1. Peck JL. Human trafficking: raising awareness to identify victims in the clinical setting. Presented virtually at: NAPNAP 2021; March 24-27, 2021.

2. Hornor G. Child labor trafficking: essentials for the pediatric nurse practitioner. Presented virtually at: NAPNAP 2021; March 24-27, 2021.