SciELO - Scientific Electronic Library Online

vol.43 número2Cincuenta años de investigación española en psicología clínica a través de la Web of Science (1971-2020).Dinámicas de Resistencia-Rechazo Filio-Parental. Historia conceptual y propuesta de denominación en Español índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados




Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google


Papeles del Psicólogo

versão On-line ISSN 1886-1415versão impressa ISSN 0214-7823

Pap. Psicol. vol.43 no.2 Madrid Mai./Ago. 2022  Epub 10-Jul-2023 


Detection of child sexual exploitation through the evaluation of risk indicators in Spain

Beatriz Benavente*  , Lluis Ballester**  , Jordi Pich***  , Noemí Pereda**** 

* Universitat de les Illes Balears. Correspondencia:

** Universitat de les Illes Balears

*** Universitat de les Illes Balears

**** Universidad de Barcelona


Child sexual exploitation in Spain is a problem that requires the early detection of victims. There are few tools that enable this detection, and none are available in Spanish. This study presents a tool for assessing the risk of suffering sexual exploitation in minors from 11 years of age, by selecting the indicators that best predict it. Based on a systematic review of publications in Europe, a battery of indicators was prepared, then studied and filtered via consultation with experts using a Delphi panel to create the first instrument, which was then evaluated in a second phase consultation with professionals considered as peers. The final construct was completed by four experts from Spanish universities. The tool for detecting the risk of sexual exploitation in childhood and adolescence, EDR-ESIA, has proven to be a good detection and screening instrument, for application in educational services, primary health care, and social services.

Keywords: Sexual exploitation; Childhood; Detection; Evaluation; Risk factors


La explotación sexual infantil y adolescente en España es un problema que requiere de una detección temprana de sus víctimas. Son escasas las herramientas que permitan llevar a cabo esta detección y no se dispone de ninguna en lengua española. En este estudio se presenta una herramienta para la valoración del riesgo de sufrir explotación sexual en menores desde los 11 años mediante la selección de aquellos indicadores que mejor la predicen. A partir de una revisión sistemática de publicaciones en Europa, se preparó una batería de indicadores, los cuales fueron estudiados y filtrados en una consulta a expertos mediante panel Delphi para generar el primer instrumento que fue sometido a valoración en una segunda fase de consulta con profesionales considerados como pares. El diseño final se acabó de perfilar por cuatro expertos de universidades españolas. La herramienta de detección del riesgo de explotación sexual en la infancia y adolescencia EDR-ESIA ha demostrado ser un buen instrumento de detección y cribado, para su aplicación en servicios educativos, de atención primaria de salud y servicios sociales de nuestro país.

Palabras clave: Explotación sexual; Infancia; Detección; Evaluación; Factores de riesgo


The sexual exploitation of children and adolescents (SECA) is a fundamental violation of children's rights and a serious form of sexual victimization where sexual abuse and assault coexist with the economic exploitation of children (Estes & Weiner, 2002). It is a type of childhood sexual victimization in which a person or group takes advantage of a situation of power imbalance to coerce, manipulate, or deceive a child or adolescent in exchange for something the victim may want or need, or in exchange for increased status or position in the social group (Beckett et al., 2017). A key element in the definition of SECA refers to the child being used not only as a sexual object but also as a commercial object (Miller-Perrin & Wurtele, 2017), which involves differences with respect to other forms of sexual victimization that must be taken into account in the intervention and treatment needs of the victims (Cole et al., 2016).

Although SECA has been considered a practice linked to developing countries, either for the exploitation of minors within these countries or for their transport to developed countries to be sexually exploited there, it is now recognized as a problem in Europe as well (Benavente et al., 2021b). Thus, recent studies have begun to analyze the phenomenon in Spain (see Pereda et al., 2021), which is both a country with minors who are sexually exploited within the region, and a transit and/or export country, according to reports by the Observatorio de la Infancia [Childhood Observatory] (2017) and other official sources of the Spanish state (Law 26/2015).

Due to the paucity of studies on SECA, victim identification remains difficult for professionals and society at large (Felner & DuBois, 2017; Marcus et al., 2012). This difficulty is due in part to the hidden and clandestine nature in which sexual exploitation is often carried out, but also to the lack of a standardized and validated screening tool for use in settings where vulnerable children and adolescents are attended to, which severely hampers the capacity for early detection of victims in order to provide targeted care (Greenbaum & Crawford-Jakubiak, 2015).

