The Paradox of Twice-Exceptionality

Packet of Information for Professionals – 2nd Edition (PIP-2)

Developed by The Connie

Belin and Jacqueline N. Blank
International Center for
Gifted Education and
Talent Development1

Susan Assouline
Megan Foley Nicpon
Staci Fosenburg

With contributions from

Zachary Sussman
Claire Whiteman
Clark Kopelman
 Purpose
Packet of Information for Professionals (2007 and 2008) was originally developed
for professionals who work with gifted and talented students with an autism
spectrum disorder (ASD) and intended for The University of Iowa Belin-Blank
Center (BBC) programs. PIP-2 is a second edition, which expands the student
population to include gifted students with other disabilities, specifically attention
deficit hyperactivity disorder (ADHD) and specific learning disability (SLD).
Students with high cognitive ability and a disability are referred to as “twice-
exceptional.” It is also our intention that PIP-2 is accessible to professionals who
work with twice-exceptional students anywhere in the world.

For nearly a decade, the BBC’s Assessment and Counseling Clinic (ACC) has
worked extensively with twice-exceptional students, completing comprehensive
evaluations, developing educational and behavioral recommendations, and
providing counseling. The ACC offers research- and experience-based information
and recommendations for educators, administrators, student program faculty, and
residential staff working with these students.
The Jack Kent Cooke Foundation provided the
funding that made PIP-2 possible.
We understand the importance of acknowledging twice-exceptional students’ academic
and cognitive strengths as well as the fact that there are vulnerabilities in their learning
We acknowledge the assistance of and/or behavior that may present difficulties in academic and social situations. Our
Clark Kopelman and Zach Sussman in creating primary goal is to offer information that will lead to positive experiences for twice-
Packet of Information for Professionals - 2nd Edition
(PIP-2). Joshua Jacobs implemented the
exceptional students who attend programs for gifted/talented students.
iBook version.
Because PIP-2 is not for use as a system for intervention, we think it is important
The original versions were made possible because
to underscore the distinction between recommendations and intervention. An
of generous funding from the Messengers of Healing intervention is a level of involvement that is intense and multifaceted, and has
Winds Foundation. change in student behavior as its primary goal. Typically, student programs are
short-term (one or two weeks), so our focus is on suggestions to professionals
PIP-2 was developed for the student program faculty for accommodations in the learning and residential environment so that twice-
and professional staff of the Belin-Blank Center for exceptional students will have optimum experiences during their educational
Gifted Education and Talent Development.
program. We hope that PIP-2 will assist professionals in structuring an educational
and social experience that is as successful and as rich as possible for twice-
We acknowledge the students and families who exceptional students. Although focused on the time period for which the student is
participated in the Belin-Blank Center’s Assessment on campus (usually one or two weeks), we believe some of the suggestions might be
and Counseling Clinic. Their patience with the
B-BC staff and their dedication to the project was
useful for professionals or students during the regular academic year.
critical to the development of the recommendations
that comprise earlier versions of the Packet of
Information for Professionals as well as PIP-2.

Structure of PIP
PIP-2 would not have been possible without the
superior clinical services provided by the team of Section I of PIP introduces general information related to both giftedness
licensed psychologists: Alissa Doobay, Ph.D.; Megan and disabilities that twice-exceptional students face. This section is followed by
Foley Nicpon, Ph.D., Associate Professor; and Claire
Whiteman, Ph.D. Drs. Doobay, Foley Nicpon, and
Section II, which includes brief descriptions about students’ academic, behavioral,
Whiteman supervised multiple doctoral students in and social functioning as they relate to being gifted and having a diagnosed
counseling psychology or school psychology who developmental, learning, or emotional disability such as an Autism Spectrum
completed a practicum through the Belin-Blank
Center’s Assessment and Counseling Clinic.
Disorder (ASD), Specific Learning Disability (SLD), or behavioral disorder (e.g.,
Attention-Deficit/Hyperactivity Disorder (ADHD)). These descriptions lead
to the focus of PIP-2 — recommendations for effectively accommodating the
complex learning, behavioral, and social needs of twice-exceptional students.
The final section, Section III, includes appendices, resources, and an annotated
1
Packet of Information for Professionals (2007) and Packet bibliography. We hope that all professionals who receive PIP-2 will use it as a
of Information for Professionals - Revised (2008) were
developed by Susan Assouline, Megan Foley Nicpon, resource for their work both in and out of summer program settings.
Nicholas Colangelo, and Matthew O’Brien.

The Paradox of Twice-Exceptionality • Introduction • i

Section I: A Paradox of Strengths and Difficulties
A Graphic Description of Research Used to Support Our Recommendations

Twice-Exceptional Students and the Challenges They Face

Gifted Students with Specific Learning Disability (SLD)

Gifted Students with Autism Spectrum Disorder (ASD)

Gifted Students with Attention-Deficit/Hyperactivity Disorder (ADHD)

Specific Disability Diagnosis and Misdiagnosis

Case Studies
Tom: Gifted with ADHD
Dan: Gifted with ASD
David: Gifted with a SLD

Section II: Addressing the Paradox: Developing Strengths

and Accommodating Difficulties
General Cognitive Ability
Intelligence Tests
The Four Indices of the Wechsler Intelligence Scalefor Children — 4th Edition (WISC-IV)

High Cognitive Ability and Difficulties in Specific Domains

Reading
Math
Cognitive Processing Speed and Multi-Tasking
Written-Language, Writing, and Fine-Motor Coordination
Gross Motor Skills

Characteristics and Behaviors of Twice-Exceptional Students

Social Characteristics
Language and Communications Characteristics
Behavioral Characteristics

Social Stories as an Intervention

Conclusion to Sections I and II

Section III: Appendices

Appendix A
A Brief History of Giftedness
Federal Definition of Giftedness

Appendix B
Disability Categories of Individuals with Disabilities Education Act (IDEA)
Explanation of Federal Protections for Students with Disabilities

Appendix C
The Talent Search Model
Comprehensive Assessment – Why it Matters
The Assessment Process at the Belin-Blank Center’s Assessment and Counseling Clinic
Annotated Bibliography

Appendix D
Web Sites for Professionals Who Work with Individuals with ASD
Web Sites for Parents and Families of Individuals with ASD
Web Sites Specifically for Individuals with ASD
 Graphic Representation The figure below provides a visual display of students’ abilities, and emphasizes the significant differences in thecognitive skills
of the Paradox of Strengths and self-concept of twice-exceptional students with ADHD. The Belin-Blank Center is an active leading contributor to this body of
and Difficulties research and several recent publications have been included in this document (see Annotated Bibliography).

ADHD

Self-reliance: 49
Social stress: 50
Physical appearance: 47 Behavioral adjustment: 51
Self-esteem: 55
Happiness: 42 Processing speed: 56
Intellectual & school status: 58
Popularity: 33

Working memory: 78

Perceptual reasoning: 93

Verbal comprehension: 97

Percentile Ranking

Low Average High

The Paradox of Twice-Exceptionality • Figure • 1

 Graphic Representation The figure below provides a visual display of students’ abilities, and emphasizes the significant differences in the cognitive, academic
of the Paradox of Strengths and adaptive functioning skills of twice-exceptional students with ASD. The Belin-Blank Center is an active leading contributor to
and Difficulties this body of research and several recent publications have been included in this document (see Annotated Bibliography).

ASD

Communication: 50
Daily living skills: 47
Learning problems: 43 Self-perception of academic functioning: 52

Reasoning skills: 40
Self-perception of emotional functioning: 55
Personal adjustment: 35
Fine motor skills: 29

Teacher-rated adaptive skills: 20 Working memory: 78

Oral language: 84

Written language: 88

Parent-rated adaptive skills: 11

Math achievement: 90
Teacher-rated appropriate behavior: 8
Reading achievement: 95

General intellectual
Socialization: 6
ability: 97
Parent-rated
appropriate
behavior: 3

Percentile Ranking

Low Average High

The Paradox of Twice-Exceptionality • Figure • 2

 Graphic Representation The figure below provides a visual display of students’ abilities, and emphasizes the significant differences in the cognitive, academic
of the Paradox of Strengths and adaptive functioning skills of twice-exceptional students with SLD. The Belin-Blank Center is an active leading contributor to
and Difficulties this body of research and several recent publications have been included in this document (see Annotated Bibliography).

SLD

Self-perception of emotional functioning: 50

Broad written language: 49
Working memory: 60
Personal adjustment: 44
Self-reported academic comfort: 39
Processing speed: 34 Math achievement: 69
Teacher-rated adaptive skills: 31 Reading achievement: 70
Parent-rated adaptive skills: 27 Oral language: 77
Teacher-rated academic comfort: 24

Teacher-rated appropriate behavior: 17

Parent-rated appropriate behavior: 12 General intellectual ability: 95

Percentile Ranking

Low Average High

The Paradox of Twice-Exceptionality • Figure • 3

 The Paradox of Twice-
Exceptionality

Packet of Information
for Professionals –
2nd Edition (PIP-2)

Section I
A Paradox of
Strengths and
Difficulties
 Section I:
Twice-Exceptional Students
A Paradox of Strengths and the Challenges They Face
and Difficulties
Who are twice-exceptional students? They are students who are both bolstered
by exceptional talent or giftedness, as well as challenged by a form of disability.
Unfortunately, this general description does little justice to describing the
significant heterogeneity among the population of twice exceptional students.
Giftedness bears many faces and, likewise, disabilities which vary in impact.

Within the PIP-2 document, we narrow our discussion of twice-exceptionality

to students affected by a Specific Learning Disability (SLD), Autism Spectrum
Disorder (ASD), or Attention-Deficit/Hyperactivity Disorder (ADHD). While these
groups do not encapsulate the entirety of twice-exceptionality, they represent the
more frequent occurrences. A brief description of each of these disability categories
is provided, followed by a discussion of how these students are identified, and
finally several case studies are presented. A more comprehensive discussion of
twice-exceptionality can be found in Lovecky (2004), Neihart (2000), or Assouline
and Whiteman (2011).

Gifted Students with Specific Learning

Disability (SLD)
A learning disorder, also called specific learning disability (SLD), refers to
significantly lower academic achievement relative to cognitive ability. In other
words, students with learning disabilities perform at a lower level in a specific
academic area than would be expected given their intellectual abilities. Learning
disorders are not general, but rather specific to an academic skill area, such as
reading, mathematics, or written expression. Within the DSM-V (APA, 2013), the
diagnosis of Specific Learning Disorder is specified by not only the broad academic
area in which the student has difficulties, but also the subskills that are impaired.
These subskills include word reading accuracy, reading rate or fluency, reading
comprehension, spelling accuracy, grammar and punctuation accuracy, clarity or
organization of written expression, number sense, memorization of arithmetic
facts, accurate or fluent calculation, and accurate math reasoning. Learning
impairments may significantly impact some students in more than one academic
area, and all of these deficits are specified in the individual’s diagnosis of SLD. For
more information, please see the IDEA definition of Specific Learning Disability in
Appendix B.

Unfortunately, identifying learning disorders in individuals with high cognitive

ability can be challenging (Assouline, Foley Nicpon, & Whiteman, 2010; Berninger
& O’Malley May, 2011; Fox, Brody, & Tobin, 1983). For these twice-exceptional
students, some methods of identification fail to recognize that a student can
achieve at or above average expectations in comparison to her or his peers, yet
also achieve significantly below the level expected based on her or his cognitive
ability level. As an example, imagine two students completing a standardized
reading test at school. Student A has Average verbal intellectual abilities, but scores
within the Below Average range on the test. Student B has Very Superior verbal
intellectual abilities, yet scores within the Average range on the same test. Student
A may be quickly identified as having difficulty with reading and will likely be
provided with interventions and accommodations to remediate this weakness. In
contrast, Student B is often overlooked. His or her performance may be viewed
as Average and not deserving of intervention or further attention if his or her

The Paradox of Twice-Exceptionality • Section I • 2

 Section I: score is not evaluated within the context of exceptional verbal abilities. However,
the discrepancy in performance on these two measures is both significant and
A Paradox of Strengths meaningful, and may even reflect greater relative difficulty with reading than a
and Difficulties
peer with Average intellectual ability! Examples such as these demonstrate the
importance of comprehensive evaluations that incorporate student context.

Gifted Students with Autism Spectrum

Disorder (ASD)
Students who are diagnosed with ASD have a developmental disorder that results in
severe social, communication, and/or behavioral impairments. For gifted students
on the autism spectrum, the “most pressing problem” is that “their emotional and
behavioral challenges are considered ‘side effects’ of being unusually bright, rather
than the manifestations of a neurological disorder,” according to Bashe and Kirby
(2001, p. 364–365). This occurs even though autism is considered to have the
best empirically based, cross-national set of criteria for diagnosis (Volkmar & Klin,
2005).

The criteria used to make diagnoses that are considered on the autism spectrum
are outlined in the Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition (DSM-V; American Psychiatric Association, 2013). To receive an
ASD diagnosis, individuals must demonstrate restricted or repetitive patterns
of behavior or activities as well as deficits in social communication. Social
communication deficits include a lack of social-emotional reciprocity, failure to use
or understand nonverbal behaviors in communication, and difficulty developing,
maintaining, and understanding relationships. Repetitive patterns of behavior or
activities may include repetitive motor movements or speech, inflexible adherence
to routines, intense and highly restricted interests, and highly increased or
severely decreased reactivity to sensory aspects of the surroundings. The overall
ASD diagnosis is also supplemented by a severity level rating, which ranges from
requiring support, to requiring substantial support, to requiring very substantial
support. Diagnostic criteria and the conceptualization of this disorder in clinical
and educational settings continue to evolve. This evolution is relevant to the
gifted child with co-existing ASD because of the risk of misdiagnosis due to the
shifting definitions and inexact use of terminology, e.g., high functioning autism.
Only qualified professionals with appropriate training, such as psychologists or
psychiatrists, can make a diagnosis of ASD.

A shift has occurred in the diagnostic criteria for ASD between the DSM-IV and the
DSM-V, the most recent revision. The diagnoses of Autistic Disorder, Asperger’s
Disorder, and Pervasive Developmental Disorder that were previously separate
have been combined into the single diagnostic category of Autism Spectrum
Disorder (ASD; DSM-V, 2013). This alteration has been met with both frustration
(e.g., Boucher, 2011; Ghazziudin, 2011) and praise (e.g., Pine, 2011) related to the
potential gains in specificity of diagnosis (i.e., correct identification of an ASD) at
the cost of sensitivity (i.e., decreased likelihood of identifying an individual with
ASD; McPartland, Reichow, & Volkmar, 2013). Early analysis suggests that higher
functioning students with ASD may be more likely to be missed with the new
diagnostic criteria.

The Paradox of Twice-Exceptionality • Section I • 3

 Section I:
Gifted Students with Attention-Deficit/
A Paradox of Strengths Hyperactivity Disorder (ADHD)
and Difficulties
The primary features of ADHD are difficulties sustaining attention/focus, high
levels of activity, and/or difficulties controlling impulsive behavior. While most
people occasionally experience difficulties with one or more of these symptoms,
individuals diagnosed with ADHD are consistently challenged by these symptoms
across all areas of their lives (e.g., at home, in school, and in social settings). This
condition is estimated to occur in approximately 5% of children and 2.5% of adults
(APA, 2013).

