Pennsylvania Physician 23-Hour Ebook Continuing Education

Child Abuse Identification and Reporting: The Pennsylvania Requirement _____________________________

Victim Identification/Warning Signs (Human Trafficking [Act 115 of 2016])

Indicators of serious mental injury include: • Expressing feelings of inadequacy • Fearful of trying new things • Overly compliant • Poor peer relationships • Excessive dependence on adults • Habit disorders (e.g., sucking, rocking) • Eating disorders • Frequent psychosomatic complaints (e.g., nausea, stom- achache, headache) • Bed-wetting • Self-harm • Speech disorders Severe Forms of Trafficking in Persons Severe forms of trafficking in persons: • 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; or – Sex trafficking: the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a com- mercial sex act  Commercial sex act: Any sex act on account of which anything of value is given to or received by any person • The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion, for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. Examples include: – Peonage: Paying off debt through work – Debt bondage: Debt slavery, bonded labor, or services for a debt or other obligation – Slavery: A condition compared to that of a slave in respect of exhausting labor or restricted freedom Labor trafficking is labor obtained by use of threat of serious harm, physical restraint, or abuse of legal process. Examples include: • Being forced to work for little or no pay (frequently in factories and farms) • Domestic servitude, defined as providing services within a household for 10 to 16 hours per day, such as, but not limited to, childcare, cooking, cleaning, yard work, and gardening

Warning signs specifically associated with victims of child traf- ficking and/or exploitation include (but are not limited to): • A youth that has been verified to be younger than 18 years of age and is in any way involved in the com- mercial sex industry or has a record of prior arrest for prostitution or related charges • An explicitly sexual online profile • Excessive frequenting of Internet chat rooms or classi- fied sites • Depicting elements of sexual exploitation in drawing, poetry, or other modes of creative expression • Frequent or multiple sexually transmitted infections or pregnancies • Is found in a hotel, street track, truck stop, or strip club • Lies about or has no identification or knowledge of personal data, such as but not limited to: age, name, and/or date of birth • Wearing clothing that is dirty, sexually inappropriate, inappropriate for the weather, or too large or too small (often dresses or skirts that are provocative in nature) • Wearing new clothes of any style, getting hair and/or nails done with no financial means • Having multiple cell phones or very expensive items that they have no way of purchasing on their own • Having unaddressed medical issues or goes to the ER or clinic alone or with an unrelated adult

• Being secretive about whereabouts • Having late nights or unusual hours

• Having a tattoo that s/he is reluctant to explain • Being in a controlling or dominating relationship • Lack of insurance or control of own finances • Exhibiting hypervigilance or paranoid behaviors • Expressing interest in or being in relationships with adults or much older men or women • Avoiding answering questions and letting someone else speak for them • Having significant change in behavior, including increased social media and new associates or friends at school • Having unexplained injuries and/or unbelievable or inconsistent explanations of injuries • Having multiple bruises or cuts in various stages of healing • Using specific terms, such as “trick,” “the life,” or “the game”

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MDPA2326

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