Twice-Exceptionality

The term twice-exceptionality is used to describe profiles where high abilities coexist with a difficulty, disability, neurodevelopmental disorder, or other need affecting learning, communication, attention, regulation, or daily functioning. It is not a single clinical diagnosis. It is a way of naming a complex combination: a person may show very prominent strengths and, at the same time, require specific support in particular areas (Pfeiffer, 2015; Lovecky, 2004; Giudice, 2024).

This idea is important because it breaks a still-frequent assumption: thinking that high ability should protect against difficulties. The reviewed sources agree on a basic point: a learning, attention, or communication difficulty does not rule out high ability, and high ability alone does not eliminate a real difficulty (Distin, 2006; Valadez Sierra et al., 2012; Sternberg et al., 2011).

This chapter does not aim to help diagnose ADHD, autism, dyslexia, or high abilities. Its objective is to explain why these profiles can go unnoticed, what precautions should be taken, and why the educational response should not focus only on “what is wrong” or only on “what stands out.”

When one part of the profile hides the other

Twice-exceptionality is often difficult to identify because strengths and difficulties can mask each other. Some sources describe three common situations: high ability compensating for a difficulty, difficulty obscuring potential, or both dimensions remaining largely invisible, making the person seem simply “normal,” inconsistent, or unmotivated (Pfeiffer, 2015; Phillipson et al., 2013; Distin, 2006).

A student with high verbal reasoning may use their general comprehension to compensate for reading problems for a time. Another may have complex ideas but produce poor written work due to difficulties with writing, planning, or speed. A child with a great capacity to learn may maintain good results in Primary school at the cost of much effort, and begin to show more difficulties when organizational demands increase. These examples do not prove anything on their own, but they help to understand why visible performance can be misleading.

Several sources warn against two simplistic interpretations. The first would be to think: “if they have high abilities, they don’t need support.” The second would be to conclude: “if they have difficulties, then they cannot have high ability.” Both leave out a part of the profile (Lovecky, 2004; Sternberg et al., 2011; Valadez Sierra et al., 2012).

If only one looks at…	Main risk	More cautious interpretation
High performance	Invisibilizing difficulties with attention, reading, writing, communication, or regulation.	Ask how much effort it takes to sustain that performance and in what contexts barriers appear.
The difficulty	Overlooking reasoning, creativity, deep interests, or rapid learning.	Also explore strengths, talent domains, and opportunities for challenge.
An overall score	Hiding profiles that are very uneven across areas.	Interpret the data set with qualified professionals.
External behavior	Confusing different causes: boredom, anxiety, ADHD, autism, dyslexia, or other factors.	Observe context, duration, interference, and trajectory.

Uneven profiles, not contradictions

In twice-exceptionality, internal differences can be wide. Lovecky describes children with high reasoning and difficulties in attention, writing, organization, social skills, or emotional regulation. She also notes that these profiles can show greater asynchrony: thinking with great complexity in one area and, at the same time, needing help with daily tasks that seem simple from the outside (Lovecky, 2004).

Sternberg, Jarvin, and Grigorenko address the combination of high ability and learning difficulties from a contextual perspective: what is considered a strength, weakness, or disability also depends on the demands of the educational environment and the skills that environment values (Sternberg et al., 2011). This idea does not deny difficulties, but it reminds us that the problem does not reside solely in the person. A school heavily reliant on fast written tasks can make a writing difficulty more visible; an assessment with a high verbal load may not accurately capture certain profiles; a classroom with little flexibility can amplify attention or communication problems.

The most appropriate response usually requires two simultaneous movements: developing strengths and supporting vulnerable areas. The consulted sources insist that intervention should not be limited to correcting deficits, because that can impoverish talent development. But it would also not be enough to offer enrichment or acceleration if difficulties affecting daily life are ignored (Lovecky, 2004; Distin, 2006; Pfeiffer, 2015).

ADHD and High Abilities: External Similarity is Not Equivalence

ADHD appears in several sources as one of the profiles that can coexist with high abilities, but also as a frequent source of confusion. Some behaviors may seem similar from the outside: moving a lot, talking excessively, interrupting, getting distracted by repetitive tasks, abandoning projects, or resisting rules that are not understood. However, the sources do not maintain that high ability and ADHD are the same (Pfeiffer, 2015; Bourse & Ricart, 2014; Giudice, 2024).

