24 October 2025
Twice Exceptional: When Giftedness and Special Needs Intersect
Some clients don’t fit easily into any category. They think quickly and sharply, yet get lost in details. They ask profound questions but freeze when faced with simple tasks. Their minds seem constantly “on,” but their performance fluctuates. Often, these are twice-exceptional individuals—people who are both gifted and have an additional developmental or learning disorder, such as ADHD, ASD, or dyslexia.
Twice-exceptional clients combine high-level thinking abilities with real challenges such as AD(H)D, ASD, or dyslexia; this mix of talent and vulnerability often leads to inconsistent functioning that is misinterpreted as stubbornness, resistance, or lack of motivation.
Because talent and difficulty can mask one another, both the giftedness and the underlying disorder often remain unseen for a long time, leading to misjudged behavior and support that starts late and in a fragmented way.
Effective care does not begin with deficits but with a strengths-based framework in which psychological safety, adjusted pacing, talent-focused interventions, and multidisciplinary collaboration are central to enabling sustainable growth.
Their functioning often causes confusion, both in the classroom and in care settings. What may appear on the surface as stubbornness, hypersensitivity, or resistance is, on closer inspection, often a sign of something else: a mind that thinks faster than the system allows, while simultaneously stumbling over practical execution. This combination of exceptional talent and genuine vulnerability makes these clients unique—and calls for a different perspective from care professionals.
Masking of Talent or Disability
In twice-exceptional clients, one characteristic often masks the other. Their giftedness can conceal the presence of a developmental or learning disorder for a long time: thanks to their strong reasoning abilities and fluent language skills, they often manage to compensate for their difficulties. They develop strategies to hide their weaker areas, which means their problems only become visible when complexity increases—for example, in secondary education, during transitions, or under performance pressure.
Conversely, the disability can also overshadow the giftedness. In an average-ability child with dyslexia, the slow reading pace and persistent spelling errors are usually what stand out most. But in cognitively strong students, these skills can also remain below average for years, preventing their giftedness from being recognized. Their sharp reasoning, original ideas, and strong desire to learn remain unseen, as these rarely surface in written work. This creates a distorted picture: the child appears average, while in reality they possess exceptional intellectual potential.
For care professionals, it is therefore essential to see both sides. Behind seemingly “inappropriate” behavior, there may be a fast-paced mind at work, and behind apparently “normal functioning,” there may be a significant vulnerability hidden. Only when we look at both perspectives together can we form a complete picture of the client—and provide truly individualized care.
Between Talent and Vulnerability
Twice-exceptional clients constantly balance between strength and limitation. Research shows that their development rarely follows a straight path: strong intellectual growth can coexist with slower emotional maturation or limited self-regulation (Foley-Nicpon & Assouline, 2015). The result is an asynchronous profile in which one ability is far ahead of another. A child who can reason like an adult may simultaneously struggle with planning, organization, or managing frustration.
In practice, this unevenness often leads to misunderstandings. The environment expects consistency—someone so intelligent “should be able to do better.” When behavior or performance doesn’t match intellectual ability, it’s quickly interpreted as unwillingness or lack of effort. Yet professionals working with these clients know the opposite is true: they want to perform but constantly bump into the limits of their executive functions, emotions, or environment. This tension between being able and not being able is often the root of anxiety, perfectionism, and loss of motivation. It calls for care that doesn’t seek to correct, but to understand.
From Problem-Focused to Strengths-Based Thinking
For many years, care for twice-exceptional clients was dominated by a problem-focused approach: identifying, labeling, and treating deficits. For these clients, however, that method is only partially effective. It often reinforces the feeling of “not being good enough,” while leaving their natural curiosity and drive to think untapped.
Research by Baum, Schader, and Hébert (2014) shows that a strengths-based, talent-focused approach is the true key to growth. In their study, conducted in a school setting for twice-exceptional youth, progress only became visible when support professionals stopped starting from what went wrong and began with what was going well. This shift in perspective—from remediation to empowerment—led to greater motivation, improved self-regulation, and increased resilience.
Their findings are directly applicable in the field of care. Even in a therapeutic context, progress often begins when we start from what the client can do. By acknowledging areas of interest, allowing space for talent development, and not reducing progress to measurable outcomes, we create room for trust and self-awareness.
Insights from both research and practice point in the same direction: twice-exceptional clients thrive in environments where they feel safe, seen, and understood. Baum and colleagues identify five factors that make this possible: psychological safety, time, tolerance for asynchronous growth, positive relationships, and a consistent focus on strengths.
In care, this translates into a guidance style that fosters calm rather than pressure. Clients need to experience that their vulnerabilities do not stand in opposition to their talents. This is only possible in a climate of trust, where mistakes and slowness are not seen as threats but as natural parts of the learning process.
Care professionals can make a real difference by slowing down the pace when needed while providing challenge where motivation lies. By starting from the client’s own way of thinking rather than from standard procedures, space for genuine growth can emerge.