Within the DSM-V (APA, 2013), ADHD as a disorder can present in three different
ways, noted as subtypes. The Predominantly Inattentive Type refers to individuals
whose main difficulty lies in sustaining attention. The Predominantly Hyperactive-
Impulsive Type refers to individuals with a primary issue of excessive activity level
and/or impulsive behavior, and the Combined Type refers to difficulties with both
issues.

As with ASD, ADHD is recognized by IDEA as a disability (IDEA, 2004;

See Appendix B). Further, this disorder has received significant national
and international attention regarding identification and treatment. Use of
psychostimulant medications, such as Methylphenidate (e.g., Ritalin), has been
demonstrated to be very effective in improving sustained focus (MTA Cooperative
Group, 1999). Although there are many ADHD resources that provide information
on treatment and diet, most of these “treatments” have limited or no evidence.
Thus, parents of children with ADHD are encouraged to be cautious when
evaluating treatment and intervention options.

Specific Disability Diagnosis and Misdiagnosis

As noted earlier, giftedness and disability are not mutually exclusive; they can and
do co-exist. For example, whereas there is limited information concerning the
prevalence of gifted and talented children with ASD, there are many clinical cases
as well as classroom anecdotes of this co-existence (e.g., Assouline, Foley Nipcon,
& Doobay, 2009; Lovecky, 2004; Neihart, 2000; Webb, et al., 2005). Also, it has
been noted (Gallagher & Gallagher, 2002) that in some individuals, characteristics
of ADHD, SLD or ASD can obscure giftedness; whereas in others, giftedness can
mask characteristics of ADHD, SLD, or ASD. These scenarios represent missed
identification of giftedness or missed diagnosis of a disorder. In other individuals,
misdiagnosis occurs; e.g., a clinician who is unfamiliar with the way in which
ASD manifests in the gifted individual may misdiagnose the individual with
another disorder. Misdiagnosis might happen when a gifted and talented student
demonstrates some behaviors (e.g., extreme interest in facts) that are characteristic
of his or her diagnosis, although upon completion of a comprehensive evaluation,
it may be that the behaviors of concern are better explained by giftedness rather
than the disability. In these cases, it is preferable to generate recommendations that
address the student’s difficulties in terms of how they interact with their gifts and
talents. The reverse scenario would attribute characteristics typically associated
with autism (e.g., socialization difficulties) to giftedness (e.g., a child demonstrates
socialization problems because he or she does not have intellectual peers). This
scenario is equally unfortunate because the student is not receiving appropriate
interventions to address challenges associated with his or her disability.

The Paradox of Twice-Exceptionality • Section I • 4

 Section I: Because twice-exceptional students are apt to be misunderstood, and consequently
under-identified and under-served, it is essential for professionals to be aware
A Paradox of Strengths of the unique needs of these students. Further, given the new DSM-V diagnostic
and Difficulties
criteria for ASD, the identification of twice-exceptional students with ASD will
require diligence and increased awareness of psychologists, counselors, and
educators.

Case Studies
In this section, we will provide 3 case studies illustrating the comprehensive
The following case studies are reprinted with
permission by Taylor & Francis, Inc. The original evaluation process for twice-exceptional students with ADHD, ASD, and/or SLD.
printing of these case studies was in the Journal of These case examples serve both to demonstrate the importance of a comprehensive
Applied School Psychology, Volume 27, pages 380- evaluation in accurate and meaningful diagnosis, treatment, and accommodations,
402. The article was written by Susan Assouline and
as well as to provide a glimpse into the complex challenges that these students face.
Claire Whiteman and titled “Twice-Exceptionality:
Implications for School Psychologists in the Post–
IDEA 2004 Era.”
Tom: Gifted With ADHD
The referral question for Tom, who was a young third grader when he was evaluated
in our clinic, was focused on determining appropriate behavioral expectations and
obtaining recommendations about how to meet his academic needs. Although it
was reported that Tom would get off task easily in the classroom, he was observed
to be attentive during time in the talented and gifted class. His cognitive ability,
as measured by the Wechsler Intelligence Scale for Children (4th edition), was
determined to be in the superior range of intellectual ability (Full Scale IQ at the
95th percentile). His behavioral profile was consistent with ADHD. Although it was
reported that medication to address his ADHD symptoms had been tried, it had
been discontinued because of significant side effects. The family had also worked
with a counselor on behavioral interventions to address ADHD symptoms. In this
case, our comprehensive assessment focused on obtaining specific information
about Tom’s academic skills, ADHD symptoms, and overall adjustment to guide
recommendations for intervention.

The academic assessment, with the Wechsler Individual Achievement Test (2nd
edition), revealed that Tom’s achievement was commensurate with his measured
ability. Not only did he score at the 98–99th percentile for his grade on the reading,
math, and written language sections of the Wechsler Individual Achievement Test,
but he also obtained a score at the 98th percentile on the Comprehensive Testing
Program (4th edition) reading comprehension and at the 99th percentile on the
Comprehensive Testing Program (4th edition) mathematics subtests designed for
and normed on a national sample of students in the spring of fourth grade, one full
grade level above Tom’s current placement.

The ADHD assessment, the Continuous Performance Test (2nd edition), the ADHD
Rating Scale, and the Brown ADD Scales, in our clinic was consistent with previous
findings, which were that significant symptoms of inattention and impulsivity/
hyperactivity were present in home and school settings. In addition, some issues
about Tom’s adjustment (Behavioral Assessment System for Children (2nd
edition) came to light, including mild symptoms of unhappiness and some acting-
out behaviors in the classroom, which were believed to be related to his ADHD
symptoms, as well as his readiness for significantly greater academic challenge in
the classroom.

The Paradox of Twice-Exceptionality • Section I • 5

 Section I: In summarizing the results of the assessment, our goal was to prepare a report that
Tom’s parents could use to advocate for changes at school that addressed his strong
A Paradox of Strengths academic performance and his ADHD. Among the issues considered in addressing
and Difficulties
Tom’s diagnosis of ADHD was the use of medication. The research literature is
consistent in supporting the use of stimulant medication as the most effective
treatment to date for management of ADHD symptoms (Connor, 2006); however,
in Tom’s case, finding the right medication posed a challenge. We recommended
that the parents work with their physician to consider other medications that could
provide symptom control without causing severe side-effects.

We also recommended that the family continue to work with their local psychologist
for behavioral strategies to address symptoms at home and in the classroom (see
Brown et al., 2008, for evidence about the effectiveness of long-term behavioral
and psychosocial interventions in treating ADHD symptoms). When a gifted
student presents with ADHD, we typically recommend accommodations within
the classroom that include allowing preferential seating to minimize distractions;
breaking larger projects down into smaller segments, and allowing a break after
completion of each segment; initiating a nonintrusive cueing system (such as an eye
blink) to prompt the student to get back to work when he or she is observed to be
off task; and providing support with organization of assignments and homework. In
some instances, development of a classroom behavioral program that emphasizes
positive reinforcement for completion of tasks is an option, which can be developed
and monitored by a local psychologist.

In addition to the recommendations regarding ADHD, it was important to identify

the most appropriate academic interventions. Tom’s outstanding ability, aptitude,
and achievement test results prompted us to recommend enrichment, acceleration,
or some combination. Often educators do not consider the option of acceleration for
students who are young (Tom was already young for his class) and/or who display
behavioral difficulties (in Tom’s case this involved problems with organization and
staying on task). However, our clinical experience is that these factors need not be
reasons to dismiss the option of some form of acceleration, but rather issues to be
considered and planned for. With respect to age, consider the fact that the typical
classroom includes students with an age range of 18 months between oldest and
youngest, as well as considerable normal variations in height, weight, and physical
coordination. An accelerated student can typically fit well within this context,
especially because he or she has more in common academically with students in the
accelerated grade than with age-mates. (For an exhaustive discussion regarding the
empirical support for acceleration as the most effective academic intervention for
highly able students, see Colangelo, Assouline, & Gross, 2004.)

The issue of behavioral challenges, such as ADHD, is more complex. There is

evidence that gifted students with ADHD who are accelerated may be at risk for
difficulties with group work, peer interaction, and management of long-term
projects because of their disability (Moon, et al., 2001; Zentall, Moon, Hall, &
Grskovik, 2001). This evidence, as well as our clinical experience, indicates that
providing appropriate accommodations within the classroom to address the
disability, as well as giving full consideration to medication options to address
ADHD symptoms, are key recommendations.

Full consideration of these factors are among the multiple reasons why we suggest
that educators take the personal bias out of the decision about acceleration
and rely on an instrument such as the Iowa Acceleration Scale (3rd edition;

The Paradox of Twice-Exceptionality • Section I • 6

 Section I: Assouline, Colangelo, Lupkowski-Shoplik, Lipscomb, & Forstadt, 2009). The Iowa
Acceleration Scale was designed to focus the discussion about academic acceleration
A Paradox of Strengths on the salient issues, specifically, academic readiness of the student. That process,
and Difficulties
which occurred in the second semester of Tom’s fourth-grade year, included
documentation of his academic strengths and of his disability. The conclusion from
the Iowa Acceleration Scale staffing was that Tom would be an excellent candidate
for acceleration. His disability was noted and recommended accommodations were
included, but the disability was not used as a reason to not accelerate him. Tom
finished fourth grade; however, at the beginning of the next school year, rather than
going into fifth grade, Tom went into sixth grade. Reports from home and school
indicated that Tom excelled. His whole-grade accelerated academic experience was
so strong that additional subject acceleration in math was implemented.

Tom’s parents recognized that he was happier socially and emotionally and his
teachers indicated that he integrated fully into the sixth-grade classroom. His
parents reported: “It’s a relief to see him finally have the opportunity to begin
reaching his potential and to be happy about school.” Regarding the acceleration,
they suggested: “It [skipping a grade] has been the best decision we’ve made so far
in regards to his education.”

Neither Tom nor his parents were unrealistic concerning the complexity of such
a decision. Tom’s parents recognized that although Tom was happy at school
and was closer to reaching his measured potential, Tom was likely still not fully
challenged, and was ready to handle more advanced coursework. However,
he also had the self-awareness to recognize that he needed a certain level of
maturity (i.e., regarding self-regulation) to handle the additional requirements for
organization or homework that would accompany an additional grade skip. His
parents understood that his ADHD symptoms, while adequately managed, still
affected his overall progress.

Tom’s mother provided additional insight regarding a comprehensive

psychoeducational evaluation and subsequent advocacy. Like many others, she
viewed advocacy as an opportunity for teachers and administrators to learn more
about the unique issues of twice-exceptional students. She reported that, as a result,
every teacher who had Tom in the classroom chose to attend an optional seminar
about twice-exceptional learners.

Dan: Gifted with ASD

Dan’s case points out the complexities of addressing the needs of high ability
students with ASD. His parents referred him for a comprehensive evaluation
during his third-grade year because of significant behavioral concerns, including
noncompliance and disrespectful, sometimes physically aggressive, behavior. His
parents reported they had experienced serious difficulties locating a preschool
program that was a good match for him when he was 3 years old; he had been asked
to leave two centers before they found a small, flexible program where he fit in
better.

According to his parents, Dan exhibited impressive early reading (including

comprehension) and mathematics skills. Nevertheless, this academic precocity,
along with his behavioral difficulties, made placement in a traditional kindergarten
setting challenging. He attended Kindergarten in a small private school; however, his
significant problems adjusting to the classroom environment resulted in placement
half the day in a preschool setting and half the day in kindergarten during the fall

The Paradox of Twice-Exceptionality • Section I • 7

 Section I: semester, with the goal of easing him into a more traditional classroom setting.
Nevertheless, because of his advanced reading and math skills, he was accelerated
A Paradox of Strengths to first grade during the spring semester. Continued concerns about emotional
and Difficulties
outbursts in the classroom led the principal to consider retaining Dan in first grade
for the next year, even though school personnel agreed that his academic skills
were at or above the first-grade level. In the end, Dan was allowed to progress to
the second grade and his academic skills continued to develop at an advanced pace
despite ongoing behavioral challenges, such as periodic refusal to complete school
work and intermittent angry outbursts.

Standardized testing completed at school during third grade revealed outstanding

academic achievement in reading, language, and math (total scores at the 97–99th
percentiles, compared with other third-grade students). Also, as a third-grade
student, he participated in the above-level testing provided by a talent search (for
a comprehensive discussion of the Talent Search testing model see Assouline &
Lukowski-Shoplik, 2011; Lupkowski-Shoplik, Benbow, Assouline, & Brody, 2003;
Olszewski-Kubilius,2004). Dan took a test designed for eighth-grade students,
EXPLORE, which is published by ACT, Inc., and earned a composite score
equivalent to the 53rd percentile compared with eighth-grade students. In other
words, as a third-grade student, he outperformed 53% of the eighth-grade students
who typically have more than 5 more years of academic exposure. This performance
was an indication that he needed additional challenge in his current grade
placement and would continue to require advanced work throughout his academic
career.

Such profound academic strengths sometimes make it difficult for students to

find intellectual peers, and this difficulty is sometimes associated with social
impairments (Assouline et al., 2009). Whether the social impairment is the result
of a mismatch between the students’ ability and challenge in the classroom, or
the expression of an underlying disorder, can only be determined through a
comprehensive evaluation.

The assessment completed to learn more about Dan’s abilities and difficulties
revealed the complexities and contrasts presented by exceptionally bright children
with ASD. First, the testing process was highly challenging. At times Dan was
cooperative and showed eagerness to talk about his interests and demonstrate his
knowledge, although he also frequently sought reassurance about his performance.
When presented with challenging testing items, his behavior quickly escalated into
dramatic displays of frustration and anger, during which he threw test materials,
kicked furniture, and engaged in name-calling. Despite his difficulties responding
to the demands of the testing situation, he periodically engaged in conversation
with the examiner and his cooperation improved with establishment of guidelines
for behavior and frequent praise for any effort he made. The intellectual evaluation
with the Wechsler Intelligence Scale for Children (4th edition), revealed exceptional
nonverbal ability (Perceptual Reasoning Index at the 98th percentile) and working
memory (99th percentile), along with strong verbal (75th percentile) ability, even
though he did not complete all items within some of the subtests on the Wechsler
Intelligence Scale for Children (4th edition). Dan refused to attempt two of the
three subtests used to assess processing speed, although he performed within the
high average range on the one (Symbol Search) that he completed. On the Wechsler
Individual Achievement Test (3rd edition), Dan completed just two of the subtests,
Word Reading and Numerical Operations, although again he showed outstanding
skills, obtaining scores at the 91st and 99.9th percentiles, respectively. Dan’s math
skills were particularly notable in that he completed written computation problems

The Paradox of Twice-Exceptionality • Section I • 8

 Section I: involving division of fractions and decimals, determination of square roots, and
definition of pi to four decimals places.
A Paradox of Strengths
and Difficulties
The psychosocial evaluation indicated significant behavioral concerns noted by
Dan’s teachers at school, including noncompliance, impulsivity, anger outbursts,
and significant anxiety on the Behavioral Assessment System for Children. Fewer
concerns were reported on the assessment by the parents, although they noted
that they made significantly fewer demands on Dan than were made at school. Dan
did not complete the Behavioral Assessment System for Children Self-Report and
did not show interest in responding to questions about home or school, although
did consistently initiate conversation about his areas of interest, science and
mathematics. The primary recommendations provided to the family at that time
were to obtain child management training to address behavioral issues, such as
compliance and aggressive outbursts, consideration of ways to provide further
enrichment and acceleration in mathematics, and strategies for addressing anxiety.

