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Understanding the critical role of parents in improving the identification and support of twice exceptional learners in the K–12 system

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Understanding the critical role of parents in improving the identification and support of twice exceptional learners in the K–12 system

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Understanding the Critical Role of Parents in Improving the Identification and Support of
Twice Exceptional Learners in the K–12 System
by
Hanna Tikkanen Merk

Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education

December 2021

© Copyright by Hanna Tikkanen Merk 2021
All Rights Reserved

The Committee for Hanna Tikkanen Merk certifies the approval of this Dissertation

Cathy Krop
Sandra Kaplan
Kimberly Ferrario, Committee Chair

Rossier School of Education
University of Southern California
2021

iv
Abstract
The identification and diagnosis of twice exceptional (2e) learners is often missed or delayed in
the K–12 system. When their unique needs are not addressed, 2e learners face academic and
socio-emotional challenges. This qualitative field study sought to understand parents’ role in 2e
diagnosis and access to supports. Data collection was conducted through in-depth interviews
following questionnaire responses of ten parents of 2e learners attending grades 4–11 in
California. All study participants indicated parent involvement was crucial to their child’s
accurate 2e diagnosis. Most parents were unaware of their right and responsibility to officially
request a free evaluation of their child from the school district. Over time, parents developed
specialized expertise to fill a perceived void in professionals’ knowledge about 2e learners.
Parents employed significant resources outside the school district for diagnosis and supports.
Parents’ socio-economic factors had an influence on the child’s access to diagnosis and supports.
The 2e parenting experience had an impact on the career progressions of some parents.
Investment in parent education was recommended to improve awareness of 2e characteristics,
path to diagnosis, and access to supports. Investment in teacher training and education was
recommended to increase awareness of 2e characteristics and to implement classroom best
practices to support 2e learners. Engaging in liberatory design thinking was recommended to
develop concrete plans for individual school districts to enhance the capacity and equity of
inclusive 2e learner education in the K–12 system.
Keywords: twice exceptional, parent involvement, 2e diagnosis, parent education,
inclusive education

v
Dedication
To my four exceptional children.

vi
Acknowledgements
I would like to thank my dissertation committee chair Dr. Kimberly Ferrario for her
guidance and unwavering support over the past 18 months. Your patience and responsiveness to
my yet another idea, a new draft, or an additional question, was exemplary. Thank you also to
the inspiration by Dr. Cathy Krop of the Organizational Change and Leadership program at the
USC Rossier School of Education. I will think of you fondly every time I pull out and put to
good use another tool from my organizational change toolkit. Thank you also to Dr. Sandra
Kaplan, whose extraordinary expertise in the field of special education was invaluable to this
work. Your questions and comments pushed me to test and sharpen my arguments, thus
improving the quality of the end product.
A special thank you to the parents who participated in this study. Your willingness to
share your personal experiences was as touching as it was invaluable to the research. It is my
hope the findings of this study will help many other parents on their journey through diagnosis
and access to supports for their 2e learners.
I would also like to thank my fellow classmates at the OCL program. The class
discussions, debates and discoveries over the past 2.5 years taught me more than any course
material ever could. While happy to conclude my dissertation, I am sad to finish the doctoral
program, as it means saying goodbye to this wonderful cohort.
Lastly, I would like to thank my dear husband Axel, who tirelessly supported me through
the trials and tribulations of this journey. Navigating the crosswinds of parenting, working, and
research is never easy, and with the additional challenges during the COVID-19 pandemic, it was
only possible thanks to having you as my experienced co-pilot from takeoff through landing.

vii
Table of Contents
Abstract .......................................................................................................................................... iv
Dedication ....................................................................................................................................... v
Acknowledgements ........................................................................................................................ vi
List of Tables ................................................................................................................................. ix
List of Figures ................................................................................................................................. x
Chapter One: Overview of the Study .............................................................................................. 1
Context and Background of the Problem ............................................................................ 1
Purpose of the Project and Research Questions .................................................................. 3
Importance of the Study ...................................................................................................... 4
Overview of Theoretical Framework .................................................................................. 5
Methodology ....................................................................................................................... 8
Definition of Terms ............................................................................................................. 9
Impact of COVID-19 on the Study ................................................................................... 10
Organization of the Study ................................................................................................. 11
Chapter Two: Literature Review .................................................................................................. 12
Characteristics of 2e Learners ........................................................................................... 12
Invisible Struggle With Emotional Toll ............................................................................ 20
Need for Tailored Instruction ............................................................................................ 21
Influence of Support ......................................................................................................... 22
Hurdles to Identification ................................................................................................... 23
Parents’ Role in Initiating Diagnosis ................................................................................ 29
Parental Influence on 2e Learner’s Self-Perception ......................................................... 32
Parents’ Role in Enabling and Advocating for Supports .................................................. 33
Conceptual Framework ..................................................................................................... 36

viii
Summary ........................................................................................................................... 41
Chapter Three: Methodology ........................................................................................................ 42
Overview of Design .......................................................................................................... 42
Research Setting and Participants ..................................................................................... 44
The Researcher .................................................................................................................. 47
Data Sources ..................................................................................................................... 48
Validity and Reliability ..................................................................................................... 57
Ethics ................................................................................................................................. 60
Chapter Four: Findings ................................................................................................................. 62
Participants ........................................................................................................................ 63
Findings ............................................................................................................................ 70
Summary ......................................................................................................................... 100
Chapter Five: Recommendations ................................................................................................ 103
Discussion of Findings .................................................................................................... 103
Recommendations for Practice ....................................................................................... 109
Limitations and Delimitations ......................................................................................... 116
Recommendations for Future Research .......................................................................... 117
Conclusion ...................................................................................................................... 118
References ................................................................................................................................... 120
Appendix A: Questionnaire ........................................................................................................ 131
Appendix B: Interview Protocol ................................................................................................. 135
Appendix C: Interview Introduction ........................................................................................... 137

ix
List of Tables
Table 1: Comparison of Behaviors and Characteristics of Gifted Students and 2e Learners ....... 19
Table 2: Data Sources and Analytical Approaches ....................................................................... 43
Table 3: Participant Overview ...................................................................................................... 46
Table 4: The Interview Protocol .................................................................................................... 53
Table 5: Participant Demographics ............................................................................................... 63
Table 6: Participants’ 2e Learner Child Demographics ................................................................ 64
Table 7: Age and Number of Years to Arrive at 2e Diagnosis ...................................................... 72
Table 8: Level of Involvement in 2e Learner’s Identification and Diagnosis .............................. 81
Table 9: Specialized Expertise Developed by Parents of 2e Learners .......................................... 86
Table 10: Private Resources Employed by Parents to Support 2e Learners ................................. 94
Table 11: Summary of Themes and Findings of the Study ......................................................... 101
Table 12: Summary of Recommendations .................................................................................. 114
Table 13: Examples for Implementation of Recommendations .................................................. 115
Appendix A: Questionnaire ......................................................................................................... 131
Appendix B: Interview Protocol ................................................................................................. 115

x
List of Figures
Figure 1: Bronfenbrenner Application to Challenging Identification of 2e Learners ................... 38
Figure 2: Gap Analysis Application to 2e Knowledge Gap .......................................................... 39
Figure 3: Conceptual Framework ................................................................................................. 40
Figure 4: Type of School Attended by Participants’ 2e Children ................................................. 65
Figure 5: Diagnosed Exceptionalities of Participants’ 2e Children .............................................. 66
Figure 6: Child’s Age and Number of Years to 2e Diagnosis ....................................................... 73
Figure 7: Closing the 2e Knowledge Gap ................................................................................... 110

1

Chapter One: Overview of the Study
The purpose of this qualitative field study was to understand the critical role parents of
twice exceptional (2e) learners play in the challenging identification process of 2e learners and
gaining access to supports in the K–12 system. The findings of the study may inform parent,
teacher and school district practices as they seek to help 2e learners reach their full potential. Ten
parents of diagnosed 2e learners participated in the study. A twice exceptional learner, often
referred to as 2e, is a learner who is both gifted and has a learning disability, for example a
learner that is gifted and dyslexic or gifted and has ADHD (van Viersen et al., 2016).
Identification of 2e learners is challenging due to many factors, which often leads to missed- or
misdiagnosis (Berninger & Abbott, 2013; Crepeau-Hobson & Bianco, 2011). Through expanding
parent knowledge about dual exceptionalities, parents can seek appropriate diagnosis and
supports for their 2e children which otherwise may not be made available to them both inside as
well as outside the school system.
Context and Background of the Problem
Estimates indicate there are at least 300,000 twice exceptional learners in K–12 schools
in the United States; in reality, the number of un-diagnosed 2e learners is likely to be
significantly higher (Baum & Owen, 2017; Clark, 2006; Neihart, 2008; Reis et al., 2014).
Identifying 2e students faces several hurdles often leading to delayed or missed diagnosis in the
K–12 system. Twice exceptional students reside at the intersection of two exceptionalities, which
may make them appear ill fit for either identity as well as invisible to the specialists warding
access to these identity groups. Thus, they risk being simultaneously ignored by the programs for
the gifted as well as outside of the protections of special needs education. Unless identified, 2e
learners’ diagnosis and access to supports may be delayed or missed (Berninger & Abbott,
2

