by Teresa Currivan, LMFT, Parent Coach
The term “Twice Exceptional” or “2e” is commonly used to describe children and adults who are intellectually gifted and who have some form of disability: they are exceptional both in their abilities and in their disabilities.
What might we be missing when we use the term “2e” too broadly? Because the highly to profoundly gifted child has a very high risk of being missed and misdiagnosed due to many factors, it would be helpful to be more clear about what we are saying when we mean twice exceptional vs. highly to profoundly gifted. These terms overlap, and we often use them interchangeably for various reasons, but there is much room for improvement in our ability to get more specific in our understanding of our gifted children and their needs.
Here is a typical list of characteristics of a 2e child:
- advanced language
- analytical thinking
- intense drive to find out the meaning of things on their own terms
- the ability to find connections between things that others can not see
- unique or higher level sense of humor
- heightened sensitivity to needs and motivations of others
- aversion to being judged; they may do really well with one teacher, and be “the awful child” with another
- strong sense of fairness and justice
- accelerated learning beyond their age group in one or more areas, while also possibly appearing to be behind in others
- intense sensory processing issues –eg, heightened sensitivities to foods, touch, sounds, sights, movement — or conversely the need for more stimulation in any of these areas. (See my article on sensory issues, link below.)
- lack of executive functioning and attention issues. In very simple terms, this is the child who has a hard time getting organized or following several steps of instructions before getting sidetracked. (ADHD is also a 2e trait that can stay through adulthood, but often the frontal lobe catches up by age 12, and then again by age 18, and the ADHD-like traits lessen. See Davidsongifted.org for more on this.)
- fluidity in learning and interest. They may be the expert in history one month and appear to have no interest the next. They also learn best when able to learn across subjects such as learning math while measuring for cooking, etc.
The “2” in “2e” implies that these gifts are paired with something wrong – commonly dyslexia, dysgraphia or ADHD, among others. While 2e children can have these disabilities, these same labels are too often applied without fully understanding the specifics of each gifted child. Being in the exceptionally gifted category comes with heightened sensitivities, intensities, perfectionism, and intense drive to learn and create. As we all know, these traits can be misunderstood as pathologies. The same child who is profoundly gifted but mistaken to be moderately gifted with disabilities is going to be less likely to thrive. This is something I see all too often. The highly to profoundly gifted cannot accurately be diagnosed with anything until these three things are first identified and addressed:
Until We Address These 3 Things, We Don’t Know What’s Going On
1. Appropriate Learning Environment
2e kids respond best to relational, hands-on learning from teachers who are as excited about the topics as they are. Access to technology and allowing them to keep their sense of agency is key. They are often top-down learners who want to get the big picture first and then (at some point) dig deeper. They may also hop from topic to topic for a long time and allowing them to be fluid from subject to subject is going to give them more room to learn. For example, a child may be interested in learning the entire history of the world and then go deeply into WWII while also studying the technology that is invented at various times. At times becoming more focused on the technology of the inventions, at times, the inventors, and at times what was happening in that historical moment and how the invention influenced history.
While gifted homeschoolers excel at properly educating the highly to profoundly gifted, using whatever tools are at their disposal, you can also find an appropriate learning environment in some micro-schools designed for the more creative child that is able to follow their fluid way of learning. Educating these children is both an art and a science. Knowing each child deeply, having information at the ready and in a way that engages and matches them is ideal.
In an improper learning environment, such as a typical school setting, especially one that is overcrowded with little individual attention, 2e boys commonly act out in the classroom by first or second grade, if not sooner, while 2e girls can become gifted at fitting in. The depression and frustration the child feels might look like anger in a boy, and depression, cutting or picking, or nothing in a girl. Girls (or boys who are more inward in their reactions) may not act out or show problems until the middle school years. As a result, many 2e boys are misunderstood as troublemakers, and many 2e girls’ problems are not addressed until later, if at all. (It is also a gifted and 2e trait to be non-gender conforming, so another way to identify these kids is to understand that some will internalize their struggles and some will externalize them.)
