Gifted and Struggling? Meet the Twice Exceptional Student, and How OT Can Help

I work with two amazing children that could be diagnosed as “twice exceptional”.  Both boys, they have amazing intellectual gifts (one verbal, one in math) but they work with me on their handwriting and their behavior.  Neither can write a simple sentence without significant errors in letter placement or formation.  But both can shock me with their mental abilities.  They are very familiar with what happens when your mom gets a note from the teacher.  It usually isn’t because of their giftedness.  Helping them to succeed in school shouldn’t be that difficult if you look at their test scores.  But it is.

Both kids feel that they are failures in school.  They get in trouble more often than their peers, their homework comes back with lots of red-lined comments, and they have no idea why people alternately compliment them on their skills and then make it clear that they are a problem in some way.  Their minds generate lots of ideas; many of them are clever ways to decrease the amount or level of challenge I throw at them in our sessions.

What is going on?  I think that the whole child has to be seen to be understood.  The gifted brain is different, not just high-powered.  Some kids have  wonderful ideas and thoughts they cannot get on paper fast enough.  Some have struggled with emotional or physical sensitivity.  They freeze or run (mentally) almost before they have written anything.  Some were not paying attention to handwriting in preschool, or figured out that the teacher would accept any effort, so they ignored the class instruction in letter formation and placement.  The other children glowed with pride to write their names neatly.  These children were gazing at the stars, quite literally!

Many, many gifted children struggle with motor skill development, and many more just don’t have the patience for practice.  The incidence of learning issues such as dyslexia in the gifted population is not insignificant.  Their cumulative test scores on their achievement tests mask the learning disability too often.  On paper, these kids look average.  They are nothing of the kind.  Look for striking subtest score disparities to identify them.  But then you have to help them.

Occupational therapists are the secret weapon for the twice exceptional student.  OT has a lot to offer these kids.  We can help self-regulation issues, we can adapt seating, listening, and learning environments for these kids.  We have skills to help them deal with anxiety and the performance issues that arise, and we have handwriting instruction and remediation strategies that work well and work fast with bright students.   Twice exceptional kids often don’t get services because they can “game” the evaluations.  Their great visual-perceptual or cognitive skills allow them to get an average score, but if their approach is carefully observed, the OT can see that happening.  The narrative in the evaluation has to highlight the issues, and the parents have to advocate for treatment.

Working with twice exceptional kids is a joy for me.  They are just as deserving of good therapy as the globally delayed children I treat.  I just have to pay attention to issues of global significance and make sure that I can keep up with the conversations they initiate!

Does your twice exceptional child have a stubborn streak a mile wide?  If so, read Is Your Gifted Child Also Your Most Strong Willed Child As Well? for my perspective on why someone so clever can also get stuck defending a position that makes no sense!