I was searching through some old files today and came across this piece that I wrote about ten years ago. Much of it is relevant to today so I thought I'd upload it in case it is of interest to anyone. It's not a blog post - it's waaaay to long for that!! I hope that it is of assistance to someone. I'm happy to send a PDF version upon your request. Just email connect@brightandbeyond.com.au.
If you have any questions or need assistance to support your 2e child, please reach out. I'd be so pleased to help.
Helen
Gifted Students with Autism Spectrum Disorders
- Best Practice for Schools
Marie (a pseudonym) is a gifted high school student with an Autism Spectrum Disorder (ASD). Her learning profile is complex - extraordinary strengths contrasted by disabling weaknesses. Assouline, Foley Nicpon and Fosenburg (2013) describe how these complexities and contrasts presented by exceptionally bright children with ASD create challenges for students, parents and educators alike. Although Marie’s journey to this point has been challenging, she is happy today and excited about her future. Marie, unlike many other twice-exceptional students, is thriving in her school and home contexts due to the appropriate supports provided to cater to her exceptional ability and significant challenges. Tragically, many other twice-exceptional students are unidentified, leaving their rich source of talent untapped and potentially leaving students to struggle through years of underachievement (Assouline et al, 2009; Assouline et al, 2013; Assouline, Foley Nicpon, & Huber, 2006; Foley Nicpon, Allmon, Sieck, & Stinson, 2011; Neihart, 2000). In order for twice-exceptional students like Marie to thrive and achieve their potential, it is imperative that their strengths as well as their disabilities are identified, and appropriate policies and programs be implemented into schools (Assouline et al, 2009; Neihart, 2000; Purcell & Eckert, 2006) to support them.
Twice-Exceptionality - Complexities and Contrasts
Paradoxically, twice-exceptionality refers to the fact that some gifted children are exceptional due to their exceptional intellectual giftedness or talent, and because they are challenged by a form of disability (Assouline et al, 2013; Assouline et al, 2006; Foley Nicpon et al, 2011; Townend, Pendergast & Garvis, 2014). They are sometimes referred to as 2e, Gifted Learning Disabled (GLD), dual exceptional or uniquely gifted; however the is no single definition for twice-exceptionality (Foley Nicpon et al, 2011).
There is also no single definition for giftedness (Foley Nicpon et al, 2011). Due to the very nature of giftedness, the gifted are a heterogeneous group, with a wide range of characteristics and behaviours. The Columbus Group (Morelock, 1992) posed the following definition in 1991, which still encapsulates the essence of our understanding of giftedness today.
Giftedness is ‘asynchronous development’ in which advanced cognitive abilities and heightened intensity combine to create inner experiences and awareness that are qualitatively different from the norm. This asynchrony increases with higher intellectual capacity. The uniqueness of the gifted renders them particularly vulnerable and requires modifications in parenting, teaching and counseling in order for them to develop optimally. (Morelock, 1992)
This definition describes the complexity faced by gifted individuals in the cognitive, behavioural and socio-emotional domains. This asynchronous development often sets gifted children apart from their non-gifted age cohort, especially in the unique ways in which they experience the world. Although people with ASDs may face severe social, communication, and/or behavioral impairments (Assouline et al, 2013; Neihart, 2000) they, like the gifted, also experience the world in unique and refreshing ways (Robinson, Shore, & Enersen, 2007).
However, unlike the vagaries of the many definitions of giftedness (Assouline, Foley Nicpon & Dockery, 2012), the definition of ASD is succinct due to its nature as a psychological disorder. The most recent diagnostic criteria used to diagnose ASD is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) (Assouline et al, 2013). Although the diagnostic criteria are succinct, there has been a significant change in these criteria and terminology used between the DSM –V and its predecessor, the DSM-IV (American Psychiatrist Association, 2013). As diagnostic criteria and understandings of ASD continue to evolve, professionals must keep abreast of these changes in order to identify and best support students. Today, students who were previously diagnosed with Asperger’s Syndrome, autistic disorder, childhood disintegrative disorder or pervasive development disorder fall under a single umbrella disorder, Autism Spectrum Disorder (American Psychiatrist Association, 2013). Assouline et al (2013) warn that the evolution of the DSM-V diagnostic criteria is relevant to the gifted child with co-existing ASD because of the risk of misdiagnosis due to the shifting definitions and inexact use of terminology between editions. This is despite the large body of clinical and educational literature developed over the past twenty years (Foley Nicpon et al, 2011). Assouline et al (2013) also warn that higher functioning students with ASD may be more likely to be missed due to the new diagnostic criteria.
