Most of us tend to associate the term “twice-exceptional ” with quirky geniuses, or exceptionally intelligent children who also happen to be on the autism spectrum. However, gifted students can also receive learning disability labels or a diagnosis of a health impairment such as Attention Deficit Hyperactivity Disorder (ADHD), both of which impact school success and fall under the umbrella of twice-exceptionality.
The term twice-exceptional indicates that a student has two forms of exceptionality: giftedness coupled with one of the 14 disabling conditions outlined in the Individuals with Disabilities Education Act (IDEA). Having a medical diagnosis of ADHD qualifies under the broad special education eligibility category of “Other Health Impaired,” which is an appropriate label for students who have a medical condition that impacts their educational success.
The tricky thing about giftedness and ADHD is that the two can look like one another and can interact and present differently in each child. The overlapping symptomology, most notably inattention and/or hyperactivity, according to a review of research on gifted students with ADHD, is a major cause for misdiagnosis. Giftedness sometimes presents similarly as ADHD, especially when the student is under-challenged and bored. Understanding this issue is extremely important as a parent, because missed ADHD or missed giftedness could result in inappropriate educational programing for your child. Sometimes gifted students with ADHD can excel academically until they hit a road block in middle or high school when the rigor of the curriculum places more demands on their ability to organize, manage their time, and attend to more challenging material for longer periods. Recognizing the potential dual existence of ADHD and giftedness early could have important implications for a student’s classroom grades, performance on standardized tests, and could reduce the chances that he or she will develop comorbid mood or behavior disorders.
Sometimes even educators are unsure of the best way to meet the academic and behavioral needs of gifted children with attentional and behavioral difficulties. In fact, the previously mentioned research indicates that students with behavioral problems like those associated with a diagnosis of ADHD are less likely to receive academic acceleration. This would be a shame for students who would attend better if appropriately challenged! Besides recommending an accelerated curriculum, school psychologists might suggest preferential seating; breaking large projects into smaller segments to teach time management skills, allowing breaks between activities to help with transitions; and explicitly teaching self-regulation skills to increase their independent self-monitoring ability.
Knowing your child is receiving academic and behavioral supports at school leaves one last major question: to medicate or not to medicate? Parents struggle with this dilemma due to the many medications available, varying dosages, and resulting side-effects. This is an important discussion to have with your child’s pediatrician, and what may work for one family is not necessarily the right choice for another. As discussed in the previously linked research, empirical findings suggest that stimulant medications continue to be the most effective treatment for symptoms of ADHD. Some students experience great success with stimulant medications, however, these should not be considered a permanent solution. Explicitly teaching your child how to inhibit impulsive behaviors coupled with medication might be the best approach to ensure long term success.
Assouline, S.G. & Whiteman, C.S. (2011). Twice-exceptionality: Implications for school psychologists in the post-IDEA 2004 era. Journal of Applied School Psychology, 27, 380-402.
Connor, D. F. (2006) Stimulants. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder (608–647). New York, NY: Guilford Press.