Over the next year and a half, Dan and his parents participated in child
management training at our center and saw significant improvement in his
compliance, as well as a decrease in the frequency and severity of behavioral
outbursts. At this point his parents agreed to further evaluation to determine
whether Dan’s profile of behavioral and developmental difficulties was the result of
ASD. This subsequent evaluation, completed when Dan was a fifth-grade student,
included the administration of the Autism Diagnostic Observation Schedule,
Autism Diagnostic Interview–Revised, and the Vineland Adaptive Behavior Scales
(2nd edition) and produced results that revealed a history and symptoms consistent
with Asperger’s disorder. The core characteristics of qualitative impairment
in reciprocal social interaction as well as restricted, repetitive and stereotyped
patterns of behavior and interests that cause impairment in daily functioning were
apparent during the interactive evaluation with Dan and in the developmental
history provided by the parents. No clinically significant delays or deviance in
language acquisition were noted, although more subtle difficulties with the social
aspects of communication (e.g., he engaged in less social conversation than
expected for his age, and did not easily engage in give and take conversation if the
topic was not one that he enjoyed) were observed.

Key recommendations centered on encouraging his parents to continue with child

management training and to provide the school with information and resources
about ASD. It was recommended that there be a specific focus on obtaining
accommodations and supportive services to promote Dan’s ability to function
effectively within the classroom and provide continued enrichment in his areas of
academic talent.

In the 2 years that followed, Dan continued to excel academically and was
accelerated another year in mathematics. However, his behavioral difficulties
within the classroom persisted and Dan was eventually asked to leave the private

The Paradox of Twice-Exceptionality • Section I • 9

 Section I: school because of his behavior. After much deliberation and exploration of
options, his parents elected to enroll Dan in a public school setting in which an
A Paradox of Strengths individualized education plan was established and he was provided with special
and Difficulties
education support and accommodations to address his needs related to ASD.
Despite concerns about Dan’s ability to fit into this larger setting, which at first was
overwhelming to him, his parents were pleasantly surprised to see the significant
progress Dan was able to make in adapting to this setting when provided with
appropriate support and a gradual increase in expectations for his participation in
classroom and school activities.

His parents also obtained a consultation from a developmental pediatrician who

works extensively with children with ASD and started Dan on medication to address
anxiety symptoms. Further hurdles were cleared the subsequent year when Dan
made the transition to middle school. His success in adjusting to new situations
was the result of careful planning by the parents and school personnel together;
provision of a lead person, the special education teacher at the school, to coordinate
Dan’s academic and behavioral plans; and ongoing close communication between
the parents and the school.

David: Gifted with a SLD or SLD

David was a fifth-grade student receiving talented and gifted services when his
parents sought an evaluation because he was struggling with writing and math
facts. Of note, David had been evaluated 2 years previously at another center and
diagnosed with a learning disability in written language. David’s parents had
requested accommodations within his school setting following this evaluation, and
David was being provided with access to a computer for completing longer written
assignments, although no formal individualized education plan or 504 plan had
been initiated. His parents had arranged for private occupational therapy services
to address fine motor delays that contributed to his writing difficulties and for
tutoring from an educational specialist, services that were provided for more than
a year. His parents expressed concern about the frustration David was experiencing
with written work at school and concern about whether he was receiving the
services he needed to address his disability. Several months prior to this evaluation,
a response-to-intervention trial was initiated to address his problems with writing
and multiplication skills; this intervention was ongoing when the evaluation at
this center was requested. Standardized grade-level tests, (the Iowa Tests of Basic
Skills) previously revealed exceptional academic achievement in Reading, Science,
Social Studies (all at the 99th percentile), and Math (92nd percentile), with lower,
although still above average, achievement in Language (76th percentile).

The comprehensive psychoeducational evaluation completed to address questions

about David’s abilities and challenges included individually administered tests
of intellectual ability (Wechsler Intelligence Scale for Children), academic
achievement (Wechsler Individual Achievement Test and Woodcock-Johnson III),
visual-motor integration, visual-spatial reasoning (NEPSY-II), memory (NEPSY-
II), and psychosocial adjustment (Behavioral Assessment System for Children).
This evaluation revealed that David was a delightful, hard-working student with
good psychosocial adjustment. He readily reported his problems with writing,
especially with learning cursive, but also described his interests in science and the
sense of awe he experienced when participating in an enrichment class on robotics.
The intellectual assessment indicated that David’s verbal intellectual abilities
were within the very superior range (99.8th percentile), while his nonverbal
and processing speed abilities were high average (84th and 79th percentiles,

The Paradox of Twice-Exceptionality • Section I • 10

 Section I: respectively). His short-term auditory memory abilities were variable, with his
memory for related verbal material (e.g., memory for stories) and spatial material
A Paradox of Strengths being stronger than his memory for unrelated material, such as number or letter
and Difficulties
sequences.

The academic assessment revealed that David’s written language skills (45th
percentile on the Wechsler Individual Achievement Test and 55th percentile on
the Woodcock-Johnson III) were significantly below the level expected given his
very superior verbal intellectual abilities (predicted difference method base rate
<1%). His difficulties with spelling and writing mechanics were particularly notable
given the level of his intellectual ability and the private therapy and tutoring he had
received, and indicated the presence of a specific learning disability in the area of
written language. David’s math reasoning skills were superior, although his written
computation skills were average to high average, which may have been due in part
to his memory for unrelated material, such as numbers, being less well-developed.

Key recommendations to address David’s talents and challenges included

implementation of accommodations and supportive services through a 504 plan
or individualized education plan within the school setting that would continue
to nurture his areas of high ability and address his learning disability. At school,
continued use of a computer for written assignments, provision of extra time for
written assignments, reduction in the length of handwritten assignments while
still requiring completion of the most difficult items to confirm understanding,
more review and explicit teaching of the writing process and rules for writing
mechanics, and use of voice recognition software to provide an avenue for
completing longer writing assignments were recommended. In addition, continued
involvement in talented and gifted services at school, including online courses as
well as participation in enrichment activities in the community, were encouraged.
Contacting the junior high school counselor in advance to consider ways to
support David in that setting, in which expectations for written language would be
significantly greater, was also suggested.

Follow-up information obtained from David’s mother a little more than a year after
our evaluation revealed some positive progress. She indicated that the information
obtained during our evaluation continued to be helpful when they encountered
new situations. They also indicated that they had benefitted from recommended
resources to provide more information about twice-exceptionality (e.g., newsletters,
journals). David’s mother noted that the school did implement a 504 plan following
our evaluation, and David was making progress in developing his spelling skills.
She reported that David had some successes in fine arts (photography and poetry)
and was continuing to enjoy school and learning. However, she noted consistent
challenges in getting the school to fulfill the 504 plan along with growing concern
about David’s difficulties with math computation. The family made contact with
the junior high school counselor to discuss the transition. This meeting had
prompted the family to begin thinking about options for David to fulfill the foreign
language requirement, because this would be a challenging process for him given
his difficulties in written language. David’s situation points to the importance of
gaining comprehensive information about a student’s abilities and achievement
as well as the essential need to consider changes required in the support and
enrichment provided to these students as they progress through school and
encounter new challenges.

The Paradox of Twice-Exceptionality • Section I • 11

 The Paradox of Twice-
Exceptionality

Packet of Information
for Professionals –
2nd Edition (PIP-2)

Section II
Addressing
the Paradox:
Developing
Strengths and
Accommodating
Difficulties
 Section II: In this section, we address multiple areas that can present challenges to twice-
exceptional students, including general cognitive ability, reading, math, written
Addressing the Paradox: language, cognitive processing speed, and motor coordination. After each area is
Developing Strengths and
briefly described, we provide specific recommendations that support strengths
Accommodating Difficulties
and, when appropriate, minimize difficulties. Following the discussion about
academically-related areas, we present extensive information about several areas that
can be challenging for individuals who are twice-exceptional. For example, students
with ASD frequently have difficulty in the areas of socialization, communication
and daily living skills, and display behaviors and interests that may be unique, even
unusual. Challenges for students with ADHD include sustaining attention, impulse
control, planning/organization, remaining focused, and modulating their behavior.

General Cognitive Ability

General cognitive ability is the first item in the federal definition of giftedness
(see Appendix A), and includes the observation that most gifted and talented
programming involves some form of assessment of general cognitive ability.
However, despite its ubiquitous nature, defining general cognitive ability is an
elusive undertaking. Psychologists who specialize in measuring cognitive ability
often associate the concept with skills that are essential to learning and solving
problems. With that in mind, many of the measures used to assess general
cognitive ability involve having individuals respond to questions and complete
tasks that measure how well they figure things out, especially as the task becomes
increasingly complex. These types of tasks and questions make up IQ tests. The
individual’s performance on an IQ test is then compared to other individuals who
are approximately the same age, and it is this comparison that helps educators
understand what the student’s strengths and weaknesses are as they relate to
coursework.

Intelligence Tests
Some intelligence tests are group-administered paper-and-pencil measures. The
most comprehensive assessments of intelligence are individually administered
tests that involve multiple modes of task presentation and response. For most
comprehensive evaluations that are conducted in a clinic, the individually
administered IQ test is the best approach because it yields extensive information
about both general and specific areas of ability. This instrument gives an indication
of a student’s various cognitive abilities, such as verbal comprehension, perceptual
reasoning, working memory, and processing speed. These are all areas that are
crucial for learning and problem solving, and many gifted students who are also
diagnosed with a disability have some unique characteristics within these areas that
require attention.

Results from an IQ test can be reported in a variety of ways, including a score, a

percentile ranking, or a descriptive category, each of which assumes a comparison
with same-age peers. Therefore, an IQ of 145 represents a score that is at the 99.9th
percentile, and is described as “Very Superior.” The 99.9th percentile means that
out of 1000 students the same age, the student with an IQ of 145 scored as well as or
better than 999 of those students! This is a remarkable performance, which implies
several important things. First, many educators will often state that they teach lots
of bright students and, indeed, they do. But, a student with an IQ of 145 is very rare
and will seldom be challenged in a classroom that does not have advanced material.
Second, a student with an IQ of 145 will still have relative strengths and weaknesses.

The Paradox of Twice-Exceptionality • Section II • 2

 Section II: Further, a student with an IQ of 145, who is also diagnosed with ASD, will have some
areas that are dramatically limited in comparison to his or her strengths. In these
Addressing the Paradox: cases, what is most important about the information from an IQ test is not the overall
Developing Strengths and
score, per se, but the profile of scores from the subtests that comprise the entire
Accommodating Difficulties
instrument.

The Four Indices of the Wechsler Intelligence Scale for

Children — 4th Edition (WISC-IV)
Verbal Comprehension A measure of the individual’s ability to use
language and acquired knowledge effectively.

Perceptual Reasoning A measure of the individual’s ability to perceive

logical relationships and solve problems using
novel information.

Processing Speed A measure of the individual’s ability to perform

simple, visual-motor tasks speedily.

Working Memory A measure of the individual’s ability to hold

information in immediate awareness and use that
information to repeat sequences in various ways.

High Cognitive Ability and Difficulties

in Specific Domains
Gifted students who have a disability and have participated in the research
sponsored by the Belin-Blank Center have exceptionally high general cognitive
ability—especially on the subtests that measure verbal comprehension and perceptual
reasoning abilities. The student’s cognitive ability is often at the 90th percentile
or higher, which is considered a superior performance. One would expect the
achievement of a students with superior ability to be well above-average; however, a
few students will struggle and difficulties should be investigated thoroughly.

Reading
Difficulties with reading may be present for many gifted students with disabilities.
For example, students with SLD in reading can have difficulty with letter or word
identification, reading speed, and/or reading comprehension. For many students
with ASD, word-reading skills are advanced in comparison to their comprehension
skills. For these twice-exceptional students who we have tested, this pattern is
similar; yet reading comprehension continues to be high. One example of this is the
case of a student we will refer to as “Jane.” Many people thought that “Jane” was
hyperlexic (i.e., could read words that were very difficult to pronounce, but could
not understand the meaning) because she could read almost any word presented
to her at an early age, but people questioned whether or not she could understand
what she read. Once Jane was tested formally, it was discovered that her reading
skills were still considered advanced for a student in her grade. This is not always
the case. Another student, whom we will refer to as “Bill” read everything that
he could get his hands on about dinosaurs. He was constantly using complex

The Paradox of Twice-Exceptionality • Section II • 3

 Section II: words in sentences that related to dinosaurs, and his eagerness for learning more
was extreme. However, once Bill was tested, it was discovered that his reading
Addressing the Paradox: comprehension skills were actually similar to grade-level expectations, especially
Developing Strengths and
when he was asked to make inferences and provide explanations about genres such
Accommodating Difficulties
as fiction or poetry. In some cases, these difficulties are so severe that they require
a diagnosis and intervention. This can only occur if there is a comprehensive
assessment, which allows for a thorough evaluation and interpretation of cognitive
and academic strengths and weaknesses.

Recommendations to Enhance Reading Achievement

and Enjoyment
• Often, twice-exceptional students, particularly those with ASD, have intense
interests in particular areas. Allow students to pick books and/or reading
materials in their area of interest and engage them in conversations related
to what they have read. This can be an effective strategy in working with
students with SLD in reading, because they may be more willing to put forth
extra effort when reading high interest material.

• Proficient readers who are twice-exceptional may want to focus only on

reading non-fiction books because of the more literal, factual nature of
the material. For these students, encourage them to read more diverse
genres in their areas of interest.

• Sometimes, abstract concepts can be difficult for twice-exceptional students.

Keep this in mind when suggesting reading material to the student in order
to maintain his or her level of confidence in reading ability.

• Gifted students with ASD, ADHD, or a SLD in reading may not read as
rapidly as one might expect. Therefore, provide adequate time for the
completion of reading tasks and focus on comprehension and enjoyment
over speed to ensure that these pitfalls are not encountered.

• It is also important to note that some exceptional readers with ASD will
do nothing but read, which may interfere with skill development in other
academic areas and can serve to socially isolate the child even more.
Therefore, it may be helpful to pair the gifted/ASD student with another
student who has similar interests and assign them the same reading
material to discuss together. That way the student can work on social
skills development while pursuing an area of high interest.

