Could Your Child Be Twice-Exceptional?

If you have an intense gifted kid, you may have wondered if your child could be twice-exceptional.

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Someone who’s twice-exceptional is exceptional in two ways. In this case, “exceptional” means “different from the norm.” A twice-exceptional person is gifted, which means some of their cognitive abilities are much stronger than average. A twice-exceptional person is also exceptional in another way - for example, they may be autistic, an ADHDer, dyslexic, have sensory processing differences, or have another learning disability.

 

Many parents of emotionally intense or sensitive gifted kids wonder if their child may be twice-exceptional, because intense and sensitive gifted kids often have characteristics that overlap with characteristics of ADHD, autism, sensory processing differences, or learning disabilities.

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Here’s what this article will cover:

• Why twice-exceptionality is often missed or diagnosed late

• Characteristics that may indicate twice-exceptionality

• Considerations when deciding whether to pursue an assessment

• Resources to learn more about twice-exceptionality and neurodiversity

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The information in this article is based on research (others’ and my own) and on my experience working with hundreds of twice-exceptional kids and their families as an educator, therapist, assessment provider, and parent coach.

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This article should not be considered medical advice, and you can’t diagnose your child by reading something online - of course. But if the information in this article resonates with you, I encourage you to keep exploring neurodiversity and twice-exceptionality. At the end of the article, I share some of my favorite resources for learning more. You can also seek out an assessment to better understand your child’s neurotype.

 

Why consider twice-exceptionality?

 

In my experience as an educator, psychologist, and parent coach, I’ve helped many gifted kids, teens, and their families explore the possibility of twice-exceptionality or process a recent diagnosis.

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Although this topic can feel daunting at first, I believe that proper identification of twice-exceptionality is a path to self-understanding and liberation.

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When twice-exceptionality is unidentified, kids often worry that they are flawed in some way - weird, awkward, lazy, irresponsible, incapable, or dumb. When these kids learn that they are twice-exceptional, they learn that there is nothing wrong with them. In fact, they learn that their different way of thinking and working has a name and a community of people like them!

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As it was put in a  popular Tweet from an autistic creator  - “’Why do you need a label?’ Bc there is comfort in knowing you are a normal zebra, not a strange horse. Bc you can’t find community w other zebras if you don’t know you belong. And bc it is impossible for a zebra to be happy or healthy spending its life feeling like a failed horse”

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If you’re curious about twice-exceptionality and whether your child (or you) could be twice-exceptional, please read on!

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Why is twice-exceptionality often missed or diagnosed late?

 

Exceptionalities such as ADHD, autism, or a learning disability are often identified later for gifted folks than they are for folks who are not gifted (see  this research ). Many families don’t learn their gifted kids are twice-exceptional until the child is in their teens or has struggled for a long time.

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Experts also believe it’s common for these exceptionalities to be missed entirely in gifted youth. For example, as awareness of autism and ADHD increase, many gifted adults are recognizing their own unidentified twice-exceptionality - often after having their children assessed.

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Why is twice-exceptionality so often missed? I describe some common reasons below.

 

Differences or difficulties are attributed to giftedness

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Twice-exceptionality is often missed when signs and characteristics of autism or ADHD are attributed to giftedness. Parents may have concerns about their gifted child’s well-being or may notice that some things are very difficult for their child. When they speak with professionals or research their concerns online, though, they are led to believe that their child’s emotional intensity, sensory sensitivities, social challenges, or sensitivity are simply part of being gifted. Many of the parents I work with were told at some point that their child’s challenges and characteristics were due to their giftedness, but the children were later diagnosed as twice-exceptional.

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For example, twice-exceptional kids may be seen as “quirky,” “weird,” or ”awkward” in a way that’s viewed as “normal” for a gifted kid or as acceptable because they are smart. Some common gifted stereotypes that may obscure twice-exceptionality are the “absent-minded professor” who loses track of their belongings and gets distracted in the middle of tasks (common for those with ADHD) and the “little professor type” who speaks in a formal, academic way about their interests or prefers the company of adults (common for those who are autistic).

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It’s true that many gifted characteristics overlap with characteristics of ADHD or autism.