Part of the literature warns that boredom, lack of challenge, or an ill-fitting curriculum can produce behaviors that resemble inattention. Other authors highlight the opposite risk: that ADHD goes undetected because high ability allows for compensation for some school demands for years (Lovecky, 2004; Pfeiffer, 2015; Ambrose & Sternberg, 2016).

The study by Gomez and colleagues compared children with ADHD with and without high ability, and children without ADHD. In that sample, the groups with ADHD clearly differed from the groups without ADHD; furthermore, the group with high ability and ADHD did not show exactly the same pattern as the group with ADHD without high ability. The authors interpret that ADHD can be a valid diagnosis in children with high ability, although they recommend caution and more research before establishing differentiated criteria for this group (Gomez et al., 2019).

In popular terms, the caution would be this: neither restlessness nor distraction is enough to speak of ADHD; nor should it be ruled out just because there is good reasoning, creativity, or high performance in some areas. The assessment must consider the persistence of difficulties, their presence in different contexts, functional interference, and developmental history, always by competent professionals (Lovecky, 2004; Pfeiffer, 2015; Williams, 2024).

Autism and High Abilities: Distinguishing Without Rigid Separation

Autism also appears in sources as a possible form of twice-exceptionality, though with important nuances. Some older works use the category “Asperger’s syndrome,” specific to previous diagnostic classifications. When using these sources, it is important to remember that part of the vocabulary comes from its era and should not be transferred without context (Lovecky, 2004; Distin, 2006; Costis, 2016).

The reviewed sources point to possible areas of difficulty in social communication, reciprocity, flexibility, interpretation of social cues, sensory sensitivity, or adaptive functioning. At the same time, they describe possible strengths: memory, specialized knowledge, honesty, deep interests, or advanced learning in specific domains. These are not universal traits or sufficient to identify autism, but they help to understand why some profiles can be very uneven (Lovecky, 2004; Costis, 2016).

Doobay and colleagues compared highly able youth with autism to highly able youth without a psychological diagnosis. In their sample, they found no significant differences in total IQ, but they did observe average differences in processing speed, adaptive skills, and adult-reported psychosocial functioning. The largest adaptive differences appeared in socialization. The authors themselves emphasize individual variability and the need for more studies on intervention (Doobay et al., 2014).

Freeman provides an additional caution: some highly able individuals may have social difficulties without that necessarily equating to autism. At the same time, the possibility that a person has both conditions should not be denied. The question is not to decide by intuition whether someone “seems autistic” or “seems gifted,” but to rigorously assess communication, flexibility, adaptive functioning, developmental history, and real needs (Freeman, 2010; Costis, 2016).

Dyslexia and other learning difficulties

Dyslexia is mentioned in several sources as a specific difficulty that can coexist with high abilities. The most repeated point is that advanced reasoning does not necessarily eliminate difficulties in reading, writing, or spelling. Similarly, a literacy difficulty does not allow one to conclude low intellectual ability (Valadez Sierra et al., 2012; Distin, 2006; Freeman, 2010).

This profile can go especially unnoticed if the school relies heavily on written performance. A student may have complex ideas, good oral comprehension, or advanced mathematical thinking, but obtain poor results when the task requires reading quickly, writing precisely, or organizing what they know in writing. Lovecky collects examples of students with high abilities, ADHD, and dyslexia, and notes that supports such as dictation, computers, or other ways of expressing thought can help to better show what the person understands (Lovecky, 2004).

Some sources describe possible visual, spatial, or creative strengths in certain students with dyslexia, but this point should be treated with caution. Not every person with dyslexia will have these strengths, nor does every visual strength indicate dyslexia. The useful idea is more modest: it is advisable to look at the complete profile, not just the mistakes, reading slowness, or written presentation (Bourse & Ricart, 2014; Farrall et al., 2007).

