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.
Further Reading
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.
Colin says
“Sometimes gifted students with ADHD can excel academically until they hit a road block in middle or high school”
Or sometimes it waits until their last year of undergraduate studies and their ability to ace aerodynamics exams while attending class once a week and not doing homework is trumped by missing a class where the professor tells everyone that the final exam date has changed, and by the anxiety of feeling that nobody in the Engineering department really likes you and crashing into a depression that causes you to skip the last 2 months of the last semester and have to come back in the fall, all while the department banquet presents you with an award for “least likely to be here.”
Then you find out it really doesn’t get better as an adult, and your child is just like you and you desperately want to help him figure out how to have a better outcome, but you see the system doing the same thing to him that it did to you, shuffling him into the corner because he’s bored, telling you “he’s so smart, he’ll be fine” to justify completely ignoring his needs, and ostracizing him because he’s different.
There are lots of good articles about parenting 2E kids, but boots on the ground is really lousy much of the time. You basically have to be committed to being in a 24×7 battle with the entire system.
Lara says
While I appreciate this article, I am not sure I appreciate the manner in which medication is addressed. The stated “explicitly teaching your child how to inhibit impulsive behaviors coupled with medication might be the best approach to ensure long term success” sounds nice, but sounds a lot like the “your child just needs to try harder to control himself” that many of us hear from the education system. A thorough ADHD diagnosis was key for us, and the recommended medication has enabled our child to focus sufficiently enough for teachers to appreciate his incredible academic potential. We would all love a therapeutic cure, but please don’t diminish medication. It’s analogous to prescription glasses for vision problems for many, many people with ADHD.
Katy Munger says
Hi Aziza,
A good start is to read the many articles on Gifted Today about ADHD and related issues. This link lists them for you: https://blogs.tip.duke.edu/giftedtoday/tag/attention-deficit-disorder/.
Hope this helps!
Aziza says
Dear writer I do read about gifted students and problems with their skip grading. I want to know a lot about gifted students in middle school and ADHD. Could you please recommend me more articles about this theme?