Munchausen Syndrome by Proxy and Other Forms of Parental Abuse in Children with Screen Addiction and a Diagnosis of Autism (ASD) and/or ADHD

This study offers a novel perspective on the growing body of literature concerning Munchausen Syndrome by Proxy (MSbP), expanding its conceptual boundaries by examining parental behaviors in the context of early childhood screen addiction. While classical cases of MSbP are characterized by medically fabricated symptoms and overt physical interventions, this report highlights a subtler - but equally destructive - form of abuse: chronic screen overstimulation induced by caregivers, resulting in developmental arrest and neuroregulatory dysfunction. The inclusion of screen addiction and delayed neurodevelopmental profiles as potential markers of abusive caregiving behavior is, to our knowledge, unprecedented in the clinical literature. An analysis of 162 clinical cases reveals an alarming pattern of parental behavior marked by significant screen exposure, denial of harm, resistance to therapeutic recommendations, and ultimately, sabotage of the child’s recovery process. Although these behaviors are often presented as forms of care, they align with the core psychological motives described in the MSbP literature - including the caregiver’s conscious or unconscious need to maintain the child in a dependent and symptomatic state in order to obtain social attention, validation, and emotional gratification. Unlike classical MSbP, however, the harmful behaviors observed in this study are rarely recognized as abuse, as they are socially normalized. Another distinctive aspect of the study is the integration of psychophysiological profiling of the parents—a methodological innovation in this field. The use of HRV, skin conductance, and other autonomic measures enabled objective assessment of self-regulation capacity, emotional availability, and stress resilience. The data revealed clear correlations between poor autonomic regulation in parents, low adherence to therapeutic guidelines, and high rates of therapy dropout. This provides new therapeutic avenues for managing the syndrome using biofeedback, significantly improving children's potential for recovery. The study also identifies a typology of parental sabotage behaviors—socially acceptable yet systematically undermining the therapeutic process. These include minimizing screen exposure, withholding key developmental information, failing to implement prescribed tasks, and abruptly discontinuing therapy during critical phases. The fact that such behaviors often intensify precisely at moments of potential recovery suggests an unconscious, yet organized, psychological mechanism for maintaining the child’s dysfunction. The study calls for a reconceptualization of caregiver-mediated neurodevelopmental disorders, particularly in cases with ambiguous etiology such as ASD and ADHD. It proposes the hypothesis that a subset of these conditions may be iatrogenically maintained - or even induced - through digitally mediated neglect, emotional enmeshment, and pathological caregiving patterns. Such a perspective has serious implications for diagnostic practices, therapeutic approaches, and child protection protocols. Keywords: Munchausen Syndrome by Proxy (MSbP), Screen Addcition, Caregiver-Induced Developmental Delay, ASD, ADHD