While the few studies that exist indicate that there are more girls than boys who are victims of SECA in Europe and that the average age is between 13 and 15 years, no young person is immune to sexual exploitation (Averdijk et al., 2020). SECA occurs in all ethnic groups and at all socio-cultural levels (Berelowitz et al., 2012), although the condition of unaccompanied migrant minor is an added risk to be assessed (Digidiki & Bhabha, 2018). In turn, it has been found that having previous experiences of sexual victimization in childhood represents a high risk of exploitation (De Vries & Goggin, 2020), as does having early and risky sexual relationships (Lalor & McElvaney, 2010). Having had contact with the protection and/or juvenile justice system is another risk factor to consider, linked to previous experiences of victimization and lack of protection in the family of origin (Panlilio et al., 2019). The consumption of alcohol and drugs is also a very relevant risk factor that additionally encourages the victim to remain in the situation of exploitation (Franchino-Olsen, 2021). Running away and being in a situation of homelessness is an established risk factor (Klatt et al., 2014). The exploiters are not just people that are unknown to the child but may also be members of the child's own family, professionals in the child's environment, or other caregivers (Beckett, 2011; Brayley et al., 2014). The need for bonding and belonging leads many adolescents to be more influenced by their peers, “loverboys,” or even their own family members and to become involved in exploitative situations (Reed et al., 2019).

In recent years, a number of screening tools have been developed to assist professionals in identifying children who are victims or at risk of SECA. Most have been developed in the United Kingdom and the USA and are based on a list of risk indicators or vulnerability factors related to SECA. The use of this type of tool facilitates decision making for professionals, establishing the level of intervention depending on whether the indicators suggest that the child is at risk of being sexually exploited or may actually be being sexually exploited (Brown et al., 2016).

SECA constitutes a serious health problem for victims as they are exposed to an increased risk of injury, sexually transmitted infections, substance abuse, untreated chronic medical conditions, eating problems and malnutrition, post-traumatic stress disorder, depression, anxiety, and other mental health problems that can even lead to suicide or suicide attempts (Greenbaum & Crawford-Jakubiak, 2015; Lanctôt et al., 2020). However, these young people have great difficulty in recognizing the abusive situations in which they find themselves, which makes the need even greater for the protection that must be provided to them by the professionals with whom they have contact (Stativa, 2000). Studies indicate that most victims have been treated in health services at one time or another during their childhood, in addition to being in school, while they are being exploited (Greenbaum et al., 2018). It is, therefore, crucial that health and education staff, as well as social service personnel, acquire a thorough understanding of the problem and are able to identify, intervene, and prevent SECA (Franklin & Smeaton, 2017).

Development of the EDR-ESIA

Knowing the risk factors of SECA is essential for the early detection of cases and the development of prevention strategies (Franklin et al., 2018). Thus, in response to the cases of exploitation that were made public in 2020 in Mallorca, which have led to the implementation of improvements in the detection of these cases and in the intervention with their victims, a tool was designed to detect the risk of sexual exploitation in children and adolescents. This tool has been named Eina de Detecció del Risc d'Explotació Sexual en la Infància i la Adolescència (EDR-ESIA).

It is an exploratory and brief instrument, as it is designed to be applied in services that have regular contact with minors, such as the health, education, and social services systems, where time is limited. Obviously, a more powerful test would have to be applied in a specialized screening context and would probably include many more items, but this would make it difficult to use among professionals who must perform early detection. This is not a diagnostic test for SECA, but an instrument capable of detecting possible SECA risk situations quickly and simply in standardized social, educational, and health services. Its role is to warn of cases in which high scores are obtained, initiating the process of examination and analysis to confirm whether a situation of exploitation is occurring.

To initiate the tool design process, a systematic review was conducted, complemented by a survey of the available instruments (Benavente et al., 2021b). The initial validation method involved three phases of consultation: (1) a Delphi panel of experts, (2) a peer review, and (3) a final review by experts, as shown in Table 1.

Table 1. Validation phases of the SECA risk detection instrument. 