2013). The challenging identification of twice exceptional learners creates a barrier to diagnosis,
and blocks access to teacher, parent and peer supports that are crucial for the development of
self-efficacy of these 2e students. Only once we are able to identify all 2e learners, will they have
a chance to have access to the support they need and deserve.
Hurdles to Identification of 2e Learners
There are several hurdles to the identification of 2e learners. Based on a meta-study of 43
empirical studies over 20 years, diagnosis of 2e learners is challenged by the interaction and
masking of the different exceptionalities, missing definition and legislation on a national level,
use of one-size for all diagnostics, as well as lack of teacher and specialist training (Foley-
Nicpon et al., 2011). Interaction of the two exceptionalities may cause masking, where giftedness
in one area may mask deficits in other areas (Berninger & Abbott, 2013; Foley-Nicpon et al.,
2011; van Viersen, et al., 2016). Standard curriculum-based assessments do not take into account
the deficit compensation and masking effects empirically found in twice exceptional students.
Despite their disabilities, twice exceptional students frequently perform on or near grade-level,
which makes it unlikely their exceptionalities are identified by standard assessments (Foley-
Nicpon et al., 2011), or by their teachers (Crepeau-Hobson & Bianco, 2011). Furthermore, 2e
learners do not fit what teachers or parents typically expect from a gifted student and are hence
rarely considered for gifted education. They are also prone to falling through the cracks during
standard learning difference screening, as their disabilities are often not visible on standard
curriculum-based assessments. In addition, research shows many 2e students compensate for
their areas of weakness by other skills, for example by using their well-developed verbal skills to
compensate for their learning disabilities, thus making identification more challenging (Van
Viersen et al., 2016).
3

Influence of Support
Support from parents, teachers, and peers can help 2e students navigate the complex
landscape of academic and social stress of adolescence, further burdened with being different.
Un-diagnosed 2e learners suffer from low self-image and low self-efficacy (Foley-Nicpon et al.,
2011), whereas the 2e diagnosis has a positive influence on their self-image and self-efficacy
(Lo, 2014). A Singapore study of 2e students found that perceived support from teachers,
parents, and peers greatly influences 2e students’ academic performance (Wang & Neihart,
2015b). Several studies have recognized the role of positive self-perception in fostering positive
school experience, which in turn increases the perceived self-efficacy of 2e students.
Identification of 2e students is imperative in order to tailor effective interventions that highlight
their individual strengths and accommodate and support their particular areas of weakness, as
well as to summon the crucial support from parents, teachers, and peers.
Lack of Prior Research on Role of Parents
Much of the existing research on twice exceptionality has been written by academics for
the use of professionals, including researchers, psychologists, and special education experts.
Emerging research is recognizing the role parents of 2e learners play in providing and advocating
for support, and in framing their child’s beliefs and expectations (Park et al., 2018; Reis &
Renzulli, 2021; Speirs Neumeister et al., 2013). There is currently very little research on the
critical role parents can play in the identification of 2e learners as the first step toward diagnosis
and access to supports.
Purpose of the Project and Research Questions
The purpose of this study was to understand the critical role parents play in the early
identification and access to supports of twice exceptional learners in the K–12 system, and to
4

inform parent practices navigating the K–12 system as they seek to help their 2e children.
Specifically, the study explored the critical knowledge and resources accumulated by parents of
ten 2e learners attending six different schools in 4
th
through 11
th
grade at the time of the study.
Nine of the ten 2e learners had at some point attended their local public schools; all ten were
currently attending private schools and a range of external programs to support the publicly
available programs. The study aimed to discover knowledge and resources these parents had
accumulated in order to understand and meet the needs of their 2e children, and how these
influenced the supports they were able to provide for their children. As such, three research
questions guided this study:
1. In the current K–12 system, what is the parents’ responsibility when they observe
behaviors and characteristics in their child that do not follow the norm?
2. What knowledge and motivation do parents currently have to advocate for their 2e child’s
diagnosis and access to supports?
3. How do environmental factors influence parents in advocating for their 2e child?
Analysis of the data yielded critical knowledge components that help parents identify the 2e
traits in their child, seek diagnosis, and advocate for their children in the K–12 system, as well as
recommendations for school districts regarding parent and teacher education about twice
exceptional learners’ identification and support needs.
Importance of the Study
To thrive and meet their full potential, 2e learners need individually tailored instruction
that specifically addresses their giftedness as well as their impairments (Berninger & Abbott,
2013; Jacobs, 2020; van Viersen et al., 2016), and a supportive environment to fend off high
levels of academic and social stress (Reis & Renzulli, 2021; Wen Wang & Neihart, 2015a).
5

Research shows 2e students often feel their school experience fails to assist them in learning to
their full potential (Gierczyk & Hornby, 2021; Willard-Holt et al., 2013). Unless identified, 2e
learners are unlikely to be diagnosed, and unlikely to receive the interventions and supports that
enable them to thrive and meet their full potential. If twice exceptional students will not reach
their full potential, the society may also not receive the full benefit of their exceptional gifts and
talents. It remains to be seen how many more Albert Einsteins, Thomas Edisons, Leonardo da
Vincis and Marie Curies – all of whom are thought to have been twice exceptional learners – the
world might have, if each 2e learner was identified and received the support they needed
(Disabled World, 2017).
To date, most research on 2e learners focuses on the diagnostics and supports among
professionals. This information is valuable to professionals that help support 2e children after
their diagnosis. Very little research has been published on the role of the family, and on the path
to identification of 2e learners before diagnosis. This work will contribute to the current
conversation and body of literature by highlighting the impact parents can have in the early
identification of 2e learners, and by suggesting concrete resources to educate parents about dual
exceptionalities. In order to improve parent education, the results of this study will decipher
pertinent information, make it available, and attract the attention of those parents who are
seeking this information. Disseminating the findings of this study to schools, parent
organizations, nonprofit organizations, and online databases may help other parents identify and
support their 2e children earlier and better than they otherwise could.
Overview of Theoretical Framework
Bronfenbrenner’s bio-ecological model and Clark and Estes’ gap analysis were used as
theoretical frameworks guiding this qualitative field study.
6

Bronfenbrenner’s Bio-Ecological Model
Bronfenbrenner’s bio-ecological systems theory depicts human development as a lifelong
process of interaction within a hierarchy of five concentric systems influencing the individual
(Bronfenbrenner, 1977; Bronfenbrenner, 1979; Bronfenbrenner, 2005). The hierarchy of the
systems starts with the child at the center, surrounded by the microsystem comprising the
immediate environment. The mesosystem refers to the interrelations between microsystem
actors, independent of the individual. The exosystem of extended family, neighbors, and media
encircles and influences in turn the meso- and microsystems. Surrounding the other four systems
is the macrosystem of ideologies, attitudes, and societal expectations. The fifth system is time,
called the chronosystem, indicating the evolving importance of various systems based on the
developmental age of the child. The model views the problem of practice in its context with
several layers of influence and recognizes that the factors contributing to the child’s development
are interlinked.
This study used Bronfenbrenner’s model to examine factors contributing to the missed
identification and misdiagnosis of 2e students on all levels of influence, and how these factors
are interlinked and interdependent. Starting with the 2e learner at the center, the model helps to
analyze the impact and engagement of the immediate environment including parents and teachers
(the microsystem); parent-teacher communication, teacher training, and access to special
education resources (the mesosystem); current screening practices, diagnostic tools, mandate for
disabilities, current laws, and funding (the exosystem); and ideologies, attitudes, societal
expectations (the macrosystem). Based on these, solutions can be formulated to aid the
identification and support development of both exceptionalities. The primary focus of this study
7

was on the parents of 2e students, who are microsystem level influencers, and the critical role
they played in the identification, path to diagnosis, and access to support for their 2e children.
Clark and Estes’ Gap Analysis
The gap analysis framework was developed by Richard Clark and Fred Estes to help
organizations reach their business goals by a performance improvement process based on
identifying and closing the gaps between their current performance and their target performance
goal (Clark & Estes, 2008). After determining the gap, a key step in the performance
improvement process is to determine whether the gap is caused by lack of knowledge,
motivation or organizational factors. Based on the analysis, solutions can be identified and
implemented within the knowledge, motivation, and organizational areas. While typically used
within organizations, the gap analysis can also be applied to an individual level as a development
tool to reach a specific goal that requires the attainment of additional knowledge, motivation, and
organizational competencies.
In this study, the gap analysis was applied to identify knowledge and motivational factors
that have enabled study participant parents to help their 2e children, and to identify the gap
between their prior level of knowledge or motivation across these factors. The desired long-term
outcome is to improve the identification of 2e learners by using parent education as the tool. The
underlying assumption is that through education, more parents may recognize the characteristics
of dual exceptionalities exhibited by their 2e children and seek diagnosis, thus opening the door
to appropriate supports. A further assumption is that parents recognize their child may be
struggling both academically and socio-emotionally, and are motivated to seek knowledge to
alleviate these struggles.
8

