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The co-occurrence of Borderline Personality Disorder (BPD) and Intellectual Disability (ID) is a sparsely covered area in the literature. This case series looks to describe the common presentations of these two disorders, both commonly presenting with self-harm, impulsivity, and intense anger. Additionally, three treatment courses of individuals with co-occurring ID and BPD will be described, illustrating the commonalities as well as the modifications of BPD treatment for individuals and in adapting ID supports for those with BPD. Of the 3,028 children, 16% of those without autism or a learning disability had been diagnosed with a psychotic disorder. And, for children who had autism or a learning disability, only 7% of those given antipsychotics had a psychotic disorder. Looking further at these records, we found that the children with an intellectual disability or autism were more likely to be given an antipsychotic drug. In fact, 2.8% of the children with an intellectual disability had been prescribed antipsychotics, and 75% of these had autism. By contrast, 0.15% of those without an intellectual disability had been prescribed the medication.