Learning Challenges

What Does Twice Exceptional Mean? Identifying and Nurturing Gifted Children with ADHD

The intellectual potential of twice exceptional youth is great but sometimes difficult to recognize and cultivate due to a co-existing condition like ADHD, a learning disability, sensory issues, or other conditions that complicate learning — and teaching.

2E (twice exceptional) stamp blocks on primary color paints

What Does Twice Exceptional Mean?

“Twice exceptional” (2e) is the term used to describe intellectually gifted children with great potential for academic achievement who also have a learning disability or neurological challenge, like attention deficit hyperactivity disorder (ADHD or ADD). Their exceptional intellectual abilities of 2e students are often masked or obscured by one or several conditions (or vice versa), making them one of the least recognized and supported populations.

Twice exceptionality requires special methods of identification and targeted educational supports that highlight a child’s strengths. Parents can help a twice exceptional teen and other 2e students by researching common characteristics, understanding how 2e brains excel, and learning how to uniquely support their needs in the classroom.

Twice Exceptional Students: Common Characteristics

The intellectual potential of twice exceptional youth is great. At the same time, they have an enduring disability or disorder that inhibits their learning experience. Common co-existing conditions include:

Their intellectual capabilities typically mean that 2e children often exhibit:

  • rapid learning
  • strong memories
  • large vocabularies
  • advanced comprehension of nuances
  • strong curiosity
  • unusual emotional depth
  • divergent thinking

As a result, 2e children are often highly creative, hold varied and intense interests, exhibit sharp problem-solving skills, and have a sophisticated sense of humor.

But 2e children also tend to struggle with:

  • social interactions
  • inconsistent performance
  • disorganization
  • executive dysfunction
  • transitions/initiative
  • fatigue

In the classroom, twice exceptional children may perform both above and below average on different scales. Their intellectual gifts may overshadow their struggles, or vice versa – a dynamic that explains why identifying these children is so difficult. What’s more, if their intellectual gifts and deficits are left unaddressed, 2e children can experience anxiety, stress, extreme sadness, and feelings of underachievement.

[Click to Read: Unlocking the Potential of Gifted Kids with ADHD]

Twice Exceptional Children: Brain Development

Research shows that the 2e brain, not accounting for any particular condition, is meta-physiologically different from a neurotypical brain. Twice exceptional brains generally tend to:

  • be physically larger
  • have more connectivity – the white matter within the brain is denser, meaning more connections and storing of information. Sensory intake capacity is also greater.
  • be “over-excitable” – emotions are more intense because the limbic system, the part of the brain thought to be responsible for emotion and other processes, is overloaded by increased sensory input (as a result of denser white matter) and the development of intense epigenetics, or sensory prints, as the brain builds knowledge based on various environmental stimuli.

The increased demands on the limbic system may explain why many 2e children have the same struggles and asynchronous development paths – their social-emotional growth is typically delayed, but their intellectual growth is accelerated.

Twice Exceptional: Signs and Identification

The process for identifying a 2e child often starts at home, even before school starts. Parents who suspect their children may be twice exceptional should first:

  • Stop to reflect on the child’s behaviors. Some parents detect differences early on, like how their child plays, communicates, behaves, or responds compared to other children. Twice exceptionality tends to be characterized by major disparities in skill, like completing complex tasks and struggling with easier, simpler tasks.
  • Look. Observe what happens when the child is struggling (and not) and consider the settings where struggles arise. Question what factors seem to be at play, and whether the child may be compensating for a deficit. Know that some 2e kids learn to camouflage their condition early on, tricking parents and even schools. Use a journal to document observations – the sooner, the better.
  • Listen to what the child says about themselves and their struggles. True listening, especially for young children, may require more interpreting than anything else, as they might lack the vocabulary to accurately describe their challenges. Using a “word wall” – a list of varying words to convey emotions – can help children be more exact.

[Read This: Twice-Exceptional and Thriving — At Last]

2e Assessment Steps

Psychologists administer varying multi-section intellectual assessments, like the Wechsler Intelligence Scale for Children (WISC-V) and the Stanford-Binet Intelligence Scales, when attempting to identify twice exceptionality. The specialist analyzes and interprets results, then provides recommendations and/or further testing. Testing is common when the child reaches school age.

