Perspectives – Directions to the Future

September, 2018

In this issue, we look back on the 15 years since we published the premier issue of 2e Newsletter in October of 2003. Here these members of our Editorial Advisory Board offer their perspectives on what may be or should be priorities with regard to twice-exceptional children in the future:

Paul Beljan, Psy.D., ABPdN, ABN

I began working with gifted children as a post-doctoral fellow in 1994. The term twice exceptional (2e) came along much later. It was an epiphany to me that the concept of 2e was even necessary. That is, I was surprised that a population of professionals existed who actually failed to consider that gifted children would not have spectrum disorder, learning disorders, or any other neuropsychological deficit with the same regularity as any other child.   

I spoke with several top gifted educators about 2e for this brief writing and got a rude awakening. I thought that by now 2e was widely accepted and numerous interventions available. These educators acknowledged that over the past 15 years the term 2e has become a popularly-used descriptor among parents and educators who are already “in the know” about giftedness. Unfortunately, outside of this group, and often within the group, the concept of 2e is misunderstood, under or incorrectly diagnosed, and underserved when correctly diagnosed. The term is out there (awareness), but the infrastructure or will to serve it is not (no insight).

My experience among school psychologists, licensed psychologists, psychiatrists, and pediatric and family physicians is worse than what the educators reported. Again, the term is known but deeply misunderstood. Public school psychologists, most licensed psychologists (even many neuropsychologists), and physicians still use outdated and disproven assessment methodology to identify spectrum disorder, learning disorders, or neuropsychological deficits in non-gifted children, let alone the gifted population. In comparison to public school learning disorder assessment methodology, you may as well have the anesthesiologist use ether during your surgery as opposed to current methodologies.

Reading, spelling, writing, and mathematical learning disorders are the most commonly overlooked or misdiagnosed in the gifted population; but how is this to change when someone like me, who has over 20 years with a psychology license, has never seen a public school diagnose a mathematical learning disorder in a non-gifted child? In fact, I can safely say that gifted children with academic learning disorders are more overlooked than their non-gifted peers because public schools throw out the eligibility rules when it comes to gifted children. I have attended many IEP meetings in which the parent of a gifted child, who reads at an average level, was told, “Your child reads in the average range, and we have children who can’t read at all [that we also don’t help]; your child does not have a learning disorder.”

I like to explain things the way they are without candy-coating the difficult parts. Although what I have written here sounds negative, I remain hopeful. I tell the parents of the gifted children I assess that the children first must have awareness about their issues in order to get them to insight. The key to taking responsibility for problems and making positive change is insight. The publishers of 2e Newsletter and many others have brought 2e to the level of awareness, and now the daunting task of insight has to be tackled.

Paul Beljan, Psy.D., ABPdN, ABN, is a licensed pediatric neuropsychologist in private practice in Scottsdale, Arizona. He has completed two post-doctoral fellowship programs, each in pediatric psychology and pediatric neuropsychology. Among his professional areas of interest are gifted intelligence, learning disorders, and executive functioning deficit. He is a co-author of Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders and of the recent Large-Scale Brain Systems and Neuropsychological Assessment: An Effort to Move Forward. Other credentials include: Service on the Arizona Governor’s Board of Psychological Examiners, diplomate certification with the American Board of Pediatric Neuropsychology and the American Board of Professional Psychology, and a post-doctoral master’s degree in psychopharmacology. 

Kim Busi, M.D.

Like many of us, I entered the world of 2e as a parent. It happened 10 years ago, when I was a practicing psychiatrist with a faculty appointment at the NYU School of Medicine, teaching and training psychiatry residents and medical students. Back then, my precocious 8-year-old had gone from a happy, engaged student in a rigorous bilingual school in Manhattan — one who loved to learn (in two languages) — to a child who became increasingly isolated and anxious. The school wanted him to stay, despite our growing concerns. (After all, he boosted their test scores!)

We found ourselves in the dilemma that all 2e parents face — making the choice between academics and support. We chose the promise of support of special education, and the result was all too familiar. As academics stalled to a standstill, my child’s sense of self-worth and self-esteem plummeted. If I chose support, why did this happen? 

