Case Studies in Twice
Exceptionality:
Helping These Learners Survive and Thrive in
Elementary Gifted Classrooms
It All Started With a Project…
• Javits government grant for .875 million
dollars for 5 year study of twice exceptional
primary school children: PROJECT 2EXCEL
• Includes 4 school districts (all serving gifted
students in homogeneous, self-contained
classrooms) with varying demographics so
we can try to generalize across schools:
District A – inner city gifted magnet school
District B – small, blue collar 2nd ring suburban district
District C – moderate 2nd ring middle class suburban
district
District D – moderate 1st ring blue collar/upper middle
class suburban district
Goals of Project 2EXCEL
• Develop a systematic identification system for gifted
learners with:
– Attention Deficit Disorder with/without hyperactivity
(ADHD)
– Emotional Behavioral Disorder (EBD)
– Autism Spectrum Disorder (ASD)
– Specific Learning Disability (SLD)
• Provide training for experimental teachers on twice
exceptionality:
– On-line certificate program (tuition free) 18 postgraduate
credits in 2X Education
– In-service training on curricular specifics with built in, paid
writing days (8 per year)
– Yearly stipends for materials and resources
– Biweekly classroom visits for observation, reflection
Goals of Project 2EXCEL
• Develop a “toolkit” of adaptations and
accommodations applicable to gifted math and
reading/language arts curriculum
• Provide training and support to parents of
twice exceptional experimental and control
students
• Disseminate what is learned about
identification, programming, and parenting
with general community via:
– Curriculum toolkit for teachers
– Website (www.stthomas.edu/project2excel )
– Parent training and resource manual
Project Implementation
• Matched pairs of gifted children identified with the
same forms (and degree) of exceptionality were
randomly assigned to experimental and control
classrooms
• Matched pairs are pre- and post-tested on math and
reading achievement levels, motivation to learn, and
self-efficacy
• Experimental students receive services for 5 years,
starting with 4th grade and controls continue with
their current levels of services (for giftedness and
special education)
• Parents of experimental and control students
receive four training sessions yearly on home-based
strategies and resources on twice exceptionality
What We Have Learned in Year One
About Identification: 10 Strategies for
Finding the Kids
• S1 -A tiered system of identification **
• Three-tiered system relying on more and more
sophisticated instruments to first include all possibles and
potentials followed by “ruling out” other variables for a
child’s inability to thrive in a gifted classroom
• S2 -Need for identification team
• Consisting of at least a special education person for each
disability area and a gifted specialist, plus others involved
such a school nurse, social worker, physicians, etc.
• S3 -Need for training for identification teams
• Practice with spectrum of instruments (objective measures)
and checklists (subjective measures) and child study
observations
Tiers for Identification
Tier 1
Tier 2
Tier 3
•Discrepancies
among subtest or
index scores on
ability test used by a
district
• District Checklists
of specific disability
category
characteristics or
behaviors provided
to teachers of
students “suspected”
of presenting with a
disability
ADHD: Connor’s
Rating Scales
EBD: Behavior
Assessment System
for Children (BASC2); Behavior &
Emotional Rating
Scales
ASD: BASC-2;
Autism diagnostic
Interview – R (ADIR)
SLD: WoodcockJohnson Tests of
Achievement
ADHD: Connor’s
Continuous
Performance Test;
Aschenbach Rating
Scales
EBD: Student Risk
Screening Scale;
Strengths and
Difficulties
Questionnaire
ASD: ADOS
SLD: CTP; wrAP
(Writing
Assessment)
What We Have Learned in Year One
About Identification: 10 Strategies for
Finding the Kids
• S1 -A tiered system of identification **
• Three-tiered system relying on more and more
sophisticated instruments to first include all possibles and
potentials followed by “ruling out” other variables for a
child’s inability to thrive in a gifted classroom
• S2 -Need for identification team
• Consisting of at least a special education person for each
disability area and a gifted specialist, plus others involved
such a school nurse, social worker, physicians, etc.
