Quick Reference ChildChild SexualSexual ExploitationExploitation For Healthcare, Social Services, and Law Enforcement Professionals G.W. Medical Publishing, Inc. St. Louis www.gwmedical.com i CONTENTS IN BRIEF CHAPTER 1: OVERVIEW. 1 CHAPTER 2: VICTIMS AND OFFENDERS . 17 CHAPTER 3: CHILD PORNOGRAPHY . 45 CHAPTER 4: PROSTITUTION OF CHILDREN . 57 CHAPTER 5: CYBER-ENTICEMENT AND INTERNET TRAVELERS . 69 CHAPTER 6: SEX TOURISM AND HUMAN TRAFFICKING . 85 CHAPTER 7: MEDICAL ISSUES . 109 CHAPTER 8: PRINCIPLES OF INVESTIGATION . 159 CHAPTER 9: INVESTIGATING CHILD PORNOGRAPHY . 173 CHAPTER 10: INVESTIGATING THE PROSTITUTION OF CHILDREN . 195 CHAPTER 11: INVESTIGATING CYBER-ENTICEMENT . 199 CHAPTER 12: LEGAL ISSUES SPECIFIC TO PORNOGRAPHY CASES . 227 CHAPTER 13: LEGAL CONSIDERATIONS IN PROSTITUTION CASES . 237 CHAPTER 14: LEGAL APPROACHES TO INTERNET CASES . 247 CHAPTER 15: SUPPORT SERVICES FOR PROSTITUTED CHILDREN . 271 CHAPTER 16: AMBER ALERT. 291 CHAPTER 17: FAITH-BASED AND RURAL COMMUNITIES. 297 CHAPTER 18: RECOMMENDED ACTIONS . 305 INDEX . 319 iii Quick Reference ChildChild SexualSexual ExploitationExploitation For Healthcare, Social Services, and Law Enforcement Professionals Sharon W. Cooper, MD, FAAP Angelo P. Giardino, MD, PhD, MPH, FAAP Adjunct Associate Professor of Pediatrics Medical Director University of North Carolina School Texas Children’s Health Plan of Medicine Associate Clinical Professor of Pediatrics Chapel Hill, North Carolina Baylor College of Medicine Clinical Assistant Professor of Pediatrics Attending Physician Uniformed Services University of Children’s Assessment Center Health Sciences Texas Children’s Hospital Bethesda, Maryland Houston, Texas Chief, Developmental & Forensic Pediatric Nancy D. Kellogg, MD Service, Womack Army Medical Center Professor of Pediatrics Fort Bragg, North Carolina University of Texas Health Science Center at Instructor, National Center for Missing & San Antonio Exploited Children Medical Director Alexandria, Virginia Childsafe Richard J. Estes, DSW, ACSW Medical Director Professor Christus Santa Rosa Center for Miracles Chair, Concentration in Social and Victor I. Vieth, JD Economic Development Director Director, International Programs NDAA’s Child Abuse Programs University of Pennsylvania School of National Child Protection Training Center Social Work Winona State University Philadelphia, Pennsylvania Winona, Minnesota G.W. Medical Publishing, Inc. St. Louis www.gwmedical.com v FOREWORD In my career as a prosecutor, and now as a congressman, I have seen tremendous improvements in our nation’s response to cases of child maltreatment. In most communities today, multidisciplinary teams work together for the best interests of children. Many elected district attorneys, sheriffs, and police chiefs have developed specialized units to respond to cases of child abuse. Perhaps the most important development is the Children’s Advocacy Center program. Children’s Advocacy Centers (CACs) are child- friendly facilities where children can be interviewed sensitively and receive medical and psychological services. As a district attorney, I had the privilege of starting the nation’s first CAC. As a member of Congress, I championed support for my National Children’s Advocacy Center in Huntsville, Alabama, and also for the National Children’s Alliance, a coalition of CACs from across the nation that is head- quartered in Washington, DC. Today there are hundreds of CACs in every part of our country. Through the work of many organizations and training centers, thousands of frontline professionals are trained annually in the art and science of handling child protection cases. In the specific area of child sexual exploitation, this quick reference will provide them a wealth of information that can be accessed from any location. We cannot, however, rest on our laurels. Commercial exploitation of children is a global problem that impacts every community in the United States, and there is some evidence to suggest that these children are just as likely to come from rural and suburban communities as urban centers. Additionally, modern technology poses a new threat to our children. It is increasingly easy for perpetrators to exploit children through the Internet, to create and disseminate child pornography, and to solicit children for illicit purposes. I want to commend the frontline investigators, prosecutors, medical and mental health professionals, and other child advocates who are in xi Foreword the trenches daily trying to spare children from every form of exploita- tion. It is for them that this book is written. You labor long hours for little pay or honor on behalf of someone else’s children. Please know that your selfless dedication is not unnoticed. Indeed, your heroism is an inspiration