Borderline intellectual functioning is a category that can be used when the focus of clinical attention is on a child or adolescent’s IQ in the 71 to 84 range. The intellectual functioning of children plays a major role in their adjustment to school, social relationships, and family function. Children who cannot quite understand class work and are slow in understanding rules of games and the “social” rules of their peer group are often bitterly rejected. Some children with borderline intellectual functioning can mingle socially better than they can keep up academically in class. In these cases, the strengths of these children may be peer relationships, especially if they excel at sports, but eventually, their academic struggles will take a toll on their self-esteem if they are not appropriately remediated.

An academic problem is a problem that is not caused by a mental disorder or, if caused by a mental disorder, is severe enough to warrant clinical attention. This diagnostic category is used when a child or adolescent is having significant academic difficulties that are not deemed to be attributable to a specific learning disorder or communication disorder or directly related to a psychiatric disorder. Nevertheless, intervention is necessary because the child’s achievement in school is significantly impaired. Therefore, a child or adolescent who is of normal intelligence and is free of a learning disorder or a communication disorder but is failing in school or doing poorly falls into this category.

Child or adolescent antisocial behavior refers to behavior that is not caused by a mental disorder and includes isolated antisocial acts, not a pattern of behavior. This category covers many acts by children and adolescents that violate the rights of others, such as overt acts of aggression and violence and covert acts of lying, stealing, truancy, and running away from home. Certain antisocial acts, such as fire setting, possession of a weapon, or a severe act of aggression toward another child, require intervention for even a single occurrence. Sometimes children without a pattern of recurrent aggression or antisocial behavior become involved in occasional, less severe behavior that nevertheless requires some intervention. The text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) definition of conduct disorder requires a repetitive pattern of at least three antisocial behaviors for at least 6 months, but childhood or adolescent antisocial behavior may consist of isolated events that do not constitute a mental disorder but do become the focus of clinical attention.

Identity problem refers to uncertainty about issues such as goals, career choice, friendships, sexual behavior, moral values, and group loyalties. An identity problem can cause severe distress for a young person and can lead a person to seek psychotherapy or guidance. It sometimes manifests in the context of such mental disorders as mood disorders, psychotic disorders, and borderline personality disorder.

Students should study the questions and answers below for a useful review of these conditions.