Fabricated or induced illness

Concerns may be raised when it is considerd that the health or development of a child is likely to be significantly impaired or further impaired by a parent or caregiver who has fabricated or induced illness. These concerns may arise when:

* Reported symptoms and signs found on examination are not explained by any medical condition from which the child may be suffering.

* Physical examination and results of medical investigations do not explain reported symptoms and signs.

* There is an inexplicably poor response to prescribed medication and other treatment.

* New symptons are reported on resolution of previous ones.

* Reported symptoms and found signs are not seen to begin in the absense of the carer.

* Over time a child is repeatedly presented with a range of signs and symptoms

* The child's normal, daily activities are being curtailed, for example school attendance, beyond that which might be expected for any medical disorder from which the child is known to suffer.

There may be a number of explanations for these circumstances and each requires careful consideration and review. A full developmental assessment should be carried out. Consultation with peers, named or designated professionals or colleagues in other agencies will be an important part of the process of making sense of the underlying reason for these signs and symptoms. The characteristics of fabricated or induced illness are that there is a lack of the usual corroboration of findings with symptoms or signs, or, in circumstances of proven organic illness, lack the usual response to proven effective treatments. It is this puzzling discrepancy which alerts the medical clinician to possible harm being suffered by the child.

There are three main ways of fabricating or inducing illness in a child. These are not mutually exclusive and include:

* Fabrication of signs and symptoms. This may include fabrication of past medical history.

* Fabrication of signs and symptoms and falsification of hospital charts and records, and specimens of bodily fluids. This may also include falsificationof letters and documents.

* Induction of illness by a variety of means.

For further information please click on the link below.

Safeguarding children in whom illness is fabricated or induced1.pdf

This information has been taken from Working Together to Safeguard Children 2010.