Evaluation of Services for the Commercial Sexual Exploitation of Children and Youth: A Scoping Review.

Commercial sexual exploitation (CSE) of youth is a public health issue with multiple negative consequences. Despite the complexities and comprehensiveness of service needs for youth experiencing CSE, the evidence base of effective services and programs lags far behind. This scoping review seeks to identify the most up-to-date evidence on programs for youth experiencing CSE that have been evaluated and found to be effective. We conducted a scoping review of current literature, including peer-reviewed articles as well as gray literature using a scientific approach to identify programs and service provisions specifically focused on youth experiencing CSE and examine empirical evidence for their effectiveness. A comprehensive search of five databases was completed in September 2020 then updated in April 2021 to identify relevant publications from January 1, 2000 to present. Additional program mining was conducted on evaluations of programs mentioned in the search results. A total of 3,597 citations from the database searches were screened for title and abstract and 190 citations were included for full-text review. The search process yielded 11 eligible articles with one additional report found through program mining. Identified programs targeted youth, providers, and consumers of CSE. While scientific rigor was not high, all included studies reported positive outcomes. Evidence base for effective services and programs is sparse. While more programs and services are being developed, studies should use rigorous research designs to test the effectiveness of these programs and services. Implications for practice and policy are discussed.

The long-term collateral consequences of juvenile justice involvement for females.

Introduction: Females are the fastest growing justice involved population in the United States, yet there is relatively little empirical research on the collateral consequences of juvenile justice involvement specifically for females. A growing body of empirical research underscores linkages between juvenile justice involvement and negative health and psychosocial outcomes, both in the short and long term. Method: The current study describes the long-term collateral consequences of juvenile justice involvement for females previously involved in the juvenile justice system, drawing from a longitudinal dataset of 166 women who were initially recruited in adolescence due to chronic and severe justice system involvement. Participants were 15 years-old on average at study enrollment and 35 years-old on average at the current assessment. This paper describes the adolescent and adult experiences of the sample, therefore depicting the developmental trajectories of risk and protective factors for females involved with juvenile justice. Results: As adults, 73% of the sample experienced arrest and 36% experienced incarceration. High rates of mental and physical health problems were reported, including that 50% of the sample met diagnostic criteria for posttraumatic stress disorder. Over 400 children were born to the sample, with high rates of documented intergenerational child welfare involvement. Discussion: Study findings are discussed in the context of best practices for supporting adolescent girls involved with the juvenile justice system.

Evaluating and Validating the Classification Accuracy of a Screening Instrument to Assess Risk for Commercial Sexual Exploitation of Child Welfare-Involved Children and Adolescents.

OBJECTIVES: Identifying children and adolescents within child welfare at risk for commercial sexual exploitation (CSE) can ensure referrals to appropriate services. However, screening measures to understand the prevalence of CSE are missing in child welfare. We evaluated the classification accuracy of a screener developed for the purpose of this study, guided by the Sexual Exploitation among Youth (SEY) risk assessment framework used in practice with child welfare-involved young people, (1) to identify young people at high versus low risk for experiencing CSE and (2) to estimate the prevalence of CSE risk for child welfare-involved children and adolescents. METHODS: We used extant data from the National Survey of Child and Adolescent Well-being study with a nationally representative sample of children and adolescents aged 11-17 years (n = 1054) investigated by child welfare from February 2008 to April 2009. The 26-item screener showed acceptable reliability (α = .73) and test-criterion validity evidence using a CSE proxy outcome (ie, narrowly defined as being paid for sexual relations). We used the receiver-operating curve to classify risk and calculate the optimal cutoff score. RESULTS: Higher scores on the SEY screener (range, 0-20 points) increased the odds of experiencing CSE by 34%. The screener was good at discriminating CSE risk at the 6-point cutoff, with 26.7% of child welfare-involved young people identified as being at high risk for CSE. CONCLUSIONS: Given the absence of accurate prevalence rates of CSE risk in the population, a theoretical cutoff index using an established method can provide an objective decision on how to distinguish risk levels. Prevalence estimates for CSE risk highlight the need for systematic screening in child welfare to identify and provide services for young people at risk.

Examining Housing Instability Among Females Who Are System-Involved: Comparing Females With and Without Histories of Commercial Sexual Exploitation.

