February 01, 2014

Federal Guidance to Address Child Trafficking: What Advocates Should Know

Jill Reyes

The views expressed herein have not been approved by the House of Delegates or the Board of Governors of the American Bar Association, and accordingly, should not be construed as representing the policy of the American Bar Association.

In July 2013 the Federal Bureau of Investigation (FBI) announced that Operation Cross Country1 resulted in the rescue of 105 child victims of sex trafficking, ranging from 13 to 17 years old, and the capture and arrest of 150 pimps across the nation.2 Although this was the largest sex-trafficking crackdown in U.S. history, many more victims remain unidentified. 

Among children reported missing in 2012 to the National Center for Missing and Exploited Children” (NCMEC) who are likely child sex trafficking victims, 67% were in foster care.3 Further, U.S. law enforcement agencies have witnessed a sharp rise in child sexual exploitation cases since the 1990s, according to The National Strategy for Child Exploitation Prevention and Interdiction 2010 report to Congress.4

On September 16, 2013, the Department of Health and Human Services, Administration on Children, Youth, and Families (ACYF) issued new guidance intended to support states, child welfare systems, and programs serving runaway and homeless youth. It aimed to increase awareness and improve how they respond to trafficking victims. The following summary highlights key aspects of this guidance for practitioners.

Summary of the ACYF Guidance 

The Trafficking Victims Protection Act 

The Trafficking Victims Protection Act of 2000 (TVPA) definition of “severe forms of trafficking in persons” includes sex trafficking, or “the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act.” 

Under the TVPA, severe forms of trafficking include:

Sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age.

Thus, a child who has not turned 18 and is involved in commercial sex is a victim.

Child victims are most vulnerable to trafficking

The guidance emphasizes that although the victims of trafficking range across cultural and age groups, children are most at risk to sex and labor trafficking. Children and youth with low self-esteem and poor social support are targeted most by traffickers. Unfortunately, these traits are common among children and youth in foster care or those experiencing homelessness who have suffered trauma, abuse, and neglect. Traffickers often recruit young people around youth homeless shelters, schools and group homes, and places they often visit, such as shopping malls, bus stops, or fast food restaurants.5

While most sex trafficking data and information address trafficking of girls, trafficking of boys deserves equal attention. Unfortunately, males often do not identify themselves as victims because of feelings of shame and stigma. Also, organizations serving trafficking victims tend to focus their limited capacity on girls.6 Evidence also suggests that lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth are up to five times more likely to be trafficked than heterosexual youth.7 Native American children with trauma-related risk factors are also targeted by traffickers.8

Cross-system coordination

Child trafficking victims often touch several systems: homeless youth service providers, child welfare, law enforcement, juvenile corrections, courts, schools, medical and mental health professionals, child advocacy centers, legal service providers, crime victim service providers, and community and faith-based organizations. A multisystem coordinated approach is needed to fight trafficking successfully. 

One successful coordinated approach is the FBI’s Innocence Lost National Initiative. This initiative brings together the FBI, Department of Justice Child Exploitation Section, and the National Center for Missing & Exploited Children to address child trafficking. Since its start in 2003, the Innocence Lost National Initiative has rescued 2,700 children from traffickers nationwide, and convicted 1,300 pimps, madams, and other players involved with trafficking and exploiting children.9

Another example of a coordinated approach is the Arizona League to End Regional Trafficking (ALERT). ALERT partners with various service providers, such as law enforcement, faith-based communities, nonprofit organizations, social service agencies, attorneys and concerned citizens.10 

The Cook County (IL) Human Trafficking Task Force is a multidisciplinary task force that is a joint project of the Cook County State’s Attorney’s Office and the Salvation Army STOP-IT Program. The task force collaborates with law enforcement, social services, and legal partners to combat trafficking, and they also have subcommittees such as training, victim services, labor trafficking, and LGBTQ. Among other guiding principles, the task force follows the principle that “All agencies share a commitment to the victim-centered approach, which respects the rights of persons under Illinois and federal law.”11

In addition, cross-system collaboration is crucial when collecting accurate data on the needs of child trafficking victims. Such data can improve targeted interventions. The guidance encourages systems to meet consistently to develop: approaches to data collection on trafficking victims, strategies to identify victims, prevention efforts, and more effective ways to serve victims.

