Twice-exceptional learners face a unique set of challenges arising from the intersection of extraordinary talent and disability. Neurobiology research has the capacity to complement pedagogical research and provide support for twice-exceptional learners. Very few studies have attempted to specifically address the neurobiological underpinnings of twice-exceptionality. However, neurobiologists have built a broad base of knowledge in nervous system function spanning from the level of neural circuits to the molecular basis of behavior. It is known that distinct neural circuits mediate different neural functions, which suggests that 2e learning may result from enhancement in one circuit and disruption in another. Neural circuits are known to adapt and change in response to experience, a cellular process known as neuroplasticity. Plasticity is controlled by a bidirectional connection between the synapse, where neural signals are received, and the nucleus, where regulated gene expression can return to alter synaptic function. Complex molecular mechanisms compose this connection in distinct neural circuits, and genetic alterations in these mechanisms are associated with both memory enhancements and psychiatric disorder. Understanding the consequences of these changes at the molecular, cellular, and circuit levels will provide critical insights into the neurobiological bases of twice-exceptional learning.

There is a long-standing association between exceptional cognitive abilities, of various sorts, and neuropsychiatric illness, but it has historically largely been investigated in an exploratory and non-systematic way. One group in which this association has been investigated with more rigor is in subjects who have been identified as twice exceptional; an educational term describing subjects who are both gifted and diagnosed with a neuropsychiatric disability. This term covers multiple conditions, but is of specific interest in particular in the study of autism spectrum disorder. Recent findings have led to the development of a hypothesis that a certain degree of the neurobiology associated with autism might even be advantageous for individuals and could lead to high giftedness, while becoming disadvantageous, once a certain threshold is surpassed. In this model, the same neurobiological mechanisms confer an increasing advantage up to a certain threshold, but become pathological past that point. Twice-exceptional individuals would be exactly at the inflection point, being highly gifted, but also symptomatic at the same time. Here, we review how existing neuroimaging literature on autism spectrum disorder can inform research on twice exceptionality specifically. We propose to study key neural networks with a robust implication in ASD to identify the neurobiology underlying twice-exceptionality. A better understanding of the neural mechanisms of twice exceptionality should help to better understand resilience and vulnerability to neurodevelopmental disorders and tofurther support affected individuals.

What began nearly a century ago with the contributions of Hollingworth and Asperger, among others, has developed into a field dedicated to the study of gifted individuals with a disability. These twice-exceptional (2e) people and their unique set of needs differ from those of their once-exceptional counterparts on either end of the spectrum and often remain unaddressed or are discovered very late in life resulting in longterm consequences. For those discovered, effective treatment options to improve their quality of life remain uncertain. The goal of the present paper was to determine whether effective interventions exist to improve domain-specific (i.e., social, emotional, or academic) outcomes for people exhibiting both signs of giftedness and disability. A query was performed using evidence databases TRIP and PDQ in addition to University at Buffalo Libraries holdings for "twice-exceptional," "Giftedness," "Disability," and "intervention." The hits were reduced to the four most relevant, freely available studies in English that were selected for critique. Despite the selected studies being found to share methodological similarities that were their strengths and conducive to comparison, they also had threats to validity that served as potential weakness. Not only can directly effective interventions improve specific domains for 2e individuals, but the effects of domain-specific interventions may carry over into another domain resulting in indirect effects.

Gifted students are usually known as students who have exceptional cognitive and learning abilities. This can be made clear through their learning performance or test scores. However, there are other students who have been identified as gifted and talented, yet have some learning and /or physical disabilities, and these are called twice-exceptional students. Identifying this population of gifted students is usually problematic because their disabilities and difficulties may mask their abilities and vice versa. It has been suggested that twice-exceptional students’ skills and abilities cannot be improved simply by working harder. Instead, these students need teachers to understand their strengths and weaknesses, use teaching strategies that fit their disabilities and serve their needs, and include their parents and educators in their learning process. Thus, this conceptual paper provides an extensive overview of the needs, challenges, and teaching strategies related to twice-exceptional students.