An individual is considered twice-exceptional when they simultaneously possess both attributes of giftedness and either a learning, physical, socio-emotional or behavioural deficit (Assouline et al, 2013; National Education Association, 2006). Although understandings and diagnoses of ASD have grown tremendously over the past fifteen years, there is a significant heterogeneity among the population (Assouline et al, 2013) and so diagnoses for ASD twice-exceptional students are particularly challenging. Additionally, diagnoses of students who possess both giftedness and an ASD are particularly difficult due to the similarity in their behavioural characteristics. See Table 1.
Areas of Comparison | Gifted Students | Students with ASD |
Giftedness & learning | Extensive knowledge base, deep and complex A range of exceptional ability - single to global. Often identified as gifted. Generally learns quickly. May lack motivation. Usually completes tasks and assignments. Generally an excellent memory. | Extensive knowledge base, deep and sometimes complex Usually single area of exceptional ability. Often not identified as gifted. Frustrated by inability to master skills. Often lacks motivation. Often fails to complete tasks and assignments – perceived as being lazy. Generally an excellent memory. |
Communication | Regular speech patterns. Appropriate affect. Awareness of reciprocity. Appropriate receptive language. Regular nonverbal behaviours. Appropriate understanding of social/emotional cues. Usually enjoy the company of older people than their age-peers. | Pedantic speech. Literal. Inappropriate affect. Unaware of reciprocity. Poor receptive language. Impairment of multiple non-verbal behaviours. Difficulty reading social/emotional cues. Usually enjoy the company of older people to their age-peers. |
Personal or daily living | Normal range of skills development. May passively resist routines when engrossed in area of interest. Able to plan time. | Delayed development of skills. Inflexible adherence to non-functional routine. Low tolerance for change; may become agitated or aggressive. Amorphous sense of time. |
Social awareness & relationships | Intuitively grasp unspoken rules. Usually keen insight. May fail to develop peer relationships. May have impaired social functioning. Full range of social fit. Spontaneous sharing of interest, joys etc. Empathetic. | Require explicit instruction of generally unspoken rules Usually absent of insight. Usually fails to develop peer relationships. Sometimes displays social dysfunction. May be socially awkward. Can lack empathy. |
Attention | May become preoccupied. May have difficulty changing subjects in school. May display anxiety. | Hyper-focused. Often obsessive. One or two intense areas of interest. Personal interests are entire focus. Often display anxiety and may respond aggressively. |
Physical development and behaviours | Usually within the normal range. Coordinated Stereotypy not present. May display sensory issues. | Delayed fine and gross motor development. Often clumsy or messy. Stereotypy may be present. Often displays sensory integration issues. |
Emotional development | Emotional intensity. May display low self-esteem. | Emotional volatility. Low self-esteem is common. |
Table 1 – Comparison of Common Characteristics of Gifted students to Students with ASD
(Assouline et al, 2012; Assouline, S.G, Foley Nicpon, M. & Doobay, A., 2009; Assouline et al, 2013; Cash, 1999; Foley Nicpon, Doobay, & Assouline, 2010; Gallagher & Gallagher, 2002; Glen Ellyn, 2010; Henderson, 2001; Little, 2002; Neihart, 2000; Olenchak & Reis, 2002; Purcell & Eckert, 2006; Reis, Baum, & Burke, 2014; Robinson et al, 2007; Silverman & Weinfeld, 2007; Townend et al, 2014)
Table 1 demonstrates that students with ASD share a number of characteristics with gifted children, but also many more that are debilitating. Raising or teaching children who have two sets of traits that sometimes overlap and sometimes conflict with one another can be very challenging (Neihart, 2000). Not knowing that a student has these two sets of traits is a whole different level of challenge.
Singer (2000) described the exponential increase in challenge from being gifted to being twice-exceptional as “If Gifted = Asynchronous Development, then Gifted/Special Needs = Asynchrony Squared”. This description aptly describes the extreme asynchrony experienced by twice-exceptional individuals. Sadly, the term twice-exceptional is still not universally accepted as some professionals are reluctant to accept that giftedness and disabilities can co-exist (Reis et al, 2014) or assert that “if they are truly gifted, their giftedness with emerge” (Johnson, Karnes & Carr, 1997, pp516) without intervention.