Females involved in child welfare (CW) or juvenile justice (JJ) systems are at-risk for commercial sexual exploitation (CSE). This study used administrative data from CW and JJ agencies in Los Angeles County to examine out-of-home care experiences and identify the types of homes that were associated with housing instability for females who experienced CSE. Demographic and case characteristics of females with a history of CSE and a matched sample without a reported history of CSE were compared using χ2 analyses and t-tests. Females with a history of CSE experienced significantly more housing instability compared to their matched counterparts. Housing instability was associated with leaving care without permission (LCWOP), and females were most likely to move because of LCWOP from group homes. These findings highlight the extremely unstable living situations for females with histories of CSE. Recommendations align with new federal policy, which aims to reduce reliance on group homes.

"It Changed My Life": Traumatic Loss, Behavioral Health, and Turning Points Among Gang-Involved and Justice-Involved Youth.

An especially vulnerable population to traumatic loss, violence exposure, and posttraumatic stress symptoms are those involved in the juvenile justice system. However, justice-involved youth are not a homogeneous group. Research looking at subpopulations within juvenile justice systems highlight the diverse backgrounds and treatment needs of justice-involved youth such as those who are also gang-involved. The current study seeks to address the interrelated issues of behavioral health, traumatic grief, loss, and self-reported turning points among a sample of formerly incarcerated youth who report extensive juvenile justice histories (N = 62). All youth participated in an extensive survey interview. Just over half (56.5%) of the youth reported being gang-involved. Chi-square analyses revealed that gang- and justice-involved youth were significantly more likely to have experienced traumatic loss compared with their justice-only peers (χ2 = 4.265, p < .05). Gang involvement approximately doubled youth's exposure to community violence, both direct and witnessed, and there were significant differences in the levels of posttraumatic stress symptoms and substance use, between the gang- and justice-involved youth compared with the justice-only youth. When asked to describe a turning point in their lives, 15% of the sample described significant loss and how it affected their lives, for better or worse. Findings lend support for a focus on supporting posttraumatic growth and increasing access to trauma-focused treatment, with an emphasis on grief and loss, for those who are both gang- and justice-involved.

Dual System Youth and their Pathways: A Comparison of Incidence, Characteristics and System Experiences using Linked Administrative Data.

Insight into the characteristics and system experiences for youth who touch both the child welfare and juvenile justice systems has increased over the last decade. These youth are typically studied as one population and referred to as "crossover youth." While this literature contributes valuable insight into who crossover youth are, studies are virtually silent on distinguishing characteristics and experiences across different pathways leading to dual system contact. This study reviews what is currently known about dual system youth generally (i.e., youth who have contact with both the juvenile justice and child welfare systems) and introduces a framework for consistently defining dual system youth and their pathways. The utility of the framework is then explored using linked administrative data for cohorts of youth aged 10 to 18 years old with a first petition to delinquency court in three sites: Cook County, Illinois between 2010 and 2014 (N = 14,170); Cuyahoga County, Ohio between 2010 and 2014 (N = 11,441); and New York City between 2013 and 2014 (N = 1272). The findings show a high prevalence of dual system contact overall, ranging from 44.8 to 70.3%, as well as wide variation in the ways in which youth touched both systems. Specifically, non-concurrent system contact is more prevalent than concurrent system contact in all sites, and individual characteristics and system experiences vary within and across these different pathway groups. Based on study findings, implications for future research on dual system youth and for developing collaborative practices and policies across the systems are discussed.

Developmental timing of polyvictimization: Continuity, change, and association with adverse outcomes in adolescence.

Children who experience polyvictimization (i.e., exposure to multiple and varied traumatic stressors) are at heightened risk for psychopathology. While polyvictims generally have worse outcomes than those with fewer types of traumatic experiences, not all polyvictims experience significant, or similar, impairment suggesting that polyvictims are a heterogeneous group. This variation in outcomes among polyvictimized children, may be due to differences in how polyvictimization is operationalized and measured. The current study examines a clinically-referred sample of adolescents (N = 3754) aged 13-18 (M = 15.3, SD = 1.4) to examine whether polyvictimization in early developmental age periods predict polyvictimization in later periods and whether there are differences in severity of adolescent psychopathology based on variations in timing of polyvictimization in childhood and adolescence. Results from latent class analysis (LCA) reveal the greater the number of developmental periods in which adolescents were classified as polyvictims, the greater the severity of PTSD, externalizing problems, and internalizing problems. In addition, there was variation in the relation between developmental timing of polyvictimization and different types of adolescent psychopathology.

Developmental Patterns of Adverse Childhood Experiences and Current Symptoms and Impairment in Youth Referred For Trauma-Specific Services.