• Students’ difficulties in generalizing information can also be very

frustrating for educators who teach material that the student does
not incorporate into the next day’s lesson. It is important to provide
informed feedback that reinforces the behavior and statements
designed to indicate the behavior is appropriate when the student does
generalize. It is also important to review or provide clear guidelines for
how to incorporate the previous day’s material.

• Text-to-speech software can be a useful tool for students with reading

difficulty. The center for assistive technology on campus, ICATER (addi-
tional information available at the following URL: http://www2.edu-
cation.uiowa.edu/centers/icater), provides university-based licens-
es for Read and Write Gold, which is a good example of this technology.

The Paradox of Twice-Exceptionality • Section II • 4

 Section II: Math
As with reading, math skill development can be quite variable among twice-
Addressing the Paradox:
exceptional students. Students diagnosed with SLD in math or with ADHD often
Developing Strengths and
Accommodating Difficulties have difficulty with speeded problem solving, such as “timed math tests.” Just as
many educators assume that students with ASD have more advanced word-reading
skills than reading comprehension skills, educators also may assume that students
have advanced skills in math computation relative to their understanding of math
concepts. This is not always the case and can lead to faulty programming, which is
one reason why formal testing is so important. Often, when the results of testing
are reviewed, it is discovered that the student’s understanding of math concepts is
advanced for his or her grade level.

Recommendations to Enhance Math Success

and Enjoyment
• When students are highly able in mathematics, it is especially important
to present advanced-level material. This is exactly the purpose of many
student programs for gifted/talented students. Nevertheless, some students
may need additional individualized attention because their skills are more
developed than those of other students in the class.

• Twice exceptional students may be ready to grasp complex material, yet

might need a little more time to do so than their talented peers, and
reviewing previously learned material may be frustrating. An effective
way to accommodate these contradictory needs is to present new material,
but let the student take his or her time to process the new information. In
this way, challenging material is provided to all students, but the amount
and exposure duration is individualized to meet each student’s cognitive
processing needs.

• Because twice-exceptional students may focus on a single aspect of math, it

will be important to offer a broad perspective of math concepts throughout
the course. Another way to think about this is to encourage students to
explore various aspects of math outside their comfort zone. For example, a
student who is intrigued with fractions might be presented with material
that extends the use of fractions to other areas of mathematics.

Cognitive Processing Speed and Multi-Tasking

Cognitive processing speed refers to the speed at which an individual can perceive
and process incoming information. The ability to process information rapidly is
essential to success in nearly all academic domains. For example, studies of reading
comprehension show a strong connection between the speed at which one reads
(i.e., an individual perceives the written word and registers that the word has
been perceived) and the ability to comprehend what one has just read. In this case,
processing speed is referring to the ability to quickly scan, recognize, and encode
text into something meaningful. Of note, many students who are diagnosed with
SLD, ASD or ADHD have deficits in processing speed that may be in direct contrast
to their high verbal ability. The paradox of very high verbal ability and slower
processing speed can be extremely frustrating for both the student, who feels the
pressure to complete tasks as quickly as peers, and for teachers, who must wait for
the student to finish tasks before moving on with the other members of the class
who have already finished.

The Paradox of Twice-Exceptionality • Section II • 5

 Section II: Multi-tasking requires rapid cognitive processing; therefore, it is another area that can
create frustration and lead to avoidance of the task altogether. For example, if students
Addressing the Paradox: are nearing completion of a written activity and the teacher orally presents new
Developing Strengths and
directions to keep them moving along, the twice-exceptional student may have trouble
Accommodating Difficulties
processing the new directions while trying to complete the activity.

Recommendations for Accommodating Slower

Cognitive Processing Speed
• Allow time in class for students to think through their answer before
responding.
• Important facts and deadlines should be written on the board.
• Allow students extended time to complete in-class tasks.
• Avoid timed tasks.
Students with ASD or ADHD experience time differently and may easily lose
track of the passing minutes. When timed tasks are unavoidable, provide
gentle verbal and/or nonverbal reminders of the time that remains. Some
students may find a beeper or egg timer to be helpful. To avoid distraction
for others, a note on the student’s desk indicating the remaining time can act
as a less intrusive reminder.
• Verbally praise persistence on tasks.
• Use visual diagrams to enhance the lecture.
• Make available a copy of the teacher’s outline prior to class.

Written-Language, Writing, and Fine-Motor Coordination

Written expression and handwriting are primary difficulties for many twice-
exceptional students. These difficulties can include poor letter formation, lack of
understanding of grammar rules, or difficulty transferring thoughts into writing. Oral
language skills are precursors to written language skills. In fact, strong language skills
are among the reasons that many high ability students with ASD are not initially
diagnosed with the disorder. Not only do these students acquire oral language skills
at an early age, but also these skills are typically exceptional in comparison to their
same-age peers. Therefore, it would be natural to expect that students with strong
oral language skills would be highly successful in the area of written language.
However, the level of success often does not match the level that would be predicted
from their earlier exceptional verbal development. This discrepancy may be due to
challenges with fine motor and cognitive processing skills, which can interact to work
as a double barrier to successful written language.

Fine-motor coordination is a skill that is often taken for granted. Yet, fine-motor
coordination is vitally important to writing and drawing tasks, detailed lab work,
or use of new tools in science projects. In all of these areas, the interaction of fine-
motor coordination and cognitive processing speed is vital to successful output.

Fine-motor difficulties for some students are manifested through poor quality
handwriting and seemingly general carelessness, which may or may not be related
to difficulty gripping a pencil or pen.

Students with ASD or SLD in written language tend to have slow, labored, and
unorganized writing. It can be frustrating for a teacher to observe that a highly
verbal student with extensive knowledge about a specific subject area produces
written work that is disorganized and may appear to be carelessly done. Sloppy
penmanship may be perceived as a sign of carelessness and/or poor quality

The Paradox of Twice-Exceptionality • Section II • 6

 Section II: work. These problems, as previously mentioned, are the manifestations of the
fine-motor difficulties combined with slower cognitive-processing speed. Many
Addressing the Paradox: times, students with these difficulties elude writing altogether to avoid negative
Developing Strengths and
comments and/or feelings about inadequate work, which often can lead to
Accommodating Difficulties
frustration and embarrassment.

Recommendations to Accommodate Difficulties in Writing,

Written Language, and Fine-Motor Coordination
• Model the fine-motor activity—especially for very young students.
• Offer an assortment of different pens and pencils so students can find the
one that is most comfortable.
• Allow use of print or cursive—whichever is most comfortable.
• Allow students to share notes, lessening the stress of rapid note taking.
• Provide copies of class notes.
• Use large graph paper for math calculations in order to help with number
alignment.
• Allow the use of computers to complete writing assignments, and use
assistive technology, such as voice-recognition software (e.g., Dragon
Naturally Speaking) if the mechanical aspects of writing are too difficult.
• If a student’s writing is slow or labored, allow extra time to complete
assignments.
• Have students record their response first and then produce written output
based on their recording.
• Intersperse required writing assignments with activities that allow the
student to write about their special interests.
• Encourage the idea of writing drafts and proofreading so that students can
focus on the content first and the mechanics second.
• Reduce assigned tasks that may have extraneous writing activities.
• Emphasize quality over quantity in written assignments.

Gross-Motor Skills
In addition to fine-motor difficulties, many twice-exceptional individuals, especially
those with ASD, also exhibit weaknesses with gross-motor skills (i.e., simple
movements of the large-muscle groups). While such skills can range greatly in
children who are diagnosed with ASD, it is not unusual to see children with ASD
involved in accidents, such as knocking things over and bumping into other people,
more regularly than their peers who do not have ASD.

It is also common for children with ASD to walk and run with an ungraceful
appearance, often characterized by a lack of arm swing and impaired balance.
Children with ASD and who are awkward may be teased and embarrassed, creating
a reluctance to participate in sports or physical activities involving running and
jumping. This is also true of sports and activities that require throwing and
catching, as children with ASD frequently struggle with throwing accuracy and
timing necessary for catching. This is particularly unfortunate considering that
most popular sports usually involve these skills. It should also be noted that while
some children tend to learn imitation of movement rather quickly, children with
ASD are less likely to be able to imitate others’ movement patterns. Thus, it can be
especially frustrating for a teacher, coach, or residential assistant to teach such a
child through demonstration of physical movements (e.g., modeling how to kick a
soccer ball).

The Paradox of Twice-Exceptionality • Section II • 7

 Section II: The main recommendation for concerns about gross-motor deficits relates to the
professional’s need to be sensitive to the student’s feelings when in group settings
Addressing the Paradox: by not placing him or her in situations that may result in embarrassment. For
Developing Strengths and
example, if the child is having difficulty with a particular gross-motor skill or
Accommodating Difficulties
activity, do not ask him or her to perform that skill in front of peers, or modify the
activity for all participants so that the motor skills necessary for the task are within
the ability range of all students.

Characteristics and Behaviors of

Twice-Exceptional Students
The following section addresses some important considerations for instructors
working with twice-exceptional students.

Most programs for gifted/talented students share the goal of providing challenging
academics in a supportive learning and social environment. Indeed, a strong social
aspect is a major component of the learning environment. With this in mind, it
is of utmost importance for professionals to be informed about the nature of
twice-exceptionality and the socially challenging situations that may arise. Such
information is necessary to prevent both inappropriate expectations of performance
based on the student’s cognitive abilities and misinterpretation of the student’s
behavior as deliberate or malevolent.

Following is a sampling of characteristics (see Attwood, 2007; Silverman &

Weinfeld, 2007) that you may (or may not) observe in twice-exceptional students.
Please note that the characteristics are not an exhaustive listing; rather, they
provide an example of what may be observed in gifted students. Please note that
the characteristics are not an exhaustive listing; rather, the provide an example
of what may be observed in gifted students, especially those with ASD. Following
the descriptions are recommendations that might be useful when or if a student
demonstrates any of these emotional or behavioral presentations.

Social Characteristics
For twice-exceptional students, especially those with ASD, social awareness is an
area that requires special attention. For example, whereas many students with ASD
are self-described “loners,” they may feel an intense desire to make friends and
have a more active social life but lack the skills necessary to make these desires a
reality. Other social difficulties may also be observed, such as:
• Social behavior that seems developmentally immature;
• Difficulty reading social cues, such as how to adjust one’s behavior depending on
the situation;
• A perceived lack of empathy or emotional interest in others (e.g., no reaction to
a person’s misfortune or fortune);
• Difficulty forming friendships with classmates;
• Trouble accepting and offering feedback;
• Lack of ability to censor comments. For example, the student may vocalize his
or her views about the physical qualities of a teacher without realizing that these
comments may hurt the teacher’s feelings;
• Difficulty understanding the need for personal space;
• Use of a raised voice during periods of stress and/or frustration;
• Trouble understanding and/or following the rules of social games during free time.

The Paradox of Twice-Exceptionality • Section II • 8

 Section II: Recommendations for Enhancing Social Skills
As a student program professional, we encourage you to cultivate students’
Addressing the Paradox:
social awareness at every opportunity—inside and outside the classroom.
Developing Strengths and
Accommodating Difficulties In situations that are socially problematic for twice-exceptional students,
particularly those diagnosed with an ASD, you may find that there is a
discrepancy between the student’s perceptions about a situation and the
perceptions of others. These differences need to be made explicit for the student
so that he or she can learn from these situations and attempt to apply new skills
in the future.

In your professional role, you may not necessarily be in a situation to improve a

students’ social skills, but you could be helpful in decreasing social stressors and
increasing positive social interactions. For example, it may be helpful to arrange
for a student to sit near a group of students at lunch and during free time so that
opportunities to cultivate social interactions are present. Offer encouragement
and recognition for all attempts made at engaging others socially.

In many cases, twice-exceptional students may need specific instructions as

to how to relate to other students. This means that a general comment such
as, “Why don’t you go sit next to Marcos today at lunch?” is not as helpful as a
comment such as, “After you get your tray at lunch, go sit in the chair next to
Marcos and see if he wants to talk about his favorite part of this morning’s class.”

It is also important to identify specific opportunities in which the student can

interact with peers. In these situations, the student can observe and learn from
the language and social skills of those around him or her. It may be helpful
to match the student with peers who have similar interests to give him or
her “common ground” on which to start a conversation and perhaps build a
friendship. What is nice about summer enrichment programs is that students
typically self-select courses they take; therefore, classes will be filled with
students who have similar interests, giving the student with ASD opportunities
to talk and make friendships with like-minded peers.

Many twice-exceptional students, especially those with ASD, lack important

social skills that would not only help them make and keep friends but would
also have a positive effect on their academic progress. For example, listening
skills are vital in the classroom as well as in social situations, but may be a
challenge for students who get caught up in their own interests to the extent that
they may have trouble focusing on what others are saying or the material being
presented in class. If this happens in your classroom, it may be helpful for you
and the student to develop a cue (e.g., an agreed-upon word or signal) to regain
the student’s focus.

The Paradox of Twice-Exceptionality • Section II • 9

 Section II: Language and Communication Characteristics
Many gifted students with social difficulties possess communication styles that set
Addressing the Paradox:
them apart from their peers. Some examples of what you may observe include:
Developing Strengths and
Accommodating Difficulties • Trouble applying social rules in conversation, such as what topics to select,
changing topics, or providing background to help the unfamiliar listener;
• Having a hard time using and understanding facial and other nonverbal
expressions that communicate emotion, or understanding how non-literal forms
of communication, like teasing, irony, sarcasm, or humor, are used;
• Little to no conversational participation in group discussion or excessive talk
that seems off topic or devoid of others’ perspectives;
• Rarely reciprocating pleasant comments or greetings (e.g., fail to respond when
you say, “It is great to see you this morning!”);
• Being literal in the interpretation of instructions given by the teacher (i.e.,
unable to “read between the lines”);
• Using a pedantic conversational style (“The Little Professor”).

Recommendations for Addressing Language and

Communication Difficulties
As a student program professional, it is important to remember that you
typically will not be in a position to change the student’s style of communicating.
However, you can set up a positive environment where the student will feel
accepted and heard.

For example, it may be helpful to let the student know when he or she is
talking about a topic with which you are not familiar and that you will need
more background to be better able to converse. Or, the student could be paired
with a peer who has a similar interest so that they can share past-times and
experiences. Sometimes, students may also need prompting to remember that
what may be an interesting or relevant topic to them may not be to the listener.

It is important to realize that the student likely will not respond like his/her
peers to gentle teasing and humor. Because these students have often been the
subject of bullying, it will be vital to monitor peer interactions to ensure that
bullying is not occurring and that the student is not in a situation where his/her
communication style is being used against him/her. It would also be helpful to
point out to the student situations in which gentle teasing and humor are being
used so that misunderstanding does not occur.

When a student takes a risk and contributes to group discussion, praise

the student for his/her efforts. Conversely, when a student seems to be
monopolizing group discussion, inform the student prior to the start that
it will be important for you to hear all students’ perspectives so you will be
calling on multiple students to contribute. When providing instructions, use
a straightforward and direct style. Ensure that students understand what is
expected of them by having them repeat back what was said.

