What is borderline intellectual functioning

A clinical interview revealed learning and social difficulties in all children with BIF. They were recruited from the Adolescence and Pediatric Neuropsychiatry Unit of our institution. All children included in the study had never taken medications and underwent a clinical evaluation in order to exclude genetic syndromes, i. The present study was approved by the scientific and ethics committees of Don Gnocchi Foundation and Catholic University of the Sacred Heart.

Parents gave written informed consent for participation in the study. All these tests are standardized and their psychometrics properties are illustrated in their respective manuals and references.

All participants were tested with a paper-pencil ToM battery in order to assess their level of mentalizing development. For a more sensitive measurement of ToM ability, the battery consisted of a first order false belief task Deceptive Box Task; Perner et al.

Each task provides for one or more control questions to test the understanding of the logical order and the explicit elements in the story without inferring mental states. These tools are designed as research assessments and are widely used to investigate this construct in a life-span perspective Fonagy and Allison, Meta-analyses confirm the validity of the ToM battery used in this study both in typical Wellman et al. The first order false belief task consists of a real experience of a false belief.

A closed candies box, whose content has been secretly substituted with an unexpected object, is shown to the participants who are asked to say what it contains. After the discovery of their own false belief, the box is closed again and the investigator asks them to predict what another person would say when shown the closed box.

The second order false belief tasks are more complex tasks, suitable to test a higher level of mentalistic reasoning.

Through the Look-prediction task it is possible to evaluate the acquisition of the second order false belief reasoning because the situation that is presented to the participants requires high order, recursive mentalistic reasoning. The main elements of the story are illustrated with pictures that remain available during the whole interview in order to reduce as much as possible the memory load.

In the same way, the Ice cream story, the classical second order false belief task, explores the abilities to manage the mental contents employed in the story.

For the Look-prediction five questions are asked, two of which are used as controls, one as an explanation, and the remaining two are the actual test questions. The Ice-cream story, included three control questions, one explanation question and one test question. In both tasks 1 point is assigned in the case of correct answer, whereas 0 in the case it was incorrect.

The Strange Stories task measures a higher level of ToM because of their complexity and structure. Each story describes a daily situation and refers to a specific mental content i. Participants have to decode not only the mental content but also the dynamic of the story in a single and coherent view see Castelli et al. For each story there is one control question except for the double bluff story, which has two and one test question. In addition, it is possible to code if subjects use mental state term MS, e.

A recent study Devine and Hughes, showed the reliability and the validity in childhood of Strange Stories. The whole battery was administered individually; answers were audio-recorded and then coded once the session was closed. This was administered with increasing complexity sequence. Statistical analyses were conducted with MedCalc software v Theory of Mind data were screened based on a conservative inclusion criteria: for each participant, only the stories in which the control questions were answered correctly were included in the analyses.

The scoring of each story included only the test and the explanation questions. Control questions were only used as inclusion criteria and thus were excluded from the total score. The two groups were compared by ANCOVA analyses with age as covariate of no interest, using a General linear model GLM to explore differences in the following variables: performance at first order false belief task Deceptive box, score 0 to 2 ; at second order false belief task Ice cream story and Look-prediction, score ranging from 0 to 6 ; Strange Stories score ranging from 0 to 8 and Physical Stories score ranging from 0 to 8.

Moreover, to explore the link between advanced ToM task Strange Stories and executive functions we performed an additional correlation analysis. Children with BIF were not significantly different from children with TD on the matching variables of age and gender Table 1. TABLE 1. Results of the neuropsychological assessment of executive functions of children with BIF are shown in Figure 1 : performances were in the borderline range in all tests.

Results of the neuropsychological assessment of executive functions of children with borderline intellectual functioning BIF. The colored box indicates performance in the borderline range, i. Regarding the performance at the ToM tasks, the two groups of children performed similarly with respect to the control questions. This means that the two groups were equal in the capacity to understand the concrete contents of the story and to remember the main information.

For the Ice-cream task, fewer participants passed the filter of the control questions only 21 children with TD and 16 with BIF , thus showing that this story was more difficult to understand in its contents, besides the false beliefs inferences, for both groups Table 2. TABLE 2. Comparison of the ToM abilities between the two groups of children. TABLE 3. To determine the impact of borderline intellectual functioning in ToM abilities we performed the same correlations as above in children with BIF.

