Case Report on Twice Exceptional Paradox - Unravelling the Potential and Challenges of Children With Neurodevelopmental Disorders and Cognitive Giftedness in Malaysia

Oct 15, 2026

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A case report examining twice-exceptional paradox in Malaysia focuses on a child and an adolescent who simultaneously present neurodevelopmental disorders and intellectual giftedness. The study highlights the learning and psychosocial challenges that stem from discrepancies between cognitive development and social-emotional skills. Psychological and cognitive assessments identify both strengths and learning disabilities, while parent psychoeducation and a strength-based approach improve mood and functioning at home and school. Findings emphasize comprehensive assessment and tailored interventions, noting gaps in services and policies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Introduction

Definition and prevalence challenges

Learning and psychosocial difficulties

Assessment, misdiagnosis, and educational placement

Role of parental support and interventions

Learning Disabilities: A Contemporary Journal 22(2), 175-195, 2024 Copyright @ by LDW 2024 Case Report on Twice Exceptional Paradox: Unravelling the Potential and Challenges of Children With Neurodevelopmental Disordersand Cognitive Giftedness in Malaysia Lee Sook Huey Universiti Pendidikan Sultan Idris Universiti Sains Malaysia Saw Jo Anne Universiti Teknologi MARA (UiTM) Hospital Al-Sultan Abdullah UiTM Fatanah Ramlee* Universiti Pendidikan Sultan Idris Chan Kah Mun Universiti Pendidikan Sultan Idris Universiti Sains Malaysia Alicia Ng Cher Ching Universiti Pendidikan Sultan Idris Universiti Sains Malaysia Twice-exceptional individuals experience learning and psychosocial challenges resulting from the discrepancies between their cognitive and social-emotional development. This case report illustrates the learning and psychosocial faced by a child and an adolescent who possess both neurodevelopmental disorders and intellectual giftedness, and the clinical difficulties encountered when assessing them. Psychological and cognitive assessments were instrumental in identifying the unique strengths and learning disabilities of these individuals. The parents received psychoeducation, and a strength-based approach involving them led to improved mood and functioning at home and school. By detailing the clinical challenges in assessment and the effectiveness of strength-based interventions, this study provides valuable insights into addressing the complex learning and educational needs of twice-exceptional children and adolescents in Malaysia. The findings emphasize the urgent need for comprehensive assessments and tailored interventions to support this population, whose potential is often hindered by unaddressed learning challenges. Additionally, the paper calls attention to gaps in current services and policies, advocating for improvements that can better support twice-exceptional learners in achieving their full potential. Keywords: autism, intellectual giftedness, twice-exceptional children, learning disabilities *Please send correspondence to: Fatanah Ramlee, PhD, Department of Psychology, Faculty of Human Development, Universiti Pendidikan Sultan Idris, 35900 Tanjong Malim, Perak, Email: [fatanah@fpm.upsi.edu.my](fatanah@fpm.upsi.edu.my). Learning Disabilities: A Contemporary Journal 22(2), 175-195, 2024 IntroductIon Twice-exceptional learners are those who have one or more disabilities and an exceptional ability in areas such as cognitive abilities or creativity (Reis et al., 2014) . Recently, this population has received increasing interest from researchers (Gelbar et al., 2022) . However, due to limited research and the complexity of the condition, estimating the prevalence rate is challenging. A recent study estimated that the theoretical probability of twice-exceptional children is approximately 14%(Lee et al., 2023). An example of twice-exceptional individuals is children with intellectual giftedness as well as one or more neurodevelopmental disorders such as Autism Spectrum Disorder (ASD) and/or Attention-Deficit/Hyperactivity Disorder (ADHD) . ASD is a neurodevelopmental disorder characterized by impairments in social communication and interaction and persistent restricted, repetitive or behaviors or stereotypes whereas ADHD is characterized by persistent inattention and hyperactivity/ impulsivity issues (APA, 2022) . Children with ASD and/or ADHD and giftedness face unique learning and psychosocial challenges due to the discrepancy between their cognitive abilities and specific developmental skills (Cain et al., 2019) . This population tends to show underachievement at school due to their learning challenges (Steenbergen-Hu et al., 2020) . Maddocks (2019) found that twice-exceptional children tend to struggle in learning due to information processing deficits or their heterogeneous achievement patterns. Twice-exceptional individuals often exhibit uneven cognitive profiles, wher

FAQs

What does the paper describe as the “twice-exceptional” condition in this context?

It describes learners who have one or more disabilities together with exceptional cognitive or creative abilities, such as intellectual giftedness alongside neurodevelopmental disorders like ASD and/or ADHD.

Why are accurate assessments difficult for twice-exceptional children?

The paper notes limited research and the condition’s complexity, and explains that uneven cognitive profiles can allow intellectual strengths to mask underlying learning disabilities, leading to misdiagnosis or underdiagnosis.

How does the study propose supporting children and adolescents with twice-exceptional profiles?

It reports that psychological and cognitive assessments help identify strengths and learning needs, and that parent psychoeducation with a strength-based approach can improve mood and functioning at home and school.

Oct 15, 2026

Upload by Oliver