Luckily, Marie was identified as intellectually gifted as a preschooler and was diagnosed as having co-existing Asperger’s Syndrome (ASD) at age seven. She has since been provided with appropriate educational experiences and supports for both of her exceptionalities, which in turn has seen the manifestation of her gifts into talents. Many other twice-exceptional students are far less fortunate (Neihart, 2000).
Gifted? Disability? The Masking Hypothesis
Sadly, many twice-exceptional students are not identified as gifted or learning disabled. These learners are unique individuals with learning characteristics that are atypical of gifted students or students with disabilities (Trail, 2011) and, as such, are often confusing for teachers and parents alike. These students may appear to be achieving at grade level and are assumed to have average ability. As their gifts mask their disabilities and disabilities mask their gifts (Assouline et al, 2013; Baum, 1989; Neihart, 2000) they appear to be achieving as expected and they are therefore not referred to special education for evaluation. They often achieve deflated scores on standardized tests and, so, do not qualify for gifted provisions (National Education Association, 2006; Neihart, 2000). These twice-exceptional students are at extreme risk of underachievement and developing emotional dysfunction.
Also distressing is the plight of the twice-exceptional student who is diagnosed as having ASD but whose giftedness is obscured (Assouline et al, 2013). These students, whose disabilities mask their gifts, are involved in programs solely focused upon remediating deficits. Their intellectual capacities are underestimated and, so, these special education programs do not reach the required level of challenge for the gifted student (Neihart, 2000). These students become bored and often disruptive, further damaging their chances for talent development (Assouline, Foley Nicpon, & Fosenburg, 2013; Neihart, 2000; Purcell & Eckert, 2006). They are also at risk of being diagnosed with an emotional disability due to their gifted socio-emotional characteristics being overlooked (National Education Association, 2006).
Marie’s journey has been a lucky one. Had Marie not been diagnosed with ASD she may not have been noticed by special education due to her compliant classroom behaviour and seemingly average achievement. She may have gone on to become an underachiever, perceived as being lazy, disengaged, lacking in persistence or unmotivated and possibly removed from a gifted program (National Education Association, 2006). She may have developed a low self-concept due to feelings of inadequacy and confusion from the continual messages by her teachers and parents of not being good enough. She may even have developed other psychological issues such as depression or even suicidal ideation (Olenchak & Reis, 2002). Her gifts would have masked her disability for only so long (Assouline et al, 2013; National Education Association, 2006; Reis et al, 2014). She may have been just able to keep up with academic demands until middle high school, where the difficulty level of the curriculum and associated required skills would have become just too great to overcome.
Marie is very fortunate. She was identified as possessing characteristics of giftedness from as young as twelve months old. At four years old she was assessed by a psychologist as being highly gifted, at the 99.5th percentile on the WISC -IV. Her local school was supportive in enabling her parents to successfully apply for Marie to gain early entrance to school. Her future looked bright.
Unfortunately, this is not the case for many twice-exceptional students, especially those with an ASD. Being gifted, these students may find a mismatch between their learning environment and their motivational needs. They may perceive that the teacher is indifferent to their needs or they may be affected by forced-choice decisions. They may even be debilitated by perfectionism, being extrinsically motivated and socially oriented or lack self-efficacy (National Education Association, 2006).
It is imperative that twice-exceptional students receive specialised assistance to reach their potential (Olenchak & Reis, 2002).
Best Practice For All Gifted Students
In order for gifted students to reach their potential, schools must implement a program of gifted services. This program of services must include:
A philosophy – clearly identifying the school’s beliefs underpinning the program
A mission statement – providing a general aim of the program
A policy including:
A definition of giftedness specific to the school population, including students who are yet to be identified such as twice-exceptional, culturally diverse and economically disadvantaged students;
Identification procedures and criteria, including multi-criteria, subjective and standardised instruments for both giftedness and talent, which are systematically linked to programs and service provisions and provided as early as possible;
Program goals and objectives;
Programs – provision of an array of research-based services, including qualitative differentiation in all curriculum content areas; extension and enrichment opportunities matched to student needs, readiness and interests (Bianco, Carothers & Smiley, 2009); grouping; acceleration; socio-emotional guidance and supports;
Personnel – dedicated, trained staff; a team of professionals overseeing the entire process;
Professional development – ongoing professional learning sessions for (at the least) key staff covering the breadth and depth of gifted education issues;
Budget;
Program evaluation – at regular intervals to monitor placement and service of students by assessing academic and socio-emotional growth of participants (Foley Nicpon et al, 2011; National Education Association, 2006; Purcell & Eckert, 2006; Robinson, Shore, & Enersen, 2007; Trail, 2011).
