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- Title
FII and Perplexing Presentations: What is the Evidence Base for and against Current Guidelines, and What are the Implications for Social Services?
- Authors
Gullon-Scott, Fiona; Long, Cathie
- Abstract
Fabricated or induced illness (FII) and perplexing presentations (PPs) are the terms used by the Royal College of Paediatrics and Child Health (RCPCH) in the UK. FII is presented as if synonymous with Munchausen syndrome by proxy, a rare presentation which is now known in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition as factitious disorder imposed on another (FDIoA). However, FII is not a diagnosis, and the definition is far broader than FDIoA. RCPCH admit that there is a limited evidence base for the prevalence, specificity or sensitivity of FII and the associated 'alerting signs', and yet local authorities across the UK have Child Protection Policies developed directly from the RCPCH guidelines. An increasing number of families of children with neurodevelopmental presentations (such as autism), or presentations of complex or less well-known conditions such as Ehlers–Danlos syndrome, are finding themselves being investigated for FII by Social Services, and consequently labelled as potential 'perpetrators' of child abuse, on the basis of FII guidelines. The present article discusses the issues relating to FII and PP, how current guidelines are creating implicit and explicit bias against certain kinds of families and the implications for Social Services.
- Subjects
UNITED Kingdom; MUNCHAUSEN syndrome by proxy; CHILD abuse; CHILD development; MENTAL health; CHILDREN'S accident prevention; RISK assessment; AUTISM; CHILD welfare; SOCIAL services; CLASSIFICATION of mental disorders; SENSITIVITY &; specificity (Statistics); CHILD development deviations
- Publication
British Journal of Social Work, 2022, Vol 52, Issue 7, p4040
- ISSN
0045-3102
- Publication type
Article
- DOI
10.1093/bjsw/bcac037