Rebecca Rebbe is an assistant professor of social work at the University of Southern California. Rebecca’s research examines community responses to child maltreatment through systems, laws, and policies. Rebecca has training in demographic methods and specializes in using population-based linked administrative datasets. Her research is informed by 7 years of post-MSW practice working with families involved with the child welfare system, in both the public and private sectors. Rebecca earned her PhD in social welfare from the University of Washington, received a MSW from Boston College, and has a master’s degree in education from Harvard University.
University of Washington: PhD, Social Welfare 2019
Boston College: MSW, Social Work 2007
Harvard University: EdM, Risk and Prevention 2006
Areas of Expertise (4)
Child Protective Services
child welfare practice
linked administrative data
Child Abuse and Neglect
Outstanding Doctoral Dissertation. American Professional Society on the Abuse of Children (professional)
Outstanding Doctoral Dissertation. American Professional Society on the Abuse of Children, 2020
Research Articles & Publications (7)
Reports and Removals of Child Maltreatment-Related Hospitalizations: A Population-Based StudyChild Maltreatment
Rebecca Rebbe, Joseph A. Mienko, Melissa L. Martinson
Despite U.S. child protective services (CPS) agencies relying on mandated reporters to refer concerns of child maltreatment to them, there is little data regarding which children mandated reporters decide to report and not to report. This study addresses this gap by utilizing a population-based linked administrative dataset to identify which children who are hospitalized for maltreatment-related reasons are reported to CPS and which are removed by CPS. The dataset was comprised of all children born in Washington State between 1999 and 2013 (N = 1,271,416), all hospitalizations for children under the age of three, and all CPS records. We identified maltreatment-related hospitalizations using standardized diagnostic codes. We examined the records for children with maltreatment-related hospitalizations to identify hospitalization-related CPS reports and if the child was removed from their parents. We tested for differences in these system responses using multinomial regression. About two-thirds of children identified as experiencing a child maltreatment-related hospitalization were not reported to CPS. We found differences in responses by maltreatment subtype and the type of diagnostic code. Children whose hospitalizations were related to abuse and associated with a specific maltreatment code had increased odds of being both reported to CPS and subsequently removed by CPS.
The Incidence of Child Maltreatment Resulting in Hospitalizations for Children Under Age 3 YearsThe Journal of Pediatrics
Rebecca Rebbe, Melissa L. Martinson, & Joseph A. Mienko
Objective: To assess the incidence of child maltreatment-related hospitalizations for children under 3 years for the population of Washington State. Study design: A population-based study using retrospective linked administrative data for all children born in Washington State from 2000 through 2013 (n = 1 191 802). The dataset was composed of linked birth and hospitalization records for the entire state. Child maltreatment-related hospitalizations were identified using diagnostic codes, both specifically attributed to and suggestive of maltreatment. Incidence were calculated for the population, by birth year, by sex, and by maltreatment subtype. Results: A total of 3885 hospitalizations related to child maltreatment were identified for an incidence of 10.87 per 10 000 person-years. Hospitalizations related to child maltreatment accounted for 2.1% of all hospitalizations for children under the age of 3 years. This percentage doubled over time, reaching a high in 2012 (3.6%). More than one-half of all hospitalizations were related to neglect. Maltreatment-related hospitalizations occurred most frequently in the first year of life for all subtypes except for neglect, which occurred the most between 1 and 2 years of age. Male children had higher incidence than female children in general (11.97 vs 9.70 per 10 000 person-years) and across all subtypes. Conclusions: Hospitalizations can be a useful source of population-based child maltreatment surveillance. The identification of neglect-related hospitalizations, likely the result of supervisory neglect, because the most common subtype is an important finding for the development of prevention programming.
What is neglect? State legal definitions in the United StatesChild Maltreatment
Neglect is the most common form of reported child maltreatment in the United States with 75.3% of confirmed child maltreatment victims in 2015 neglected. Despite constituting the majority of reported child maltreatment cases and victims, neglect still lacks a standard definition. In the United States, congruent with the pervasiveness of law in child welfare systems, every state and the District of Columbia has its own statutory definition of neglect. This study used content analysis to compare state legal statutory definitions with the Fourth National Incidence Survey (NIS-4) operationalization of neglect. The resulting data set was then analyzed using cluster analysis, resulting in the identification of three distinct groups of states based on how they define neglect: minimal, cornerstones, and expanded. The states’ definitions incorporate few of the NIS-4 components. Practice and policy implications of these constructions of neglect definitions are discussed.