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Gifted and autistic folks may share these common traits or experiences:

• Skilled at analytical, logical thinking

• Interest in language, strong vocabulary, early reading (with autistic folks more likely to be hyperlexic)

• Strong sense of justice; upset by unjust or illogical rules and actions

• Highly attuned to details and sensory input

• Relative (personal) weaknesses in processing speed, compared to their strong gifted cognitive abilities (see the research  here )

• Strong interests or passions (though autistic folks are more likely to info dump about their passions and hyperfocus on passions for hours at a time)

• Difficulties making or finding friends (though for gifted kids, these difficulties are often due to difficulty finding peers with similar interests and similar ability levels, and not due to differences in communication preferences or styles - see  this helpful illustration of autistic/allistic (non-autistic) communication differences from Neurowild on Instagram )

• Sleep problems (up to 80% of autistic people experience significant sleep problems in their lifetime, and there is some evidence that gifted folks may sleep less or have difficulty falling or staying asleep compared to peers).

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Gifted folks and ADHDers may share these common traits or experiences:

• Strong interests or passions. Unlike gifted folks without ADHD, ADHDers are more likely to hyperfocus on passions for hours at a time yet not be able to focus on other tasks that are less interesting to them.

• School problems, including difficulty focusing, behavioral problems, or underachievement. School problems for gifted folks without ADHD are often due to the fact that the gifted child is not adequately challenged and is therefore bored or disengaged. In contrast, gifted folks with ADHD may struggle to pay attention, regulate their behavior, or perform to their cognitive potential in school because of underlying neurological differences in how attention is controlled. That is, they struggle to focus on tasks that are not interesting to them, even if the tasks are adequately challenging and a good match with their ability. They may also under-perform in their grades because they struggle to keep track of assignments and organize larger projects due to executive functioning differences.

• Sleep problems. Many ADHDers experience significant sleep problems in their lifetime, and there is some evidence that gifted folks may sleep less or have difficulty falling or staying asleep compared to peers.

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Without a thorough assessment by a qualified professional, it is usually tricky and sometimes not possible to tell if a child’s challenges are due to their giftedness or another exceptionality.

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At the end of this article, I share more thoughts about when to consider a full psychological assessment and what the benefits or challenges may be.

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Difficulties are attributed to anxiety, OCD, or ODD

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Many gifted folks who are eventually identified as autistic or an ADHDer are first identified with anxiety, OCD, ODD, or dyslexia. If your child has been diagnosed with anxiety, OCD, ODD, or dyslexia but you notice other challenges or subtle differences that seem to not quite fit with that diagnosis, your child may also be twice/multi-exceptional or a diagnosis of autism or ADHD may be more appropriate.

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Anxiety. Most autistic folks experience higher than average levels of anxiety, often throughout their lives.  Gifted autistic people are particularly prone to high levels of anxiety , for reasons that are not yet fully understood.

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Some amount of autistic anxiety is believed to stem from the fact that someone with an autistic brain has to live in a world designed for neurotypical brains. Social situations and “norms” can be confusing or annoying and may cause social anxiety. Many autistic people experience an “atpyical” type of anxiety that can feel near-constant and which is not improved by typical anxiety treatment such as cognitive behavioral therapy or exposure. As some autistic folks will tell you, their anxiety is often well-founded and not irrational - they do experience frequent social friction or rejection, and settings are often overwhelming.

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Autistic people with sensory sensitivities often experience sensory anxiety related to uncomfortable or distressing sensory experiences such as being exposed to noises that feel too loud or having to wear clothing that feels itchy, restrictive, or irritating. Sensory anxiety is different than typical anxiety - it is created by a sensory stressor and ends when the stressor is removed or stopped. It does not get better with exposure to the stressor; instead it gets worse.

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Folks with ADHD can also experience high levels of anxiety, especially if their ADHD is unrecognized. Kids with ADHD are often corrected and redirected, which can lead to anxiety about making mistakes or being criticized. They may worry about disappointing others, missing deadlines, losing belongings, falling behind, or failing to meet expectations. As with autistic folks, ADHDers’ anxieties rooted in these real experiences are not “irrational” - instead, many people with ADHD have been stressed or traumatized by repeated negative feedback for something outside of their control.

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Obsessive-compulsive disorder (OCD). Autistic folks may be misdiagnosed with OCD because of repetitive behaviors that are more accurately understood as autistic stimming (self-stimulatory behaviors) or as a preference for repetition and sameness versus obsessions and compulsions per se. Many autistic folks also have symptoms of OCD such as difficulty throwing things away; a diagnosis of OCD may be appropriate in addition to identification as autistic.

