Sixteen children said to be "borderline" were referred for comprehensive evaluation. None met DSM III criteria for borderline personality disorder. Referring psychiatrists and psychologists seemed to base their impressions on the child's disorganized thinking and irrational, erratic behavior, problems that were better understood and treated from a developmental perspective. The borderline label had a negative impact on some children, and was not helpful for treatment planning or disposition. Clear guidelines for the application of this ambiguous and controversial diagnostic term in child psychiatry are nonexistent.