Conceptual Framework
These two theoretical models helped investigate the challenging identification of 2e
learners and the role of parents from two perspectives: to understand the impact parents can have
in the early identification and support of their 2e children using Bronfenbrenner’s model, and to
identify the concrete resources to educate parents to close the knowledge gap about dual
exceptionalities using the gap analysis. The parental impact can be conceptualized both as an
individual agency of parents, who are microsystem influencers to their children, as well as
structural forces related to parent education on meso- through macrosystems. The gap analysis is
a practical tool to identify the knowledge, motivational, and organizational factors that parents of
already diagnosed 2e students possess, and which are necessary for those with un-diagnosed 2e
learners to accumulate. These theoretical models helped to frame the parent education needs into
categories that are implementable by school districts, nonprofits, and parent organizations.
Methodology
As the purpose of the study was to understand the critical role of parents of 2e learners,
and the knowledge they perceived pertinent in order to help their children, a qualitative
methodological field study approach was well suited. Qualitative research concerns itself with
increasing the understanding of social phenomena, groups, and situations (Creswell & Creswell,
2018). Narrative and thematic analysis were employed as the specific strategies of inquiry.
Narrative analysis focuses on participants’ experiences, whereas thematic analysis is used to
develop themes emerging from the data to answer research questions (Ravitch & Carl, 2021). In-
depth interviews with parents of 2e students accompanied by a questionnaire were utilized as the
methods of data collection. Collected data was analyzed using an inductive and comparative
9

analysis strategy. Inductive and comparative data analysis aims to discover common patterns that
can be categorized into themes emerging from the collected data (Merriam & Tisdell, 2016).
Definition of Terms
This is a list of key concepts and terms used throughout the research, and the way they
are defined in the context of this study.
• Developmental Asynchrony means students can develop faster than their peers in one or
more areas, while at the same time being behind their peers in other areas. 2e students are
often asynchronous in their development (Bridges Academy, 2020).
• Disability can take many forms; this study focuses on learning disabilities that have a
challenging impact on the student’s learning process and outcomes.
• Dual Differentiation means modifications are made to the curriculum that cater both to
the advanced cognitive abilities of the student, as well as support or accommodate their
particular learning challenge.
• Exceptionality refers to a student’s ability or challenge that falls at the extremes of
statistical norms (Bridges Academy, 2020).
• Giftedness can take many forms; this study focuses on giftedness in the form of a high
cognitive potential measured by psychometric testing.
• Learning Difference is a diagnosed or undiagnosed learning challenge. Learning
disability and learning difference are often used interchangeably. Some sources make a
point of using the term learning difference to highlight that these individuals simply learn
differently. Other sources use the term learning disability to ensure such learners fall
under the protections of the Federal Individuals with Disabilities Education Act
(Learning Disabilities Association, 2021).
10

• Self-Concept is a collection of persons’ beliefs about themselves. Self-concept includes
concepts of self-image and self-esteem as well as the concept of ideal self (Leflot et al.,
2010).
• Self-Efficacy refers to persons’ confidence in their own abilities to complete a certain task
in a certain setting (Bandura, 2012).
• Socio-Emotional Development refers to the building of a child’s social and emotional
skills that are important to build resilience, self-regulation, and self-awareness.
• Strength-Based refers to an approach to teaching and curriculum design that puts the
primary focus on helping the student develop their area of strength while also supporting
areas of weakness.
• Twice exceptional refers to a learner with dual and opposing exceptionalities, for
example, a student that is cognitively gifted and dyslexic or gifted and has an Attention
Deficit Hyperactivity Disorder (van Viersen et al., 2016).
Impact of COVID-19 on the Study
While the COVID-19 pandemic had no direct impact on the background, purpose and
importance of the study, its influence was felt in three fundamental ways. First, the switch to
online learning negatively impacted students with special needs, including twice exceptional
learners, by cutting them off of the supports designed and deliverable only in brick-and-mortar
classroom settings. Second, parents of students with special needs, including 2e learners, were
stretched to their limits with balancing their own work, managing home schooling or daycare
needs of their children, and providing additional academic and socio-emotional support to their
children with special needs. Third, the data collection and participant checks for this study had to
take place solely through digital means, thus limiting the opportunity to deepen and broaden the
11

conversation as desired. On the other hand, the physical separation may have aided the
researcher in maintaining empathetic objectivity. In addition, the soaring interest in engaging
online resources combined with increasing digital literacy forced by COVID-19 may in the
medium and long term help disseminate the findings of this study and other resources to those
seeking them around the world.
Organization of the Study
This dissertation is presented in five chapters. Chapter One provided the introduction, the
background of the problem, purpose of the project, the research questions and the conceptual
framework used to approach the project. Chapter Two provides a review of the research
literature on twice exceptionality structured under five topic areas: Characteristics of 2e learners;
hurdles to identification; parents’ role in initiating diagnosis; parental influence on student’s self-
perception; and parents’ role in enabling and advocating for supports. In addition, it reviews
literature on the two theoretical models used to frame this study. Chapter Three describes the
chosen research design as well as the methods for data collection and analysis. Chapter Four
presents the findings of the study and the implications of the analysis. Finally, Chapter Five
discusses the findings of the study in relation to previous research, and proposes
recommendations based on the findings. Furthermore, it discusses limitations and areas for
improvement with the current study and identifies topics for which future research is
recommended.

12

Chapter Two: Literature Review
Much of the existing research on twice exceptionality is written by academics for the use
of professionals, including researchers, psychologists, and special education experts. It focuses
on screening, identification, characteristics, interventions, and support of 2e learners by
professionals. Emerging research is recognizing the role parents play in identifying their child’s
dual exceptionalities, in providing and advocating for support, and in framing their child’s
beliefs and expectations (Park et al., 2018; Rubenstein et al., 2015; Speirs Neumeister et al.,
2013). The purpose of this literature review is to reflect on the challenges of identifying 2e
learners and to investigate the potential role of parents in the identification and support of twice
exceptional learners in K–12 schools. This review covers literature under five topic areas that
emerged from the review process: Characteristics of 2e learners; hurdles to identification;
parents’ role in initiating diagnosis; parental influence on student’s self-perception; and parents’
role in enabling and advocating for supports. In addition, the review covers literature on
Bronfenbrenner’s Socio-Ecological Model and Clark and Estes’ KMO Framework, the two
theoretical models used in the study.
Characteristics of 2e Learners
In order to identify 2e learners, it is helpful to know for what characteristics to look. The
identifying characteristics vary depending on the type of dual exceptionality the learner exhibits,
as well as due to unique combination of talents and challenges and individual characteristics of
the learner. Four main types of dual exceptionalities are identified and discussed based on prior
research findings. While often appearing within the norm to the outside, research has presented
evidence that undiagnosed 2e learners frequently struggle with school and in social situations,
and suffer from a negative self-perception, causing an invisible burden on the child’s
13

development both academically as well as socio-emotionally. Based on prior research findings,
this burden can be lessened through tailored instruction on the academic side and parental
supports on the socio-emotional side, matching the characteristics of the individual 2e learner.
To put these characteristics in context, it is useful to understand how 2e is defined, and how that
definition has evolved over time. Part of this evolution is in response to the history of
controversy between gifted education and special education.
Definition of 2e
A twice exceptional learner is a student that is gifted or talented in one or more areas and
concurrently has one or more disabilities (Assouline & Whiteman, 2011; Foley-Nicpon et al.,
2011). More often than not, giftedness, in this context, is reduced to an equation of intelligence
with the IQ score as the measure of cognitive abilities. Adding more specificity and context, the
National Twice Exceptional Community of Practice created a more comprehensive definition in
2014 highlighting the fact that 2e individuals evidence exceptional ability and disability resulting
in a unique circumstance in which neither may be recognized or addressed (Baldwin et al.,
2015). Work by Reis and colleagues (2014) highlighted the importance of a shared operational
definition of 2e with implications for programs and practices to serve the complex needs of this
unique population with diverse needs. Their research-based recommendation promotes “the idea
that 2e students are not simply gifted and disabled…but rather should be viewed as complex
combinations of dualities” (Reis et al., 2014, p. 227). Many researchers have helped further map
the 2e space by categorizing different types of dual exceptionalities depending on the particular
learning disability the student presents (Dare & Nowicki, 2015; Foley-Nicpon et al., 2011;
Foley-Nicpon & Kim, 2018).
14

History of Controversy Between Gifted and Special Education
While researchers have hypothesized about the concept of dual exceptionality starting
with Hans Asperger in the 1940s, and even though research on the 2e population has increased
over the past 30 years, the topic area remains an obscure footnote within the specialization of
gifted and talented (GT) education (Reis et al., 2014). GT education promotes investing in the
talent development of those identified as gifted in order to reach their cognitive potential. Yet the
original premise of GT education, emphasizing the IQ score as the measure of intelligence as
articulated by Lewis Terman (1877-1956), has itself become controversial since the 1950s
(Warne, 2019). Criticizing the idea of fixed intelligence, contemporary research supports
evolving conceptions of intelligence and the role of education to increase social equity
(Matthews & Dai, 2014). Special Education, on the other hand, concerns itself with ensuring that
students with disabilities are provided access to general education. This historic controversy of
traditional models of gifted education not sufficiently addressing issues of equity, and the deficit
reduction orientation of the special education camp, are likely to have contributed to the all but
mutual exclusivity of the labels of giftedness and learning disability. As a result, many 2e
learners may be excluded from opportunities for the gifted, including talent development. As
Baum and Novak (2010) note: “for many educators, talent development is reserved for students
who are achieving at the top of their class” (p. 249). Since many 2e students’ school performance
is below their cognitive potential due to the challenges resulting from their learning difference,
these students are frequently ignored when selecting students for talent development (Baum &
Novak, 2010). Outside the area of gifted education, the twice exceptional term and concept
remain unknown or misunderstood (Foley-Nicpon et al., 2013).
15