The policy must be clear, comprehensive, feasible and research-based (Purcell & Eckert, 2006).
Best Practice To Support All Twice-Exceptional Students
In addition to the above listed best practice for gifted students, it is vitally important for twice-exceptional students’ successful development that schools implement a program of twice-exceptional services, supplemented by the Special Education support services in the school. These include the employment of a Lead Coordinating Teacher, comprehensive assessment and Individual Education Programs for each student.
1. Lead Coordinating Teacher
A fundamental role in the supporting of twice-exceptional students is the dedicated staffing of a ‘Lead Coordinating Teacher’ (Assouline et al, 2013) who is assigned as a case manager working between Gifted Education and Learning Support and alongside the family. This Lead Coordinating Teacher should be a special education teacher whose primary function is to coordinate academic and behavioral plans, and maintain ongoing close communication between the parents and the school (Assouline et al, 2013). This teacher must have undergone recent professional development in gifted education in order to understand the plethora of issues facing twice-exceptional students. Research by Foley Nicpon et al (2013) uncovered interesting findings regarding gifted education professionals’ significantly greater knowledge and experience with twice-exceptionality than special educators and general classroom teachers; therefore, charged them with the responsibility of facilitating professional development opportunities for those outside the field of gifted education.
2. Comprehensive Assessment
It is imperative that a comprehensive evaluation is undertaken for students who display paradoxical behaviours. A comprehensive assessment is a thorough evaluation and interpretation of cognitive and academic strengths and weaknesses, which enables a diagnosis and intervention to follow (Assouline et al, 2013; Reis et al, 2014). Assessment must include both standardised tests of ability (eg. WISC, SB, CogAT) and performance (achievement tests such as PAT).
Intervention must include educational and social experiences tailored to the individual’s academic strengths and specific impairments (Purcell & Eckert, 2006). To conduct these assessments, staff must be thoroughly training in the assessment of disabilities, as well as having a thorough understanding of giftedness.
“Relying on brief or screening assessments to make a diagnosis may increase risk of inaccurate diagnostics or insufficient identification of academic strengths. Further, comprehensive assessment is necessary to avoid mistaking a student’s combination of strengths and weaknesses as a balanced average profile, which misses both the need for increased challenge as well as appropriate accommodation and interventions to address learning or mental health diagnoses.” (Assouline et al, 2013, Appendix, pp.1).
3. Individual Education Programs
All students who undergo a comprehensive assessment and are assessed as twice-exceptional must be provided an Individual Education Program (IEP). This program must provide:
Programs to challenge the student’s cognitive strengths. Differentiation must include modifications that are high enough to challenge a student, without the challenge being unachievable. This optimal challenge level should encourage students to develop perseverance, increasing their self-esteem, self-concept and self-efficacy and assist them to develop study habits required for further academic progress (Purcell & Eckert, 2006);
Programs to ameliorate deficits in areas of weakness, including academic and socio-emotional domains (Assouline et al, 2013; National Education Association, 2006; Reis et al, 2014; Townend et al, 2014).
The Response to Intervention (RtI) model may prove to be a beneficial model upon which to base interventions for twice-exceptional students in the future (Trail, 2011); however Assouline et al (2012) warn that RtI may not be enough due to these students’ complex neuropsychological profiles. Further, the capacity for RtI to address students’ strengths as well as challenges must be considered more thoroughly from a research perspective prior to implementation (Foley Nicpon et al, 2013).
Best Practice To Support The Needs of Gifted Students With ASD
As with the best practice to support all twice-exceptional students, gifted students with an ASD require a Lead Coordinating Teacher, comprehensive assessment and Individual Education Program for each student. For the student with ASD, the comprehensive assessment and program of services are specific to their disability, and outlined below.
1. Comprehensive Assessment
Accurate assessment is the first step in understanding the confusing discrepancies between these students’ cognitive, academic, adaptive functioning and socio-emotional profiles. This comprehensive assessment must include a psychoeducational battery of tests that thoroughly measures multiple dimensions of psychosocial behavior and cognitive ability (Assouline et al, 2009). All professionals involved with the assessment process must have experience in working with gifted students as well as expertise in diagnosing children with ASD. (Assouline et al, 2013; Foley Nicpon et al, 2011; Neihart, 2000; Trail, 2011). Parents must also be included in the process as they hold vital information regarding a student’s developmental history. The assessment must include a cognitive functioning evaluation, a psychosocial evaluation and an ASD evaluation.