Twice-exceptional children I see who have been in a poorly fitting school setting almost always come with a list of diagnoses, including psychiatric ones, while deep depressive symptoms, usually due to lack of school fit, remain unaddressed. Not only do they begin to see themselves as defective, but their depression (sometimes masked as anger) gets more intense as the years go by because their intellectual drive and creativity, the place where they can feel most alive, is often not met and becomes deadened. When poor school fit is left unaddressed, it can become a true diagnosis of depression or other psychiatric conditions at some point. In some cases we are finding profoundly gifted children (who are less able to try to fit in, as hard as they may try,) put in restraints.
3. Sensory Issues
Highly to profoundly gifted individuals have heightened senses. Sometimes sensory issues can come along with heightened senses.
Sensory processing disorders are often misunderstood. They have more to do with how the brain processes the senses rather than the senses themselves. One example is the child who has excellent hearing capabilities in the ear, but whose brain does not register the sounds correctly. The white matter leading the sound information from the ear to the brain is where the issues are. It is commonly understood that in a protective mechanism to prevent the brain (and therefore child) from becoming overwhelmed by excessive noise.
Some common diagnoses that have similar symptoms to sensory issues are ADHD, dyslexia, and oppositional defiance disorder. Usually, these children feel unsettled, anxious, overwhelmed, and other children and family members find them annoying. Leaving the cause of their behavior misunderstood and misdiagnoses is unfair. Dyslexia should not be diagnosed when there are unaddressed vision issues and auditory issues. Treating a child with dyslexia who has untreated vision issues is like giving a child with a broken leg training in running while his leg is still broken.
A professional who understands giftedness and sensory issues is going to be the most helpful here. Understanding typical gifted sensitivities and traits vs. sensory disorders that need to be addressed can be tricky. One example is of a first-grade boy who was diagnosed with dysgraphia and weakened muscles in the hands by an occupational therapist who did not understand his impatience with writing letters and numbers (due to giftedness). This same child could draw detailed and precise drawings of bugs and animals.
For more on sensory issues, see my article, linked below.
Any combination of the above three can exponentially increase the likelihood of misdiagnosis. At the same time, once these three issues are accurately addressed, it will become clear if there are other issues that need to be identified, or that the child is simply highly to profoundly gifted with all of the complicated the side effects that can come with it.
As the father of a profoundly gifted 11-year-old said of gifted individuals, “It’s like we’re all lopsided, and the more gifted, the more lopsided.” It is often difficult to describe the differently wired brain. I would add to this that the children can appear even more lopsided than the adults.
I cannot stress enough that professionals who do not understand the highly to profoundly gifted population are not going to understand or be able to accurately diagnose them. If your child has been diagnosed as 2e, or you suspect they are in the higher ranges of giftedness, they may just be a typically highly to profoundly child, or “exceptional”.
Teresa Currivan is a mother, licensed marriage and family therapist, school therapist, coaches parents by phone at Help My Child Thrive Coaching, and offers parent support groups. Teresa has been published on sites such as fb.me/TeresaCurrivanCoaching., Filter Free Parents, and is a blogger at GHF and Hoagies Gifted Education. She specializes in giftedness, twice exceptionality, educational fit, and family dynamics, as well as gifted adults. She lives in the San Francisco, California Bay Area with her husband and son. You can find more articles on this website. Follow her on her Facebook at
***Not sure if your child is gifted? Or maybe you have a question about your gifted child or family? I offer free 20 minute consultations for first-timers. Email me and we’ll set up a time to talk. I’d love to hear from you. TeresaCurrivan@gmail.com ***
Want to read about a typical 2e child’s story? I recommend this article:
You may also find these helpful:
As of March 1, this article is part of a blog hop over at Hoagies Gifted Education. Hoagies Gifted Education page is an amazing resource for everything gifted. Go check them out, and check out the other bloggers on the Topic of Special Gifted Populations: HoagiesSpecialPopulationsBlogHop
©2019 Teresa Currivan