The Paradox of Twice-Exceptionality • Section II • 10

 Section II: Behavioral Characteristics
There are several behavioral characteristics that may be present in twice-
Addressing the Paradox:
exceptional students. Some of these include, but are not limited to:
Developing Strengths and
Accommodating Difficulties • Failure to decipher private versus public habits or to engage in personal hygiene
needs (e.g., the student who picks his/her nose or does not take showers);
• Absence of relaxation or recreational activities;
• Limited or unusual clothing preferences;
• Intense sensory sensitivities (touch, sound, light, color, odor, taste);
• Self-stimulatory actions, often to reduce anxiety, stress, or express pleasure;
• Self-injurious behaviors when frustrated;
• Sleep disturbance
• Easily distractible
• Strict adherence to rules and routines (unable to finish one task before starting
another one; trouble with change);
• Trouble understanding the importance of details depending on the situation;
• Difficulty understanding when a task is actually “finished”;
• Anger or behavioral problems related to unexpected changes in routine or
behavior.

Recommendations for Supporting Behavioral Difficulties

As a student program professional, you may find that some twice-exceptional
students exhibit behaviors that can be problematic in and out of the classroom.
Several behavioral management techniques may be of assistance, depending on
the particular student’s specific needs. Typically, the emergence of a behavior
problem is a signal that the student is experiencing stress. If so, consider
removing the student from the source of the stress and allowing him/her to go
to a safe place. If available, involve staff with expertise in behavior management
to identify in advance locations that can serve such a purpose. When possible, it
may be helpful to have a comforting object or person available to help calm the
student, or to engage the student in a familiar and enjoyable activity.

You may also find that a twice-exceptional student may experience behavioral
difficulties during “down times.” To avoid problems during these occasions, plan
ahead to find out what activities and areas the student is interested in and be
prepared to make specific suggestions about things the student should do. This
might include playing cards, reading a book, listening to music with headphones,
or playing on a computer. For students with ADHD, you may need to regularly
check in with the student to ensure adequate understanding of class directions.
These “check ins” can also help serve as reminders to the student to maintain on-
task behavior.

There may be cases where a child’s behavior seems to require specific, program-
wide guidelines to deal with the issues whenever they arise. If you feel that a
behavioral intervention plan would be helpful to you, we recommend that you
bring this to the awareness of program staff very early so that an individualized
plan can be developed. When possible during intervention planning, the
consultation of psychologists, graduate students, and other professionals
with specialized training in behavior management and twice-exceptionality is
recommended. Whatever guidelines are determined should be discussed with
the student in an explicit, rule-governed fashion, and everyone involved with

The Paradox of Twice-Exceptionality • Section II • 11

 Section II: the student should be aware of the plan so that consistency across staff, settings,
and situations is maintained.
Addressing the Paradox:
Developing Strengths and
Parents of all student participants are required to complete health forms. These
Accommodating Difficulties
forms are the ideal place for parents or guardians to identify environmental
factors that are likely to cause their child distress. A careful review of the forms
will be helpful in taking steps to minimize or eliminate these issues before
the week begins. For example, the student may be sensitive to certain sounds;
therefore, this student may benefit from wearing headphones during individual
work time to eliminate possible distractions. Other students may be sensitive to
fluorescent lights, so placing the student near a window, if available, may help.

Many twice-exceptional students, particularly those with ASD, have intense

interests that may result in social and communication problems. However, these
interests can be used in a positive way. For example, an interest can be used to
grab attention in particular subject areas. If a student is fascinated with baseball
statistics, use this interest to teach him/her about fractions and decimals or find
books that feature baseball players with impressive statistics.

Many students with ASD also have an adverse reaction to change; thus, a new
learning environment or program can be extremely stressful to the student.
Students would benefit from having a written schedule where each component
of the day is outlined. Once a routine is established, he or she may become
anxious if it is changed or if the setting is altered. It is imperative to make the
student aware in advance of changes that are likely to cause distress (e.g., a
changed field trip, shortened break time, etc.). In all likelihood, the twice-
exceptional student will take longer to adjust to any changes than it would take
his/her peers, so discuss the transition with him/her before informing the whole
group, and be patient if the student does not understand right away.

In our one-on-one and group work with twice-exceptional students, we have

noticed several times that it is difficult for students to generalize what is learned
outside of classroom, group therapy, or individual therapy setting.

Students’ difficulty generalizing information can also be very frustrating for

educators who teach material that the child seems to grasp, yet loses the ability
to relate it to the next day’s lesson. Repeating information, such as directions
for an assignment, may not always be necessary for typical gifted students, but it
may be necessary to the success of these twice-exceptional students.

Social Stories as an Intervention

Social Stories is an intervention that introduces potentially challenging or
confusing topics and situations to students by presenting the information from the
perspective of the child or adolescent. These short stories are most often written
for students with difficulties in social functioning and communication, which are
central characteristics of students with ASD. The purpose of Social Stories is to
help the student learn appropriate ways to react to social situations or to highlight
positive achievements.

The following eight Social Stories introduce topics and situations that students
in enrichment programs may encounter. Some are presented in check-list format
and others are in paragraph form. We have kept them general so that they can be

The Paradox of Twice-Exceptionality • Section II • 12

 Section II: tailored to the individual student in various ways, such as incorporating the child’s
name, interests, or particularly troubling situations. Also it is important to know
Addressing the Paradox: that students who attend summer programs range in age from early elementary to
Developing Strengths and
high school. Therefore, some stories will not be appropriate for the specific child or
Accommodating Difficulties
adolescent with whom you are working. In these cases feel free to modify the story
so that it is age-appropriate and fits with your student’s needs.

For more information on Social Stories, including how to construct them on your
own, see Carol Gray’s The New Social Story Book (2000 edition), published by
Future Horizons, Inc.

Introduction to Programs
1. This summer I am going to a special Program for gifted students.

2. Programs are different than school. At Programs I can learn about specific topics
that interest me.

3. Sometimes I will be in a classroom for 3 or 4 hours learning from a teacher and

at other times I will participate in fun activities outside of the classroom.

4. There will be many other students at the Programs. Some of the students will
Weekday Schedule have the same interests as I. Some will not be interested in the same things that
interest me. I can learn new things from other students, even those who do not
7:00-7:30 AM Wake up! Students are responsible for
setting their own wake–up time. Early risers may want share my interests. I can do this by listening to them and asking them questions
to get together to do some early morning exercise or
read quietly in the residence hall. about what they like to do.
7:00-8:30 AM Breakfast—All meals will be served in
the newly renovated Burge Dining Hall. You will have a
choice of hot entrees, fruit, juices, cold cereal, and an
assortment of breads. Checking My Schedule
8:30-8:45 AM Morning Meeting—A daily meeting for 1. The Daily Schedule is a list of times and locations for each of the activities that I
announcements.
will be participating in for that day. On the left side of this page is an example of
9:00-12:00 PM Morning Academic Session
a general weekday daily schedule:
12:00-1:00 PM It’s back to Burge Hall for lunch
where you will have the choice of hot entrees, a
complete line of vegetarian entrees, soup, sandwiches, 2. I will receive my Daily Schedule each morning from my Resident Assistant.
and a complete salad bar.

1:00-4:00 PM Afternoon Academic Session—This

early afternoon period usually involves additional
3. Each day before my classes start I need to check my Daily Schedule.
academic class work. Sometimes the afternoon session
is reserved for class projects, special workshops,
lectures, exhibits, field trips, and other activities. 4. My Daily Schedule will not be the same as all of the students in the program. It
5:00-6:30 PM Dinner is served in Burge Dining may not even be the same as that of my roommate.
Hall. A complete line of vegetarian entrees is served
along with a variety of other meal choices.
5. My Daily Schedule might change every day so I should look at it daily.
6:30-9:30 PM Evening Activity—Most evenings
include special events ranging from arts performances
and special guest speakers to student activities and
games. Some programs have a mandatory study period 6. I should pay attention to the times listed on the schedule because they will tell
during this time. The times of these activities will vary.
Check the daily schedule located on your RAs door for me when the activity starts. I can check a clock or wear a watch to know the time.
details.

10:00-10:30 PM Curfew—All students must be on 7. I should also pay attention to the location of the activity so that I know where to
their floors by the time designated for their individual
program unless directly involved with an activity go and can estimate how long it will take. It may take as long as 5 minutes to get
scheduled by the program staff.
to an activity, so I need to start walking earlier than the start time listed in my
11:00 PM Bed Check or Lights Out—Students must
be in their own rooms ready for bed check if they are
Daily Schedule.
junior high students, or in their rooms getting ready for
bed if they are high school students. If you want to go
to bed earlier, please feel free to do so. 8. If I have any questions or if I do not understand the schedule then I should ask a
11:30 PM Lights Out for High School Programs— Resident Assistant for help before classes start.
You may be used to staying up later, but with the
busy schedule you will need your sleep. RAs will do
bed checks promptly at 11:30 PM for the high school
programs.

The Paradox of Twice-Exceptionality • Section II • 13

 Section II: 9. My Daily Schedule will help me get to the places I am supposed to be at the
correct times so that I will have a good time at summer camp. It will also help
Addressing the Paradox: me remember all our activities so I can tell my family and friends about them
Developing Strengths and
later.
Accommodating Difficulties

Eating in the Cafeteria

1. When I attend a residential program for gifted kids at the Belin-Blank Center, I
will eat breakfast, lunch, and dinner in the Cafeteria.

2. The Cafeteria is called the Burge Dining Hall.

3. I will have lots of choices of what to eat in the Cafeteria. For breakfast, there will
be hot entrees, fruit, juices, cold cereal, and breads. For lunch, there will be hot
entrees, vegetarian entrees, soup, sandwiches, salad bar, and deserts. For dinner,
there will be choices similar to what there was at lunch.

4. I will fill up my plate one time and only get as much food as I can eat in the
Cafeteria. I will make sure to only get one dessert.

5. I get to chose where I sit in the Cafeteria. I can eat with a staff person or a
classmate.

6. After I am finished eating in the Cafeteria, I will put my tray in a designated area.
My Resident Assistant can show me where if I am confused.

7. I will not bring food out of the Cafeteria.

Taking Care of Myself

Sometimes people get dirty or sweat a lot and they start to look dirty or smell funny.
Other people might not want to be around me if I look dirty or smell funny. Every
day that I am at the program I need to make sure that I am clean and smell good.
It is a good idea to take a shower or bath every day and to use soap to clean off any
dirt. I should also wash my hands whenever they are dirty and before I eat food.

Other things need to be cleaned as well. Clothes can become dirty and smell funny,
so I should wear a clean set of clothes each new day. My teeth need to be brushed
every day too so that they are clean and my breath smells good.

I might become sick while I am at my program. When I am sick I may spread germs
to other people and make them sick and other people do not want to be sick. If I
become sick I should tell my resident assistant or my teacher. If I feel fine but have
a cough I should cover my mouth with my hand or cough into the middle of my arm
when I feel like coughing. I should wash my hands each time I cough or sneeze into
them.

The Paradox of Twice-Exceptionality • Section II • 14

 Section II: Personal Space
1. Sometimes people need Personal Space. This means that I should not get too
Addressing the Paradox:
close to them.
Developing Strengths and
Accommodating Difficulties
2. Getting too close to someone or invading his or her Personal Space may upset
that person or make them feel uncomfortable.

3. To keep good Personal Space, I can always give a high-five, thumbs up, or a
handshake to others, but I should not hug someone else or invade his (her)
Personal Space.

4. I should also make sure that there is enough Personal Space between me and my
friend. When I give other people their Personal Space they will not feel upset or
uncomfortable.

In the Classroom
1. When I go to summer programs I will be Learning in a Classroom.

2. There will be many other students in the Classroom.

3. My teacher will help us Learn new things.

4. When the teacher is talking I will try to be quiet and listen so that I can Learn.

5. Teachers like it when the students use an inside voice in the Classroom and
when they listen to what is being said.

6. If I want to say something in the Classroom or if I have a question for the

teacher I will raise my hand so that the teacher knows that I would like to talk.
When the teacher calls my name I will know that it is my turn to talk.

7. I have to remember that other students may also raise their hands to talk in the
Classroom so I may not be the first person the teacher calls on. This is okay.

When I am Upset
When I attend a program I will participate in many activities in and out of class.
Some activities may be easy and some activities may seem difficult. When things
seem difficult people sometimes get frustrated or angry. Everyone gets angry at one
time or another. People can also get angry at other people.

When I get angry it is NOT okay to hit, push, or yell at other people. Instead I will
have several good options. One option is to ask my teacher or resident assistant for
help. If I am in the classroom, another option is to tell my teacher that I need “a
break” from class for awhile and I can go to the quiet place that I identified with my
teacher. The quiet place is a room where I can go to calm down and feel better. I can
talk with a staff member in the quiet place about what happened. I should only use
the quiet place when I feel it is necessary.

The Paradox of Twice-Exceptionality • Section II • 15

 Section II: Finding Someone to Help
At the programs I will meet many students and adults. Sometimes it is hard to
Addressing the Paradox: remember everyone’s name and recognize everyone’s face. If I am in trouble or if I am
Developing Strengths and
Accommodating Difficulties lost I should look for an adult wearing a white t-shirt with the word STAFF written on
the back. That person is a safe person who can help me with my problem or show me
where to go. If I cannot find a person wearing the STAFF t-shirt, I should find another
adult and tell that person who I am and what I need help with.

Conclusion to Sections I and II

Section I of PIP-2 was preceded by a figure that graphically presented research
results highlighting the paradox of twice-exceptionality. This figure was followed
by an extensive discussion of the intersection between giftedness and disabilities
such as ADHD, SLD, and ASD. Section I concluded with three case studies that
were included to help the reader feel connected to the real people who are the
motivation for PIP-2. In Section II, we tried to describe the unique learning and
behavioral characteristics of gifted students who have these diagnoses. Because
your time with the students in programs is relatively short, we have emphasized the
recommendations for academic and social accommodations by highlighting their
headlines in gold. Section III includes the appendices, an extensive list of resources,
and an annotated bibliography. We hope that you will find the final section to be as
informative as Sections I and II.

The Paradox of Twice-Exceptionality • Section II • 16

The Paradox of Twice-
Exceptionality

Packet of Information
for Professionals –
2nd Edition (PIP-2)

Section III
Appendices
 Appendix A
A Brief History of Gifted Education
A Brief History of Gifted Education The Role of the Marland Report
For more than three decades, the federal definition of giftedness has served as the
Federal Definition of Giftedness
dominant basis for the definition of giftedness that is used in school settings in
most states. This definition came from the first national report on gifted education,
Education of the Gifted and Talented, which was a product of an effort initiated
in 1972 by U.S. Commissioner of Education, S. P. Marland. The report, often
referred to as the Marland Report, is credited with giving gifted education national
stature by emphasizing the need for programming as well as by suggesting that
a failure to meet the academic needs of gifted students would place them at risk
for psychological difficulties. However, validation of gifted students’ needs for
specialized programming was the extent of the report’s impact, because it did not
include legislation leading to significant rights for gifted students, their parents, or
their teachers.