International systematic review We selected the studies that included specific instruments for the detection and/or assessment of SECA, discarding those that focused on child trafficking for other purposes. The tools consulted are currently in use in other countries and some of them have been empirically validated (Armstrong, 2017). The items that appeared most frequently in these tools were grouped by categories: identification of the minor, family structure, school level, substance use, problems with the law, physical appearance, health, interpersonal relationships, belongings, information provided (Benavente et al., 2021b).
International Delphi consultation to test the first proposal A Delphi expert panel consultation was carried out in which 22 national and international experts participated in the two complete rounds. Agreements were reached on the relevance of certain indicators, conducts, and behaviors in predicting the risk of being a victim—either currently or in the future—of SECA. This panel included not only the opinion of academic experts, but also that of professionals working in institutions dedicated to direct care and intervention with young victims of SECA (Benavente et al., 2021a). As a result, a draft of the tool was created with the items resulting from the Delphi consultation, plus those found in the literature review of the screening tools that currently exist (Armstrong, 2017; Polaris Project, 2019).
Consultation of national professional experts involved in social intervention processes with minors Thirty-six qualified informants met in working groups after receiving a draft of the tool. The professionals made the pertinent indications for the adaptation of the instrument to the current reality of the children and adolescents who are attended to in their services and, therefore, proposals for improvement of the instrument.
Consultation of national research experts Four expert researchers from different Spanish universities (University of Barcelona, University of the Balearic Islands, University of Oviedo, and University of the Basque Country) participated in this last phase and reviewed the tool, thus defining its fourth and final version.

Description of the EDR-ESIA

The final version of the EDR-ESIA tool consists of 88 items to be completed by the professional, collected from the reports, medical history, and/or records of the child, divided into four sections: (1) Identification of the child and the family (22 items), (2) SECA target indicators (13 items), (3) Risk indicators subdivided into (a) Significant risk indicators, (b) Medium risk indicators, (c) Other risk indicators with 12 items in each subcategory (up to 49 items in total indicators), and (4) Vulnerabilities of the child (17 items).

For use during the empirical validation phase, and to facilitate the professional's decision-making criteria, it has been considered to score only the 'SECA target indicators' included in Table 2.

Table 2. Selected SECA Target Indicators 

1. Obtaining goods in exchange for sex.
2. Recruiter of other minors for sexual exploitation.
3. Unjustified possession of money, jewelry, cell phones, or other valuables.
4. Under 13 years of age and sexually active.
5. Risky sexual relations.
6. Involvement in online sexual activity.
7. Repeated sexually transmitted infections.
8. Acquaintances and/or friends linked to sexual exploitation.
9. Relationship with people and places close to prostitution.
10. Relationships with friends and/or partners that are older than the minor (age difference of more than 5 years).
11. Online relationships and/or encounters with strangers.
12. Alcohol and/or other drug abuse/dependence.
13. Repeated physical injuries of unknown origin.

To facilitate their completion, each of the risk indicator items are defined in the tool itself, and it is indicated how to score them according to the degree to which they are displayed. The score for each of these items is indicated as mild: 1; moderate: 2; severe: 3, with the final result being considered as the following score >9 points: established risk; 6-9 points: probable risk; 1-5 points: at professional discretion.

Sensitivity and specificity values were calculated by generating 507 different cases, using a simulation procedure of situations of sexual exploitation and borderline situations, with combinations of different situations. They were subjected to identification with the 13 target indicators. Only in cases where more than 9 points were obtained was the identification of SECA considered positive, corresponding to the highest levels of "established risk on the scale". These situations were also assessed with a gold standard constructed from the parallel identification as a case of SECA on three international reference scales, such that it was only considered that a true case of SECA had been identified when the identification was coincident among the three scales. These scales are Basson's (2017) Commercial Sexual Exploitation-Identification Tool (CSE-IT), Clutton and Coles' (2007) Sexual Exploitation Risk Assessment Framework (SERAF), and the Kent and Medway Safeguarding Children Board (2017) guidance.

Applying the criteria for interpreting diagnostic tests to the SECA situation, sensitivity has been defined as the probability of correctly classifying a person in a SECA situation, configuring the capacity of the scale to detect SECA (Pérez et al., 2021). In the estimation performed, the probability is high, at 94.87%, taking as a reference the situation with more than 9 points, according to the threshold established above.