These experiences led me to start The Quad Preparatory School. I did so not only from the perspective of a parent, but also from that of a physician. I embraced the strength-based learning model of my predecessors, and I wholeheartedly believed that our wonderfully diverse kids are our future innovators and changemakers — precisely because of their combined gifts and challenges. I also believed that access to gifted education was a must. But I was puzzled by what seemed to me a false dichotomy: that a strength-based approach was mutually exclusive to clinical intervention in the school setting. To me, it seemed that when the clinical side was outsourced, clinical expertise failed to have the impact it could. So I founded a school where my goal from the beginning was to break down the silos of education and psychological support and have, instead, a new kind of integrated model.

What we do as physicians is compare the risks and benefits of a treatment — be it medication, psychotherapy, occupational therapy — to the risks and benefits of not treating. I wholeheartedly agree that there are significant risks involved in a focus on pathology; however, I believe that there are also risks to not clinically intervening. Because children spend most of their waking hours in school, getting the academic/clinical balance right in the school setting provides the perfect opportunity to intervene successfully. Achieving this balance can benefit all children — not only the subset of children whose needs are so severe that they require a therapeutic school. 

Quad Prep students, and my son, happen to be proudly diverse. They are incredible individuals, and I would never want them to be anything other than who they are. However, 2e children, like all of us, experience diversity in terms of both strengths and weaknesses. With evidence-based clinical interventions that inform a social and emotional learning curriculum, children can be more themselves. They have the opportunity to develop skills so that they are not misunderstood, so that their anxiety can be managed, so that they are able to learn, and so that their ideas can elevate significant parts of our future discourse, culture, and way of being.
My hope for the growth of the 2e movement is to leave behind an either/or approach to the education of these children and to widely evolve to shatter stereotypes and stigma. The result, I believe, will lead to a more tolerant and better future.

Kim Busi, M.D., is the founder of The Quad Preparatory School, for 2e students in grades K-12, and Quad Manhattan, a Manhattan after-school and summer program for twice-exceptional children. She received a medical degree from Brown University Medical School and went on to get additional training in pediatrics and psychiatry. For several years, she had a faculty appointment in clinical psychiatry at the New York University School of Medicine.   

Deirdre Lovecky

It’s been 15 years since the first 2e Newsletter was published. The initial issue coincided with the publication of my book, Different Minds: Gifted Children with AD/HD, Asperger Syndrome and Other Learning Deficits. A lot has changed in those 15 years in terms of our knowledge and experience in working with gifted children who have a second exceptionality, but some things have not changed very much at all.

Finding twice-exceptional children is still an issue. Despite the focus of some researchers and clinicians on the reality of disabilities in gifted children, there is still a vast amount of misconception and lack of knowledge about their needs.

Gifted children with disabilities commonly lack identification as both gifted and disabled due to several factors:

  • Focusing only on the child’s giftedness, which can result in misreading signs of disability as traits of giftedness
  • Focusing only on the child’s disability, either missing or disregarding the giftedness
  • Overlooking the signs of both giftedness and disability because the gifted child appears to be average.

While there has been progress in identifying gifted children with disabilities through comprehensive evaluation, many are still missed. For some of those who remain unidentified — those able to use their strengths and camouflaging techniques — failure per se never happens. Still, the gifted person knows that something is wrong and experiences a disconnection between what the outside world says about the self and what the inner self feels. Sometimes failure to have a disability identified leads to underachievement in adulthood. Other times, it does not. Instead, the gifted adult, despite achieving, can feel out of synch, always running to catch up, never quite able to achieve with the ease that others of equal ability do. This discomfort with the self can remain throughout the individual’s life.

Helping the gifted child with a disability be recognized and supported for both weaknesses and strengths is the work of the coming years.

Look for an expanded version of these thoughts in an upcoming article by Deirdre Lovecky in 2e News from Bridges 2e Media.

Deirdre V. Lovecky, Ph.D., is a clinical child psychologist at the Gifted Resource Center of New England, Providence, Rhode Island, where she does assessments, treatment, and consultation for gifted children, adolescents, and their parents. She is currently working on the second edition of Different Minds: Gifted Children with ADHD, Asperger Syndrome and Other Learning Deficits. She can be reached at 

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