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Oppositional defiant disorder (ODD). Some intense gifted kids are diagnosed with ODD because they refuse to do certain tasks, want to do things their own way, or resist being told what to do. Some of these kids may simply be strong-willed gifted kids, but others are often autistic with a PDA profile. These kids have an extremely strong drive for autonomy and require a sense of autonomy to feel safe and regulated. Requests, demands, and questions can be perceived as threats and can trigger fight/flight/freeze/fawn responses.

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Gifted kids who experience higher-than-average levels of anxiety may also display some traits or characteristics of ADHD (such as difficulty concentrating) and autism (such as rigid thinking).

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Giftedness masks challenges

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Autism, ADHD, and learning disabilities often look different in gifted kids. Sometimes exceptionalities are described as more “subtle” in gifted folks, but a less-obvious or less-stereotypical presentation can hide internal experiences of differences, difficulty, or distress.

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Internally, twice-exceptional folks often share similar or overlapping subjective experiences with autistics and ADHDers who have more classical or stereotypical presentations.

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This means that many twice-exceptional kids, teens, and adults look “fine” from others’ perspective but are struggling or overwhelmed inside.

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These kids often experience overwhelm, stress, confusion, sensory anxiety, and loneliness associated with their differences, but they don’t know where it comes from or how to advocate for themselves.

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For example, many gifted kids with ADHD look like average or excellent students, and others may assume that school is easy for them. Internally, though, these kids may feel overwhelmed by their workload. They may feel confused when they miss content during class and may re-teach themselves concepts or “catch up” by checking in with friends, doing extra reading, or using other techniques. They may find homework excruciating, or work twice as long because their attention drifts and they work half as quickly.

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Similarly, gifted students with learning disabilities may compensate for their struggles with their excellent verbal abilities. Gifted kids with dyslexia often use context clues and their knowledge of text structure to understand what they’re reading without having to read every word accurately.

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Gifted autistic folks may analyze and memorize social norms so they can perform “neurotypical” social behavior and fit in. Research suggests that non-autistic people form negative opinions or autistic people even from short video clips and photos, but for gifted kids these first impressions may be described as “quirky,” “odd,” or “awkward” instead of recognizing that the child could be autistic.

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Difficulties are attributed to personality

 

Many parents I talk with worry that their gifted child has a difficult or flawed personality, but these characteristics may be better understood in terms of twice-exceptionality.

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For example, many parents worry their undiagnosed autistic child is rude, selfish, overly sensitive, or lacks empathy. What’s often perceived as rudeness is actually a preference for direct communication or difficulty monitoring voice tone. Behavior perceived as selfish or lacking empathy is often related to a misunderstanding or to the autistic child’s difficulty understanding how others perceive them.

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Unidentified ADHDers are often described as lazy, careless, just doing the bare minimum, or not willing to put in effort. But I don’t believe anyone is lazy - if someone isn’t doing something, it’s usually because it’s too difficult in some way or not meaningful enough to motivate them. Many kids and teens with ADHD begin to worry they are lazy and irresponsible - when in fact there’s often a poor fit between the way their brain works and what they’re being asked to do.

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Unidentified twice-exceptional kids often feel ashamed and confused when their difficulties are attributed to their personality and personal shortcomings - they worry there is something truly wrong with them, instead of recognizing they just have a different neurotype. Understanding these characteristics through a twice-exceptional lens can be a great relief to parents and children alike by reducing shame and blame.

 

What are some signs your child might be twice-exceptional?

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How can you know whether your gifted child might be twice-exceptional? Below I’ve listed characteristics and traits that are common among twice-exceptional kids or that may indicate twice-exceptionality. This is not an exhaustive list - there are too many traits associated with twice-exceptionality to list all of them here, and the science is always developing.

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This list is also not diagnostic - many of these characteristics can be related to giftedness/high IQ, anxiety, trauma, or other differences instead of or in addition to ADHD, autism, dyslexia, or other learning disabilities.

However, if your child has a number of the characteristics below, I encourage you to learn more about twice-exceptionality or to keep exploring the source of your child’s experiences or intensity. It’s also important to note that many gifted people are multi-exceptional, not just twice-exceptional - for example, autistic people are more likely to be dyslexic and an ADHDer than allistic (non-autistic) people.