Table 3 summarizes the correlation analysis between the Strange Stories task and IQ scores. To test the relation between ToM abilities and executive functions we performed a correlation between Strange Stories and the fluency tests and Working Memory Index. Results showed a significant correlation between Strange Stories performance and semantic fluency and Working Memory Index, and a tendency toward the significance with phonological fluency Table 4.

TABLE 4. The principal aim of this study was to determine if children with BIF, characterized by a low IQ and difficulties to meet developmental and socio-cultural standards, show a pattern of ToM abilities which deviates from the one observed in typically developing children. The first result that we found was the absence of significant differences between the two groups in the control questions of the ToM tasks. This demonstrates that all participants were able to overcome the task when mental contents were not included in the reasoning, presenting a comparable instruction comprehension and understanding of the cause—effect relationship of the facts narrated in the stories.

Indeed, in these exercises, participants were required to understand the logical order of the events and to answer questions only on the basis of the elements that are explicit in the story, i. This was true across all ToM tasks, from the simplest one, the first order false belief, to the more advanced ones, the Strange Stories.

In fact, children with BIF performed lower than children with TD at Deceptive Box, a task that can be considered as the baseline of ToM reasoning, as it evaluates first-order false belief, and it is usually overcome around 4 years of age Wimmer and Perner, Nevertheless, our data show that children with BIF did not perform at the expected developmental standards.

In addition, children with BIF performed lower than children with TD in the second order false belief tasks, which evaluate a more difficult level of recursive thinking. This aspect of ToM is usually successfully managed around 7—9 years of age Perner and Wimmer, The story is more complex than the first order false belief one, with an increasing number of agents engaged in embedded mental states. Children with BIF were not able to distinguish what each character actually knew from their own omniscient knowledge.

In all these stories, characters have only incomplete or partial information about the events, as happens in daily life. It is from this lack of information that the false belief reasoning takes place.

In order to do that, they must identify and keep in mind all the relevant information to have various prospects at the same time and manage the situation. These results seem to indicate a delay in ToM abilities development. This hypothesis deserves future investigation with a control group matched for mental age. Because ToM, in particular advanced ToM ability, is closely embedded with cognitive competences, we explored the impact of global intelligence on this complex process.

We looked into the specific intellectual functioning of each group to determine how this interacted with advanced ToM tasks such as the Strange Stories. Results showed a positive correlation with the Picture Completion and the Picture Arrangement subtests in children with TD. These two tasks require rapid visual-perceptive analysis and processing.

To be effectively solved, they necessitate the use of global cognitive strategies for a rapid and complete analysis of all the elements rather than an analytical approach that focuses on perceptual details Vakil and Lifshitz-Zehavi, Indeed, the latter is more time demanding. These subtests assess short-term and working memory Digit span and Coding , inhibitory control and novel material learning ability Coding and verbal fluid reasoning Similarities , all abilities that engage functions connected with the frontal lobe executive functions and FI.

Moreover, we found that performance of children with BIF at executive function tests were in the borderline range and correlated verbal fluency and working memory index significantly with the Strange Stories task scores.

Our explanation is that our results may be due to the poor executive functions of children with BIF leading to an overload of information with the increasing of the complexity of the tasks.

Poor executive functions could affect the capacity to keep online the main information of the story for example the characters or their actions while they select and handle those necessary to master the situation.

The hypothesis of an overload of data could, also, underpin the preference of children with BIF for analytic analysis, as highlighted in another study Vakil and Lifshitz-Zehavi, The connection between ToM abilities and executive function that we found is also supported by several studies see for a review, Devine and Hughes, An important aspect of executive functions relates to the ability to constantly update personal knowledge with new information, to learn by experience and master real life situation adaptively and to be socially competent.

Recent studies have demonstrated that psychosocial adaptation is also connected to fluid intelligence FI; Huepe et al. FI and executive functions are, indeed, engaged not only in cold information processing, such as logical and abstract reasoning, but also in hot processing, such as social cognition.

This confirms the cross-influences existing between the cognitive and the social-affective processes Liverta Sempio and Marchetti, In our study, the positive correlation between the Strange Stories task and the Similarities that we found in children with BIF can be connected not only with FI but also with a deficit in meta-representational competences, as demonstrated in other studies involving children with mild to borderline intellectual disabilities Karmiloff-Smith et al.

Indeed, ToM requires meta-representational abilities, such as lower-order representations i. We suppose that when there is an overload of information to be processed, children with BIF face difficulty with both types of meta-representations that are necessary for both tasks: Strange Stories and Similarities. Moreover, our results showed that children with BIF perform poorly on all false belief tasks, even the easiest ones. These children seem to be still dealing with the belief-desire psychology stage, which is an early around 3—4 years of age evolution step.