In many cases, 2e children tend to have significantly different scores across assessment sections. These disparities and inconsistencies (called discrepancy scoring) typically signal to psychologists where they might go next to narrow in on deficits.

Parents should consider the following in the specialist’s interpretations and recommendations, as well as in the testing experience:

  • Signs of anxiety, stress, and/or discomfort. 2e children need to build a trust relationship with their proctor to be relaxed and give their best effort. Breaks are OK, and should be worked into testing if needed.
  • A 2e-friendly testing environment so that sensory stimuli does not interfere with concentration (especially true for kids with ADHD). Even the pencil and paper used for testing can be challenging for certain students!
  • In some sections, assessors should consider perfectionist tendencies 2e children tend to have that can slow them down in a bid for accuracy.
  • Tasks that involve immediate recall may be a struggle for 2e children. 2e children process a great deal of information but it may not be organized sequentially in the brain. It takes time to organize, sort the best response, and deliver the most accurate result.
  • Intense minds (especially those with ADD or ADHD or similar symptoms) may struggle with “sluggish cognitive tempo” – if a child is reluctant to engage and do the work, if they find the task boring, or are uncertain of what to do, they may score lower on certain test sections as a result.
  • Remember – average scores on sub tests may look normal, but can still represent an area of difficulty, especially in comparison to the child’s strengths

It is absolutely crucial for assessments to be performed by a specialist with experience working specifically with 2e children. There are many nuances when dealing with 2e children, from how the assessment is administered to how the results are interpreted, that may be lost when working with a general specialist. A trusting relationship between specialist and child is needed, so parents should check that the specialist spends time getting to know the child prior to assessment. The nonprofit I’m associated with, SENG (Supporting Emotional Needs of the Gifted), has a directory that lists 2e professionals.

Twice Exceptional: Support & Strategies

Parents play an important role in supporting their 2e children at home and when advocating with the school. A twice exceptional student thrives when their school addresses their deficits but also makes sure they are intellectually challenged. Schools that understand this dual responsibility and provide proper accommodations can help place a 2e child on the path to personal, academic, and social success.

Supports at Home: Advice for Parents

  • Know your child. Understand your child’s unique needs, interests, development, strengths, weaknesses, and ways of responding to their surroundings. Observe behaviors at home and at school. Teach your child who they are, how they operate, and why they are different. Do your best not to confuse support with helicopter parenting, as the latter may be detrimental in the long run. Find a support group to help you work through challenges, share ideas, and feel less alone.
  • Teach social-emotional intelligence. This area is one of the biggest hurdles for 2e kids. Help your child expand their emotional vocabulary to better express their needs, and seek out healthy friendships (sometimes, intellectual friends are more important than chronological friends).
  • Provide resources. Schools offer very little training for teachers on twice exceptionality. To compensate, provide easy-to-find resources, like checklists and pamphlets, to your child’s teachers. Also try to bring a calm presence to any interactions with staff.

School Accommodations: Advice for Educators

2e accommodations may be as informal as providing notes prior to class or permitting doodling or fidgeting to help with focus. Accommodations ultimately come down to knowing how the child’s condition manifests, and valuing strengths and interests over weaknesses.

Some ideas for 2e classroom accommodations include:

  • extended time on assessments and assignments (ask for Measures of Academic Progress tests, which are not timed)
  • individualized curriculums, created through diagnostic assessments that test their knowledge before and after learning units
  • alternative projects, especially if the child can explore concepts through their interests
  • assistive technologies (using recording devices, typing rather than writing, learning apps, etc.)
  • multimedia resources (such as video lessons over typical lectures)
    Use of thematic instruction that can include the child’s passions or interests

Twice Exceptional: Next Steps


The content for this article was derived from the ADDitude Expert Webinar “2e 101: A Parents’ Guide to Understanding and Supporting Twice Exceptional Children” (also available as ADDitude ADHD Experts Podcast #320) by Michael Postma, Ed.D., which was broadcast live on August 20, 2020.

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