• S3 -Need for training for identification teams
• Practice with spectrum of instruments (objective measures)
and checklists (subjective measures) and child study
observations
Study Procedure
• Each district used a 3-Tier identification
protocol
– Tier 1: discrepant WISC index scores when WISC used
for GT identification or for SPED identification (additional
IQ testing was done for learners identified by other
means); use of screening checklists by teachers and
parents
– Tier 2: additional measures when identification unclear
or measures inconsistent; Connor Rating Scales, BASC2 for EBD, BASC-2 or ADIR for ASD, WoodcockJohnson Achievement for LD
– Tier 3: Connor’s Continuous Performance for ADD,
ERB for EBD, ADOS for ASD, wrAP Writing Assessment
for SLD
Tiers for Identification
Tier 1
Tier 2
Tier 3
•Discrepancies
among subtest or
index scores on
ability test used by a
district
• District Checklists
of specific disability
category
characteristics or
behaviors provided
to teachers of
students “suspected”
of presenting with a
disability
ADHD: Connor’s
Rating Scales
EBD: Behavior
Assessment System
for Children (BASC2); Behavior &
Emotional Rating
Scales
ASD: BASC-2;
Autism diagnostic
Interview – R (ADIR)
SLD: WoodcockJohnson Tests of
Achievement
ADHD: Connor’s
Continuous
Performance Test;
Aschenbach Rating
Scales
EBD: Student Risk
Screening Scale;
Strengths and
Difficulties
Questionnaire
ASD: ADOS
SLD: CTP; wrAP
(Writing
Assessment)
Prevalence Results Summary
• Approximately 14% of the 504 GT children in
self-contained classes were 2X. At 30 GTs per
classroom, that means we could expect 4 of
those GTs to present with a second
exceptionality in each classroom.
• GT/AD/HD learners represented 7% of the 504
GT children. At 30 GTs per classroom, we
could expect 2 of those GTs to present with a
AD/HD disorder in each classroom.
Prevalence Results Summary
• EBD and SLD represented 3%, respectively, of
the 504 GT children. At 30 GTs per classroom,
we could expect 1 EBD and 1 SLD child in each
4th grade classroom
• GT/ASD learners represented 1% of the 504
GT children. At 30 GTs per classroom, we
could expect 1 GT child with ASD in every third
classroom.
Developmental Prevalence Results
Summary
• Except for the anomaly at 5th grade, there
appears to be a slight increase overall in 2X
presentation as gifted learners grow older
• GT/AD/HD seems to be the most prevalent
twice exceptionality to crop up over time.
• Sixth grade appears to be a time when SLD
may rear its ugly head.
• EBD tends to remain constant and at a
relatively high second as most prevalent twice
exceptionality.
• When looking across the grade levels,
approximately 1 GT child in 5 in this study
presented with some twice exceptionality.
What We Have Learned in Year One
About Identification
• S4 -The WISC-4 is valuable in providing
“inclusive” data on potential 2X children
• Children with discrepancies among index scores of 23 or
more points are assessed with subsequent tiers for twice
exceptionality
• S5 -Don’t look too far from the family tree
• Traits of twice exceptionality are likely found in other family
members
• S6 - Finding twice exceptionals is easier in
gifted self-contained classrooms than in
mixed ability classrooms
• In the latter, the giftedness may allow children to look
“average” so they are not recognised as either gifted or
special education qualified
What We Have Learned in Year One
About Identification
• S7 -Look harder than we have previously
for eligible girls
• Especially for disabilities that are emotional,
attentional In attentive ADHD), or for SLD – girls
seem to be able to “hide” their issues more
effectively
• S8 -Identification for twice exceptional may
have developmental differences
• We are more likely to find ADHD and ASD fairly
early, but EBD and SLD may not show up until the
middle school years
• S9 - The school nurse may be one of the
best identifiers of twice exceptionality
• Knows which are on medication and for what
reasons
What We Have Learned in Year One
About Identification
• S10 -Need to help parents understand
importance of early identification
• Many don’t want their children “labeled” so will
allow child to struggle but remain “average” rather
than to address and perhaps countermand many
permanent self-efficacy and intrinsic motivational
issues.
• NUMBER 11 (I know I promised 10): we must
look in three places for twice exceptionality
• A -Self-contained gifted classrooms for children
who are not thriving (ruling out underachievement,
low motivation, ethnic issues)
• B -Mixed ability classrooms for children who seem
to have a “spark”
• C -Special education files, especially at children
with highly discrepant sub-scores on objective
tests
And Now About the Kids
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Jonah
Kelly
Nate
Ricky
Charlie
Linus
Sally
Lucy
Jonah
8-years-old
Cheerful
Outgoing and friendly
Diagnosed with ADHD
Mischievous eyes and grin
Interested in EVERYTHING
ADHD Associated Behaviors
High activity level
Impulsive, inability to delay gratification
Impaired adherence to
commands to regulate or
inhibit behavior in social
contexts
Behaviors must be excessive and longterm, and affect all aspects of the child’s
life
Behaviors that happen
more often in this child
than in the child’s peers
Behaviors that occur in several settings,
not only in one place, such as the
playground, classroom, or home
Behaviors that are a
continuous problem
Loses Things, Often Forgetful
Test Results
• IQ (Ability)
–
–
–
–
Percentiles
Verbal
Perceptual Reasoning
Working Memory
Processing Speed
• ITBS (Achievement):
– Reading
– Math w/Computation
– Math w/o Computation
98th
94th
99th
58th**
Percentiles
82nd
81st
99th
95th**
92nd**
84th**
Teacher’s Perspective
• Very likeable
• Strengths: sense of humor, compassion, insight,
good friend
• Shares in class and enjoys the spotlight
• In “charge” of making sure other students are
enjoying themselves
• Not concerned about doing class work
• VERY active in class
• Often has “too many ideas in my head. I can’t
pick one.”