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Here are some characteristics that can be signs of twice-exceptionality:

• Multiple diagnoses over time (sensory, fine motor, anxiety, OCD, ODD, etc.).

• Very early reading/math skills ( kids who are twice-exceptional may develop these skills earlier than gifted, non-2e kids ).

• Sometimes described as “lazy,” “manipulative,” “doing the bare minimum,” “irresponsible,” “defiant,” “rude” - or you worry that your child has these characteristics (although I don’t believe laziness exists).

• Difficulty with transitions - they need to be reminded of transitions multiple times, they get upset with transitions, or transitions take a long time.

• Difficulty organizing their time, belongings, or behavior - for example, they lose items frequently, find it hard to clean their room, do things in an unusual order.

• Experience strong emotions - they may cry easily, feel easily overwhelmed by their feelings, melt down when disappointed or frustrated, or shut down due to overwhelm.

• Daily tasks are a struggle - seemingly simple tasks like brushing teeth, getting dressed, eating breakfast, bathing, or getting ready for bed are difficult, often because the executive functioning demands are too high, the tasks are too boring to maintain focus, the demands trigger a stress response, and/or the sensory aspects of the tasks are unpleasant.

• Inconsistent abilities - they manage certain tasks one day but struggle with or get upset by the same tasks another day. Or, their academic performance may be inconsistent across tasks, subjects, or time.

• Very strong drive for autonomy - resists being told or asked what to do; may refuse to do tasks when asked or may avoid tasks in other ways.

• Perceive themselves as equal to adults and others - likes to have a say in how things are done; does not defer to authority; believes their opinions and input are as important as those of adults or the person “in charge.”

• Sensory sensitivities or sensory processing differences - they may be bothered by certain sounds, textures, or smells that don’t bother others. They may not notice when they are in others’ personal space, or they may have a difficult time noticing internal cues like hunger, sleepiness, or needing to use the bathroom.

• School performance seems below their intellectual capabilities - their skills are on grade level instead of advanced, or they struggle with certain subjects or academic tasks.

• Homework is a battle or takes a long time.

• Seems overwhelmed by school projects - they may have a hard time getting started, organizing their work, prioritizing tasks, breaking tasks into smaller chunks, or putting different pieces together.

• Hates or avoids certain academic tasks - for example, they refuse to write or they say that they dislike reading.

• Has great ideas or enjoys story-telling but struggles to express these ideas in writing.

• Poor spelling (e.g., cannot remember correct spelling or they memorize it for a test but can’t remember to apply these spellings while writing).

• Dislike reading, have difficulty understanding what they read, read on-grade level despite strong verbal abilities, or make many errors when reading aloud.

• Struggle with fine motor tasks like tying their shoes, manipulating zippers and buttons, or writing by hand.

• Their handwriting is difficult to read or they complain that writing by hand is painful or tiring.

• Cannot easily remember math facts or do simple calculations mentally.

• Often make small errors in their work and do not seem to notice. These errors may be seen as “careless” work, but the child often struggles to catch the errors even if they are motivated to do so.

• “Rush through” work; try to do uninteresting or demanding tasks as quickly as possible - some kids who are ADHDers try to work quickly because they know they will lose stamina for the task over time.

• Hyperfocus on their interests but can’t focus on and complete tasks that are easy for peers. For example, they may focus on an interest like video games, puzzles, reading, drawing, or Legos for an hour or more without stopping to eat or use the bathroom, but they cannot focus on the tasks in the morning routine without multiple reminders.

• Social differences

  • Interested in relationships but find it hard to start or maintain friendships.

  • Socially awkward or uncomfortable with peers.

  • Experience bullying or are frequently misunderstood by others.

  • Are perceived as missing subtle social cues and norms, or they may perceive these cues but don't know how to respond.

  • Don’t understand or see the point of social dynamics such as hierarchies, drama, gossip, small talk, etc.

  • Social niceties and formalities (e.g., saying hi and smiling; thanking others) don’t come naturally to them or don’t seem important to them.

  • Pick up on others’ emotions but misinterpret the meaning - for example, they may think a parent is angry at them when the parent is actually tired, distracted, or frustrated about something else.