Gifted Education Programs

Shortly after the release of the Marland Report, gifted education programs
appeared throughout the nation’s schools. Many of the programs were developed
according to the Enrichment Triad Model (Renzulli, 1976), which is the core
of Renzulli’s Schoolwide Enrichment Model (SEM). Because an enrichment
model aims to provide a comprehensive menu of challenging opportunities, it
is understandably attractive to many educators who want to provide a broad
spectrum of gifted-education opportunities to their students. In addition, most
enrichment programs use an identification system that features above-average
achievement (based on grade-level tests), creativity, and motivation. The first
step to participation in an enrichment-focused program often is an evaluation of
the student’s performance on a nationally-normed, grade-level achievement test.
The next step often involves the student taking a group-administered ability test,
such as the Cognitive Abilities Test (CogAT). A more comprehensive discussion of
general cognitive ability is provided in Section II.

The Myth of Giftedness as a General Attribute

Although an enrichment model is an effective intervention for many gifted students;
ironically, for gifted students with a disability, the model’s emphasis on high
general achievement and demonstrated motivation may inadvertently exclude from
participation in the school’s gifted program those gifted students who have learning
difficulties, behavioral problems, or social-skill deficits.

An enrichment model has also resulted in a myth that giftedness is very general
in its nature. Although we are not sure how this myth originated, even in the most
respected school systems its impact is obvious by the global or general approach
of gifted-student identification systems and subsequent programming. While
scholars have demonstrated that most individuals are not equally talented in the
variety of talent areas that are typically addressed in educational settings (e.g.,
verbal, quantitative, musical, and leadership; see the Marland Report definition of
giftedness on the next page), schools continue to base entry into gifted education
programs on global or composite standardized test scores.

Because of these practices, there is a denial of the enormous diversity of talent

that exists among gifted students. For example, educators may assume that all
gifted students love school, read well, process information quickly, or are able to

The Paradox of Twice-Exceptionality • Appendix A • 2

 Appendix A complete work or learn new material independently. Professionals who adhere
to this particular myth usually are not open to the possibility that a student can
A Brief History of Gifted Education be gifted even though he or she does not process information quickly. These are
often the same people who believe that gifted students do not require any special
Federal Definition of Giftedness
intervention because they will “make it on their own.”

The above description of enrichment programs begs the following question: Is the
generally gifted approach the only way to find and develop programs for gifted
students?

Federal Definition of Giftedness

Gifted and talented children are those identified by professionally qualified persons
who, by virtue of outstanding abilities, are capable of high performance. These are
children who require differential educational programs and/or services beyond
those provided by the regular school program in order to realize their contribution
to self and the society.

Children capable of high performance include those with demonstrated

achievement and/or potential ability in any of the following areas, singly or in
combination:
1. General intellectual ability
2. Specific academic aptitude
3. Creative or productive thinking
4. Leadership ability
5. Visual and performing arts
6. Psychomotor ability*

It can be assumed that utilization of these criteria for identification of the gifted and
talented will encompass a minimum of 3 to 5% of the school population.

*This was later removed.

The Paradox of Twice-Exceptionality • Appendix A • 3

 Appendix B
The Fourteen Individuals with Disabilities
Disability Categories of Education Act (IDEA) Disability Categories for
Individuals with Disabilities
Education Act (IDEA) Children Aged 3-21
Explanation of Federal Protections 1. Autism (A required category for reporting beginning in 1992)
for Students with Disabilities 2. Deaf/Blindness
3. Deafness
504 Plans •
4. Emotional Disturbance
Individualized Education • 5. Hearing Impairment
Plans (IEPs) •
6. Intellectual Disability
7. Multiple Disabilities
8. Orthopedic Impairment
9. Other Health Impairment
• ADHD falls in this category
10. Specific Learning Disability, which includes the categories of:
• Oral expression.
• Listening comprehension.
• Written expression.
• Basic reading skills.
• Reading fluency skills.
• Reading comprehension.
• Mathematics calculation.
• Mathematics problem solving.
11. Speech or Language Impairment
12. Traumatic Brain Injury
13. Visual Impairment
14. Developmental Delay

Children Aged 3–9

As noted in this link, the term “developmental delay” can be used for children aged
3 through 9. Specifically, the term is employed if an individual has developmental
delays in one or more of the following areas: physical development, cognitive
development, communication development, social or emotional development, or
adaptive development1.

Explanation of Federal Protections

for Students with Disabilities
Students with disabilities are afforded specific rights under IDEA, which can
typically be categorized into an Individualized Education Program (IEP) and 504
plans. Though both IEPs and 504 plans protect the rights of individuals with
disabilities, they operate in different ways in an educational setting.

Explanation of Individualized Educational Programs (IEPs)

The IEP specifies for each individual the explicit disability-related needs and the
way in which the educational setting must meet the needs. The IEP is a formal

The Paradox of Twice-Exceptionality • Appendix B • 1

 Appendix B acknowledgment that the student’s diagnosis results in an individualized need to
establish the program of instruction, which includes goals and objectives that are
Disability Categories of evaluated annually to determine the effectiveness of the plan. The plan is written
Individuals with Disabilities
and must be agreed upon by parents. There is some federal funding for services
Education Act (IDEA)
offered to children with an identified disability. An IEP focuses on a written plan
Explanation of Federal Protections detailing intervention strategies for the student.
for Students with Disabilities

504 Plans •
Explanation of a 504 Plan
Individualized Education • A 504 Plan refers to a section of the Americans with Disabilities Act (1990) that
Plans (IEPs) • prohibits discrimination against individuals based upon his or her disabilities.
It offers protections in a school setting that are similar in nature to protections
provided by Section 504 of the Vocational Rehabilitation Act of 1973. A 504 Plan is
much less precise than an IEP. If a student has an IEP, it will supersede the 504.

In essence, the 504 specifies the accommodations that are needed to ensure that
the student has access to an appropriate education. These are accommodations that
may structure the environment or the mode of instruction to assure that the student
has an optimal learning experience. The suggestions that were presented in Section
II are more typically found in 504 Plans.

Finally, the 504 Plan does not require a written plan that is agreed to by parents. As
well, 504 Plans do not include funding for the services.

Subtle but Important Differences Between IEPs and 504s

Not all students who have disabilities require specialized instruction. For students
with disabilities who do require specialized instruction, the Individuals with
Disabilities Education Act (IDEA) controls the procedural requirements, and an
IEP is developed. The IDEA process is more involved than that of Section 504 of the
Rehabilitation Act and requires documentation of measurable growth. For students
with disabilities who do not require specialized instruction but need the assurance
that they will receive equal access to public education and services, a document
is created to outline their specific accessibility requirements. Students with 504
Plans do not require specialized instruction, but, like the IEP, a 504 Plan should
be updated annually to ensure that the student is receiving the most effective
accommodations for his/her specific circumstances.

References

1. https://docs.google.com/
viewer?a=v&q=cache:vWuBBU4VrscJ:nichcy.org/wp-content/
uploads/docs/gr3.pdf+&hl=en&gl=us&pid=bl&srcid=ADGEESiU
6FcWuaWbcHEGVAt2XN-fRmHx1ixhYxjC4JZ9zgPDJMH-OXdt
6T28DllpTxJV4YgO7QKBEeXwYSgEYj7a7YB-cxYsVDJ1eugj6jS_
zirh0BCno7KOIvxvvPRDYSGCpOwfBjLU&sig=AHIEtbQ9U3
TXVz5nReF4YVNrLVzo4_082w

2. http://www.aacld.org/thelaw/504plans.html.

The Paradox of Twice-Exceptionality • Appendix B • 2

 Appendix C The Talent Search Model of Gifted Identification
The Talent Search Model There is a system for gifted education programming that has existed since the
early 1980s, when programs for high-ability students first were offered through
Comprehensive Assessment –
Why it Matters university settings. Typically presented as a benefit of participation in university-
based talent searches (Lupkowski-Shoplik, Benbow, Assouline, & Brody, 2003;
The Assessment Process at the Olszewski-Kubilius, 2004), these programs are almost entirely outside of the
Belin-Blank Center’s Assessment K–12 domain (Assouline & Lupkowski-Shoplik, 2012). The talent-search model
and Counseling Clinic
for discovering academic talent is a two-step process, and the first step, as with an
Annotated Bibliography enrichment model, often emanates from the student’s performance on a nationally-
normed grade-level achievement test; however, this is the only point at which
the talent-search programs resemble the enrichment programming. So, while
enrichment usually serves as the basis for the majority of pull-out programs for
gifted students in the K–12 setting, the talent-search model serves as the basis for
university-based programs; and thus, these two kinds of programs operate in a
parallel gifted world (Assouline & Lupkowski-Shoplik, 2012). Because these two
programs rarely intersect, it is not uncommon for students to qualify for university-
based programs, yet not qualify for their school’s gifted program.

Belin-Blank Center programming is more aligned with a talent development/

university-based talent- search model. For many students, this approach can
help not only to discover a need for additional academic challenge, but also to
help establish clear modifications that provide the necessary challenge. Further,
the talent-search model provides a unique and complementary perspective on
traditional methods of gifted identification, student achievement.

Comprehensive Assessment — Why It Matters

Evaluation of gifts/talents and disabilities is a complex process, and requires a
comprehensive assessment that is tailored to identifying the student’s specific
particular impairments and academic strengths. Because an accurate diagnosis
drives the formulation of appropriate recommendations, it is critical to gather
information from every area that could be affected by the student’s disability.
Therefore, specialized training in the assessment of disabilities, as well as a
thorough understanding of giftedness are necessary qualifications for professionals
who evaluate students who are suspected to be twice-exceptional.

Comprehensive assessment has been demonstrated to be necessary to identify both

the strengths and areas of challenge that growth within twice-exceptional students
exhibit (Assouline, Foley Nicpon, & Doobay, 2009; Assouline, Foley Nicpon, &
Whiteman, 2010). Relying on brief or screening assessments to make a disagnosis
may increase risk of inaccurate diagnostics or insufficient identification of academic
strengths. Further, comprehensive assessment is necessary to avoid mistaking
a student’s combination of strengths and weaknesses as a balanced average
profile, which misses both the need for increased challenge as well as appropriate
accommodation and interventions to address learning or mental health diagnoses.

The Paradox of Twice-Exceptionality • Appendix C • 1

 Appendix C
The Assessment Process at the Belin-Blank
The Talent Search Model Center’s Assessment and Counseling Clinic
Comprehensive Assessment – The Assessment and Counseling Clinic (ACC) is dedicated to providing clinical
Why it Matters services to gifted and talented students, their families, and school personnel. These
services include, but are not limited to: identification of ability levels, determination
The Assessment Process at the
of psychological and educational needs, assistance with adjustment and emotional
Belin-Blank Center’s Assessment
and Counseling Clinic difficulties, and outreach and consultation services.

Annotated Bibliography The ACC is staffed by highly trained professionals with experience in working
with gifted individuals from various backgrounds and a wide variety of concerns.
The entire staff works in collaboration with Belin-Blank Center Director, Susan
Assouline, Ph.D., a well-known expert in the field of gifted education. In addition
to expertise in gifted education, Dr. Assouline is a certified school psychologist.
The ACC is comprised of several professionals: a full-time licensed psychologist,
Dr. Alissa Doobay; a full-time clerical support staff member, Ms. Nancy Whetstine;
and advanced practicum students from the school psychology and counseling
psychology program. Other faculty from the College of Education participate
in clinic activities. Dr. Megan Foley Nicpon, associate professor of counseling
psychology, supervises practicum students and consults with clinic staff on research
and assessments. ACC staff also includes Dr. Volker Thomas, PhD, a licensed
marriage and family therapist in the College of Education who supervises advanced
doctoral students who work with ACC families.

Although the ACC has established itself as a leader in assessment and counseling for
gifted individuals, more recently the ACC has developed a one-of-a kind focus on
services for and research with twice-exceptional students. Of particular importance
are a variety of services available to twice-exceptional students whose disability is
ASD.

Assessment
In addition to the ACC’s psychoeducational assessments to determine levels
of ability and educational achievement, members of the ACC have completed
extensive training in the use of autism spectrum diagnostic instruments considered
the “gold-standard” in the field. Additional assessment in the areas of social-
emotional development, adaptive functioning, and behavior are included in the
assessment process, which culminates in a written report with interpretation of the
assessment results and individualized recommendations to improve the student’s
social, psychological, and educational well-being.

Individual and Group Counseling

Dr. Doobay and Dr. Foley Nicpon supervise doctoral-level counseling students
and facilitate individual counseling sessions for twice-exceptional students at the
ACC. Individual counseling sessions typically focus on helping students cope with
adjustment and emotional difficulties that accompany their twice-exceptionality.
Doctoral-level counseling, marriage and family therapy, and school psychology
students who are supervised by Dr. Thomas facilitate group counseling sessions for
gifted students with co-existing disabilities who fall into specific age ranges. These
sessions are primarily focused on developing social skills and relationships.

The Paradox of Twice-Exceptionality • Appendix C • 2

 Appendix C Consultation
The ACC offers consultation to students and their families on a variety of topics;
The Talent Search Model
some examples include acceleration planning, decision-making for college, and
Comprehensive Assessment – second opinions regarding diagnosis. In addition, consultation can include
Why it Matters dialoguing with teachers and school administrators to advocate for optimal services
for our clients.
The Assessment Process at the
Belin-Blank Center’s Assessment
and Counseling Clinic
Research
Annotated Bibliography In 2005, the Belin-Blank Center, in partnership with the Iowa Department of
Education, was awarded a competitive federal Jacob K. Javits grant to study
twice-exceptional students. This research is focused on establishing best practices
for discovering twice-exceptional students and providing evidence-based
recommendations that are relevant in schools. Since being awarded the Jacob K.
Javits grant, research involving twice-exceptional students has greatly expanded
at the BBC and across the nation. The Annotated Bibliography provides an
introduction to the exploration of characteristics of twice-exceptional students.

The Paradox of Twice-Exceptionality • Appendix C • 3

 Appendix C
Annotated Bibliography
The Talent Search Model

Comprehensive Assessment –
Why it Matters

The Assessment Process at the

Belin-Blank Center’s Assessment
and Counseling Clinic

Annotated Bibliography

Assouline, S., Foley Nicpon, M, & Abstract: We are not well informed regarding the ability-achievement relationship
Dockery, L. (2012). Predicting the for twice-exceptional individuals (very high cognitive ability and a diagnosed
academic achievement of gifted disability, e.g., autism spectrum disorder [ASD]). The research question for
students with autism spectrum this investigation (N = 59) focused on the predictability of achievement among
disorder. Journal of Autism and variables related to ability and education in a twice-exceptional sample of students
Developmental Disorders, 42(9), (cognitive ability of 120 [91st percentile], or above, and diagnosed with ASD). We
1781-1789. determined that WISC-IV Working Memory and Processing Speed Indices were
both significantly positively correlated with achievement in math, reading, and
written language. WISC Perceptual Reasoning Index was uniquely predictive of
Oral Language test scores. Unexpected findings were that ASD diagnosis, Verbal
Comprehension Index, and forms of academic acceleration were not related to the
dependent variables.