Types of Dual Exceptionalities
In their 20-year review of research literature, Foley-Nicpon et al. (2011) identified 43
empirical studies that have examined three types of dual exceptionalities: 2e with specific
learning disabilities; 2e with attention deficit hyperactivity disorder (ADHD); and 2e with autism
spectrum disorder (ASD). Researchers Dare and Nowicki (2015) used a purposeful maximum
variation sampling combined with open-coding thematic analysis to identify commonalities and
differences between four types of dual exceptionalities, including specific learning disabilities,
attention issues, autism spectrum disorder, and emotional or behavioral disorder. Other
researchers have followed a similar grouping, and some focus their research in one or more of
the four types of dual exceptionalities under the twice exceptional sphere.
2e With Specific Learning Disabilities (GLD)
Specific learning disabilities (SLD) are neurologically based lifelong learner
characteristics that have an impact on the brain’s information processing functions. They affect
how the brain processes, stores, and retrieves information (American Psychiatric Association,
2021). Dyslexia, dysgraphia, and dyscalculia are examples of SLDs. Gifted students with
specific learning disabilities are sometimes referred to with the acronym GLD. Many gifted
students with specific learning disabilities develop coping strategies and work very hard to hide
and compensate for their area of weakness by using their area of strength (Baum & Owen, 2017;
Reis et. al., 2014).
This compensation, called a masking effect, causes one of the main challenges to the
identification of 2e learners with specific learning disabilities (Foley-Nicpon et al., 2013). Unless
identified and diagnosed, GLD students will neither receive the programming appropriate for
their giftedness nor the support for their disability (Dare & Nowicki, 2015). Even after diagnosis,
16

educational strategies for 2e students often focus on the weaknesses (Baum & Owen, 2017) thus
ignoring the giftedness and social issues. This is likely to cause the 2e student to continue
muddling through, but will not enable them to reach their full potential, nor will it address their
socio-emotional needs. Indeed, the academic self-concept of 2e learners is often very low, fueled
by feelings of inadequacy (Baldwin et al., 2015).
2e With Attention Deficit Hyperactivity Disorder (ADHD)
Gifted students with attention deficits constitute another type of 2e learners. Students
with ADHD may have difficulty with organization, paying attention, excessive fidgeting or
talking in a way that is not situation appropriate (American Psychiatric Association, 2021).
While parents or teachers are often the first to identify the signs of ADHD, the formal
identification is made by a psychiatrist or by a health professional. Given that there are
similarities between the behavior of gifted and ADHD learners, the giftedness of a 2e learner
with ADHD is easily overlooked during the ADHD diagnosis. In addition, as students with
ADHD typically have difficulties with sustained attention, they may not perform up to the level
of their intellectual ability in standardized testing, thus falling through the cracks of gifted
student identification (Fugate et al., 2013). As a result many 2e students with ADHD are labeled
as ADHD only, and not identified as gifted, thus blocking the access to content that would be
commensurate to the level of their intellect. Research suggests 2e students with ADHD suffer
from lower self-esteem, lower self-concept, and lower happiness scores than gifted students
without ADHD (Foley-Nicpon et al., 2012). Both GLD and 2e with ADHD students have a
heightened self-awareness about their differentness, which causes academic stress, emotional
anxiety, problems in peer relationships, and in family life (Foley-Nicpon et al., 2012).
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2e With Autism Spectrum Disorder (ASD)
Giftedness combined with autism spectrum disorder is another form of twice
exceptionalism. Autism spectrum disorder encompasses the formerly used categories of autism,
Asperger’s, and pervasive developmental disorder. ASD, in short, is a communication disorder
that affects the behavior and social interaction of the person and varies in both severity and
expression along the spectrum (American Psychiatric Association, 2021). Accurate identification
of 2e students with ASD is challenging as some of the behaviors associated with high ability, for
example the difficulty of finding intellectual peers, or intense focus on select areas of interest,
have similarities with high functioning ASD (Assouline & Whiteman, 2011; Foley-Nicpon &
Kim, 2018). Sequential, rather than parallel, diagnosis is therefore quite common, with the one
exceptionality discovered and attended to before the other (Baum & Owen, 2017). This could be
addressed by seeking the initial diagnosis from a professional with expertise in both giftedness
and in ASD (Assouline & Whiteman, 2011). However, this recommendation comes with the
obvious caveat that in order to seek a diagnosis from a professional with expertise in dual
exceptionalities, the teachers or parents must first acquire the knowledge, expertise, and
experience to suspect a dual exceptionality. This again points to the critical role of the parents of
2e learners at the fountainhead of the path to identification and diagnosis of 2e learners. To this
effect, newer research recommends dissemination of educational materials regarding dual
exceptionalities to parents and caregivers, as well as teachers and school personnel (Speirs
Neumeister et al., 2013; Besnoy et al., 2015; Foley-Nicpon & Kim, 2018).
2e With Emotional or Behavioral Disability (EBD)
Gifted students with EBD are the fourth and final group of 2e learners. EBD is a learning
disorder that has a negative impact on a student’s academic performance due to persistent and
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specific emotional or behavioral challenges (Reid et al., 2004). Fear, anxiety, compulsive
reactions, and difficulty of building or maintaining personal relationships are some of the
difficulties a learner with EBD might face (Salvia et al., 2010). Due to educators viewing the
EBD label negatively, 2e students with EBD are less likely to be given a chance to participate in
gifted education. Based on research by Bianco and Leech (2010), teachers are reluctant to refer
an EBD student to a gifted program even if their academic performance merits it. Their research
indicates that some teachers may hold the challenging behavior by some twice exceptional
students against them. Research about this final group of 2e students is very sparse, but the little
research that exists indicates that these 2e learners with EBD have been among the least often
identified (Morrison, 2001). Further research indicates that students with EBD in general suffer
from poor learning outcomes. Based on a meta-analysis of the academic status of students with
EDB indicated that students with EDB exhibited significant academic deficits in comparison to
their peers (Reid et al., 2004). This further emphasizes the importance of identification and
diagnosis of all types of 2e learners so that they can receive the support they need and deserve.
The first step toward identification is recognizing the identifying characteristics of twice
exceptional learners.
Identifying Characteristics
Recognizing twice exceptional learners is not easy. In order to recognize 2e learners,
educators and parents need to know what characteristics they are looking for, and understand
what behaviors may be involved. While each twice exceptional learner exhibits their own set of
characteristics following their unique combination of talents and disabilities, prior research has
identified some characteristics and behaviors commonly associated with 2e learners (Baldwin et
al., 2015). These behaviors and characteristics are summarized in Table 1.
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Table 1
Comparison of Behaviors and Characteristics of Gifted Students and 2e Learners
Indicator Recurrent gifted
behaviors and
characteristics
Possible 2e learner behaviors
and characteristics
Learning Easy: Ability to learn
basic things quickly and
retain information with
less repetition.
Difficult: Struggles to learn basic things. May need
strategies in order to acquire basic skill and
information.
Verbal skills High Variable: May demonstrate high verbal ability but
may also demonstrate extreme difficulty in
written language area. May use language
inappropriately.
Reading skills High Variable: May need strategies to learn. May mask
reading deficits through compensation.
Organization
skills
Variable Difficult: Usually struggles with organization.
Observation
skills
High High, but may have memory deficits.
Critical
thinking
High Exceptional: may demonstrate outstanding critical
thinking and decision-making skills
Attention High Variable: May be able to concentrate for long
periods in areas of interest.
Curiosity High High: May appear disrespectful when questioning
information and facts.
Creativity High High: Original and out of the box ideas. May
appear daydreaming.
Risk taking Willing to take risks Variable: Often unwilling to take risks in areas of
deficit; may take risks outside academics without
considering consequences.
Sense of
humor
Unusual Used to divert attention
Independence High Variable: Needs teacher support in deficit areas but
highly independent in other areas. Can appear
stubborn and inflexible.
Social skills Difficult: May feel
isolated
Difficult: Difficulty being accepted by peers, may
feel isolated
Leadership
ability
High High
Focused
interests
High High: Interests often outside of school