Parents’ Perspective
•
•
•
•
Good natured
Monty Hall of the family
Enjoys solitary activities, yet is a “joiner”
Suspected giftedness when at age 3 he
designed a pulley system and tested it
with different weights
• Hobbies: chess, fishing, Legos, basketball
• Doesn’t sleep much
• ADHD history possible in family
All is Right With the World
When…
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•
•
•
•
Fishing
Playing with Legos
Reading a good fantasy book
Playing chess (against himself or others)
Searching for “just the right worms”
Child’s Perspective
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Fall 2009
Hard to behave the way
others expect
Average confidence in
Reading
Not happy about
appearance
Feels smart in school,
but not important
Important to have
friends

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
Spring 2010
A little easier to behave
the way others expect
Less confidence in
Reading - Slow
Happier with
appearance
Feels smart in school,
but still not important
Feels much more
socially accepted (Mom
and teacher)
“Accommodations”
•
•
•
•
•
•
•
•
Yoga
Aerobic ball
Desk position in room
Chewing gum
Tennis ball
Alternative assessments
One-on-one instructions
Approval and encouragement
Jonah After 1st Year
• Motivation from 8th to 56th Percentile in Math
• Reading achievement from 82nd to 95th
Percentile
• Math with computation from 81st to 92nd
Percentile, but Math without computation
dropped from 99th to 84th percentile
• More friends
• A little easier to behave the expected way
• Acceptance of methodical work lessened
frustration (high executive functioning/slow
processing speed)
Kelly
Obsessive Compulsive Disorder
Anxiety
Affectionate
Desire to Please
Emotion Control Issues
OCD Associated Behaviors
• Problems with information processing
• Obsessions and compulsions
• Imagining losing control or having aggressive
urges
• Fears
• A need to have things “just so”
-- International OCD Foundation, 2010
Test Results
• IQ (Ability)
Percentiles
– Verbal
98th
– Perceptual Reasoning
90th
– Working Memory
68th*
– Processing Speed
94th
• ITBS (Achievement)
Percentiles
– Reading
93rd
93rd
– Math (w/Computation) 92nd
99th
– Math (w/oComputation) 98th
99th
Teacher’s Perspective
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•
•
•
•
•
Domineering and egocentric
Clever, smart, and capable
Impulsive
Completes work and follows instructions
Needs approval and encouragement
Eager to make friends
Family Life
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•
•
•
•
Frequent “groundings”
Uninvolved in activities outside of school
Parents going through divorce
Few friends outside of school
Mom concerned about lack of friendships
Child’s Perspective
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


Fall 2009
High Reading confidence
VERY high Math
confidence
Average social
acceptance
Dislikes appearance
(compared to other girls)
Behaves very well
High global self worth
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Spring 2010
Higher Reading confidence
High Math confidence, but
lower than in Fall 2009
Higher social acceptance
than in Fall 2009
Dislikes appearance even
more
Behaves most of the time
Very low global self worth
All is Right With the World
When …
• Reading
• Sketching/Drawing
• Writing -- especially poetry
Where will we be?
The fire is strong and fierce, the water mellow and soft
The earth changes not fast or slow.
What do you think is going on down below?
Lava heating up to explode? Ice so cold it can freeze all?
What do you think the world will be in 1,000,000 years?
Healthier … Fully polluted … Or does it even exist?