By the time children reach adolescence, most have experienced at least one type of severe adversity and many have been exposed to multiple types. However, whether patterns of adverse childhood experiences are consistent or change across developmental epochs in childhood is not known. Retrospective reports of adverse potentially traumatic childhood experiences in 3 distinct developmental epochs (early childhood, 0- to 5-years-old; middle childhood, 6- to 12-years-old; and adolescence, 13- to 18-years-old) were obtained from adolescents (N = 3485) referred to providers in the National Child Traumatic Stress Network (NCTSN) for trauma-focused assessment and treatment. Results from latent class analysis (LCA) revealed increasingly complex patterns of adverse/traumatic experiences in middle childhood and adolescence compared to early childhood. Depending upon the specific developmental epoch assessed, different patterns of adverse/traumatic experiences were associated with gender and with adolescent psychopathology (e.g., internalizing/externalizing behavior problems), and juvenile justice involvement. A multiply exposed subgroup that had severe problems in adolescence was evident in each of the 3 epochs, but their specific types of adverse/traumatic experiences differed depending upon the developmental epoch. Implications for research and clinical practice are identified.

Child maltreatment reporting patterns and predictors of substantiation: comparing adolescents and younger children.

Adolescents, and especially male adolescents, make up a disproportionately smaller portion of maltreatment reports compared to younger children. This study used the National Child Abuse and Neglect Data System to better understand the characteristics of adolescents reported to Child Protective Services (CPS), to examine whether these characteristics changed over time, and to determine whether certain child or CPS report characteristics predicted CPS involvement. Although adolescents were the focal group, younger children were also analyzed for comparison. Between 2005 and 2010, reports of neglect and the proportion of children of Hispanic and unknown racial/ethnic origins increased. Concurrently, the proportion of cases resulting in CPS involvement declined. Although race/ethnicity predicted CPS involvement, this pattern was not consistent across all age groups or races/ethnicities. The type of alleged maltreatment did not typically predict CPS involvement; however, allegations of sexual abuse among school-aged children and adolescents, particularly among girls, were more likely to result in CPS involvement. These findings can assist child welfare professionals in determining appropriate services tailored to families and developing prevention programs targeting adolescents.

Trauma histories among justice-involved youth: findings from the National Child Traumatic Stress Network.

BACKGROUND: Up to 90% of justice-involved youth report exposure to some type of traumatic event. On average, 70% of youth meet criteria for a mental health disorder with approximately 30% of youth meeting criteria for post-traumatic stress disorder (PTSD). Justice-involved youth are also at risk for substance use and academic problems, and child welfare involvement. Yet, less is known about the details of their trauma histories, and associations among trauma details, mental health problems, and associated risk factors. OBJECTIVE: This study describes detailed trauma histories, mental health problems, and associated risk factors (i.e., academic problems, substance/alcohol use, and concurrent child welfare involvement) among adolescents with recent involvement in the juvenile justice system. METHOD: The National Child Traumatic Stress Network Core Data Set (NCTSN-CDS) is used to address these aims, among which 658 adolescents report recent involvement in the juvenile justice system as indexed by being detained or under community supervision by the juvenile court. RESULTS: Age of onset of trauma exposure was within the first 5 years of life for 62% of youth and approximately one-third of youth report exposure to multiple or co-occurring trauma types each year into adolescence. Mental health problems are prevalent with 23.6% of youth meeting criteria for PTSD, 66.1% in the clinical range for externalizing problems, and 45.5% in the clinical range for internalizing problems. Early age of onset of trauma exposure was differentially associated with mental health problems and related risk factors among males and females. CONCLUSIONS: The results indicate that justice-involved youth report high rates of trauma exposure and that this trauma typically begins early in life, is often in multiple contexts, and persists over time. Findings provide support for establishing trauma-informed juvenile justice systems that can respond to the needs of traumatized youth.

Brief report: piloting the Positive Life Changes (PLC) program for at-risk adolescents.

The purpose of this study was to pilot the Positive Life Changes (PLC) program, a comprehensive cognitive-behavioral intervention for at-risk adolescents that aims to promote social competencies and to prevent aggression. The program was piloted in 4 intervention groups with a sample of 31 self-referred adolescents (M age 15.64) attending an alternative high school. Questionnaires at pretest and 6-week posttest included five social competencies that represent an expansion of social information-processing (SIP) skills, a measure of aggressive behavior, and a new measure of aggression propensity. Three-level hierarchical linear models showed increases in three social competencies and reductions in physical and verbal aggression propensity from pretest to posttest. Number of program sessions attended did not moderate pretest-posttest change. Findings are discussed in the context of program implementation and future research in school and community settings.