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Behaviors and characteristics listed in table 1 may be helpful in aiding the initial
identification, or inkling of twice exceptionality by teachers, and parents. Based on research by
Nielsen et al. (2000), Baldwin et al. (2015) adapted a list of behaviors and characteristics of
gifted students in comparison to 2e learners across a number of indicators, which may serve as a
tool for parents and teachers to indicate whether a further diagnosis of the student may be
beneficial. As noted on the left-hand-side of Table 1, gifted students without learning differences
commonly find learning easy, building on their high verbal and reading skills. 2e students, as
noted on the right hand side of Table 1, struggle to learn basic things, and demonstrate variable
verbal and reading skills. Gifted students and 2e students have similarly high observation skills
and creativity and curiosity levels. 2e students appear to have even higher critical thinking skills
than gifted students without learning differences. Their profiles diverge on their attention levels,
willingness to take risks, and independence. On the social and communication side, their profiles
appear fairly similar with both gifted and 2e learners having a difficult time developing social
skills yet exhibit high leadership skills. Failure to identify a 2e student with these behaviors and
characteristics may lead to a missed or misdiagnosis with the student continuing their invisible
struggle without receiving the help they need and deserve.
Invisible Struggle With Emotional Toll
Missed diagnosis or misdiagnosis of twice exceptionality may lead to underachievement,
adverse academic outcomes and emotional and social stress. Based on a 20-year review of
empirical literature, many 2e students suffered from internalized feelings of failure and anxiety
due to stressors and frustrations at school, including negative interactions with teachers and peers
(Foley-Nicpon et al., 2011). Other research has found that un-diagnosed 2e learners may
underachieve academically (Foley-Nicpon & Assouline, 2015), and suffer from low self-esteem
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and poor self-concept (Assouline & Whiteman, 2011). The social and emotional struggle of un-
diagnosed 2e learners remains less studied than the cognitive elements. To this effect, Foley-
Nicpon (2015) found it is important to understand the influence of the intersectionality of
giftedness and disability on the development of the 2e learners’ self-concept. Other researchers
have noted 2e learners’ high level of anxiety, anger, and poor self-concept due to the discrepancy
between their gifts, abilities, and academic performance (Baum & Owen, 2017; Reis et al.,
2014). Similarly, a study found socio-emotional problems were suffered by 61% of 2e students
(Yssel et al., 2010). This invisible emotional toll highlights the importance of identification,
diagnosis, and support, as well as the need to individually tailor instruction to address the
academic as well as socio-emotional needs of the 2e learner.
Need for Tailored Instruction
To thrive academically and emotionally, 2e students need individually tailored instruction
that specifically addresses their strengths and weaknesses. Research indicates that 2e learners
require a strength-based dual approach that focuses on developing the students’ strengths and
talents, while also supporting their specific disabilities (Assouline & Whiteman, 2011; Berninger
& Abbott, 2013; Foley-Nicpon et al., 2011; Foley-Nicpon et al., 2013; Gierczyk & Hornby,
2021; Jacobs, 2020; Willard-Holt & Morrison, 2013). When not receiving such supports, 2e
students may have negative school experiences and social interactions that can lead to under-
achievement, low self-confidence, frustration, depression, as well as behavioral issues. A meta-
study of 43 empirical studies found that many 2e students suffer from internalized feelings of
failure and anxiety due to stressors and frustrations at school, including negative interactions
with teachers and peers, and that their attitude toward school significantly improves after
receiving strength-oriented accommodations (Foley-Nicpon et al., 2011). Individually tailored
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instruction that emphasizes 2e students’ strengths and interests bolsters their self-confidence and
academic self-efficacy, which contributes to improvement in learning outcomes. Strength-based,
as opposed to a deficit-focused, instruction planning is well supported in the literature and hinges
on the educator’s understanding about both the giftedness and disabilities of the student
(Gierczyk & Hornby, 2021; Reis et al., 2014). A small but detailed study of 2e students in
Singapore found academic self-efficacy is linked to focus on individual areas of strength and
self-perceived strengths are found in areas in which the individual students are interested (Wang
& Neihart, 2015b). Twice exceptional students need individually tailored instruction that is
designed based on a thorough assessment of their learning profiles and specifically addresses
their impairments as well as their giftedness. A multigenerational family genetics study found
that 2e students with dyslexia may struggle throughout their school years and into adulthood if
not identified and given specialized instruction that fits their needs (Berninger & Abbott, 2013).
Twice exceptional students who are correctly diagnosed and receive individualized interventions
for both of their exceptionalities may exhibit increased academic self-efficacy that contributes to
learning outcomes. In addition, support by parents, teachers, and peers influences 2e students’
academic self-confidence and self-efficacy.
Influence of Support
Support from parents, teachers, and peers can help 2e students navigate the complex
landscape of academic and social stress of adolescence, further burdened with being different.
Twice exceptional students often struggle with low self-perception and perceived low support
from their home environments. A study of 90 adolescents found that on average, 2e students
have significantly lower self-concepts, and less positive perceptions of their relationships with
their mothers when compared to other students (Barber & Mueller, 2011). At the same time,
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other research stressed that family members are instrumental in supporting the socio-emotional
needs of their 2e children (Neumeister et al., 2013). Reis and Renzulli (2021) specifically focus
on the importance of the role of parents to nurture and encourage their 2e children. Academically
successful 2e students have a positive self-concept in their area of strength that appears to be
linked to perceived support from teachers, parents, and peers. A Singapore study of 2e students
found that perceived support from teachers, parents, and peers greatly influences 2e students’
academic performance (Wang & Neihart, 2015b). Finding true peers appears critical for the
development of 2e students’ positive self-perception, which is positively correlated with both
academic achievement and emotional wellbeing. True peers are individuals with equal passion
and competence in a shared talent area (Olszewski-Kubilius, 2010, p. 561). Wang and Neihart
(2015a) found that students self-reported the importance of peer support more frequently than
teacher or parent support; Barber and Mueller (2011) identified the importance of access to true
peers especially for 2e students’ emotional wellbeing. Both studies recognized the role of
positive self-perception in fostering positive school experience, which in turn increases the
perceived self-efficacy of 2e students. Identification of 2e students is imperative in order to tailor
effective interventions that highlight their individual strengths and accommodate and support
their particular areas of weakness, as well as to summon the crucial support from parents,
teachers, and peers.
Hurdles to Identification
Identification of 2e students faces several hurdles often leading to delayed or missed
diagnosis in the K–12 system. There are three ways in which identification of 2e students can be
missed: student identified as gifted but disability undiagnosed; student diagnosed as disabled, but
giftedness un-identified; neither giftedness nor disability diagnosed (Dare & Nowicki, 2015;
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Foley-Nicpon et al., 2011; Reis et al., 2014). Diagnosis of 2e students is challenged by the
interaction and masking of the different exceptionalities, missing definition and legislation on a
national level, use of ill-fit diagnostics, as well as lack of teacher and specialist training (Foley-
Nicpon et al., 2011). Expectations of giftedness may also be a hurdle, as twice exceptional
students do not often fit the picture teachers and parents have in their mind about what a gifted
student should look like (Neihart, 2008).
Interaction and Masking of Exceptionalities
Twice exceptional students have unique cognitive profiles characterized by both the
deficits linked to their particular disabilities as well as strengths associated with their particular
giftedness, which can interact in a way that masks their dual exceptionalities. According to a
Dutch study of 121 primary school children, gifted children with dyslexia performed in between
typically developing children and children with dyslexia indicating that typical weaknesses due
to dyslexia can be moderated by other skills which may mask literacy difficulties; this masking
can potentially cause dyslexia to remain undetected for a protracted time despite student
achievement being lower than expected based on the student’s cognitive ability (Van Viersen et
al., 2016). A study of 174 students with dyslexia in grades 1–9 found that giftedness in verbal
reasoning may partially compensate for dyslexia-caused deficits in some other areas including
reading. There are other areas, such as working memory, however, where such compensation is
not taking place (Berninger & Abbott, 2013). Forcing a learner with working memory
impairment to memorize spelling words or multiplication tables is not only futile but can cause a
cognitive overload that impedes on deeper learning and long-term memory transfer (Paas et al.,
2003). In addition to the diagnostic difficulties due to masking, missing guidance, and regulation
on national level may be to blame.
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Missing National Regulation
As gifted education is not regulated on national level, every state, or often even every
school district is left to define, identify, and support giftedness based on its own definition (Bell,
2020; Crepeau-Hobson & Bianco, 2010; Foley-Nicpon et al., 2011; Jacobs, 2020). Due to
missing regulation or funding on federal level, each state has the freedom to select its own
identification process based on its own definition of giftedness (Foley-Nicpon et al., 2011,
Jacobs, 2020). Furthermore, in the absence of federal level guidance, school districts often
default to standard curriculum-based achievement level tests as the means to identify and
channel students to their gifted and talented programs (Crepeau-Hobson & Bianco, 2010). Due to
rigid diagnostics used for identification of giftedness and learning disabilities, many 2e learners
remain undiagnosed or are misdiagnosed, and thus do not receive the programming that fits their
high ability, or the support they need for their disabilities (Dare & Nowicki, 2015). Thus, such
diagnostics are ill-fit for the purposes of identifying 2e learners.
Ill-Fit Diagnostics
Achievement level tests and screening tests are commonly used assessments to identify
students for gifted education and to identify potential learning disabilities. Due to their disability,
2e learners’ achievement on a curriculum-based achievement test is likely to be lower than their
cognitive ability, thus the giftedness of many 2e learners is usually not identified by such
assessments (Foley-Nicpon et al., 2011). In addition, if only a very low achievement level is used
to identify disabilities, 2e learners are prone to fall through the cracks as their superior
achievement in one or more talent areas masks deficits in other areas (Berninger & Abbott,
2013). Indeed, 2e learners’ composite test results may appear average or slightly below average
hence not triggering the cut-off point warranting a further look by special education services. As
26