At this level children understand that actions are driven by desires, thought, intention and true belief but they are not able to comprehend that behavior can also be justified by misinterpretation, i. The results of our study show that children with BIF have a deficit in ToM that is strictly connected with their executive functions and meta-representation competences.

These results can be important to develop treatment strategies able to support these children in their social skills during childhood and to prevent the social disadvantages that they might face in adulthood. Many evidences from the literature prove that ToM is not an all-or-nothing process, but rather it is a set of skills that people continue to develop during the whole life Fonagy and Allison, The results suggest that an early intervention is essential to support the mentalization development Fabio et al.

In the specific case of children with BIF, the timing of the intervention is crucial. Furthermore, recent studies have demonstrated a cerebral cortical developmental delay in children with BIF Baglio et al. According to these evidences, it is essential to better understand the functioning difficulties of children with BIF.

This will allow for the development of targeted strategies to minimize the gap with their peers as soon as possible and to redirect these children toward a typical developmental pattern. All authors have reviewed critically the work, provided important intellectual content and approved the final form. GB, VB, and FB designed the research, analyzed data, interpreted the results and drafted the manuscript; GB also performed neuropsychological and ToM evaluation; MZ recruited patients and analyzed the clinical data.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors wish to thank all the children and their families for participating in the study and Dr.

Niels Bergsland for his careful revision of the English language. Adrien, J. Disorders of regulation of cognitive activity in autistic children. Alexander, J. Development of metacognition in gifted children: directions for future research. Alexander, K. As a result, a full-scale IQ score may not give perfect results.

Adaptive functioning is tested through standardized measures with three areas under consideration:. Borderline intellectual functioning is a lifelong condition but timely intervention can improve functioning and help a person to thrive.

With timely support, people with intellectual disabilities can be fully included in the community. Special education and related services should be free for every eligible child with borderline intellectual functioning.

Moreover, people with borderline intellectual functioning should get support from friends, family, community members, and co-workers. Employers can provide job coaching. With proper support and strategies, people with borderline intellectual functioning can become successful with productive societal roles. Various therapies can improve borderline intellectual functioning. Some of them have been discussed below:. In borderline intellectual functioning , the cognitive abilities of individuals are affected.

There is a need to create awareness of the condition. Such individuals can be integrated into society through the provision of proper medical attention and support strategies. Like every relationship, marriages too have their ups and downs. Couples get into conflicts for various reasons, including time, money, and stress.

These unprecedented times. Thought broadcasting is a mental condition that makes a person believe that his thoughts can be read by other people. Thought broadcasting is the symptom. The whole world is going through a mental health crisis, that not only destroys health but threatens lives as well.

Mental illness and addiction problems. In the theory of multiple intelligences, naturalistic intelligence, interpersonal intelligence, and intrapersonal intelligence are some developed by Gardener.

In comparison, naturalistic intelligence is similar yet. Neuropathy is a condition when your nerves are damaged, leading to irritation, pain and immobility. Here is why you should try brain neuropathy treatment. Check our help guide for more info. Submit Type above and press Enter to search.

If IQ scores came out below 70, the individual was considered to have an intellectual disability. People with "intellectual development disorder" are diagnosed using DSM-5, and while IQ scores still play an important role, other issues are considered. Borderline intellectual functioning refers to estimated intelligence quotient scores within the 70 to 75 range on an intelligence test with an average of and a standard deviation of The range is called borderline because it is on the borderline of the criteria for the diagnosis of intellectual disabilities historically referred to as mental retardation in the Diagnostic and Statistical Manual of Mental Disorders DSM.

Consistent scores within the 70 to 75 range are considered suggestive of borderline intellectual functioning and may indicate a mental disability.

No diagnosis should be made on the basis of a single test. Multiple test instruments should be administered to confirm a diagnosis. Interviews with family members, teachers, and caregivers are also important. In the past, because of the weight given to IQ scores alone, people with scores between 70 and 75 were generally denied services and supports provided to people with scores below Today, however, there is more of an emphasis on individuals' ability to function and manage daily living skills.

Thus, if an individual has a borderline intellectual disability, they may or may not receive services. The determination will depend on upon a number of factors. If your child or another loved one has been diagnosed with a borderline intellectual disability, they will likely need your help to advocate for them and to learn important self-care skills. While it's important and essential to seek advice and support from professionals, you know your child best and are in the best position to make sure their needs are met.

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