A Practical Example
Lars, thirteen, was referred because of anger outbursts and poor work habits. In class, he appeared unmotivated and defiant, but during conversations it became clear that he thought deeply about abstract topics and was extremely bored by repetition. Cognitive testing revealed a pronounced discrepancy between his verbal reasoning and working memory—a typical twice-exceptional profile.
In consultation with the school and his parents, Lars was given more autonomy in his assignments and allowed to work on a project about technology, his great passion. At the same time, therapy focused on emotional regulation and strategies to recognize frustration early. After a few months, his resistance decreased—not because the disorder disappeared, but because he finally felt seen for his strengths.
This example illustrates what many studies confirm: when guidance integrates both the cognitive and emotional realities of the client, growth follows naturally.
Early Recognition: Seeing What Often Remains Invisible
A large part of the challenges in twice-exceptional clients arises because their giftedness is recognized too late. When professionals focus solely on behavior, they often overlook the underlying cognitive potential. Yet giftedness can already be observed early on—even within healthcare settings, during consultations or intake sessions.
By paying attention to learning characteristics—such as quickly making connections, asking complex questions, needing autonomy, and showing frustration with repetition—care professionals can identify signs of giftedness as early as preschool age. This helps prevent giftedness from remaining invisible because the child’s talents cannot be expressed in an environment that doesn’t match their way of thinking and learning.
The e-book Learning Characteristics for Care Professionals (available for free download via our webshop, in Dutch) describes how these signals may appear in practice—from the general practitioner’s office to speech therapy or psychotherapy. Recognizing these traits lays the foundation for timely and appropriate support.
When giftedness is identified early, it also becomes easier to recognize when something more is going on. If a child who clearly demonstrates advanced thinking continues to struggle with reading, planning, or social behavior, it’s more likely that an additional learning or developmental disorder may be present alongside the giftedness.
The Role of the Care Professional
Supporting twice-exceptional clients requires a dual perspective: looking at both the cognitive and the emotional, both what a person can do and where they struggle. It starts with listening, not diagnosing. What occupies the client’s mind? Where does their energy drain—and where does it flow freely?
From that understanding, tailored interventions can emerge: a psychologist who aligns therapy with the client’s high level of reflection; a physician who takes extra time to explain how the body works because the patient shows genuine curiosity; a speech therapist who designs sessions with creative tasks to stimulate intellectual engagement. Twice-exceptional clients do not respond well to superficial, standardized approaches. They need guidance that understands their cognitive world while offering concrete support for their weaker areas.
No care provider can do this alone. The best outcomes arise when care, family, and education work together in a shared language. When the school recognizes what the child can do, the parents provide both rest and challenge, and the care professional coordinates the whole, sustainable support becomes possible.
The same principle applies to adults. An employer who understands that a gifted employee with ADHD needs both autonomy and structure can make as much of a difference as a therapist who offers the right coping strategies. Collaboration, therefore, isn’t an optional extra—it’s the foundation of integrated care.
Conclusion
Working with twice-exceptional clients requires an open mind and the courage to let go of familiar frameworks. It means looking beyond labels, being curious about the underlying thinking style, and seeing the person behind the behavior. As one parent once said during a counseling session:
“Everyone told me what was wrong with my child—until I finally met someone who asked what was going right.”
That’s exactly the essence of it: care that starts not from deficit but from potential. Twice-exceptional clients don’t need more care—they need different care: attuned, strengths-based, and human. Care that sees the talent, understands the limitation, and makes growth possible.
Why are twice-exceptional clients so often misinterpreted?
Because their strong cognitive abilities can mask their limitations — and vice versa. This creates an inconsistent profile that teachers and care providers frequently interpret as unwillingness, laziness, or emotional instability, while in reality it reflects a mismatch between high cognitive capacity and weaker executive or sensory functions.
How can you recognize giftedness in clients whose difficulties stand out most?
By looking beyond behavior and paying attention to learning and thinking characteristics: making rapid connections, asking deep and complex questions, showing frustration with repetition, having a strong need for autonomy, and demonstrating a notably advanced and analytical way of thinking. When such signals occur together with persistent difficulties in areas like reading, planning, or social interaction, a twice-exceptional profile is likely.
What supports care professionals most when working with twice-exceptional clients?
A dual focus: acknowledge both the cognitive potential and the vulnerability. Use a strengths-based framework, offer predictability and psychological safety, and tailor interventions to the client’s thinking style. Collaboration between family, school, and care providers is essential to ensure that both their strengths and challenges are properly supported.
References
Baum, S. M., Schader, R. M., & Hébert, T. P. (2014). Through a different lens: Reflecting on a strengths-based, talent-focused approach for twice-exceptional learners. Gifted Child Quarterly, 58(4), 311–327. https://doi.org/10.1177/0016986214547632
Foley-Nicpon, M., & Assouline, S. G. (2015). Counseling considerations for the twice-exceptional client. Journal of Counseling & Development, 93(2), 194–204. https://doi.org/10.1002/j.1556-6676.2015.00194.x
Sypré, S. (2023). Leerkenmerken voor zorgprofessionals: Begaafdheid herkennen in de zorgpraktijk. Hoogbloeier®
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