2e learners often exhibit developmental asynchrony they may be ahead of their peers in some
subjects, while behind peers in other subjects, further complicating the suitability of curriculum-
based assessments. Furthermore, if only composite scores are used, the uneven ability profile of
a 2e student may result in high-ability scores in some areas being netted against low-ability
scores in other areas, thus missing the student’s giftedness as well as their disability (Ottone-
Cross et al., 2017). This leads to the high probability of neither the giftedness nor the disability
of a 2e learner being identified through such assessments. To date, there does not appear to be a
universally accepted screening protocol that would fully take into account student characteristics
that would encompass both giftedness and disabilities; In fact, it appears that the screening
processes for gifted programs and access to learning disability services appear mutually
exclusive (Assouline et al., 2010; Wormald et al., 2015). Based on the review of empirical
research on 2e learners, Crepeau-Hobson and Bianco (2011) proposed a model integrating
targeted assessments and a comprehensive evaluation with a three-tiered model of Response-to-
Intervention as the best way to identify twice exceptional learners. However, unless the child’s
parents or teachers are knowledgeable of the characteristics of twice exceptionality, and as these
particular evaluation methods are not typically employed in the K–12 system, teachers are
unlikely to recommend, or parents request, such testing. Teacher training might therefore
contribute to the challenge of identification of 2e learners.
Lack of Teacher Training
Teachers have a significant impact on the educational outcome and on the emotional
development of all students. However, outside the small sub-section of gifted-education, general
education teachers have limited awareness of dual exceptionalities (Foley-Nicpon et al., 2013).
To boot, they appear ill prepared to recognize and address the special needs of 2e learners
27

(Berman et al., 2012). As 2e learners tend to perform on or near grade level, and muddle through
curriculum-based assessments, they are rarely referred to special education or gifted testing by
their general education teachers, where such a comprehensive evaluation could take place
(Crepeau-Hobson & Bianco, 2011). Research also indicates newly minted teachers rarely have
the skills to recognize or address the needs of gifted or talented students. Based on analysis of
data collected over 3 years from 199 teacher education students, teacher training is not adequate
to create awareness and change teachers’ attitudes, or to build skills to address the needs of
gifted and talented students (Berman et al., 2012). Teachers themselves believe they are not well
prepared to meet the needs of students with special needs, including 2e learners. A large-scale
mixed-methods study of 971 newly graduated teachers found that teachers feel less than prepared
to teach learners with a range of abilities, to provide adequate support for learners with disability,
and to create partnerships with parents regarding the needs and support of their children (Rowan
& Townend, 2016). Other research highlights that twice exceptionality is often considered a
small sub-section of gifted education and recognizes the need for expanding professional
understanding in order to increase the services to 2e learners. A survey of 317 educators
indicated that gifted education professionals were more knowledgeable about 2e than other
educators or psychologists (Foley-Nicpon et al., 2013). Lacking teacher training regarding gifted
and special needs education in general, and dual exceptionalities in particular, may lead to many
2e learners flying under the radar of their general education teachers in the K–12 system. In
addition, teachers’ and parents’ expectations of giftedness may add a complicating factor.
Expectations of Giftedness
Teachers and parents have formed certain expectations about what a gifted student
typically looks like; when these expectations are not met, the student may not be considered a
28

candidate for testing for gifted education, even if they would qualify for it. Baum & Owen
(2017) observed that 2e students neither fit the stereotypical characteristics of gifted students, nor
the typical characteristics of students with disabilities, thus presenting a confusing enigma to
teachers. Based on a comprehensive review of empirical research, Neihart (2008) observed
teachers and parents equate giftedness with good academic performance, self-control, advanced
social skills, good study habits, and compliance with rules. However, 2e learners may exhibit
problematic behavior, resistance to schoolwork, disruptive behavior, hyperactivity, negative
attitude, and poor school performance, in particular before diagnosis and access to support
(Neihart, 2008). Therefore, Neihart (2008) posited 2e children are not getting identified because
they do not exhibit the kinds of behaviors that teachers and parents usually expect to see under
the gifted label. Additional research also supports the idea that 2e learners do not match teachers’
stereotypical expectations on how gifted students typically behave and perform, causing these
students to be blocked from access to services they deserve and would benefit from (Bianco &
Leech, 2010). In their mixed-methods study of 277 special education, general education, and
gifted education teachers, Bianco and Leech (2010) found evidence that teachers are much less
willing to refer a gifted and disabled student to gifted programs, than an identically described
student that does not have a disability label. The reluctance by teachers to refer disabled students
to gifted and talented programs has also been supported by more recent research. A 2015 study
of over 13,000 children diagnosed with disability found that while over 300 of the children tested
in or above the 90
th
percentile in achievement tests, only 33 of them had been referred to
programs for gifted and talented (Barnard-Brak et al., 2015). This means 89% of the gifted
students in this sample of 13,000 students with disabilities had not been identified as twice
exceptional and were not receiving the programming to match the level of their cognitive
29

abilities. Using this 89% missed-diagnosis rate as a proxy and applying it to the estimated
300,000 2e learners in the K–12 system, the total population of 2e learners would be over 2.7
million, with 2.4 million of them remaining undiagnosed and without access to supports.
Identification of 2e students is challenging due to the masking effect between
exceptionalities, lack of regulation and teacher training, the use of standard assessments that do
not take into account the deficit compensation empirically found in twice exceptional students, as
well as expectations of giftedness by teachers and parents. Due to misdiagnosis or missed
diagnosis, a large majority of twice exceptional students do not have access to individually
tailored instruction that matches their unique cognitive profiles.
Parents’ Role in Initiating Diagnosis
Relatively little is known about how parents become aware of the dual exceptionalities of
their children. However, a newer body of research is highlighting that parents are often the first
to recognize the signs of their child’s giftedness. Other research notes that parents’ face
dismissiveness about their observations of the characteristics of their child. Some research
indicates that family characteristics could be a factor in the parents’ role in initiating diagnosis.
Parents Are First to Recognize
In a study of five families with 2e children, each with a unique combination of strengths
and challenges, the parents were the initiators of the process leading to identification and
diagnosis (Dare & Nowicki, 2015). A study of 10 Asian American families finds that parents are
the first to recognize and attempt to address their child’s dual exceptionalities, and often have to
face a discrepancy between their own and the school’s perception of the 2e learner’s strengths,
weaknesses and support needs (Park et al., 2018). A case study of a 2e learner concludes that
parents were the initial identifiers of the twice exceptional characteristics of their child and had
30

to continuously re-confirm this with schools and professionals (Wormald et al., 2015). Similarly,
a study based on in-depth, semi-structured interviews with primary caregivers of academically
successful 2e students finds that the parent’s role was critical in recognizing the child’s
intelligence and co-existing disability (Speirs Neumeister et al., 2013). Research indicates that
parents may be not only the initial, but also the most accurate identifiers of the twice exceptional
characteristics of their child (Speirs Neumeister et al., 2013; Wormald et al., 2015). Given that 2e
learners are easily missed by teachers and by standard assessments, this research indicates that
parents could be critical catalysts for initiating 2e learners’ identification and diagnosis.
Parents Face Dismissiveness
Once parents recognize the signs of their child’s giftedness and disabilities, they
frequently have to push back on others being dismissive of these signs. An in-depth longitudinal
case study of a 2e learner recorded that the teacher of their academically gifted son with severe
learning disabilities would assume the child was developmentally delayed because he could not
write his name, and was thus excluded from reading groups in kindergarten. Only after proving
to the teacher via an IQ assessment that the child was in the upper range of intelligence, was the
child allowed to join the reading group. Shortly thereafter, the student learned to read and was
eventually advanced to the top reading group in kindergarten “to the surprise of the teacher”
(Wormald et al., 2015, p.130). The same researchers reported a recurring theme of the parents of
the 2e learner having to re-test and re-demonstrate his intellectual abilities at multiple occasions
during his K–12 schooling in order for him to receive access to both advanced learning as well as
to the support he needed. Other research notes that parents struggle with advocating for their 2e
children as the school system is not set up for their needs. A grounded theory study with 8
parents of elementary age 2e students found that the school systems ignored the parents’ efforts
31

to have the children’s disability diagnosed until these parents acquired professional knowledge
and fought their way to advocate for their children by using educational terminology and
identifying official policies that gave the parents the rights to request diagnosis (Besnoy et al.,
2015). Other studies have uncovered examples where the school personnel resisted providing
services to 2e learners even after an official diagnosis had taken place. A grounded theory study
of 10 sets of primary caregivers and 2e students found that school personnel would continue to
be resistant to provide services for diagnosed issues without the persistent and sometimes
adversity-facing advocacy by the parents (Speirs Neumeister et al., 2013).
Family Characteristics
Starting with Bronfenbrenner (1979), research reminds that family characteristics and
relationships can have a positive or negative impact on a child’s talent identification and
development. Based on the review of empirical research on the role of family in talent
development, Olszewski-Kubilius (2008) found that family characteristics, such as marginality
and generational history, as well as family relationships, including family conflict, affect the
family’s ability to recognize and support their children’s talents. Other research reminds of the
critical role of primary caregivers in supporting 2e learners’ talent development (Speirs
Neumeister, 2013). Trainor (2010) highlighted the importance of cultural and social capital,
intertwined with economic capital, on the effectiveness of parent advocacy, thus pointing at a
potential source of inequities. Based on interviews with families that actively advocated to get
their 2e children diagnosed and sought outside support as necessary, Dare and Nowicki (2015)
questioned what would happen to children from less privileged families who do not have the
resources to do the same. Along the same vein, Besnoy et al. (2015) concluded that successfully
advocating for 2e learners can be intimidating and overwhelming, requiring time, resources, and
32