Assouline, S., Foley Nicpon, M, & Abstract: A case study of the psychometric characteristics of two profoundly
Doobay, A. (2009). Profoundly gifted gifted girls, one with autism spectrum disorder (ASD) and the other without ASD,
girls and autism spectrum disorder: A is used to describe the nuances and subtleties most relevant in understanding
psychometric case study comparison. the relationship between extreme giftedness and social difficulties. Through the
Gifted Child Quarterly, 53(2), 89-105. presentation of the results from psychoeducational and psychosocial assessments,
we demonstrate how data from a comprehensive evaluation can distinguish
between the manifestation of extreme giftedness and concomitant social
impairment indicative of ASD. Comparison of the assessment results highlights
the relevance of cognitive and achievement information as well as the need for
specific measures to diagnosis ASD. The girls demonstrated virtually identically
superior cognitive and achievement performances. However, an in-depth analysis
of additional measures, especially those specific to ASD, indicates that information
about adaptive behavior and executive functioning can reveal important
distinctions that are helpful in understanding the need for unique interventions
specific to ASD.

The Paradox of Twice-Exceptionality • Appendix C • 4

 Assouline, S., Foley Nicpon, M., & Abstract: Gifted and talented students who also have a specific learning disability
Whiteman, C. (2010). Cognitive (SLD) are typically referred to as twice-exceptional and are among the most
and psychosocial characteristics of underserved students in our schools. Previous special education laws promoted a
gifted students with written language wait-to-fail approach; therefore, gifted students with SLD often were overlooked
disability. Gifted Child Quarterly, because their average academic performance was not “failure” enough. The flip side
54(2), 102-115. to this was the fact that students’ giftedness, as measured by general ability tests,
often was masked by average, yet relatively weak, academic achievement. They
were not only waiting to fail, they were failing to flourish. The authors present the
data gathered from 14 gifted students with SLD, specifically a disorder of written
expression. Students were determined to be gifted if they earned a score of 120
(Superior) on the Verbal Scale of a cognitive ability test. They were considered to
have a written language disability through an evaluation of their written language
skills. The average Verbal IQ for the group was close to a standard score of 130,
whereas the average Written Language Score was close to a standard score of
99. In addition to the cognitive profile for these students, the authors obtained
measures of their psychosocial functioning. On average, parents, teachers, and
students reported typical adaptive behavior, yet group elevations also were present
on several clinical scales. The authors’ main conclusion is that a comprehensive
assessment plays a critical role in (a) determining whether a student is twice-
exceptional, (b) identifying the possibility of psychosocial concerns, and (c)
developing educational recommendations. Putting the Research to Use: The results
from our empirical study suggest that only through a comprehensive evaluation,
which includes both individualized achievement and ability tests and allows for an
analysis of the performance discrepancy between the two, is it possible to discover
cognitively gifted students with a disorder of written expression. Diagnostic/
identification procedures that do not include a comprehensive evaluation place
gifted students at serious risk for “missed” diagnosis and ultimately, missed
opportunity for intervention. The missed diagnosis arises from the observation that
their written work is average relative to that of their peers. Equally important is
the concern that some very capable students may be over-looked for screening for
gifted programming because their achievement is average. Educators of students
who appear to have high verbal ability while simultaneously demonstrating
difficulty completing written assignments—and may even appear to be lazy or
unmotivated—have a responsibility to further investigate the students’ difficulties
and strengths.

Assouline, S., Foley Nicpon, M., & Abstract: Reply by the current authors to the comments made by Benjamin J.
Whiteman, C. (2011). Cognitive Lovett on the original article. Our article describing the characteristics of gifted
and psychosocial characteristics of students with a specific learning disability (SLD) in written language was criticized
gifted students with written language for emphasizing an ability achievement discrepancy as an indication of a written
disability: A reply to Lovett’s response. language disability and for not ruling out alternative explanations for the observed
Gifted Child Quarterly, 55(2), 152-157. difficulties. The three primary alternative explanations include measurement error,
(lack of) motivation, and/or past experiences. In our reply, we offer extensive
evidence that refutes these alternative explanations. The critique also offers an
interpretation, which we determined to be inaccurate, of our data; therefore, we
correct the misinterpretation. We conclude with a confirmation of our original
findings: identification of gifted students with specific learning disabilities requires
a comprehensive psycho-educational evaluation that includes an examination of
the cognitive profile generated from individually-administered tests of ability and
achievement. In combination with a psychosocial profile that addresses behavior,
self-concept, interests, and motivation, educators have the necessary information to
guide them in identifying and developing the unique talents of gifted children with
SLD.

The Paradox of Twice-Exceptionality • Appendix C • 5

 Assouline, S. & Lupkowski-Shoplik, Abstract: The Talent Search model, founded at Johns Hopkins University by Dr.
A. (2012). The talent search model Julian C. Stanley, is fundamentally an above-level testing program. This simplistic
of gifted identification. Journal of description belies the enduring impact that the Talent Search model has had on
Psychoeducational Assessment, 30(1), the lives of hundreds of thousands of gifted students as well as their parents and
45-59. teachers. In this article, we compare the Talent Search model to school-based
models of gifted education. The comparisons are both broad and narrow. Broad
contrasts are made in the discussion of the historical impetus, whereas specific
differences are presented in the discussion of numbers of students served and
costs. Bridging the Talent Search model and K-12 gifted education models is
addressed. Assessment information from Talent Search above-level testing offers
valuable information for parents and teachers and recommendations for advocacy
are presented. Finally, we highlight major findings from Talent Search research
emphasizing that Talent Search research has made a significant contribution to
our understanding of gifted and talented students. We conclude with a strong
endorsement to recognize the founder of the Talent Search model, Julian C. Stanley,
by referring to the impact of the Talent Search model as the Julian Stanley Effect.

Assouline, S., & Lupkowski-Shoplik, Abstract: This text offers a focused look at educating gifted and talented students
A. (2011). Developing math talent: for success in math. The book offers a comprehensive approach to mathematics
A comprehensive guide to math education for gifted students of elementary or middle school age. The authors
education for gifted students in provide concrete suggestions for identifying mathematically talented students,
elementary and middle school (2nd tools for instructional planning, and specific programming approaches. The second
ed.). Waco, TX: Prufrock Press. edition features topics such as strategies for identifying mathematically gifted
learners, strategies for advocating for gifted children with math talent, how to
design a systematic math education program for gifted students, specific curricula
and materials that support success, and teaching strategies and approaches that
encourage and challenge gifted learners.

Assouline, S., & Whiteman, C. (2011). Abstract: Increased awareness of twice-exceptional students is important for
Twice-exceptionality: Implications for all educators and psychologists; however, for school psychologists, improved
school psychologists in the post-IDEA understanding of twice-exceptionality will enhance their unique role in assessing
2004 era. Journal of Applied School twice-exceptional students and in recommending appropriate interventions in
Psychology, 27(4), 380-402. schools. In this article, the authors address giftedness and disability as separate
topics and then connect them as they relate to twice-exceptionality. The authors
explore twice-exceptionality in 3 separate case studies, with a specific focus on
attention-deficit/hyperactivity disorder, autism spectrum disorder, and specific
learning disability. The article includes a discussion of the Individuals With
Disabilities Education Act 2004, specifically as it relates to specific learning
disability and giftedness. The authors conclude with 10 recommended practices that
include the importance of a comprehensive evaluation to understand a student’s
strengths and weaknesses as well as the critical nature of differential diagnosis as a
foundation for making recommendations for intervention.

Attwood, T. (2007). The complete

Abstract: The Complete Guide to Asperger’s Syndrome is the definitive handbook
guide to Asperger’s Syndrome.
for anyone affected by Asperger’s syndrome (AS). It brings together a wealth
London: Jessica Kingsley Publishers.
of information on all aspects of the syndrome for children through to adults.
Drawing on case studies and personal accounts from Attwood’s extensive clinical
experience, and from his correspondence with individuals with AS, this book is
both authoritative and extremely accessible. The chapters examine: causes and
indications of the syndrome; the diagnosis and its effect on the individual; theory
of mind; the perception of emotions in self and others; social interaction, including

The Paradox of Twice-Exceptionality • Appendix C • 6

 Attwood, T. (2007). The complete friendships; long-term relationships; teasing, bullying and mental health issues;
guide to Asperger’s Syndrome. the effect of AS on language and cognitive abilities, sensory sensitivity, movement
London: Jessica Kingsley Publishers. and co-ordination skills; and, career development. There is also an invaluable
(continued) frequently asked questions chapter and a section listing useful resources for anyone
wishing to find further information on a particular aspect of AS, as well as literature
and educational tools. Essential reading for families and individuals affected by
AS as well as teachers, professionals and employers coming in contact with people
with AS, this book should be on the bookshelf of anyone who needs to know or is
interested in this complex condition.

Bashe, P. R., & Kirby, B. L. (2001). Book Description: Asperger Syndrome has become an increasingly common
The OASIS guide to Asperger disorder. One in 300 individuals may have AS—exhibiting characteristics such
Syndrome: Advice, support, insight, as average to high intelligence, obsessive behavior, intense special interests, and
and inspiration. New York: Crown. difficulty dealing with everyday social situations—and it is now more prevalent than
childhood cancer and Down’s syndrome.
As the mother of a boy diagnosed with AS in 1994, Barbara Kirby found scant
resources and support. She developed the internationally renowned OASIS (Online
Asperger Syndrome Information and Support) Web site in 1995 to help other
parents find the information they need. She teamed up with Patricia Romanowski
Bashe, now co-owner of OASIS and herself the mother of a son with AS, to write
The OASIS Guide to Asperger Syndrome, which has become the standout authority
in the field and a must-have for this growing audience.

Now Bashe and Kirby have crafted a fully revised edition of this comprehensive
resource for parents, teachers, therapists, and anyone who knows or works with
someone with AS. In addition to discussing what AS looks like and how parents can
guide their unique child through the social, emotional, and intellectual challenges
of growing up, this edition includes new developments made in AS research over
the past four years, new thinking on diagnosis and evaluation, the latest approaches
to medication and social skills development, and tips on navigating the maze of
interventions, therapies, and special education. The authors know firsthand the joys
and frustrations of raising children with AS, and they share their own experiences
as well as those of dozens of parents facing the same issues.

Filled with practical information and emotional support, this is the most complete
and authoritative guide available. Whether your child has been diagnosed or
troubling symptoms are just becoming apparent, this book will point you in the
right direction as you face the particular challenges of loving and raising a child
with Asperger Syndrome.

Berninger, V. W., & O’Malley May, M. Abstract: Programmatic, multidisciplinary research provided converging brain,
(2011). Evidence-based diagnosis genetic, and developmental support for evidence-based diagnoses of three specific
and treatment for specific learning learning disabilities based on hallmark phenotypes (behavioral expression of
disabilities involving impairments in underlying genotypes) with treatment relevance: dysgraphia (impaired legible
written and/or oral language. Journal automatic letter writing, orthographic coding, and finger sequencing), dyslexia
of Learning Disabilities, 44, 167-183. (impaired pseudoword reading, spelling, phonological and orthographic coding,
rapid automatic naming, and executive functions; inhibition and rapid automatic
switching), and oral and written language learning disability (same impairments as
dyslexia plus morphological and syntactic coding and comprehension). Two case
studies illustrate how these differential diagnoses can be made within a conceptual
framework of a working memory architecture and generate treatment plans that
transformed treatment nonresponders into treatment responders. Findings are

The Paradox of Twice-Exceptionality • Appendix C • 7

 Berninger, V. W., & O’Malley May, M. discussed in reference to the importance of (a) considering individual differences
(2011). Evidence-based diagnosis (diagnosis of impaired hallmark phenotypes) in planning and evaluating response
and treatment for specific learning to instruction and modifying instruction when a student is not responding; (b)
disabilities involving impairments in recognizing that teaching may change epigenetic gene expression at one stage
written and/or oral language. Journal of schooling, but not the underlying gene sequences that render individuals still
of Learning Disabilities, 44, 167-183. vulnerable as curriculum requirements increase in nature, complexity, and volume
(continued) in the upper grades; and (c) using evidence-based diagnoses of specific learning
disabilities that are consistent across states for free and appropriate education
K to 12 and for accommodations throughout higher education and professional
credentialing.

Foley Nicpon, M., Assouline, S., Abstract: We report preliminary results from comprehensive assessments of the
Schuler, P., & Amend, E. (2011). initial group of 18 gifted and talented students with co-occurring autism spectrum
Gifted and talented students on the disorder (ASD). Our sample originally included 19 students who were referred
autism spectrum: Best practices for by their parents because of a possible ASD diagnosis. Of these, 18 (16 boys and 2
fostering talent and accommodating girls) were diagnosed with ASD in our clinic. Of the 18 students with ASD, 14 were
concerns. In J. Castellano & A. in elementary school, two in middle school, and two in high school; their ages
Frazier (Eds.), Special populations ranged from 6-17. As previously stated, a comprehensive evaluation is required for
in gifted education: Understanding accurate diagnosis of both gifts and disabilities. Therefore, all 19 participants were
our most able students from diverse administered a battery of tests that were designed to identify areas of academic
backgrounds (pp. 227-247). Waco, and cognitive strength, and social-emotional needs, as well as confirm or rule out a
TX: Prufrock Press. diagnosis of ASD. The Wechsler Intelligence Scale for Children-Fourth Edition, the
Woodcock-Johnson Tests of Achievement-Third Edition, the Vineland Adaptive
Behavior Scales, Second Edition, the Autism Diagnostic Interview-Revised, the
Autism Diagnostic Observation Schedule, the Behavior Assessment System for
Children, Second Edition, and the Piers-Harris Children’s Self-Concept Scale,
Second Edition were administered. Preliminary results from the Iowa Twice-
Exceptional Project demonstrated that a comprehensive assessment needs to be the
first step toward identifying strengths and areas for growth in a gifted and talented
student with ASD. For example, among our group of students, there are distinct,
large differences within their academic, ability, and adaptive functioning profiles
that have ramifications for educational interventions. Additionally, it has become
clear that a comprehensive, developmental assessment must be completed with
both the student and the parent or the primary caregiver so that interventions can
be individualized to match each student’s needs. Lastly, there seems to be common
behavioral and emotional patterns that are observed by parents and teachers; yet,
students often do not have similar self-perceptions. Although interventions always
need to be tailored to the individual student, some general suggestions can be made
for optimizing the twice-exceptional student’s educational experience. Examples
of accommodations in various areas of functioning that could benefit a gifted and
talented student with ASD are provided.