  • They may be well-liked and treated kindly by peers but feel on the outside of social situations and struggle to form lasting friendships or close friendships.

• Prefer sameness and repetition - For example, they may insist that certain tasks are done the same way each time; they may enjoy doing certain tasks over and over, such as listening to the same audiobook, same story, same episode of a show, or wearing the same clothes or types of clothes repeatedly.

• Have a rich fantasy life; enjoy pretend play and role play such as pretending to be cats or other animals, even in the late elementary years when same-age peers prefer other activities.

• Are perceived as “rigid” or inflexible - in many areas, or in certain tasks or domains.

• Uncommon medical needs - allergies, immune abnormalities, autoimmune disorders, hypermobile joints, epilepsy, cerebral palsy, migraine/headaches, and some rare genetic or congenital disorders are more common in autistic people.

• Gastrointestinal problems - chronic constipation, chronic diarrhea, reflux, bloating, discomfort, food intolerance, nausea and/or vomiting, ulcers, colitis, inflammatory bowel disease, food intolerance, and/or failure to thrive are all more common in autistic folks.

• Unusual sleep patterns - for example, it takes them a long time to fall asleep, they wake frequently in the night, they wake early, and/or they need less sleep to feel rested. Sleep difficulties are more common in kids who are autistic and ADHDers.

• Toileting difficulties - incontinence, later-than-usual toileting accidents or bed wetting, and other toileting concerns are more common for autistic kids and ADHDers. In addition to higher rates of gastrointestinal problems, these kids may not perceive internal signals as clearly or may have other medical or physical conditions that contribute to toileting difficulties.

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What if some of this resonates? What should I do?

 

If some of this information resonates, there are several things you can do.

 

(1) Learn more about neurodivergence.

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Social media is actually a great place to learn about twice-exceptionality from creators who are autistic, ADHDers, or learning disabled themselves as well as from educational accounts.

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Some Instagram accounts I recommend include:  @autienelle ,  @fidgets.and.fries ,  @neurodivergent_lou  , @neurodivergent_insights  , @theexpertally  , @rds_for_neurodiversity  , @play.learn.chat  , @learnplaythrive  , @developmental_discoveries ,  @pda_our_way  , @neurowild_  , @_kristyforbes  , @chloeshayden  , @morganharpernichols  , @tendingpaths  , @neuronandrosepsych.

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Helpful podcasts include The Neurodiversity Podcast ,  Tilt Parenting , and  Two Sides of the Spectrum.

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I also recommend the books Nurturing Your Autistic Young Person, and  Unmasking Autism: Discovering the New Faces of Neurodiversity, The Family Experience of PDA , and Declarative Language Handbook.

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(2) Talk to your child about their experience.

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Although it’s almost impossible to tell from the outside whether a child’s behaviors and challenges are due to giftedness or other neurological difference, the subjective experience of a twice-exceptional person is usually a good indicator that their brain works differently.

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If you’ve noticed that your child has some of the characteristics above, you could ask your child if they have noticed the same things. If you can approach your child with genuine curiosity about their experience, you may learn something new about the way their brain works and how they understand the world!

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If you plan to have this conversation, plan to validate your child’s feelings and opinions about what they find hard, unpleasant, boring, difficult, pointless, or unintuitive.

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Adults often think that twice-exceptional kids are over-reacting, over-reporting, whining, complaining, or making a mountain out of a mole hill - when actually these kids are trying to express that some things are truly too hard!

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By trusting your child’s descriptions of their own experience, you can learn more about what it’s like to be them and which expectations are appropriate or too difficult.

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Some gifted teens discover on their own that they resonate with descriptions of ADHD or autism that they see on social media, learn about from their friends, or research online and in books. If your intense gifted kid or teen tells you they think they may be autistic, have ADHD, or have a learning disability, this is an important revelation. Honor their self-advocacy and self-exploration by asking them what they have noticed and taking their suspicion seriously.

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Together, you can decide if an assessment would be helpful.

 

(3) Consider an assessment.

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In the past, I have strongly encouraged parents to pursue an assessment if they believe their child could be twice-exceptional. I still believe that a high-quality assessment is an excellent investment, but accessing a high-quality assessment is not always a possibility and is not always necessary. See the section below for more of my thoughts on this option.

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Should I pursue an assessment?

