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Parent Carer Blame has been created by the failures in the Social Care system not differentiating between the needs of disabled children and their families and those who are at genuine risk of neglect and abuse. (Clements & Aiello, 2021)

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Families are nearly always viewed through a Child Protection lens completely disregarding the support needs of the child and family, even when there is no evidence of abuse or neglect.  Furthermore, there is no requirement for those assessing the child to have any specialist training or prior knowledge in this area, unlike the national guidance concerning the assessment of adults. (Clements & Aiello, 2021)

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It is not uncommon, when parents, as experts of their child’s impairment, try to educate the social worker in the hope of a needs-based assessment, find themselves victim of suspected Fabricated or Induced Illness (FII), on the grounds of having too much knowledge.  In my experience, parents trawl the internet and read every available article in a desire to help their child by having a better understanding of their needs not to fabricate the condition.

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When you consider the emotional strain of caring for a child with a PDA profile, having to relearn how to parent, possible breakdown in relationship and ability to work; it is 

understandable that parents become desperate for support, which can then further feed into this idea of “parental blame” with the mother’s mental health being brought into question.

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The survey results showed that “trauma for family carers is multi-layered and has a significant impact on them emotionally”. (Challenging Behaviour Foundation, 2020)

What that support looks like when it finally arrives is a postcode lottery, guidance state social workers should inspect a child’s bedroom and talk to the child alone, with no differentiate between a safeguarding concern or support for a disability. 

This adds further stress to the family, who by now may have become unexpected victims of parent carer blame simply by asking for support.

 

It could be argued processes such as these without evidence is a breach of the UN Convention on the Rights of the Child (UNCRC), the UK ratified the UNCRC in 1991, Article 3.1 of which provides “the best interests of the Child shall be the primary consideration”. Policies of this nature interfere with the fundamental rights of families to respect for their private and family lives and their home. (Clements & Aiello, 2021)

 

Treating someone less favourably because they are working to advocate for someone with a disability is classed as disability discrimination. (Special Needs Jungle , 2022)

Whether institutionalised parent carer blame comes from genuine ignorance or a way of deflecting the needs away from the budget and staffing constraints (Special Needs Jungle , 2022) of the local authority, the result is the same and the family either fail to or suffer delays in the support they are entitled to.  

 

The Children Act (CA) 1989 s17(1) places a duty on English children’s services authorities “to safeguard and promote the welfare of children within their area who are in need’ and do so “by providing a range and level of services appropriate to those children’s needs”. (Clements & Aiello, 2021)

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Parental Blame, Fabricating, or Induced Illness (FII) or Perplexing Presentations is not a new phenomenon but has been described more recently by Sally Russell OBE “It feels like we are witnessing an epidemic of “parent blame”; with the assumption of that when a child is in distress, it must be the fault of the parents. (Russell, 2022)

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Published in 2003, The Curious Incident of the Dog in the Night-Time, won more than 17 literacy awards including the Whitbread Book of the Year.

With more than 10 million copies sold “Asperger’s” as it was then known was thrown into the limelight with charities such as the National Autism Society now known as the National Autistic Society contacting them to report disturbing cases of Social Services investigating parents.

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A child with Asperger’s or High Functioning Autism, as previously known before the publication of DSM-V, will not have an intellectual disability and often will have an above normal IQ despite the lack of social skills.

This exaggerated difference in abilities or spiky profile often resulted in misunderstood behaviours in schools with bad parenting be cited as a result.

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Professor Baron-Cohen, of Cambridge University stated “It risks turning the clock back 50 years to when parents of children with the related condition of autism were blamed for having caused their child’s condition. (Chapman, Matthew; The Guardian, 2004) (Chapman, Matthew; BBC News, 2004)

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Meanwhile, John Coughlan of the Association of Directors of Social Services remarked “Just because a child has Asperger’s doesn’t necessarily mean there isn’t a problem with parenting” and “some studies have shown children who suffer disabilities are at potentially greater risk of abuse, so we always have to look carefully at every case”. (Chapman, Matthew; BBC News, 2004) (Chapman, Matthew; The Guardian, 2004) This position is still used today citing “disabled children are vulnerable and therefore more likely to suffer abuse”.

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During the first week of May 2022, Sunshine Support, a SEND Consultancy based in Derby, UK launched the first “FII Awareness Week”. On the 6th. May 2022 the British Association of Social Workers (BASW) published new practice guidance for Social Workers, written by Cathleen Long, Dr Judy Eaton, Sally Russell OBE, Dr Fiona Guillon Scott and Professor Andy Bilson. (Long, Eaton, Russell, Guillon-Scott, & Bilson, 2022)

Conclusion

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With the ongoing debate of the validity of PDA, and its position as a diagnosis there will not only be a barrier for families to receive timely and correct support but there will also be an opening for parent carer blame and unfounded accusations of FII.

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We have seen a surge in late diagnosis especially in women who tend to mask to fit in more than males.  Loxley-Blount cites “the influence of ill-informed psychiatrists and the mislabelling of some mothers with undiagnosed autism as having FII as additional factors responsible for the surge in FII cases.” (Autism Eye, 2014)

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The priority for all those working with children must always be to identify risk in a timely fashion but by attempting to predict risk and identifying every case of Factitious Disorder Imposed on Another (FDIoA) using the criteria for FII, families are being traumatised by a system that is made to support them. (Gullon-Scott & Long, 2022)

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Families investigated wrongly for child abuse and put through the child protection arena may never get over the trauma of being accused of harming their child, leading to a family breakdown and poor mental and emotional health. The idea that somebody truly believes you are fabricating your child’s difficulties for attention or financial gain, as suggested as possible reasons for FII by parents is total abhorrent.

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“Unable to function – panic when the phone rings, panic when the doorbell rings. Can’t focus. Can’t trust anyone ever. Find it extremely difficult to keep calm with ‘professionals’ who are utterly ignorant of Autism, (and most of them are). I overthink everything, relive it every day.” (Challenging Behaviour Foundation, 2020)

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Families who have their children removed even temporarily may never get over the trauma and even those who don’t but are subjected to the child protection arena with accusations of harming their child will have their mental and emotional health impacted and high chance of family breakdown caused by the stress involved fighting for their innocence. (Gullon-Scott & Long, 2022)

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There is an abundance of evidence documenting the psychological and emotional harm to children separated from their families even on a temporary basis. (Gullon-Scott & Long, 2022) (Hawk & Mccall, 2010), (Skelton, 2019)

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As the accuracy levels reported by Lauren Devine (2016) appendix f - show and the tragic cases of infant deaths caused by parents and/or partners abuse in recent years, show there will always be some that are tragically missed but is this approach of traumatising so many families in the process of assessing risk morally right, a good use of understaffed social care departs or even cost effective?

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The subsequent trauma caused to families will continue to reverberate through generations, breeding distrust and pushing the goalposts ever further away from services and families working together to support the needs of all children not just those who have an impairment of some kind.

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Written by Penny Chapman

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