Twice Exceptional Kids with ADHD

By Dr. Mary Rooney, Ph.D.

Twice exceptional (2e) kids have a learning difficulties or attention problems but are also highly gifted in at least one area. The term “twice exceptional” is most often used to describe kids with exceptional academic abilities, but many 2e kids also have musical or artistic gifts. While all kids have strengths and weaknesses, twice exceptional kids have these in the extreme. For example, a 2e child may score in the 99th percentile on a test of verbal language abilities but only in the 10th percentile on a measure of processing speed. Or they may have highly advanced conceptual math abilities but struggle to produce written work that is legible and meets basic grade-level requirements.

What happens when a 2e child has ADHD?

When ADHD is part of the picture, a 2e child may be gifted in his or her ability to grasp complex concepts, engage in critical thinking, and communicate his or her knowledge and understanding verbally, but the child’s test scores reflect only average (or even below-average) performance. Without a clear understanding of the impact of ADHD symptoms on factors like motivation, attention to detail, persistence, and organization, parents and teachers become frustrated by what they perceive as willful underperformance. They complain that the child is being lazy or simply doesn’t care about the quality of his or her work. In reality, the 2e child may be working very hard to compensate for his or her weaknesses, but without proper support the efforts rarely translate into lasting improvements. Unfortunately, the messages that these kids hear about laziness and carelessness take a toll over time and their self-esteem suffers. To make matters worse, their sub-par academic performance prevents them from getting one of the things 2e children need the most at school: recognition of their strengths and access to classes and activities that challenge and engage their exceptional intellect.


All 2e kids are at risk for being excluded from the advanced classes that they need to reach their full potential. 2e kids with ADHD are also at risk for having their ADHD go undetected and undiagnosed. Why? With their high intelligence, 2e kids can often perform in the average range academically despite their ADHD symptoms. While they are underperforming relative to their true abilities, they are not necessarily underperforming relative to their classmates. As a result, the school doesn’t identify them as needing an evaluation or extra support. Parents may be frustrated that their child isn’t achieving at the level they believe he or she is capable of, but they also aren’t seeing some of the typical red flags that would normally trigger an ADHD assessment.


What can parents do to help?

  1. Obtain an evaluation. Twice exceptional kids are complex, and a full psychoeducational assessment or neuropsychological assessment (which includes cognitive and achievement testing) can help parents, teachers, and the child develop a clear picture of their strengths and weaknesses. In some cases, schools will provide a psychoeducational assessment as part of their special education services. In other cases, parents need to seek out these evaluations privately through a psychologist, neuropsychologist, or learning specialist.
  2. Seek out special education services and academic support. Many 2e children qualify for special education services – services that address their weaknesses and their gifts. An Individualized Education Plan (IEP) will outline the educational goals, accommodations, and services that your child needs. His or her access to these services and progress toward individual goals will be tracked and reviewed regularly in team meetings that parents (and often the child) attend. If your child has areas of academic weakness, consider supplementing his or her school-based services with individualized academic support from a private learning center or learning specialist.
  3. Advocate for your child. 2e kids need access to advanced classes just as much as any other gifted child. With the proper support and accommodations, 2e children can thrive in an accelerated academic environment. Without a high level of intellectual stimulation, 2e kids with ADHD are at high risk of becoming bored at school, which will exacerbate their ADHD symptoms and ultimately lead to even greater academic underachievement (see my previous post on this topic [link to “Understanding Boredom and ADHD]).
  4. Provide emotional support. Talk to your child about his or her strengths and weakness, and his or her unique gifts. Help your child process feelings about being different from other kids, and frustration over his or her ADHD symptoms getting in the way. Many 2e kids will feel like “there is something wrong with them,” and unconditional love and support from parents can go a long way in counteracting these feelings. Getting to know other 2e kids can also help. If you don’t know of other families of 2e kids in your area, check out one of the many Facebook groups for parents to 2e kids to get connected.
  5. Treat the ADHD symptoms. 2e kids can reach their full potential when their ADHD symptoms are well managed. Work with mental health providers to obtain evidence-based treatments for your child and consider including medication in your child’s symptom management plan.



Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.


Huntington Learning Center is the tutoring and test prep leader. Its certified tutors provide individualized instruction in reading, phonics, writing, study skills, elementary and middle school math, Algebra through Calculus, Chemistry, and other sciences. It preps for the SAT and ACT, as well as state and standardized exams. Huntington programs develop the skills, confidence, and motivation to help students of all levels succeed and meet the needs of Common Core State Standards. Founded in 1977, Huntington's mission is to give every student the best education possible. Call us today at 1.800.CAN LEARN to discuss how Huntington can help your child. For franchise opportunities please visit

This website does not provide medical advice, diagnosis, or treatment. The material on this site is provided for educational purposes only.

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