• Spending time with friends
“Accommodations”
•
•
•
•
Praise and encouragement
Attempt to publish poetry
Coping skills
Encouraged to draw sketches to accompany
writing
• Re-grouped frequently to make a friend
Kelly After 1st Year
• At a crossroads:
• Self-esteem fell from a high level to below
average
• Appears less anxious, but finishes lunch well
before lunchtime
• Motivation for Math dropped significantly, but
achievement rose dramatically
• Feels more socially accepted, but has few
friends
• Knows that behavior is worse -- trying out
personas / “dumbing down” for classmates -but has no plan to change
Nate
Non-Verbal Learning Disorder, ADHD
Immature Speech Patterns
Friendly
Sense of humor
Dysgraphia Associated Behaviors
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•
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Distorted writing
Incorrect writing
Inappropriately sized or spaced writing
Wrong or odd spelling of words
Use of wrong words, though similar
-- National Institute of Neurological Disorders and Stroke (NINDS)
Test Results
• IQ (Ability)
–
–
–
–
Verbal
Perceptual Reasoning
Working Memory
Processing Speed
• ITBS (Achievement)
Percentiles
99.9th
39th **
27th **
9th **
Percentiles
– Reading
73rd
– Math (w/Computation)N/S
– Math w/oComputation82nd
87th **
82nd
99th **
Teacher’s Perspective
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•
•
•
•
Auditory learner
Grasps concepts quickly
Witty and has many friends
Challenges teacher to challenge him
Full of ideas and uses assistive
technology well
• Mom doesn’t want homework
assignments -- his responsibility
Family Perspective
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•
•
•
•
Witty, good-natured, fun
Smart
Immature Speech Patterns
Forgetful
Helping him become independent by NOT
accepting homework assignments from teacher
• ADHD history in family
Child’s Perspective
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Fall 2009
Very low Reading
motivation
Average motivation in
Science
Highly confident in
writing ability
High self-esteem
High to very high
global self-worth
Teacher does nothing
different for him
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Spring 2010
Still low (but higher)
Reading motivation
Extraordinarily highly
motivated in Science
VERY highly confident in
writing ability
VERY high self-esteem
VERY high global selfworth
Teacher did nothing
different for him
All is Right With The World
When …
• Playing sports with friends
• Reading -- loses sleep
• Entertaining friends
“Accommodations”
All were provided for whole class
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•
•
•
Allowed to record test responses
Use of word processing for writing
Word prediction software
Flexible deadlines
Alternative assessment strategies
Movement in class: arm shakes, wrist
shakes, finger movement
• Co-writing
Nate After 1st Year
• Possibly the highest level of self-esteem of
anyone in the study
• Doesn’t worry about taking tests or writing
• Using digital recorders and word processing,
writes beautifully
• Ran for student council
• Twice-exceptionality not getting in the way of
learning
RICKY
Diagnosed with Asperger’s Syndrome
Clever
Sense of Humor
Asperger’s Syndrome
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Limited interests or unusual preoccupation
Repetitive routines or rituals
Peculiarities in speech or language
Socially and emotionally inappropriate behavior
Problems with non-verbal communication
Clumsy and uncoordinated motor movements
-- National Institute of Neurological Disorders and Stroke (NINDS)
Test Results
• IQ (Ability)
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–
–
–
Verbal
Perceptual Reasoning
Working Memory
Processing Speed
• ITBS (Achievement)
Percentiles
96th
99th
86th *
99th
Percentiles
– Reading
96th
– Math (w/Computation) 99th
– Math w/o Computation 99th
90th *
99th
99th
Teacher’s Perspective
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Brilliant
Requires a great deal of one-on-one
Highly motivated when interested
Great sense of humor
Genuinely likes him -- even his “ornery” side
Prefers hands-on activities
Sometimes seems to say random things, but
nothing inappropriate
• Plays devil’s advocate
Family Perspective
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Forgetful in daily activities
Extremely sensitive, cries easily
Sponge for learning facts
Few friends -- has trouble making and then keeping
friends
Fidgety, always on the move
Frequent nightmares
Listens to reasoned arguments
Kind-hearted and creative
“Outside the box” thinker in all things
Child’s Perspective
• Unhappy with himself -- would like to
have more friends
• Sad that he is unpopular
• Confidence in writing ability
• Thinks the way he does things is just fine
• Being smart in school is very important
to how he feels about himself as a
person
All is Right With the World
When …
• Reading
• Conquering a difficult problem
“Accommodations”
• Allows him to work ahead in Math
• Lets him calm himself when annoyed
• 3 options when he does not understand: (1) let teacher
show how; (2) return to seat until ready; (3) go on with
lack of understanding
• Created class culture of acceptance
• Lets him “daydream” -- his way of concentrating
• Daily schedule on his desk
• Uses word processing software
• Increased communication with parents
Ricky After 1st Year
• Probably the best example of the
difference a teacher can make
• Self-esteem soared in all areas except
social acceptance, although he is
learning rules of social interaction
• Motivation exploded:
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–
Reading
Math
Social Studies
Science
61st to 90th **
41st to 86th **
53rd to 95th **
51st to 91st **
Charlie, age 9
LD
Learning Disability
Identification
• 37 point discrepancy between verbal and
perceptual reasoning indices on WISC IV
• Highly gifted range in perceptual reasoning
• Average range in verbal, processing speed, and
working memory
2009-2010 Testing Results
• CAIMI scores indicate lukewarm feelings about
school
• Shows good gains in both math and reading on
the ITBS
• Harter’s Measure of Self-Perception scores
indicate that Charlie likes his appearance, is
comfortable with his social abilities, and has
increased confidence in his athletic ability.