Assessing and Supporting Without Reducing to Labels

Twice-exceptionality requires particularly careful assessment. Sources insist on using multiple sources of information: appropriate tests, school history, observation, reports from family and teachers, productions, daily functioning, and context. They also warn that an overall score can hide important internal differences, and that some tests can be affected by difficulties in attention, language, reading, processing speed, or communication (Pfeiffer, 2015; Sternberg et al., 2011; Valadez Sierra et al., 2012).

In educational practice, the question should not be only “what label do they have,” but what they need to learn and participate better. Some measures can address the difficulty: executive function support, anticipation, structure, explicit strategy teaching, adjustments in reading or writing, visual aids, adequate time, or alternative ways of demonstrating knowledge. Others must nurture the development of strengths: enrichment, depth, complex projects, acceleration when appropriate, mentorship, or access to more advanced content. The sources do not promise that a specific combination will work in all cases; they recommend adjusting the response to the individual profile (Lovecky, 2004; Distin, 2006; Pfeiffer, 2015).

It is also important to be careful with language. A child is not “just ADHD,” “just autistic,” “just dyslexic,” or “just highly able.” Labels can open doors to support and understanding, but they can also narrow the perspective if they become the complete explanation of the person. Twice-exceptionality precisely invites us to maintain a dual perspective: recognizing real abilities without denying real difficulties.

Perhaps the most prudent criterion is this: when there are large discrepancies between what a person seems to understand, what they manage to express, how they learn, and how they function in different contexts, it is worth looking in more detail. Not to multiply labels, but to prevent one part of the profile from erasing the other.

Sources used

• Ambrose, D., & Sternberg, R. J. (Eds.). (2016). Giftedness and talent in the 21st century: Adapting to the turbulence of globalization. Sense Publishers.
• Bourse, P., & Ricart, D. (2014). Brilliant Children, Outstanding Students: A Manual for Parents and Teachers on Students with High Intellectual and Creative Potential. Bonum.
• Costis, P. A. (2016). Seeing the paradigm: Education professionals’ advocacy for the gifted student with autism spectrum disorder [Doctoral dissertation, The College of William and Mary in Virginia]. ProQuest LLC.
• Distin, K. (Ed.). (2006). Gifted children: A guide for parents and professionals. Jessica Kingsley Publishers.
• Doobay, A. F., Foley-Nicpon, M., Ali, S. R., & Assouline, S. G. (2014). Cognitive, adaptive, and psychosocial differences between high ability youth with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 44, 2026-2040. https://doi.org/10.1007/s10803-014-2082-1
• Farrall, J., Matison, A., Minchin, M., & Stewart, W. (2007). Raising your gifted and talented child: The joys and the challenges. Gifted and Talented Children’s Association of South Australia.
• Freeman, J. (2010). Gifted lives: What happens when gifted children grow up? Routledge.
• Giudice, A. (2024). Brief introduction of giftedness in adults. Preprint. https://doi.org/10.13140/RG.2.2.16087.48804
• Gomez, R., Stavropoulos, V., Vance, A., & Griffiths, M. D. (2019). Gifted children with ADHD: How are they different from non-gifted children with ADHD? International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-019-00125-x
• Lovecky, D. V. (2004). Different minds: Gifted children with ADHD, Asperger Syndrome, and other learning deficits. Jessica Kingsley Publishers.
• Pfeiffer, S. I. (2015). Essentials of gifted assessment. John Wiley & Sons.
• Phillipson, S. N., Stoeger, H., & Ziegler, A. (Eds.). (2013). Exceptionality in East Asia: Explorations in the actiotope model of giftedness. Routledge.
• Sternberg, R. J., Jarvin, L., & Grigorenko, E. L. (2011). Explorations in giftedness. Cambridge University Press.
• Valadez Sierra, M. D., Betancourt Morejón, J., & Zavala Berbena, M. A. (Eds.). (2012). Gifted and Talented Students: Identification, Assessment, and Intervention. A Perspective for Teachers (2nd ed.). Editorial El Manual Moderno.
• Williams, J. (2024). Raising their voices: Lived experiences of gifted women with ADHD [Doctoral dissertation, University of Denver]. ProQuest Dissertations & Theses.