Cognitive functioning evaluation in the form of IQ testing using the Wechsler Intelligence Scale for Children (4th edition) is vital. This individually administered IQ test is the best approach because it yields extensive information about both general and specific areas of ability (Assouline et al, 2013). It is very important that the subtest data is evaluated. The current practice of many psychologists to provide ‘words’ rather than ‘numbers’ in testing reports seriously affects the possible interpretation of student abilities and asynchrony depicted therein, due to the vagaries expressed in these descriptions of ranges of ability. It is, therefore, imperative to access numerical subtest scores. It is also vitally important that the assessing team be adept at interpreting this data, in order to interpret the relative weaknesses compared to relative strengths, to inform IEP decisions (Assouline et al, 2013; National Education Association, 2006; Neihart, 2000).
Psychosocial profile evaluation provides information about a student’s social functioning. It is important to include a screening tool such as the Behavioural Assessment System for Children, including the Self-Report form (National Education Association, 2006)
ASD evaluation is crucial for accurate diagnosis of an ASD. Screening tools that are appropriate include the Autism Diagnostic Observational Schedule (ADOS), Autism Diagnostic Interview – Revised (ADI-R) (Foley Nicpon, Assouline & Stinson, 2012), and the Vinelands Adaptive Behavior Scales (2nd edition) (National Education Association, 2006).
2. Program of Services (IEP)
Students with ASD commonly require the following eight generalized interventions:
1) Extension and enrichment for academic gifts in one or more academic areas eg non-negotiable inclusion in clustered or special classes for gifted students;
2) Intervention for interpersonal communication issues, which is often receptive language related eg. help the student learn ‘neurotypical’ (Attwood, 2007) socially acceptable ways of behaving;
3) Support to ameliorate personal or domestic daily living skills deficits eg. assist students with organizational challenges;
4) Support for poor socialisation skills - social awareness training such as Theory of Mind and counseling on relating to others, or introducing peers with similar interests;
5) Support for difficulties adapting to change;
6) Support for emotional difficulties - specific and targeted individual counseling by a psychologist, such as Mindfulness or “The Cool Kids program”;
7) Support for fine and gross motor coordination difficulties eg. providing adaptive technology to circumvent handwriting issues;
8) Support for career planning – investigate careers that are a good fit for the student’s gifts and areas of difficulty.
(Assouline et all, 2013; Foley Nicpon et al, 2011; National Education Association, 2006; Neihart, 2000; Olenchak & Reis, 2002); Purcell & Eckert, 2006; Reis et al, 2014; Townend et al, 2014; Trail, 2011).
It is essential that the selected interventions be research-based from the larger body of clinical and educational literature of students with co-existing diagnoses of giftedness and ASD (Foley Nicpon et al, 2011).
Marie’s parents were relieved once the assessment process concluded that Marie, in fact, was twice-exceptional and not just gifted. Instinctively, Marie’s parents knew that something ‘wasn’t quite right’ and were determined to ascertain what was causing Marie’s socialisation, organisational, emotional, mental health and motor difficulties. They described what they felt was a ‘merry-go-round’ of visiting a range of health professionals up until that point. Once the psychologist confirmed the diagnosis of ASD they felt empowered to plan interventions and work with Marie’s teachers and schools to ensure she had every opportunity to reach her potential.
Conclusion
“Growing up can be rough…It took a long while for me to get to this place,
to learn who I am. My days of hiding in the corner or crawling under a rock are over”.
Robison, 2007, pp8-9.
Twice-exception students with ASD face huge challenges. The combinations, ranges and significant number of innate dysfunctions make achieving their potential almost impossible without intervention. It is crucial for every twice-exceptional student’s long-term success in their academic, socio-emotional and daily living domains that schools implement specific interventions including comprehensive assessments and IEPs that are overseen by trained, dedicated staff. The ramifications of failing to do so will result in twice-exceptional students, especially those with ASDs, remaining hidden, underserved and chronically underachieving. Marie is one of the lucky ones. Her identification as gifted and her diagnosis with ASD were early. Interventions were targeted, specific, ongoing and successful. Marie is thriving, well-balanced and on-track to fulfilling her dreams.
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