Incidence and Risk Factors for Abusive Head Trauma: A Population‐Based StudyChild Abuse Review
Rebecca Rebbe, Joseph A. Mienko, Melissa L. Martinson
Previous studies of abusive head trauma (AHT) suggest that incidence may vary by geographic location, and there is limited information regarding population‐based risk factors for this form of child maltreatment. This study provides new knowledge regarding these two aspects using the population of the US State of Washington born between 1999 and 2013. We used a linked administrative dataset comprising birth, hospital discharge, child protective services (CPS) and death records to identify the scale and risk factors for AHT for the state population using quantitative survival methods. We identified AHT using diagnostic codes in hospital discharge records defined by the US Centers for Disease Control and Prevention. A total of 354 AHT hospitalisations were identified, and the incidence for the state was 22.8 per 100 000 children under the age of one. Over 10 per cent of these children died. Risk factors included a teenaged mother at the time of birth, births paid for using public insurance, a child's low birth weight and maternal Native American race. The strongest risk factor was a prior CPS allegation, a similar finding to a California study of injury mortality. The practice and policy implications of these findings are discussed.
Child protection reports and removals of infants diagnosed with prenatal substance exposureChild Abuse & Neglect
Rebecca Rebbe, Joseph A. Mienko, Emily Brown, Ali Rowhani-Rahbar
Background A frequent response for prenatal substance exposure (PSE) is intervention by child protective services (CPS). Previous research has examined differences in reports to CPS regarding PSE by substance exposure and by maternal race. However, little is known regarding the frequency of immediate removals by CPS relating to PSE and maternal race. Methods We investigated hospital reports to CPS and CPS removals of PSE infants by using linked birth, hospital discharge, and CPS records for all children born in Washington State between 2006 and 2013 (N = 760,863). We identified PSE using diagnostic codes, calculated prevalence by substance type and maternal race, and tested for differences by interactions of race and substance using multinomial logistic regression. Results Prevalence of PSE births varied by race with 8.1% of Native American, 2.8% of black, 1.9% of white, and 0.8% of Hispanic births diagnosed with PSE. Opioids was the most common type of PSE diagnosis at 48.2%. The majority of PSE infants (86.7%) were not removed by CPS but variations by substance type were observed. Of the interactions in the multinomial logistic regression model, only black infants exposed to alcohol were more likely to result in reports to CPS without removal than the referent group of white infants exposed to opioids. Conclusions Findings indicate that most infants diagnosed with PSE were not removed by CPS and minority PSE infants were not reported to CPS or removed by CPS more than white infants. Racial differences identified in the prevalence of PSE present opportunities for targeted prevention efforts.
Hospital Variation in Child Protection Reports of Substance Exposed InfantsThe Journal of Pediatrics
Rebecca Rebbe, Joseph A. Mienko, Emily Brown, Ali Rowhani-Rahbar
Objective To examine whether hospital-level factors contribute to discrepancies in reporting to Child Protective Services (CPS) of infants diagnosed with prenatal substance exposure. Study design We used a linked dataset of birth, hospital, and CPS records using diagnostic codes (International Classification of Diseases, Ninth Revision) to identify infants diagnosed with prenatal substance exposure. Using multilevel models, we examined hospital-level and individual birth-level factors in relation to a report to CPS among those infants prenatally exposed to substances. Results Of the 760 863 infants born in Washington State between 2006 and 2013, 12 308 (1.6%) were diagnosed with prenatal substance exposure. Infants born at hospitals that served larger populations of patients with Medicaid (OR, 1.25; 95% CI, 1.07-1.45) and hospitals with higher occupancy rates (OR, 1.43; 95% CI, 1.15-1.77) were more likely to be reported to CPS. Infants exposed to amphetamines (OR, 2.58; 95% CI, 2.31-2.90) and cocaine (OR, 2.33; 95% CI-1.92, 2.83) were more likely to be reported and infants exposed to cannabis (OR, 0.62; 95% CI-0.55, 0.70) were less likely to be reported to CPS than infants exposed to opioids. Infants with Native American mothers were more likely to be reported to CPS than infants with white mothers (OR, 1.47; 95% CI, 1.27-1.70). Conclusions Hospital-level and individual birth-level factors impact the likelihood of infants prenatally exposed to substances being reported to CPS, providing additional knowledge about which infants are reported to CPS. Targeted education and improved policies are necessary to ensure more standardized approaches to CPS reporting of prenatal substance exposure.
Adverse childhood experiences among youth aging out of foster care: A latent class analysisChildren & Youth Services Review
Rebecca Rebbe, Paula S. Nurius, Kym R. Ahrens, & Mark E. Courtney
Research has demonstrated that youth who age out, or emancipate, from foster care face deleterious outcomes across a variety of domains in early adulthood. This article builds on this knowledge base by investigating the role of adverse childhood experience accumulation and composition on these outcomes. A latent class analysis was performed to identify three subgroups: Complex Adversity, Environmental Adversity, and Lower Adversity. Differences are found among the classes in terms of young adult outcomes in terms of socio-economic outcomes, psychosocial problems, and criminal behaviors. The results indicate that not only does the accumulation of adversity matter, but so does the composition of the adversity. These results have implications for policymakers, the numerous service providers and systems that interact with foster youth, and for future research.