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Twice Exceptionality: What It Is and How To Help

As a child psychologist who performs neuropsychological and psychological testing, I frequently receive referrals regarding a child’s capabilities, and whether there are challenges that are impacting learning, such as AD/HD, learning disorders, autism and executive dysfunction. When a significant cognitive weakness is identified, it’s very clear to both parents and teachers as to why a child or adolescent is having difficulty completing particular tasks or succeeding at school. But what about the children who are highly gifted and continue to struggle academically, emotionally and behaviorally? We consider this underidentified and often misunderstood group of students as Twice Exceptional, or 2e.

Twice exceptionality means that a student has both immense ability and disability in different areas. However, given their significant strengths, 2e students can often mask the difficulties that they have into later years of education. For example, a student who is gifted with AD/HD may not demonstrate significant difficulties with executive functioning until middle and high school when the expectations are increased, with more shifting, transitions, need for organization, etc. Another example would be a 2e child with a learning disability that has difficulty decoding words but is able to use context clues and inferential reasoning to get by with average grades.

Conversely, the giftedness of a 2e student may go unidentified due to the severity of their disability. Children who are gifted already often present with overexcitabilities, quirks and other atypical features that elicit questions and frustration from peers and others in their environment. With comorbid AD/HD or Autism, these behaviors are intensified and can result in inappropriate supports at school and in therapy. If placed in a special education classroom, for example, these students may experience excessive frustration as a result of not being challenged, thereby increasing emotional and behavioral struggles, as well as decreasing self-esteem.

To remedy the issue, it is important that parents, teachers and therapists be aware of the concept of twice exceptionality so that they can refer for an assessment. When a child performs exceptionally well in a few areas or all but one, it is recommended that the family pursue a neuropsychological evaluation. This enables greater understanding of the child’s strengths and weaknesses, and can inform how to best support the child both in and outside of the school. However, parents and schools are faced with yet another dilemma, which is how to best cultivate their strengths while remediating their weaknesses.

At present there is no definitive solution as to the best way to support this population, which necessitates individualized interventions. Experts recommend that parents first pursue Section 504 accommodations (if in the public school), or an Individualized Education Plan (IEP) if more intensive services are needed. If possible, some parents may choose to enroll their child in private schools, schools with smaller teacher-to-student ratios, or in settings that offer individualized curriculum. Outside of schools, it is recommended that parents provide enrichment opportunities for their children, such as through the Davidson Institute for Talent Enrichment or the Northwestern Center for Talent Development. Locally, the Texas Association for the Gifted and Talented provides a list of enrichment programming throughout the state.

Accessing support services can enable these students to meet their exceptional potential academically, behaviorally and emotionally. Research supports improvements in self-esteem and performance following identification and intervention. At Neurobehavioral Institute of Austin, we offer assessment, consultative and therapeutic resources to support twice exceptional individuals. Please visit our website or contact us at (512) 329-8222 or [email protected] to learn more about how we can support your child in establishing a comprehensive plan to meet their needs.