Specificity has been defined as the probability of correctly classifying a person who is not experiencing SECA (Trevethan, 2017). That is, the probability for a person who is not in an SECA situation to obtain a negative result (equal to or lower than 9 points), leaving out situations that may determine the level of risk based on other investigations or expert professional judgment. In the estimate made, the probability is high, at 82.91%, although it is lower than that of sensitivity.

Predictive values have also been calculated as measures of discriminant capacity. The positive predictive value consists of the probability of being in an actual SECA situation if a positive result is obtained on the scale. The result is 86.62%. The negative predictive value is the probability that a person with a negative result on the scale (less than or equal to 9 points) is really in a no risk situation. In this case the probability is 93.27%.


SECA is a problem that we have recently started to confront in Spain, similar to what has happened in the other European countries (Benavente et al., 2021), for which professionals need tools and resources. There is a broad consensus on the need for early diagnosis of SECA for the effective protection of victims (Felner & DuBois, 2017). Therefore, it is urgent to develop tools that increase the capacity for professional detection and for this to be done early, given the difficulties of handling and managing cases of SECA by professionals responsible for the care of minors in our country.

Although there are some instruments similar to the one presented in this article at the international level (Basson, 2017; Clutton & Coles, 2007; Kent and Medway Safeguarding Children Board, 2017), these initiatives are scarce, they come from English-speaking countries, and there is no similar resource in the Spanish language to which professionals in our country can have access. Thus, the results of this first validation study of the EDR-ESIA tool, carried out in several phases and compared with the three most recognized international instruments in this field, show that Spanish professionals can have an instrument capable of predicting with a high degree of accuracy high-risk situations of SECA in children aged 11 years or older.

The EDR-ESIA is intended for application in primary care services in education, health, and social services. The use of a common tool is an important advance in this field that will provide professionals involved in the care of minors with a shared and accessible work instrument, with which the aim is to reduce the subjectivity component as much as possible. This common tool is intended to focus on situations that are not of great importance when presented in isolation, but that, when they occur together, constitute risks to which anyone in contact with children and adolescents must be vigilant.

The characteristics of the indicators considered allow us to conclude that there is no differential functioning in relation to different individuals in the same situation, since the descriptive language allows little room for distorted evaluations. Technically, these are observations by professionals of situations that can be described (Anguera et al., 2018). The statements of the individuals analyzed are secondary, with respect to these observations, so the margin for distortion is almost negligible, i.e., if the situation can be documented, the indicator always works in the same way in different subjects. This facilitates and favors early detection and, therefore, more effective prevention work. However, it should be borne in mind that although obtaining a high score on the key indicators of the instrument indicates that the child is at probable risk of SECA, there is no certainty that this is the case. Conversely, low scores on the instrument's key indicators do not mean that the child is not at risk. In this sense, a low score may be due to a lack of collaboration or attention on the part of the professional who completes it, and therefore the scores do not necessarily reflect the real risk in all cases. The creation of a new instrument also involves training professionals in the particularities of SECA in Spain, making them aware of the importance of early detection of these situations and of its potential consequences for the young person, and also creating supervision mechanisms. SECA is a multicausal and complex problem that does not respond to simple solutions (Pereda et al., 2021).

SECA is a problem on which much remains to be done in our country. Future studies in this area should include the perspective of the victims and the risk factors and motivations they allude to when they become involved in situations of exploitation, respecting ethical principles and the protection of children and adolescents (Pereda, 2019). It is also worth assessing the effectiveness of the EDR-ESIA applied to a sample of professionals from different regions of Spain, and recognizing the existence of a problem that, as we are seeing, affects all the autonomous communities of our country.


The aim of the present study was to present the EDR-ESIA scale, developed to improve the detection of SECA risk situations in our country. The final scale, compared with the few current international instruments (Basson, 2017; Clutton & Coles, 2007; Kent and Medway Safeguarding Children Board, 2017) and with the research carried out in this field (Armstrong, 2017; Brown et al., 2016; Felner & DuBois, 2017), has been shown to include the most relevant indicators for the identification of SECA and to be easily applicable in the context of services in contact with minors. The EDR-ESIA scale represents a promising instrument that has good content validity, and is feasible, and operational for screening SECA situations in Spain. The tool fulfills the functions of assessing the risk of SECA, recording the recommended action according to the current risk assessment, and alerting the competent authorities to risk situations. Thus, it is a resource for Spanish professionals who detect a situation of vulnerability and/or risk in minors linked to possible situations of exploitation, and it represents a step forward with regards to an issue that we are beginning to tackle in our country and for which more research and studies are needed.