Unique health and mental health needs 

Trafficked children have significant health and mental health needs that advocates and service providers must address. These include: 

  • physical health problems associated with beatings and rapes; 
  • reproductive health problems; 
  • post-traumatic stress disorder (PTSD); 
  • malnutrition; 
  • alcohol and drug use, trauma; 
  • extreme anxiety and fear; 
  • changed relationships with others, 
  • self-destructive behaviors (e.g., suicide attempts); 
  • changed feelings or beliefs about oneself; 
  • despair and hopelessness; and 
  • changed perception of the perpetrator (e.g., a traumatic bond).

Child welfare agencies and programs serving runaway and homeless youth must provide support for these victims, including “trauma-informed, culturally appropriate, and individualized care.”12 In fact, it is ACYF’s broader goal to decrease trafficking among children and youth by providing these agencies and programs with the tools and resources to recognize vulnerable youth and intervene early so they will not fall victim to traffickers.

Need for proper screenings and assessments 

The guidance recommends screenings and assessments on trauma, social-emotional well-being, and physical health at key periods. These assessments can help caseworkers and other systems track child victims’ progress towards recovery, and help service providers understand their needs and gain a more holistic view on their victimization experiences. 

ACYF calls for a comprehensive method that collects information on children’s strengths and potential difficulties, and social-emotional well-being outcomes.13 When functional assessment tools are applied to all children at key periods, then the system can better track how effective its practices have been with trafficking victims. Examples of functional assessment tools appropriate for children and youth include: the Behavioral and Emotional Rating Scale (BERS-2),14 the Child Behavior Checklist (CBCL),15 the Emotional Quotient-Inventory,16 the Social Skills Rating System (SSRS),17 and the Strengths and Difficulties Questionnaire (SDQ).18

The guidance also provides examples of reliable trauma screening tools that service providers can use: the Child and Adolescent Needs and Strengths (CANS) Trauma Version,19 the Child PTSD Symptom Scale,20 the Trauma Symptom Checklist (TSC),21 and the UCLA PTSD Index.22

In physical health screening, specific indicators and tools usually used in screening and assessment instruments can be incorporated by child welfare and service providers working with runaway and homeless youth. These indicators are:

  • evidence of physical, mental, or emotional abuse;
  • inability to speak on one’s own behalf;
  • inability to speak to an official alone;
  • excess amounts of cash on-hand;
  • working for long hours, often with little or no pay;
  • presence of older male or boyfriend who seems controlling;
  • loyalty and positive feelings towards trafficker;
  • fear, tension, shame, humiliation, nervousness;
  • inability or unwillingness to identify self as victim; and
  • oversexualized behavior23

Services for trafficking victims 

ACYF recommends the following elements be considered in existing programs or when developing new programs for trafficking victims:

Training—Train providers to identify trafficked youth, understand the social and cultural perceptions of these youth, learn the subculture of prostitution, and understand the effects of trauma and trauma bonding among youth.

Meaningful engagement—Teach case managers how to help youth navigate the services available to them, such as legal services, medical and mental health services, housing, etc. Meaningful engagement also involves culturally sensitive, gender-appropriate and trauma-informed services.

Education Outreach—Improve outreach services by training staff and volunteers to identify trafficking victims, and teaching youth to be empowered and resist recruiters.

Cross-System Coordination— Work with and across multiple systems to support outreach, including law enforcement and service providers.

Expand capacity to serve child victims

The guidance encourages child welfare agencies to expand their internal capacities to work with child trafficking victims. It also urges them to participate in systemwide outreach in other systems, such as those involved with runaway and homeless youth and juvenile justice.

The Center for the Human Rights for Children at Loyola University Chicago released policy directives that child welfare agencies can incorporate:

  • Train all child welfare professionals--guardians ad litem, law guardians, attorneys for children, mental health professionals, refugee service providers, etc.-- on the needs of trafficked children.

  • Use multidisciplinary case staffing and make referrals when youth have been trafficked.

  • Ensure legal counsel is available for domestic and foreign national children involved in the juvenile justice or criminal justice systems. 

  • Make sure placement options are available, such as kinship or family foster care, for citizen and noncitizen child victims.

Federal assistance for child trafficking victims

ACF details what services are now available for child trafficking victims: Temporary Assistance for Needy Families (TANF), Medicaid, State Children’s Health Insurance Programs (CHIP), Substance Abuse and Mental Health Service Administration programs (SAMHSA), Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and public housing programs.

For noncitizen child trafficking victims, they may acquire an Eligibility Letter or an Interim Assistance Letter from the HHS Office of Refugee Resettlement (ORR), and as a refugee may access TANF, SNAP, Medicaid, and CHIP.

Additional educational and other resources available to states include:

ACYF increased the focus on domestic trafficking and child welfare by providing direction for what state agencies can do to combat domestic trafficking of children. Child welfare agencies, service providers working with homeless youth, and other advocates should work strategically to combat child trafficking. This guidance is just one resource to support this crucial work.

