Mind the Gap: A Systematic Review of Borderline Intellectual Functioning in Childhood and Adolescence

Borderline intellectual functioning (BIF) is characterized by an IQ between 70 and 84/85, representing a cognitive condition associated with significant learning, academic, and behavioral challenges. Despite its prevalence and impact, BIF remains underrecognized in diagnostic classifications, leading to inconsistent clinical management and limited research attention.

This systematic review is aimed at synthesizing the current literature on BIF in childhood and adolescence, focusing on its neuropsychological profiles, prevalence, and effective strategies to improve quality of life.

We conducted a systematic review following the PRISMA 2020 guidelines. Articles published between 2013 and 2023 were identified through electronic databases, including MEDLINE, PsycInfo, and CINAHL. Inclusion criteria were studies presenting empirical data on BIF in individuals aged 0-18 years, with quantitative results on intellectual and adaptive functioning. Excluded were intervention studies, reviews, and studies focusing on unrelated neuropsychological domains.

From 455 articles identified, eight met the inclusion criteria. Key findings include that BIF is associated with cognitive deficits, particularly in working memory and academic skills, with a 2-year developmental lag in reading and arithmetic. Prevalence estimates range from 7% to 14%, influenced by socioeconomic factors and environmental stressors. Tailored educational programs and vocational training are effective in addressing cognitive and adaptive challenges, highlighting the need for personalized interventions.

BIF presents significant clinical, educational, and social challenges that require standardized diagnostic criteria and targeted interventions. Future research should focus on refining diagnostic approaches, exploring cognitive subtyping, and implementing cost-effective support systems to enhance the well-being of individuals with BIF.