The Paradox of Twice-Exceptionality • Appendix C • 8

 Foley Nicpon, M., Allmon, A., Sieck, Abstract: Gifted students with coexisting disabilities, also known as twice-
R., & Stinson, R. D. (2011). Empirical exceptional, are increasingly recognized in America’s schools. This increasing
investigation of twice-exceptionality: awareness needs to be met with equal enthusiasm for empirical investigation
Where have we been and where are into the identification and treatment needs of this group of students. In this
we going? Gifted Child Quarterly, article, a 20-year review of the empirical literature examining twice-exceptionality,
55(1), 3–17. specifically gifted students with learning disabilities, attention deficit hyperactivity
disorder, or autism spectrum disorder, was conducted. Research strongly suggests
that gifted students can have a coexisting disability and that comprehensive,
individualized approaches toward diagnosis are necessary. Less is known about
effective treatments and interventions that simultaneously highlight strengths
and accommodate for areas of growth. Future research directions are offered that
ideally will encourage scholars to discover more about effective diagnostic and
intervention techniques for this very important group of gifted learners.

Foley Nicpon, M., Assouline, S. G., & Abstract: The cognitive and academic profiles of high ability students with
Stinson, R. D. (2012). Cognitive and autism spectrum disorder were examined. Inclusion criteria were a diagnosis of
academic distinctions between gifted autism (high functioning) or Asperger syndrome and at least one ability and/or
Students with autism and Asperger achievement index standard score of 120 or above. Results indicated that despite
syndrome. Gifted Child Quarterly, the restricted range of cognitive abilities, students diagnosed with Asperger
56(1), 77-89. syndrome had significantly higher Verbal Comprehension Index scores than did
students diagnosed with autism. However, students with autism had significantly
higher scores on tests of math fluency and written expression than did students
with Asperger syndrome. Implications for assessment, diagnosis, and intervention
are discussed.

Foley Nicpon, M, & Doobay, A., & Abstract: Parent, teacher, and self-perceptions of 54 high ability students with
Assouline, S. (2010). Parent, teacher, autism spectrum disorder (ASD) were assessed through administration of the
and self perceptions of psychosocial Behavioral Assessment Scales for Children, Second Edition. Parent reports resulted
functioning in intellectually gifted in clinically elevated scores on the Atypicality, Attention Problems, Depression,
children and adolescents with autism Hyperactivity, Withdrawal, Activities of Daily Living, Adaptability, and Social
spectrum disorder. Journal of Autism Skills subscales, and teacher reports resulted in clinically elevated scores on the
and Developmental Disorders, 40(8), Atypicality, Depression, Withdrawal, and Adaptability subscales. Self-report scores
1028-1038. were in the average range. Parents and teachers of adolescents reported greater
adaptability and fewer symptoms of atypicality than parents and teachers of
children. Psychosocial functioning appears impacted in high ability students with
ASD and developmental differences in severity may exist.

Foley Nicpon, M. Rickels, H., Assouline, Abstract: Intellectually gifted students with attention-deficit/hyperactivity
S., & Richards, A. (2012). Self-esteem disorder (ADHD) face unique academic and social challenges, yet little research
and self-concept examination among has been conducted with this population. The purpose of this study was to examine
gifted students With ADHD. Journal the self-esteem and self-concept of intellectually gifted children with and without
for the Education of the Gifted, 35(3), a coexisting diagnosis of ADHD. Data were gathered from 112 children, aged 6 to
220-240. 18, identified as having high cognitive ability (IQ of 120, 91st percentile, or above);
54 participants also met diagnostic criteria for ADHD. Despite having similar IQs,
gifted students with ADHD had lower scores on measures of self-esteem, behavioral
self-concept, and overall happiness than gifted students without a comorbid
diagnosis. Among all participants, children had higher reported overall happiness
than adolescents. Professionals working with gifted students with ADHD should
be aware of the potential for coexisting self-esteem difficulties and, if warranted,
address these issues in educational and clinical environments.

The Paradox of Twice-Exceptionality • Appendix C • 9

Gillham, J. E., Carter, A. E., Volkmar, F. Abstract: Traditional approaches to diagnosing autism emphasize delays in
R., & Sparrow, S. S. (2000). Toward a communication and socialization. Traditional diagnostic schemes typically
developmental operational definition list symptoms (e.g., lack of eye contact), but provide little guidance on how to
of Autism. Journal of Autism and incorporate information about developmental level in making a diagnosis. Because
Developmental Disorders, 30(4), 269– standardized measures of adaptive behavior can provide information about
278. children’s communication, socialization, and other behavior relative to their age,
they may be useful tools for diagnosing autism. This study investigated the ability
of the Vineland Adaptive Behavior Scales to identify children with autism. Vineland
scores and measures of intellectual functioning were obtained for children with
autism, PDDNOS, and other developmental disorders (DD). Discriminant function
analyses indicated that the autism and combined nonautism (PDDNOS and DD)
groups could be differentiated on the basis of socialization, daily living skills, and
serious maladaptive behaviors. Socialization alone accounted for 48% of the
variance in diagnosis. Using regression analyses derived from a large normative
sample, adaptive behavior scores were predicted from chronological age (CA)
and mental age (MA). Socialization scores in the autism group were substantially
below the level predicted from CA or MA. An index derived from the ratio of
actual to predicted socialization scores correctly classified 86% of both autism
and nonautism cases. Findings suggest that comparison of obtained Vineland
socialization scores to those predicted by CA or MA may be useful in clarifying the
diagnosis of autism.

Grigorenko, E. L., Klin, A., Pauls, D. Abstract: In this study, we evaluated the incidence of hyperlexia in a clinically
L., Snft, R., Hooper, C., & Volkmar, referred sample of 80 children with developmental delays. Based on hypotheses
F. R. (2002). A descriptive study of previously formulated in the literature, the study investigated the frequency of
hyperlexia in a clinically referred hyperlexia among boys and girls, the incidence of hyperlexia in children with
sample of children with developmental Pervasive Developmental Disorders (PDD)-spectrum compared with non-PDD
delays. Journal of Autism and diagnoses, the range of IQ and of various cognitive skills in children with and
Developmental Disorders, 32, 3–12. without hyperlexia, and the developmental outcomes of children with and without
hyperlexia. The results revealed no significant differences in the frequency of
hyperlexia in girls compared with boys. However, the frequency of hyperlexia was
significantly elevated among children with PDD compared with children with non-
PDD diagnoses. The range of IQ and other cognitive skills and the developmental
outcomes of children with hyperlexia were comparable to those of children without
hyperlexia.

Lovecky, D. V. (2004). Different Description: Recognizing the different levels and kinds of giftedness, this book
minds: Gifted children with AD/ provides an insight into the challenges and benefits specific to gifted children
HD, Asperger Syndrome, and other with attention difficulties. Explaining why certain children are gifted and how
learning deficits. London: Jessica giftedness is manifested, each chapter on a specific topic addresses the relevance
Kingsley Publishers. for children with AD/HD, autism and Asperger Syndrome. Lovecky guides parents
and professionals through methods of diagnosis and advises on how best to nurture
individual needs, positive behavior and relationships at home and at school.

The Paradox of Twice-Exceptionality • Appendix C • 10

 Neihart, M. (2000). Gifted children Abstract: Asperger’s Syndrome is a pervasive developmental disorder
with Asperger’s Syndrome. Gifted characterized by deficits in social communication and by repetitive patterns of
Child Quarterly, 44(4), 222–230. behaviors, or interests. It is observed in some gifted children. The author proposes
that gifted children with Asperger’s Syndrome may not be identified because
their unusual behaviors may be wrongly attributed to either their giftedness or
to a learning disability. The article discusses ways in which Asperger’s Syndrome
might be missed in gifted children and proposes guidelines for differentiating
characteristics of giftedness from characteristics of Asperger’s Syndrome.

Rogers, S. J., Cook, I., & Meryl, A. Description: This book chapter describes the imitation and play behaviors of
(2005). Imitation and play in Autism. children diagnosed with an autism spectrum disorder. It is part of a behavioral
In F. R. Volkmar, R. Paul, A. Klin & D. section of a larger book on autism and other pervasive developmental disorders.
Cohen (Eds.), Handbook of autism and
pervasive developmental disorders (5–
42). New Jersey: John Wiley & Sons.

Shepard, S., Foley Nicpon, M., & Abstract: This study compared self-report ratings of self-concept before and after
Doobay, A. (2009). Early entrance the first semester of college among a group of 21 early entrance college students.
to college and advanced academics: The measures included a genera! demographic questionnaire and the Piers-Harris
Comparisons across the first semester Self-Concept Scale, 2nd edition (PH-2). Results indicated that students maintained
of enrollment. Journal of Advanced their overall level of self-concept following their first semester of college. Mild
Academics, 21(1), 40-57. increases in self-concept were noted in the domains of Physical Appearance and
Attributes, as well as Happiness and Satisfaction. Overall, mean group scores on the
PH-2 total and subtest self-esteem measures were in the average range, both before
and after the participants’ first semester of college. This is a positive finding that
points to this group of students’ generally positive impressions of their behavior,
intelligence, physical appearance, popularity, feelings of anxiety, and overall
happiness. These findings offer additional support that academic acceleration
among gifted students is not related to decreases in self-concept.

Silverman, S. M., & Weinfeld, R. Description: Hundreds of thousands of children face life with Asperger’s
(2007). School success for kids with syndrome, a mild form of autism spectrum disorder that affects a child’s language
Asperger’s Syndrome. Waco, TX: and social skills. Kids with Asperger’s have average to above-average intelligence,
Prufrock Press. but often have obsessive interests, are socially awkward, and do not understand
the subtleties of language and conversation. With concentrated effort on the part
of parents and educators, these children can begin to overcome the difficulties
of this disorder and find success in school and life. School Success for Kids with
Asperger’s Syndrome covers topics such as recognizing and diagnosing Asperger’s
syndrome, addressing the needs of students with Asperger’s, implementing
successful practices in the classroom, working with the school system, and
providing interventions in the home to help develop needed skills.

Sparrow, S. S., Pfeiffer, S. I., &

Description: This is a brief section within a manual for uses of a common
Newman, T. M (2005). Assessment of
intellectual assessment tool, the WISC-IV. The section addresses how to use the
children who are gifted with the WISC-
WISC-IV in the identification of intellectual giftedness.
IV. In A. Prifitera, D. H. Saklofske, & L.
G. Weiss (Eds.). WISC-IV: Clinical use
and interpretation. Burlington, MA:
Elsevier Academic Press.

The Paradox of Twice-Exceptionality • Appendix C • 11

 Volkmar, F. R., & Klin, A. (2005). Description: The authors provide clinical and research considerations in the
Issues in the classification of Autism diagnosis and identification of autism spectrum disorders. This chapter is in a
and related conditions. In F. R. larger book addressing many facets of autism spectrum disorders.
Volkmar, R. Paul, A. Klin & D. Cohen
(Eds.), Handbook of Autism and
Pervasive Developmental Disorders
(5–42). New Jersey: John Wiley &
Sons.

Webb, J. T., Amend, E. R., Webb, N., Description: Our brightest, most creative children and adults are often
Goerss, J., Beljan, P., & Olenchak, being misdiagnosed with behavioral and emotional disorders such as ADHD,
F. R. (2005). Misdiagnosis and Oppositional-Defiant Disorder, Bipolar, OCD, or Asperger’s. Many receive
dual diagnoses of gifted children unneeded medication and inappropriate counseling as a result.
and adults: ADHD, Bipolar, OCD,
Asperger’s, Depression, and other Physicians, psychologist, and counselors are unaware of characteristics of gifted
disorders. Scottsdale, AZ: children and adults that mimic pathological diagnoses. Six nationally prominent
Great Potential Press. health care professionals describe ways parents and professionals can distinguish
between gifted behaviors and pathological behaviors.

The Paradox of Twice-Exceptionality • Appendix C • 12

 Appendix D Web Sites for Professionals Who Work with
Individuals with ASD
Web Sites for Professionals Who
http://www.med.umich.edu/yourchild/topics/autism.htm
Work with Individuals with ASD
University of Michigan Health System webpage on Autism Spectrum Disorders.
This is a terrific page full of helpful information on spectrum disorders as well as
Web Sites for Parents and
links to many other sites and resources.
Families of Individuals with ASD
http://medicine.yale.edu/childstudy/autism/index.aspx
Web Sites Specifically for Yale Developmental Disabilities Clinic/The Yale Child Study Center webpage,
Individuals with ASD which offers information on current research being conducted, as well as links to
other informational websites.

http://www.autism.com
The Center for the Study of Autism (CSA) provides information about autism
to parents and professionals, and conducts research on the efficacy of various
therapeutic interventions.

http://www.aspergersyndrome.org
Asperger Syndrome Coalition of the United States is a national nonprofit
organization committed to providing the most up-to-date and comprehensive
information on social and communication disorders, with particular emphasis
on Asperger syndrome.

http://www.colour-se7en.co.uk/autism.html
This site includes wonderful tips for persons working with individuals, as well as
information to better understand the mind of the individual.

http://aspergerlife.com/ideas-that-work
This page includes several articles aimed at helping in the school or education
setting.

http://www.aspergersyndrome.org/Articles/Understanding-the-
Student-With-Asperger-s-Syndrome.aspx
This page has an article titled “Understanding the Student with Asperger’s
Syndrome: Guidelines for Teachers,” which includes tips and possible
accommodations for AS students.

http://www.aspergersyndrome.org/Articles/Tips-for-Teaching-High-
Functioning-People-with-Aut.aspx
This page includes an article titled “Tips for Teaching High-Functioning People
with Autism” with excellent tips for working with AS students.

http://www.aspergersyndrome.org/Articles/Girls-With-Social-Deficits-
and-Learning-Problems-.aspx
This page includes an excellent article titled with case studies on girls with
autism.

The Paradox of Twice-Exceptionality • Appendix D • 1

 Appendix D
Web Sites for Parents and Families of Individuals
with ASD
Web Sites for Professionals Who
http://www.autismspeaks.org
Work with Individuals with ASD
Autism Speaks is a national organization that promotes advocacy, research, and
education for individuals and families with autism.
Web Sites for Parents and
Families of Individuals with ASD
http://www.snichol.freeserve.co.uk/asperger.htm
This is a wonderful page put together by the father of an AS child.
Web Sites Specifically for
Individuals with ASD http://www.aspergersyndrome.org/Articles/Especially-for-
Grandparents-of-Children-With-Asper.aspx
On this page is an article written by a former journalist who is also the parent
of a child with AS. It’s meant to be shared with grandparents in the hopes that
they’ll better understand our children.

http://www.autism-society.org
This is the website of the Autism Society of America, which is aimed at
promoting opportunities for persons with autism spectrum disorders and their
families.

Web Sites Specifically for Individuals With ASD

http://www.wrongplanet.net/
Wrong Planet provides an online community and resources for those with
Asperger Syndrome.

http://www.asperger-advice.com/asperger-teens.html
This is a web page that provides information about the challenges faced by many
teens with HFA.

http://www.angelfire.com/amiga/aut
Personal website of individuals with AS, including biographies and discussions
of important aspects of life with AS.

http://ask-an-aspie.blogspot.com/
On this page an individual with AS writes about his experiences.

The Paradox of Twice-Exceptionality • Appendix D • 2