The often perplexing and challenging work with the twice-exceptional student

Children and adolescents who are both gifted and have one or more disabilities—often described as “twice-exceptional” or 2e —encounter distinct challenges in being accurately identified and supported. The goal of supporting 2e learners is to foster inclusive educational environments that enable them to thrive academically, nurture resilience, and ensure that their exceptional abilities and overall well-being are not compromised by unaddressed difficulties. Importantly, early and preventive intervention is more effective than delayed remediation, as it avoids the cumulative effects of repeated academic failure and emotional distress. Several factors can contribute to the challenges experienced by twice-exceptional youth. These include inconsistent definitions of giftedness, how exceptional cognitive abilities can alter the presentation of mental health symptoms and responses to treatment, the developmental timing of both talents and difficulties, and the potential for one domain to obscure the other. Although child psychiatry provides a range of evidence-based interventions, their applicability to twice-exceptional populations remains underexplored, with existing research often limited by methodological weaknesses. This paper synthesizes research and clinical insights to highlight the diagnostic challenges seen in this population. It advocates for strength-based, culturally responsive, and developmentally sensitive approaches while emphasizing the importance of professional development for clinicians and educators. Holistic, evidence-informed, and context-aware strategies are essential to unlocking the full potential of twice-exceptional learners.