the building of specialized knowledge to which parents from lower socioeconomic and culturally
diverse backgrounds may not have access. This indicates that family characteristics and
relationships may keep some 2e learners from being diagnosed, thus blocking equitable access to
support. In addition to parents’ potential role as the gateway to diagnosis and support, parents’
attitudes and actions may have an impact on the 2e learner’s development and self-perception.
Parental Influence on 2e Learner’s Self-Perception
In a review of research on families of gifted children, Olszewski-Kubilius (2008) found
the way a child is viewed by its family and surroundings has profound psychological effects on
the talent development process. She posited that if parents do not recognize and treat their twice
exceptional children as “smart” the children are unlikely to live up to their full intellectual
capacity. An example of this could be how parents provide access to stimulating extracurricular
activities more often to their “smart” child, than to a child they do not perceive as smart. This
indicates that the simple fact of labeling a child as smart may have an impact on how the child
develops. Similarly, the label of 2e has an impact on the child’s development.
Impact of 2e Diagnosis
While research indicates 2e students frequently feel a sense of failure and anxiety at
school, their attitude toward school significantly improves after diagnosis and receiving strength-
oriented accommodations (Foley-Nicpon et al., 2011). Similarly, Lo (2014) found 2e students
feel empowered after the diagnosis of their dual exceptionalities and that learning their potential
positively influences 2e students’ goal setting and self-advocacy. Lo (2014) contributed this
positive effect to the reconciliation of field-knowledge with self-knowledge. Specifically,
research indicates mothers, as opposed to teachers or other professionals, appear key in helping
2e students make sense of the labels following their diagnosis (Lo, 2014).
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Making Sense of 2e Label
This sense making is supported by the ideas presented by Bandura in his social cognitive
theory (1977), where he suggests parents can model behavior that has an impact on children’s
self-efficacy and self-esteem. Bandura (2005) further theorized that much of our learning is
through social modeling, which can be reinforced by goal setting and feedback to achieve
desired self-regulated behavior, thus increasing the self-efficacy of the individual. As an example
of Bandura’s theory in practice, research indicates parents’ role is critical in framing 2e child’s
beliefs and expectations (Speirs Neumeister et al., 2013). In addition to modeling effective
coping strategies and setting high expectations, parents can encourage independent thought and
help children develop the ability to work alone in a supportive psychological environment
(Olszewski-Kubilius, 2008). Recent research highlights the need for parents of 2e learners to
nurture and encourage their children’s strengths to compensate for the negative feedback from
teachers (Reis & Renzulli, 2021). Alas, the parents’ role is not always easy. Through often
challenging interactions with teachers, psychologists, school systems, and often conflicting
cultural expectations, parents of 2e children develop resilient parenting practices that adapt to the
needs of their twice exceptional children. A study of Asian American families of 2e children
found that parents find themselves in a variety of roles in their effort to instill perseverance, self-
determination, and self-advocacy in their 2e learners (Park et al., 2018).
Parents’ Role in Enabling and Advocating for Supports
Research indicates that 2e students may struggle throughout their school years and into
adulthood if not identified and given specialized instruction that fits their needs (Berninger &
Abbott, 2013). However, individualized and specialized instruction is rarely readily available in
the K–12 system, even after a 2e diagnosis takes place. The unique academic and social needs of
34

students with dual exceptionalities are often not met by typical educational environments, posing
a challenge for parents to step in to fill the void. Navigating the school system and providing
support to their 2e children, parents’ need specific knowledge and strategies.
Parents Step In to Fill the Void
A qualitative study of interviews with 13 parents of gifted students with autism spectrum
disorder found that the incompatibility between their child’s characteristics and educational
systems required them to take an active role in both finding and designing appropriate
educational opportunities for their children (Rubenstein et al., 2015). Similarly, a study based on
inductive and iterative data analysis of interviews with 10 Asian American families found that
parents of twice exceptional children find school services inadequate for their children’s learning
needs. In response, these parents are actively and directly involved in their children’s education,
apply persistent effort to advocate for their children inside the school system, and constantly
educate themselves and their children about twice exceptionality and support strategies (Park et
al., 2018). Findings of a small but thorough purposeful maximum variation study of five families
with 2e learners concluded that parents played a critical advocacy role for their 2e children (Dare
& Nowicki, 2015). The parents involved in the study were passionate in their support of their
children’s learning outcomes and used all their available resources to advocate for their children.
This indicates parents can have a crucial role to play in shaping the educational environment of
their 2e children. In their in-depth case study of an academically gifted student with severe
learning disabilities, Wormald et al. (2015) concluded that in the absence of school support,
parents played a critical role in the success or failure of their 2e child both academically as well
as in life. Researchers Reis and Renzulli (2021) call for a parenting paradigm shift from deficit
reduction to focusing on strengths to compensate for negative perceptions 2e students often face
35

from their teachers. Further research indicates such parents provide and seek support for their 2e
children despite the considerable cost and inconvenience (Speirs Neumeister, et al., 2013).
Need for Knowledge and Strategies
Finding such support is not always easy. Without help and access to professional
knowledge, many parents find advocating for their 2e children both intimidating and
overwhelming. Dare and Nowicki (2015) suggested that while their findings indicate parents are
often the first to recognize the characteristics indicating potential dual exceptionality, parents
cannot be assumed to have the skills and expertise to identify them as 2e. In addition, while
parents were found to play a critical advocacy role for their 2e children, they needed support to
be able to do so (Dare & Nowicki, 2015). A study based on interviews with 8 parents found that
all initially struggled with developing advocacy strategies, and only became successful advocates
for their 2e children after acquiring professional knowledge about educational terminology and
policies (Besnoy et al., 2015). Other research supports that teachers refuse to acknowledge the 2e
learner’s giftedness and their ability to achieve when supported with adjustments, leaving it to
the parents to figure out how to help their 2e child outside of the school system. As a result, 2e
learners may need a combination of education systems, specialists, and programs to address their
particular needs, the coordination and funding of which is left on the shoulders of the parents
(Wormald et al., 2015). This leads to inevitable questions involving equity: what happens to
diagnosed 2e learners whose parents do not have the time, education, resolve, and resources to
engage in this level of activism in advocacy for their twice exceptional children? And what
happens to the innumerable un-diagnosed 2e learners who may continue to underachieve
throughout their school years, while likely suffering from social isolation and poor self-concept?
36

Conceptual Framework
The conceptual framework for this study was built on applications of Bronfenbrenner’s
(2005) bio-ecological model and Clark and Estes’ (2008) Gap analysis, which were applied to
answer the three research questions:
1. In the current K–12 system, what is the parents’ responsibility when they observe
behaviors and characteristics in their child that do not follow the norm?
2. What knowledge and motivation do parents currently have to advocate for their 2e child’s
diagnosis and access to supports?
3. How do environmental factors influence parents in advocating for their 2e child?
Bronfenbrenner’s (2005) Bio-Ecological Model
Bronfrenbrenner’s original Biological Systems Theory (1977), and the two models based
on the theory—the Socio-Ecological Model (1979), and the Bio-Ecological Model (2005)—
capture the complexity of human development within the influence of multi-level environmental
factors. Later iterations of the model include proximal processes which take into account the
context within which actions happen which are influenced by the relationships within the system
(Bronfenbrenner, 2005). The holistic nature of the theory, emphasizing the interactive nature of
relationships in child development, seems to fit well with exploring 2e learners’ development
and interaction with their environment. Some 2e researchers have used these models to study the
effectiveness of evidence-based interventions for twice exceptional students (Besnoy et al.,
2015), whereas others have focused on the sociocultural context of the relationships between
learners, teachers, parents, and communities for diverse learners (Stack et al., 2016).
This study used Bronfenbrenner’s Socio-Ecological Model to investigate the crucial role
parents potentially play in helping their 2e children in their path to identification, diagnosis, and
37

support, and how they may be influenced by environmental factors. Bronfenbrenner’s model
helps to examine factors contributing to the missed identification and misdiagnosis of 2e learners
on all levels of influence, and how these factors are interlinked and interdependent. The model
identifies five levels of influence on human development surrounding the child: the microsystem
(parents, teachers); the mesosystem (interactions between microsystem actors); the exosystem
(extended family, neighbors, media, organizations, laws); the macrosystem (ideologies, social
expectations); and the chronosystem (time, development). These five levels help analyze specific
sources of influence while also providing a visual reminder of the hierarchy and interdependency
of the system. On each system level, one can formulate solutions to aid the identification and
support development of both exceptionalities.
Starting with the 2e learner at the center, one can analyze the impact and engagement of
the immediate environment including parents and teachers (the microsystem); parent-teacher
communication, teacher training, and access to special education resources (the mesosystem);
current screening practices, diagnostic tools, mandate for disabilities, current laws and funding
(the exosystem); and ideologies, attitudes, societal expectations (the macrosystem). According to
this model, a twice exceptional learner would start with a certain potential, which may or may
not be developed to the level of its full potential, depending on the interactions and activities
with people in their immediate proximity (Foley-Nicpon et al., 2018). This implies, for example,
that depending on their actions, parents and teachers could have a neutral, positive, or negative
influence on a 2e learner’s learning outcome and emotional wellbeing.
Figure 1 summarizes some of the key factors discovered during the literature review that
contribute to the challenging identification of 2e learners, and the researcher’s illustration of how
they might interact on the different levels of the Bronfenbrenner’s model.
38

