Fabricated or induced illness in children: A guide for Australian health-care practitioners

Abstract

Many paediatricians have, or will have at some time in their career, a child under their care who has, or is suspected to have, Fabricated or Induced Illness in a Child (FIIC). Often a pattern of investigation, treatment and referral develops, with things ‘just not quite adding up’ and the diagnosis of FIIC is not considered. How can Australian health-care practitioners better recognise and respond to concerns around fabricated or induced illness? When should concerns be reported to protective services? How should we talk to families when we suspect fabrication or induction of illness in their child, and what is the role of specialised forensic paediatric services in Australia in relation to such cases? FIIC is almost certainly not as rare as commonly perceived and it can be identified early. Although challenging, FIIC can be managed effectively with a thoughtful multidisciplinary team approach. This article aims to provide paediatricians with a strategy that will hopefully serve to raise awareness, facilitate earlier intervention and simplify the approach to management, encouraging the view that taking action need be no different to addressing any other complex paediatric problem.