to us all. Congressman Robert E. “Bud” Cramer, Jr. Member of the US House of Representatives (1999-present) Founder of the Children’s Advocacy Center movement xii FOREWORD It is common to hear pronouncements from public figures that children are society’s most important and treasured assets. To an overwhelming majority, this concept is fundamentally true. To a marginal and deviant minority, however, children are viewed as a commodity to be traded, imported, and exported like any other piece of merchandise. Parents and professionals need help combating the alarming growth of child exploitation, and this book is a valuable tool in the fight to protect our children from predators who would use them for financial gain or prurient reasons. The information in Child Sexual Exploitation Quick Reference was contributed by individuals who represent a wide array of backgrounds, disciplines, and perspectives. Some speak from distant lands that are growing ever closer with the ease of air travel and where youths are being sold to travelers seeking to indulge their perverse needs with someone else’s children. Some voices are actually electronic particles from cyberspace delivering images of unspeakable abuse to our home and office computers. The 2-volume set from which this quick reference is derived is the most comprehensive text on this subject that I have seen, and it represents the efforts of an impressive collection of premier investi- gators, judicial participants, child protection agency personnel, and clinicians. This quick reference maintains the same quality of research and is invaluable for frontline professionals who deal with the victims and perpetrators of child sexual exploitation. Robert M. Reece, MD Clinical Professor of Pediatrics Tufts University School of Medicine Visiting Professor of Pediatrics Dartmouth Medical School Editor, The Quarterly Update xiii PREFACE When the concept of mass communication began with Gutenberg’s printing press in the 14th century, its purpose was to disperse informa- tion and promote new ideas. Seven centuries later, the Internet has expanded upon the original purpose of the printing press and now threatens the deception and entrapment of our most vulnerable resource: children. As methods of victimization have become more innovative, sophisticated, and elusive, professionals are challenged in their efforts to prevent, detect, intervene, and treat children that fall victim to online predators. Knowledge of Internet crimes against children has been primarily limited to media coverage of the topic. This text serves to separate fact from fiction and to dispel several myths and misconceptions, including the belief that prostituted youths typically market themselves by choice and can easily escape from this form of abuse. To the uninformed, it is inconceivable that children and youths are often sold from within their own homes, that the Internet is used in numerous capacities to make such arrangements, and that Internet cafés present a nearly untraceable means of making the deal. Online solicitation has become an increasing threat to children. Many naïve children and youths unwittingly receive unwanted sexual solicitations and may be enticed to leave their homes and families to meet online predators; such encounters may end tragically in sexual or physical assault, abduction, or murder. Images of abuse can now be taken and disseminated with Web cameras, mobile/cellular phones, and video iPods. What was slavery and bondage in the past has now become human trafficking for forced labor and sexual exploitation. These crimes continue to escalate worldwide. Investigations of high profile cases of sexual exploitation have resulted in an organized response to sex tourists, child pornographers, and pimps of prostituted children. Guidelines on how to identify and respond to sexual exploitation situations are listed clearly in this quick reference for law enforcement, medical, and social science professionals who work with victims and offenders directly. xv Preface From a child maltreatment perspective, this groundbreaking work provides comprehensive and diverse information on this contem- porary, yet daunting and misunderstood, form of child abuse. As the Internet, the “printing press” of the 21st century, has opened new doors for the worldwide exchange of information and ideas, so too has it opened a Pandora’s box of opportunities for criminals who victimize children and youths. At present, the knowledge of Internet crimes against children is fragmented, scant, and discipline specific. This text is a step toward comprehension, effective intervention, and the multidisciplinary coordination of frontline investigations of crimes involving exploited children. It will open your eyes and your mind