Recent Research On Fabricated Or Induced Illness (FII)

Photo by Louis Galvez on Unsplash

In November 2023 Professor Luke Clements and Dr Ana Aiello completed some research on the prevalence of alleged Fabricated or Induced illness. To read the report click here.

Fabricated or Induced Illness (FII) is the UK name for what is usually called Munchausen’s by Proxy. However, the definition that generally is used in the UK nowadays has a much broader definition than Munchausen’s by Proxy, which means there are likely even more false allegations. Put simply, Munchausen’s by Proxy is defined as a parent or carer using deception to trick a doctor or other professional into believing their child is ill or disabled, but for FII there is no need for deception to be proven, a difference in opinion is enough. The assumption is that the doctor (or other professional) is correct and the mother is wrong.

Research on FII is scarce so the research by Clements and Aiello (2023) was much needed. They surveyed 387 parents of disabled children who had been accused of FII, sent FOI requests to 51 local councils and did desktop analysis of their websites regarding FII training and guidance for children’s assessors. For an accessible summary of the key findings click here.

In this blog post I will summarise the key findings that relate to autistic parents.

Key findings for autistic parents

Disabled parents 4x as likely to be accused of FII than non disabled parents: Over 50% of parents accused of FII identified as a disabled parent, and of those over 40% had an invisible disability (This would include autism or other neurodivergence, mental health conditions and many of the co-occurring physical conditions that are not immediately obvious to an observer such as fibromyalgia). This compares with only 12% of the general population which suggests that the current practice is unlawful. Disability is a protected characteristic in the Equality Act 2010 (see section 5.17 in the Clements and Aiello report.

58% of allegations happen after a parent has complained:  (see section 5.18 in the Clements and Aiello report. This could suggest that the safeguarding system is being abused in order to silence parents who are causing problems for the professional, unless one assumes that complaining is a genuine sign of FII (as RCPCH claim in their guidance) but this is not supported by research. Logically you would expect a parent of a genuinely ill or disabled child to complain if they were not getting the support they needed. We urgently need research on whether the signs of FII (as described in the RCPCH guidance) actually differentiate between FII and a child who is not getting their medical or educational support needs met. In my experience as an autistic parent and from knowing autistic people, conflict resolution is something many of us find difficult. Sometimes because of our black and white thinking style or our fierce hatred of injustice. It is possible our autistic neurology and our communication style partially contributes to our greater risk of being accused of FII.

Most allegations (84%) result in no follow up or get abandoned: This is hopefully reassuring for parents and is in my view further evidence that there are many false allegations. Sadly though, the process of being accused is traumatic for the families even where the allegations are unfounded and eventually get dropped.

This research by Clements & Aiello hopefully will put pressure on the RCPCH to take another look at their guidance. Professionals should not be publishing guidance based purely on ‘clinical experience’ without more robust evidence such as peer reviewed research. I also believe research from fields other than the medical profession is needed too as medical academics are not necessarily experts on other potentially important factors such as sociology and law. It is also important that parent views are included in the guidance as they are also experts. Academia and professional experience are not the only way of becoming an ‘expert’ on a topic, lived experience provides a different perspective and a different kind of expertise that is just as valid. In the case of both autism and FII this type of expertise has been ignored for too long and has led to a great deal of unnecessary suffering for autistic parents.

There is an upcoming online panel discussion being hosted by APUK on Monday 29th April 2024, details below. To book tickets click here.

Blog written by Shona Murphy

Autistic Parent & Postgraduate Researcher, April 2024

Shona is looking for more participants from ethnic minority groups for her PhD research into FII, for more details or to apply to participate in her research please see advert below or to contact Shona by email. To take part click here.