 

A lot of peer-reviewed research on twice-exceptionality emphasizes the importance of a comprehensive assessment to understand whether a person’s characteristics are due to twice-exceptionality.

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In my own research on twice-exceptional identification, I’ve touted the importance of a comprehensive assessment by a qualified professional. As a psychologist who has completed such assessments, I do believe that a compassionate, detailed assessment process can help clarify strengths, challenges, and the best types of supports.

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There are caveats, however.

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It’s often not possible to find a psychologist who understands twice-exceptionality and can provide an accurate, thorough assessment of autism, ADHD, or learning disabilities in a gifted individual. Unfortunately, most psychologists receive no training in giftedness or twice-exceptionality. Many “gold standard” measures for identifying autism, ADHD, or learning disabilities are less sensitive with gifted individuals - this means that gifted folks can appear more neurotypical on these measures even when they are actually autistic, have ADHD, or have a learning disability. For example, research has shown that gifted kids with ADHD can often focus well in the highly structured testing environment and therefore earn “average” or “good” scores on tests of attention - despite significant difficulties regulating their attention in everyday life. Similarly, the “gold standard” test for autism, the ADOS-2, under-identifies autism in gifted kids because autism often looks different in kids with high intelligence and strong verbal abilities.

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Over the past few years, I have also been immersing myself in the writings and voices of autistic and ADHDer adults, many of whom are twice-exceptional. In these communities, self-identification is often seen as a valid alternative to official diagnosis. As I mentioned above, it is very difficult to find an assessment provider who understands gifted presentations of other exceptionalities. Furthermore, many assessment processes are steeped in the medical model, which views autism, ADHD, and learning disabilities as disorders; hearing your child’s personal characteristics described as deficiencies, deficits, or disorders can feel traumatic for you or for your self-aware child.

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What’s the purpose of an assessment?

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A good assessment will help you understand your child and provide greater clarity about your child’s intensity and other characteristics that may have seemed puzzling or baffling in the past.

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A good assessment will help you understand how your child’s mind works and what they need to thrive. It will help you identify areas of strength that you can nurture and areas where your child needs more support or accommodations. For many parents, their child’s assessment results help them understand their child’s capacity better so they can adjust their expectations to something that's more reasonable for their child and thereby prevent power struggles and emotional overwhelm.

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If you’re wondering about twice-exceptionality, a diagnosis of autism, ADHD, or a learning disability can provide a clear name or narrative to understand your child. A diagnosis can also provide a sense of community and pride as kids or teens learn how their brain works and that there are many other people like them. It may feel hard to take pride in being “awkward,” “disorganized,” or “a bad speller,” but many people take pride in being autistic, an ADHDer, or dyslexic as they learn how their neurotype is part of who they are.

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Depending on your child’s school’s policies, a diagnosis of a second exceptionality could qualify your child for a 504 plan or individualized education plan (IEP) to receive additional accommodations or supports at school. Even if your child attends a private school, you may find that the school is more open to accommodations if they understand that your child is twice-exceptional.

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There are many reasons families choose not to pursue an assessment, though. They may not be able to find an affirming, appropriately skilled provider in their area. They may not be able to afford an assessment at this time. They may conclude that an assessment process would be so stressful for their child at the moment that it is not worth the stress at this time.

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What do I do while I wait for our assessment? Or what do I do if I decide not to get an assessment?

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I often remind parents that if they suspect their intense gifted kid is also twice-exceptional in any way, the parents can begin to provide supports, accommodations, and advocacy right away - they don’t need to wait for a diagnosis.

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Many of these parents begin to learn more about autism, sensory sensitivities, ADHD, or learning disabilities and begin to make brave and effective changes in their parenting approach that reduce their child’s stress and help their children thrive - whether or not they plan to pursue an official assessment.

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Similarly, I've worked with teens who are aware that they process the world differently than others and who have recognized their own autistic or ADHD characteristics without a formal assessment. If your kid tells you they wonder if they’re twice-exceptional or they believe they are autistic, you may still decide to pursue an assessment - but you can start listening to your child’s insights and providing supports and accommodations right away.

 

If you want to provide new supports and parenting approaches for your kid, but you’re not sure how, check out my small-group parent coaching program,  Support Your Intense Gifted/2e Kid . I love helping parents through this exploration and discovery process!