Page 72 - Getting it Right for Vulnerable Children and Young People in North Ayrshire

• Risk of death Fabrication of illness may not necessarily result in the child experiencing physical harm. However, there may still be concern about them suffering emotional harm and a thorough assessment of the child’s needs should be carried out. Educational, Health and Social Work professionals, and other supporting professionals, should be aware of the factors which can indicate that a child may be at risk of harm as a result of FII, they include: • The parent/carer has a history of seeking disability and medical diagnoses. This may include for instance parent/carer actively promoting sickness in the child or young person by exaggeration or non-treatment of real problems, fabricating or falsifying signs and/or induction of illness (sometimes referred to as “true” FII). • The parent/carer has a strongly driven self-belief there is something seriously wrong with the child • The parent/carer refuses treatment for the child to clarify/rule out possible explanations for reported conditions on the part of the parent/carer • The child presents as normal when not in the presence of the parent/carer • Evidence of symptom coaching with the child by the parent/carer • The child participates in the fabrication of symptoms i.e. becomes complicit with the parent • School non-attendance • There is a family history of mental health difficulties, problems at birth and family relationship difficulties • The parent/carer has a style of intimidation and registering complaints if professionals do not comply with their mind-set or when issues are solved or parental claims about illness proved to be unfounded. This may in some cases be associated with depressive illness in the carer • There is a repeat pattern of non-engagement with professionals when solutions are found • The child may present unexplained physical symptoms (e.g. salt poisoning) Multi-Agency Assessment & Intervention All agencies and practitioners should: • be alert to potential indicators of illness being fabricated or induced in a child; • be alert to the risk of harm that individual abusers, or potential abusers, may pose to children in whom illness is being fabricated or induced; • share, and help to analyse, information so that an informed assessment can be made of the child’s needs and circumstances; • contribute to whatever actions (including the cessation of unnecessary medical tests and treatments) and services are required to safeguard and promote the child’s welfare; • regularly review the outcomes for the child against specific planned outcomes; Getting It Right For Vulnerable Children and Young People in North Ayrshire DRAFT V1.1 March 2014 Page No:72