Jill Reyes, Esq. is a recent graduate of Whittier Law School, Costa Mesa, CA. She is currently a law clerk for the ABA Center on Children and the Law.

Federal Action Plan for U.S. Trafficking Victims

Recognizing the scope of domestic sex trafficking, the Departments of Health and Human Services and Homeland Security have developed a joint action plan to provide services and supports to victims in the United States. The plan outlines four goals:1

Goal 1: Increase Coordination and Collaboration: Increase guidance, collaboration, and civic engagement at the national, state, tribal, and local levels.

Goal 2: Increase Awareness: Increase understanding of human trafficking among key government and community leaders and the public.

Goal 3: Expand Access to Services: Increase victim identification and expand the availability of services for victims throughout the United States.

Goal 4: Improve Outcomes: Promote effective, culturally appropriate, trauma-informed services that improve the short- and long-term health, safety and well-being outcomes of victims.

1. Coordination, Collaboration, Capacity: Federal Strategic Action Plan on Services for Victims of Human Trafficking in the United States. Washington, DC: Administration on Children, Youth and Families, 2013, 6. April 2013. 

Hot Topic in U.S. Congress

Seven federal bills and a congressional resolution addressing child sex trafficking await action by the U.S. Congress this year. 

Federal Bills

Several federal bills aimed at addressing child sex trafficking were introduced in the U.S. House or Senate in 2013 and are awaiting action. They include:

Congressional Resolution


1. Operation Cross Country was a nationwide enforcement action in July 29, 2013 by the Federal Bureau of Investigation that included the FBI’s partnership with local, state, and federal law enforcement agencies and the National Center for Missing & Exploited Children. The efforts of Operation Cross Country spanned a total of only three days, occurring in 76 cities nationwide, and resulted in 105 rescues of child sex trafficked victims and 150 arrests. Operation Cross Country is part of the FBI’s Innocence Lost National Initiative, established in 2003. It is the seventh and largest enforcement action to date.

2. Operation Cross Country: Recovering Victims of Child Sex Trafficking. Washington, DC: Federal Bureau Investigation Stories, 2013. July 29, 2013. 

3. Testimony of John D. Ryan, CEO of the National Center for Missing & Exploited Children, for the United States House of Representatives Committee on Ways and Means Subcommittee on Human Resources. Washington, DC, 2013. October 23, 2013.  

4. The National Strategy for Child Exploitation Prevention and Interdiction: A Report to Congress. Washington, DC: Children and U.S. Department of Justice, 2010. August 2010.

5. Ibid, 4.

6. Ibid, 4, citing to ECPAT-USA. And Boys Too.  

7. Guidance to States and Service on Addressing Human Trafficking of Children and Youth in the United States. Washington, DC: U.S. Department of Health and Human Services Administration for Children, Youth and Families, 2013, citing Minnesota Indian Women’s Resource Center, Minnesota: Shattered Hearts: The Commercial Sexual Exploitation of American Indian Women and Girls in Minnesota, 2009, 5.

8. Ibid, 5, citing Clawson, H.J. et al. Human Trafficking Into and Within the United States: A Review of the Literature. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services, 2009.

9. Innocence Lost. Washington, DC: Federal Bureau Investigation Violent Crimes Against Children Unit, 2013. October 2013.

10. Arizona League to End Regional Trafficking

11. The Cook County Task Force.

12. Coordination, Collaboration, Capacity: Federal Strategic Action Plan on Services for Victims of Human Trafficking in the United States. Washington, DC: Administration on Children, Youth and Families, 2013, 6. April 2013. 

13. Ibid, 9.

14. See California's example of a Behavioral and Emotional Rating Scale.

15. An example of a Child Behavior Checklist  can be found at www.state.sc.us/dmh/schoolbased/2010_school_based_outcomes.pdf.

16. See an example of the Emotional Quotient-Inventory

17. See an example of a  Social Skills Rating System.

18. Learn more about the Strengths and Difficulties Questionnaire

19. See an example of the Child and Adolescent Needs and Strengths (CANS) Trauma Version.

20. See an example of a Child PTSD Symptom Scale.

21. See an example of a Trauma Symptom Checklist

22. See an example of the UCLA PTSD Index

23. Coordination, Collaboration, Capacity, 2013, 6, citing from Center for the Human Rights for Children, Loyola University Chicago & International Organization for Adolescents. Building Child Welfare Response to Child Trafficking, 2011.