Observations
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Frustration
Huge gestures
Moves around a lot
Tries to be quiet
Checks in frequently
Craves one-on-one time
Talks his way through problems
Accommodations/Modifications
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Frequent check ins.
Wiggle seat
Freedom of movement
Work space choice
Communication with parents
Less work assigned
Partial work agreement
Linus, age 9
ASD
Autism Spectrum Disorder
Asperger’s Syndrome
Identification
• IQ in the superior range, no major score
discrepancies on WISC IV indices
• Exhibits strong intellectual curiosity
• Has a history of emotional outbursts in class
• Diagnosed with Asperger’s Syndrome
2009-2010 Testing Results
• CAIMI shows fairly high motivation toward all
subjects except for social studies
• Scored in the 99th percentile on ITBS math and
reading both pre- and post-test
• Harter’s scores indicate that Linus’ feelings of
competence in writing increased dramatically
Observations
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•
•
•
•
•
Likes to be center of attention
Is well liked by peers
Blurts answers
Thinks out loud
Is frustrated by failure
Needs help with day-to-day problem solving
Accommodations/Modifications
• Help Linus cope with frustration
• Separate him for math tests because of thinking
out loud
• Build executive functioning skills
– Getting work turned in
– Bringing what he needs when transitioning for
math
Sally, age 10
AD/HD
Attention Deficit/Hyperactivity
Disorder
Identification
• High Verbal and Perceptual Reasoning scores,
average Working Memory and Processing Speed
scores. 23+ point discrepancy
• Diagnosed with ADD – on medication
• Very quiet
• Very slow worker
2009-2010 Testing Results
• CAIMI scores indicate highest motivation in
reading, lowest in math
• Shows gains in math and reading on ITBS,
averaging 2 grade levels of growth
• Harter’s scores indicate high self-esteem.
Observations
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•
•
•
Is very quiet in class
Loves to read
Has a hard time following along
Works slowly
Is persistent
Accommodations/Modifications
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•
•
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Pair with another student
Ongoing communication with parents
Graphic organizers
Allow more time for assignments
Frequent check-ins
Ask her to verbalize prior to writing
Lucy, age 10
EBD
Emotional Behavioral Disorder
Identification
• 26 point discrepancy between Verbal and
Processing Speed indices on the WISC-IV
• Has a slight speech impairment and talks very
fast
• Works very quickly
• Shows her feelings openly
2009-2010 Testing Results
• CAIMI scores show very high motivation for all
subjects
• Performed at the same level in reading on the
ITBS, but improved in math, scoring in the 99th
percentile
• Harter’s scores show a slight drop in feelings of
competence in math
Observations
• Works very quickly – frequently the first
one finished with a task
• Wants to be sure others are doing what
they are supposed to be doing
• Enjoys teaching her peers
• Is in tune with her surroundings
• Wears her feelings on her sleeve
Accommodations/Modifications
• Weekly meeting
• Reinforce student-teacher roles
• Group with kids who can benefit from her desire
to share her knowledge
• Give Lucy leadership roles whenever reasonable
Individuals
• Jonah
– Class entertainer
– Difficult to meet others’ expectations for behavior
• Kelly
– Needs approval and praise
– A sensitive poet
• Nate
– Grasps concepts quickly, witty and clever
– Needs assistive technology and alternative assessments
• Ricky
– Mathematician who hates to make a mistake
– Needs one-on-one more often than other children
Individuals
• Charlie
– frustrated and intense
– larger than life.
• Linus
– eager about learning
– needs help with organization, appropriate responses to
frustration, and thinking out loud
• Sally
– quiet and a slow worker
– flies under the radar
• Lucy
– In tune with her surroundings to an unusual degree
– likes to be in control of her learning
Last Words…
• These 8 case studies show the idiosyncratic nature
of twice exceptional children. No two are alike.
• Strategies that work for one may not work at all for
others
• Strategies that may work one week for one may not
work at all the next week
• It takes a team of professionals to track what occurs
for these children – teachers, social workers,
psychologists, special ed folk, GT specialists,
nurses, and Project 2EXCEL
personnel/observations
Stay Tuned – We have 3-1/2
more years…
• Stay in touch with us at
• www.stthomas.edu/project2excel