Anguera, M. T., Blanco-Villasenor, A., Losada, J. L., & Portell, M. (2018). Pautas para elaborar trabajos que utilizan la metodología observacional [Guidelines for developing studies using observational methodology]. Anuario de Psicología, 48(1), 9-17. ]

Armstrong, S. (2017). Instruments to identify commercially sexually exploited children: Feasibility of use in an emergency department setting. Pediatric Emergency Care, 33(12), 794-799. ]

Averdijk, M., Ribeaud, D., & Eisner, M. (2020). Longitudinal risk factors of selling and buying sexual services among youths in Switzerland. Archives of Sexual Behavior, 49(4), 1279-1290. ]

Basson, D. (2017) Validation of the Commercial Sexual Exploitation-Identification Tool (CSE-IT). West Coast Children’s Clinic. ]

Beckett, H. (2011). Not a world away: The sexual exploitation of children and young people in Northern Ireland. Barnardo’s Northern Ireland. ]

Beckett, H., Holmes, D., & Walker, J. (2017). Child sexual exploitation: Definition & guide for professionals: extended text. University of Bedfordshire. ]

Benavente, B., Ballester, L., Pich, J., & Pereda, N. (2021a). Risk factors for commercial sexual exploitation of children and adolescents: Results of an international Delphi panel. Psicothema, 33(3), 449-455. ]

Benavente, B., Díaz-Faes, D. A., Ballester, L., & Pereda, N. (2021b). Commercial sexual exploitation of children and adolescents in Europe: A systematic review.Trauma, Violence, & Abuse. ]

Berelowitz, S., Firmin, C., Edwards, G., & Gulyurtlu, S. (2012). I thought I was the only one. The only one in the world. The Office of the Children’s Commissioner’s Inquiry into Child Sexual Exploitation In Gangs and Groups. ]

Brayley, H., Cockbain, E. and Gibson, K. (2014). Rapid evidence assessment: The sexual exploitation of boys and young men. UCL, Barnardo’s and Natcen ]

Brown, S., Brady, G., Franklin, A., Bradley, L., Kerrigan, N., & Sealey, C. (2016). Child sexual abuse and exploitation: Understanding risk and vulnerability. Early Intervention Foundation. ]

Clutton, S., & Coles, J. (2007). Sexual exploitation risk assessment framework: A pilot study. Barnardo’s Cymru. ]

Cole, J., Sprang, G., Lee, R., Cohen, J. (2016). The trauma of commercial sexual exploitation of youth: A comparison of CSE victims to sexual abuse victims in a clinical sample. Journal of Interpersonal Violence, 31(1), 122-146. ]

Digidiki, V., & Bhabha, J. (2018). Sexual abuse and exploitation of unaccompanied migrant children in Greece: Identifying risk factors and gaps in services during the European migration crisis. Children and Youth Services Review, 92, 114-121. ]

Estes, R. J., & Weiner, N. A. (2002). Commercial sexual exploitation of children in the U.S. and Mexico. University of Pennsylvania. ]

Felner, J., & DuBois, D. (2017). Addressing the commercial sexual exploitation of children and youth: A systematic review of program and policy evaluations. Journal of Child & Adolescent Trauma, 10(2), 187-201. ]

Franchino-Olsen, H. (2021). Vulnerabilities relevant for commercial sexual exploitation of children/domestic minor sex trafficking: A systematic review of risk factors. Trauma, Violence, & Abuse, 22(1), 99-111. ]

Franklin, A., Brown, S., & Brady, G. (2018). The use of tools and checklists to assess the risk of child sexual exploitation: Lessons from UK practice. Journal of Child Sexual Abuse, 27(8), 978-997. ]

Franklin, A., & Smeaton, E. (2017). Recognising and responding to young people with learning disabilities who experience, or are at risk of, child sexual exploitation in the UK. Children and Youth Services Review, 73, 474-481. ]

