WHO I AM

I am Shona Murphy, a PhD researcher at Edge Hill University with an interest in Autism and Fabricated or Induced Illness. I teach people about autism and I am the treasurer and event co-ordinator at Autistic Parents UK, which is a charity that supports autistic parents.

Autistic people are subject to injustice in most areas of life and parenting is no different. My qualitative research on the pros and cons of autistic parenthood, which formed part of my MA in autism, found that, for my participants, relationships with professionals was one of the most difficult aspects of parenting. Parent blame and misunderstandings were rife. Currently there is a concerning number of parents of autistic children (many of whom are autistic themselves) accused of fabricated or induced illness. These allegations are often unfounded and perhaps born out of misunderstandings about the different ways of parenting, that are often essential when raising autistic children.

Essentially, we do not know a lot about what is going on because there is little research. There is a lot of literature but it almost all comes from medical professionals. It is essential that we get to hear from other stakeholders, particularly parents, who up until now have been silenced by fear and stigma. My research project aims to address this.

WHAT IT IS

What is fabricated or induced illness?

Fabricated or Induced Illness (FII) is a term which was introduced by Royal College Paediatric and Child Health (2006) to describe a situation where healthcare professionals believe that a parent or a carer is behaving in such a way as to convince doctors that the child is ill or disabled (or more ill or disabled than they actually are). The parent does not need to be doing it intentionally.

The critical part of this definition (added by me as there is no acknowledgement that it is a subjective opinion in the RCPCH 2021 guidance on FII) is that it is based on the medical professionals view. There is a pervasive assumption throughout most of the FII literature that professionals are the 'experts' and their views are 'objective'. As this website grows, it will become increasingly apparent that this assumption is flawed. Humans are never objective and there are different kinds of expertise. We all have our back stories through which we filter what we perceive to form views. My view of a situation as an autistic mother, and a social scientist is likely to be different to the view of a paediatrician who will approach the situation from a medical perspective and will be less familiar with the social factors that are often at play.

The concept of FII is not new. Many names have been used for what is essentially the same concept (e.g. Munchausen's by proxy, fictitious disorder imposed on another, medical child abuse) but the difference (and a major concern) is that the most recent definition of FII is much more inclusive. There is no need to prove deception - anxiety and mistaken belief of the parent is enough to fall into the definition. My reading and research has led me to the conclusion that these miscarriages of justice are not new, but I wonder if the number of them is increasing. It is difficult to know without accurate data, and data on FII specifically is not collected by local authorities.

The concept of FII is problematic for a number of reasons:

1. It is not evidence based

2. It does not acknowledge that doctors are human and therefore fallible and with bias

3. Particular groups of people are more likely to be accused (e.g. autistic women)

I can justify these views but there is not enough space here. Contact me, Shona Murphy, if you are interested in learning more.

WHAT IT IS

What is Autism?

The medical definition of autism bears no resemblance to my lived experience of autism. For me:

'Autism is cognition and sensory processing which when combined with an inappropriate environment can give rise to disability, distress or social misunderstandings' (Murphy, 2022)

This definition of autism recognises the role of the environment in outcomes for autistic people. A medical model of autism risks leading to parent blame by assigning problems to the people involved, when the reality is much more complex than that. If the blame is assigned incorrectly then interventions are often misplaced and unethical - such as trying to change the person rather than their social circumstances. I support the neurodiversity paradigm.