Resources for Frontline Professionals

Though most professionals working with children will come across a case during the course of their career, the majority of medical providers, CPS workers, and law enforcement professionals never receive any specific training about how to deal with a suspected Munchausen by Proxy case. Misinformation about MBP runs rampant in the media, and these cases are notoriously complex and fraught. MBP victims face a system that’s not designed to help them. MBP can have life-long consequences and is certainly a misunderstood form of abuse. Because Munchausen by Proxy is underreported, it is difficult to know how many children are victimized by this type of abuse each year.

More training for frontline professionals is needed. In the meantime, those who find themselves in the midst of a case will often need to self-educate.

The American Professional Society on the Abuse of Children’s Munchausen by Proxy Committee is an interdisciplinary group made up of some of the most notable experts in the world who have been working together for nearly forty years. Below, the Committee’s professional guidelines is listed, as well as a 2018 APSAC Advisor publication that includes information about law enforcement, epidemiology, intervention, treatment, and more.

If you would like to share your professional expertise with the group, please reach out (link).

APSAC Practice Guidelines for Munchausen by Proxy can be found here.

To read more the APSAC’s Munchausen by Proxy committee’s Advisor go here.

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Warning Signs of MBP
According to the American Professional Society on the Abuse of Children (APSAC), here are some common signs of MBP maltreatment to watch out for:

  • Reported symptoms or behaviors that are not congruent with observations. For example, the abuser says the child cannot eat, and yet the child is observed eating without the adverse symptoms reported by the abuser.
  • Discrepancy between the abuser’s reports of the child’s medical history and the physical medical record.
  • Extensive medical assessments do not identify a medical explanation for the child’s reported problems.
  • Unexplained worsening of symptoms or new symptoms that correlate with the abuser’s visitation or shortly thereafter.
  • Laboratory findings that do not make medical sense;, are clinically impossible or implausible;, or identify chemicals, medications, or contaminants that should not be present.
  • Child’s symptoms resolve or improve when the child is separated and well protected from the influence and control of the abuser.
    Other individuals in the home or the caregiver have or have had unusual or unexplained illnesses or conditions.
    Animals in the home have unusual or unexplained illnesses or conditions – possibly similar to the child’s presentation (e.g., seizure disorder).
  • Conditions or illnesses significantly improve or disappear in one child and then appear in another child, such as when another child is born, and the new child begins to have similar or other unexplained symptoms.
  • Caregiver is reluctant to provide medical records, claims that past records are not available, or refuses to allow medical providers to discuss care with previous medical providers.
  • The abuser reports that the other parent is not involved, does not want to be involved, and is not reachable.
  • A parent, child, or other family member expresses concern about possible falsification or high-healthcare utilization.
  • Observations of clear falsification or induction by the caregiver. This may take the form of false recounting of past medical recommendations, test or exam results, conditions, or diagnoses.

Munchausen by Proxy
(APSAC Practice Guidelines 2017)