Fabricated or Induced Illness (FII)

The home of real life stories, research and education of FII, to improve practice and reduce trauma.

What is FII?

Fabricated or Induced Illness

FII is a term used by professionals to describe parents who's description of their child's presentation does not match that observed by involved professionals.  

FII is not in itself a diagnosis. It's a set of characteristics observed by professionals that aren't understood which cause them to suspect a parent is creating or exaggerating their child’s difficulties, with no identifiable evidence to substantiate their existence. 

FII is not the same as Munchausen's Syndrome by Proxy.

But, it is fast becoming a something that parents are wrongfully accused of; which in turn prevents children from getting the help they need and, instead, causes life-long trauma.

Practice Guidance for Professionals

In May 2022 BASW (British Association of Social Workers) published a practice guide on FII and Perplexing Presentations. This was researched and written by Cathleen Long, Dr. Fiona Gullon-Scott and Prof. Andy Bilson.

The information found below is taken from this practice guide. 

Early Professional Observations

When a child or young person is presented by their parents/caregivers with a condition which cannot be medically explained, it is deemed as a Perplexing Presentation (PP).  

PP is an alerting sign to possible FII which is described by the Royal College of Paediatrics and Child Health (RCPCH) as ‘a clinical situation in which a child is, or very likely to be, harmed due to parent(s) behaviour and action, carried out in order to convince doctors that the child’s state of physical and/or mental health and neurodevelopment is impaired (or more impaired than it actually is)’ (RCPCH, 2021, p. 11). 

Whilst this is an opportunity to seek further clarity on the situation for professionals, it is not a call for immediate judgment and/or punitive action. We explain more throughout the website.

Diagnosis & 

It's important to remember, FII is not in itself a diagnosis and more about professionals suspecting a parent is creating or exaggerating their child’s difficulties, with no identifiable evidence to substantiate their existence. Is a title given to describe a set of characteristics, that are often brought about by anxiety and trauma that require validation, curiosity and support.

Often there is a misassumption by professionals that FII is the same as Factitious Disorder Imposed on Another (FDIOA), which is an extremely rare psychiatric diagnosis and used to be more commonly known as Munchausen Syndrome by Proxy (MSbP). 

The RCPCH suggests FII can cause emotional and physical abuse and can lead to neglect, however there is no evidence to support the assumption that FII characteristics lead to abuse, neglect or critical harm. 

Trends and Improving 

We know from research that there is a growing trend for false accusations of FII to be made where Autism in present in the family. 

A large portion of false FII accusations are made against Autistic parents (usually mothers) with Autistic children.

This doesn't mean, however, that all Autistic parents/mothers are accused; just that there is a worrying trend when their presentation is misunderstood by professionals. 

There are other conditions and presentations that are commonly linked with false accusations of FII, the include Ehler's Danlos Syndrome (EDS), Pathological Demand Avoidance (PDA) and PANS PANDAS. This list is not exhaustive.

This is why the practice guide is vital when supporting families who live with Special Educational Needs & Disabilities.


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