Twice Exceptional (2E) Children: A Neurodiverse Profile Requiring a Unique Balance

November 1, 2022 Kathryn Soraya Khamsi

Twice-Exceptionality (or 2E) is not a diagnosis but the profile of a child who exhibits an exceptional ability or giftedness alongside a developmental challenge. One of the distinguishing features of 2E children is their asynchronous development, either a gap between their intellectual and physical development, or their inability to use or express their gifts due to their area of challenge.

Giftedness is a form of neurodiversity. Although the term “gifted” may be familiar, it is often misunderstood. A distinguishing characteristic of neurodiversity is intensity, and giftedness is best understood as a particular type of intensity, or better put, an overexcitability.

In his Theory of Positive Disintegration, Polish psychiatrist Kazimierz Dabrowski observed a heightened sensitivity/awareness and responsiveness to sensory stimuli among “gifted” individuals and categorized them into the following five areas of overexcitability, each with its strengths and challenges: intellectual, emotional, sensual (sensorial), psychomotor, and imaginational.

Dabrowski’s framework provides a more dynamic and nuanced understanding of giftedness and one that goes beyond social tropes and high IQ. You can read more about it in this post.

A 2E child has additional needs beyond their area(s) of overexcitability. Some common coexisting conditions include ADHD, Asperger’s syndrome, Autism, sensory processing issues, developmental differences in emotional regulation, anxiety, social-emotional skills, speech and language delays, and other processing and learning differences.

These dual exceptionalities create unique circumstances for a 2E child. A 2E profile helps provide the extra support required for their strengths and challenges, but it can sometimes be hard to identify. For example, a 2E child may:

use aspects of their overexcitability to compensate for their challenge, masking their disability,
find their challenge masks their overexcitabilities, and/or
find their overexcitabilities and area(s) of challenge equalize, and they perform averagely.

Disconnects between your child’s concerted efforts and their grades can be telling. Getting adequate support may be difficult even when a child has a recognized 2E profile.

Appropriate testing is crucial to identifying 2E children and their incongruent development. Some comprehensive assessments (e.g., from a pediatric neuropsychologist) may catch their asynchronicity, but many standardized assessments within the educational environment may not. Differences in temperament or learning styles can also affect performances on these tests, especially for children with neurodiversity. High anxiety, struggles with abrupt changes to routine, sensory issues, and attentional differences impact a child’s outcomes on these assessments at school. For example, a common trait among children with autism is weak central coherence, or the ability to see the big picture when presented with details. Many children on the spectrum relish the details and are drawn to them but fail to see the bigger picture. For example, when asked about a forest, they may go into all the intricacies of forest mosses but forget to tell you about the collection of trees. High-functioning autism with giftedness (intellectual overexcitability) in math and literacy is not uncommon. Yet, these children may not qualify for school-administered gifted programming due to assessments that don’t consider a weak central coherence. School-based accommodations may help but may not always be enough, and parents must be proactive in seeking these out in a public school setting.

Strengths may be used to disqualify some children from access to traditional in-school support. Many school districts emphasize “access to education” and “educational benefit” which is often interpreted as anything that isn’t an academic regression or plateau. This is not a commitment to potential or anticipated future challenges. Access to educational safety nets and Individual Education Plans (IEPs) are needs-based. As support is not proactively offered, a child may be put into the position to “fail” or have severe struggles to qualify. If a child is identified as at-risk in academic standards or falling below average, IEPs and supportive pull-out programs are available. Due to their areas of strength, a 2E child may not qualify without parental advocacy and external clinical evaluations.

External expectations are mismatched when a child’s asynchronous profile isn’t well understood. Because they have distinctive strengths, there can be an expectation of higher competence across all areas of their development. It can puzzle others when they respond immaturely in certain areas, which adds a stress load on them.

It’s a balancing act to help a child manage their asynchronous gaps. Part of your role as a parent of a child with a 2E profile is to help identify their areas of giftedness and difference, manage the disparity in their maturity and capability, and advocate for them within an educational setting. It is not uncommon for children with a 2E profile to find success in alternative schooling options, such as homeschooling.

As discussed in a previous post, behaviors are a form of communication, so they can also communicate a child’s gaps and incongruence in skills. A child with a 2E profile will have an easier time figuring out who they are, understanding their particular learning style, and developing agency and confidence when there is a partnership between teachers, parents, and specialists. Leading with strengths and supporting incongruent development is usually a good approach.

I find the images of yin and yang and the oppositional electrical charges of a circuit needing balance as good analogies for children with 2E profiles. Both my sons have 2E profiles with very different presentations. One was much easier to identify, and the other had layers to uncover.

If you suspect your child may have a 2E profile, reach out or visit some of the following resources.

Books

Smart but Scattered: The Revolutionary “Executive Skills” Approach to Helping Kids Reach Their Potential by Peg Dawson and Richard Guare

Bright Not Broken: Gifted Kids, ADHD, and Autism by Diane M. Kennedy

Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders by F. Richard Olenchak et al.

The Mislabeled Child: Looking Beyond Behavior to Find the True Source and Solutions for Children’s Learning Challenges by Brock Eide

Different Minds: Gifted Children with ADHD, Asperger’s Syndrome, and Other Learning Deficits by Deirdre V. Lovecky

Boost: 12 Effective Ways to Lift Up Our Twice-Exceptional Children by Kelly Hirt

Exceptionally Gifted Children by Miraca U.M. Gross

Emotional Intensity in Gifted Students: Helping Kids Cope with Explosive Feelings by Christine Fonseca

Living with Intensity: Understanding the Intensity, Excitability, and the Emotional Development of Gifted Children, Adolescents, and Adults by Susan Daniels

Off the Charts: Asynchrony and the Gifted Child by Stephanie Tolan