Fabricated or Induced Illness

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There is a very rare condition called 'Fabricated or Induced Illness' (FII), previously known as 'Munchausen's by Proxy', where a parent (usually the mother), due to her own psychological distress, creates the appearance of an illness in her child, sometimes even creating pyschological or physical conditions to make them unwell.

Coverage on BBC 5 Live Investigates today highlighted that cases of FII investigations are increasing and explored some of the reasons for this. FII came to the PDA Society's attention when we had requests for support and advice from 4 families in the space of a single week. This prompted us to start keeping records - we have seen 15 enquiries over the last 4 months. To date, none of the cases that have been concluded found any evidence of FIISince then we have been working with the BBC and others to highlight the issue. 

There are several things about PDA that could leave families vulnerable to unfounded suspicions of FII:

  •  as PDA is often misunderstood or missed or misdiagnosed, parents may have been seeking help from many different sources for a long time with increasing desperation - this sometimes causes concerns to be raised

  • children with PDA can often mask their difficulties at school so there’s often a big mismatch between what schools see and what parents experience at home. Also school refusal is very common with PDA (in our Being Misunderstood survey last year we found that 70% of children with a PDA presentation aren’t in school or regularly struggle to attend) and this can be another 'red flag' for concerns about FII 

  • the approaches which are helpful for PDA turn traditional parenting on its head: so in place of strict boundaries/rewards/consequences it’s much more about negotiation, collaboration and flexibility, and this can leave parents open to criticism if the reason for their unconventional parenting isn’t properly understood.

Many of the cases we hear about follow the same pattern, with the trigger for an investigation being that parents are seeking support and/or where there is a big discrepancy between what a school sees and what parents report at home. The PDA Society is concerned that unfounded FII cases are further delaying children from being understood and supported. All the focus is taken away from the child and how the family can be supported and put into investigating the parent.

In our view, the following changes need to take place:

  • all services should have appropriate training in autism, including presentations such as PDA and the female presentation 

  • before commencing an FII investigation it should first be established whether there is an underlying special need or hidden disability and ensure that everything possible is being done to identify and support a child's needs.

The impact on families of FII investigations is enormous: it is a brutal process that has a really devastating emotional impact and leaves families traumatised. Families are being betrayed – their lives are already challenging with children who have complex needs, and then the very services which are supposed to support them turn on them instead.

The BBC 5 Live Investigates programme can be listened to via a downloadable podcast. If you are affected by any of the issues, please do contact us


 
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