Greenbaum, J., & Crawford-Jakubiak, J. (2015). Committee on Child Abuse and Neglect. Child sex trafficking and commercial sexual exploitation: Health care needs of victims. Pediatrics, 135, 566-574. ]

Greenbaum, V. J., Dodd, M., & McCracken, C. (2018). A short screening tool to identify victims of child sex trafficking in the health care setting. Pediatric Emergency Care, 34(1), 33-37. ]

Kent and Medway Safeguarding Children Board. (2017) Safeguarding children at risk of sexual exploitation. Risk assessment toolkit. ]

Klatt, T., Cavner, D., & Egan, V. (2014). Rationalising predictors of child sexual exploitation and sex-trading. Child Abuse & Neglect, 38(2), 252-260. ]

Lalor, K., & McElvaney, R. (2010). Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs. Trauma, Violence, & Abuse, 11(4), 159-177. ]

Lanctôt, N., Reid, J. A., & Laurier, C. (2020). Nightmares and flashbacks: The impact of commercial sexual exploitation of children among female adolescents placed in residential care. Child Abuse & Neglect, 100, 104195. ]

Marcus, A., Riggs, R., Horning, A., Rivera, S., Curtis, R., & Thompson, E. (2012). Is child to adult as victim is to criminal? Social policy and street-based sex work in the USA. Journal of Sex Research and Social Policy, 9, 153-166. [ Links ]

Miller-Perrin, C., & Wurtele, S. K. (2017). Sex trafficking and the commercial sexual exploitation of children. Women & Therapy, 40(1-2), 123-151. ]

Panlilio, C. C., Miyamoto, S., Font, S. A., & Schreier, H. M. (2019). Assessing risk of commercial sexual exploitation among children involved in the child welfare system. Child Abuse & Neglect, 87, 88-99. ]

Pereda, N. (Dir.). (2019) Guía práctica para la investigación ética en violencia contra la infancia y la adolescencia [Practical guide for ethical research on violence against children and adolescents]. Federación de Asociaciones para la Prevención del Maltrato Infantil (FAPMI). [ Links ]

Pereda, N., Codina, M., & Kanter, B. (2021). Explotación sexual comercial infantil y adolescente: Una aproximación a la situación en España [Commercial sexual exploitation of children and adolescents: An approach to the situation in Spain].Papeles del Psicólogo. ]

Pérez, I., Taito-Vicenti, I. Y., González-Xuriguera, C. G., Carvajal, C., Franco, J. V. A., Loézar, C. (2021). Cómo interpretar las pruebas diagnósticas [How to interpret diagnostic tests]. Medwave, 21(07). ]

Polaris Project. (2019) The U.S. National Human Trafficking Hotline. ]

Observatorio de la Infancia (2017). Actuaciones para la detección y atención de víctimas de trata de seres humanos (TSH) menores de edad. Anexo al protocolo marco de protección de víctimas de TSH [Actions for the detection and care of child victims of human trafficking (HT). Annex to the framework protocol for the protection of victims of HT]. ]

Reed, S. M., Kennedy, M. A., Decker, M. R., & Cimino, A. N. (2019). Friends, family, and boyfriends: An analysis of relationship pathways into commercial sexual exploitation. Child Abuse & Neglect, 90, 1-12. ]

Stativa, E. (Coord.) (2000). Survey on child abuse in residential care institutions in Romania. ]

Trevethan, R. (2017). Sensitivity, specificity, and predictive values: Foundations, pliabilities, and pitfalls in research and practice. Frontiers in Public Health, 5, 307. ]

De Vries, I., & Goggin, K. E. (2020). The impact of childhood abuse on the commercial sexual exploitation of youth: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 21(5), 886-903. ]

Citar como: Benavente, B., Ballester, L., Pich, J., y Pereda, N. (2022). Detección de la explotación sexual en la infancia y la adolescencia mediante la evaluación de indicadores de riesgo en España. Papeles del Psicólogo 43(2), XX-XX.

Received: February 11, 2022; Accepted: May 12, 2022

Conflict of interest

There is no conflict of interest.

Creative Commons License Este es un artículo publicado en acceso abierto (Open Access) bajo la licencia Creative Commons Attribution Non-Commercial No Derivative, que permite su uso, distribución y reproducción en cualquier medio, que el trabajo original sea debidamente citado, no tenga fines comerciales y no se hagan modificaciones.