Figure 1
Bronfenbrenner Application to Challenging Identification of 2e Learners

Clark and Estes’ (2008) Gap Analysis
The gap analysis by Clark and Estes (2008) is a practical framework for identifying and
addressing gaps between current performance and desired goals. The initial step in any gap
analysis is to determine the performance goals reflecting business goals of the organization. This
is followed by the measurement of the current performance, and the identification of the gap to
the goal performance. Each performance element is then evaluated to determine the root causes
for the gap. These causes are grouped under three categories of knowledge, motivation, and
organizational factors, collectively referred to as KMO influences (Clark & Estes, 2008).
Individual
• Unique cognitive profile characterized by strengths and deficits
(Van Viersen, Kroesbergen, Slot, and de Bree, 2016)
• Gap between intellectual capabilities and academic performance
(Berninger & Abbot, 2013)
• Low self-esteem (Foley Nicpon & al., 2011)
Microsystem
• Lack of true peers (Wang and Neihart, 2015)
• Inadequate teacher training (Foley Nicpon & al., 2011)
• Lack of individualized teaching (Berninger & Abbott, 2013)
• Missing parental support (Barber & Mueller, 2011)
Mesosystem
• Delayed or missing diagnosis due to interaction and masking of
different exceptionalities (Foley Nicpon & al., 2011)
• On-size fits all screening (Berninger and Abbot, 2013)
Exosystem
• Falls outside of existing support mandate, missing definition and legislation on a
national level (Foley Nicpon, Allmon, Sieck, and Stinson, 2011)
• Lack of resources for teacher training (Foley Nicpon & al., 2011)
Macrosystem
• Invisible struggle through school years and adulthood
(Berninger & Abbott, 2013)
• Lack of awareness (Barber & Mueller, 2011)
39

In this application, the research focused on the knowledge gap between what typical
parents and teachers know about dual exceptionalities compared to the specific knowledge
parents of 2e learners have acquired. Research question two is closely aligned with this
application of the gap analysis. The review of literature identified three topic areas where
specific parental knowledge acquisition was required from parents of 2e learners in order for
them to advocate for their children. These topic areas include initiating diagnosis; influencing 2e
learner’s self-perception; and enabling and advocating for supports. Figure 2 illustrates the gap in
knowledge between what typical parents and teachers know about dual exceptionalities and the
knowledge parents of 2e learners have acquired over time to support their 2e learner children.

Figure 2
Gap Analysis Application to 2e Knowledge Gap

Typical Parents and Teachers Parents of 2e Learners
2e
Knowledge
Gap
Specific parental knowledge required for:
• Initiating diagnosis (Speirs Neumeister et al.,
2013; Wormald et al., 2015 )
• Influencing 2e learner’s self-perception
(Olszewski-Kubilius, 2008; Lo, 2014)
• Enabling and advocating for supports (Rubenstein
et al., 2015; Dare & Nowicki, 2015)
Increasing Knowledge
40

Conceptual Framework: Applying Bronfenbrenner and Gap Analysis
Figure 3 combines Bronfenbrenner’s theory with the Gap Analysis as the basis for the
Conceptual Framework for this study. The key concepts of the study include parent knowledge,
advocacy, resources, and support, as well as their application through parent advocacy in order to
enhance the 2e learner’s self-efficacy in the context of the environment, with its laws,
expectations, attitudes, and practices. Of key interest is the gap in knowledge between typical
parents and the knowledge acquired by the parents of 2e learners in order to advocate effectively
for their children, thus enabling these 2e learners to improve their self-efficacy.

Figure 3
Conceptual Framework

Influence Self-
perception
Persist Against
Dismissiveness
Advocacy
First to Recognize
Signs
Sense-making
Resources and
Support
Knowledge
and Strategies
Masking Effect
Missing Regulation
Lack of Teacher
Training
Expectations
Screening
Practices
Undiagnosed
Parents of
Undiagnosed 2E
Learners
Diagnosed
Parents of
Diagnosed 2E
Learners

2E Knowledge
Gap
Macrosystem:
Environment – Laws – Practices - Attitudes
Individual
2E Learner
Microsystem
Exosystem
Mesosystem
Self-
Efficacy
41

Summary
In conclusion, research suggests parents can be critical catalysts for initiating 2e students’
identification and diagnosis. This opens the door to targeting and educating parents about twice
exceptionalities as a possible way to increase the chances a 2e learner is referred for a
comprehensive evaluation. Research also indicates parents’ attitudes and actions have profound
effects on the self-perception of 2e students. This again points to parent education as a
potentially powerful lever for improving the equitability of outcomes of 2e learners following
identification and diagnosis. Finally, research findings support the impact parents can have on
enabling and advocating for adequate supports for 2e learners. However, the parental perspective
is naturally only one side of this multivariable equation of dual exceptionalities. Future research
could include larger scale parent interviews to test these suggestions as well as interviewing 2e
learners themselves regarding what contributed to their success. This information could then be
used to build parent education programs about twice exceptionality for elementary and middle
school students, as well as student self-education programs for high-school-aged students.

42

Chapter Three: Methodology
The purpose of this field study was to understand the critical role parents of twice
exceptional children play in 2e learners’ early identification and access to supports in the K–12
system. 10 parents of 2e learners participated in the study. On their journey to help their own 2e
children, each of these parents had forged their own path through different systems and
specialists, discovering both roadblocks and resources on their way. The study aimed to discover
knowledge and resources these parents had accumulated in order to understand and meet the
needs of their 2e children, and how these influence the supports they are able to provide for their
children. Furthermore, the study was used to collect and compile knowledge and resources these
parents had built that could potentially help other parents as they seek to support their 2e
children. Three research questions guided this study:
1. In the current K–12 system, what is the parents’ responsibility when they observe
behaviors and characteristics in their child that do not follow the norm?
2. What knowledge and motivation do parents currently have to advocate for their 2e
child’s diagnosis and access to supports?
3. How do environmental factors influence parents in advocating for their 2e child?
This chapter describes the methodological design chosen to explore the topic, the
research setting, and the positionality of the researcher. Furthermore, it describes the data
collection and analysis processes, as well as the actions taken to ensure validity and reliability of
the study. Lastly, it summarizes ethical considerations of the study.
Overview of Design
The researcher chose a qualitative field study with supporting quantitative elements as the
methodological design for the field study. Qualitative research concerns itself with increasing the
43

understanding of social phenomena, groups, and situations (Creswell & Creswell, 2018).
Strategically combining qualitative and quantitative research methods with complementary
strengths is one way to strengthen the quality of research (Johnson & Christiansen, 2014). Given
the purpose of the study was to enhance the understanding of the critical role of parents’ of 2e
learners, a qualitative design was well suited. Narrative analysis and thematic analysis were
employed as the qualitative approaches to data analysis. The focus of narrative analysis is on the
individual experiences of the participants. Thematic analysis is used to develop themes emerging
from the data in response to the research questions (Ravitch & Carl, 2021). Descriptive statistics
focusing on measures of central tendency were employed as the quantitative approach to data
analysis. To collect data, a questionnaire and an interview protocol were designed. Table 2
summarizes how the two data collection methods were utilized with respect to the three research
questions of the study, as well as the analytical approaches applied.

Table 2
Data Sources and Analytical Approaches
Research question Questionnaire Interviews Analytical approach
RQ1: In the current K–12 system, what is
the parents’ responsibility when they
observe behaviors and characteristics in
their child that do not follow the norm?
√ √ Qual: Narrative and
thematic analysis
Quant: Measures of
central tendency
RQ2: What knowledge and motivation do
parents currently have to advocate for
their 2e child’s diagnosis and access to
supports?
√ Qual: Narrative and
thematic analysis
RQ3: How do environmental factors
influence parents in advocating for their
2e child?
√ √ Qual: Narrative and
thematic analysis
Quant: Measures of
central tendency
44

Research Setting and Participants
The target participants for the field study were parents of diagnosed twice exceptional
learners in the K–12 system that had deep knowledge to respond to the questionnaire and
interview questions. The common denominator of the participants was their personal experience
parenting a 2e learner, independent of any organizational affiliation. Building on
Bronfenbrenner’s (1977) model, each of the research participants is a part of their own unique
system of influence on the individual, micro-, and mesosystem levels, while sharing the same
broader exo- and macrosystem influencers and constraints. The rationale for participant selection
was to focus on parents that have personal experience with 2e learners and have built expertise in
how to support them independently from any organizational support structure. This also ensured
the participants had sufficient knowledge and relevant experience to respond to the questionnaire
and interview questions. The goal was to determine the knowledge and experience of these
particular parents in order to increase the understanding of the critical role of parents in the
identification, path to diagnosis, and access to supports for 2e learners.
Participant Selection Criteria
Three criteria were set for participant selection. The rationale for the criteria was to
identify parents who had sufficient access and knowledge about the 2e learners’ particular gifts,
challenges and support needs over a sufficiently long time to provide a rich description of their
2e children’s development both academically as well as socio-emotionally. The three participant
selection criteria were:
• Criterion 1: Parent of a child who has been identified as a twice exceptional learner.
• Criterion 2: The 2e learner has completed at least 2 years of K–12 education.
45

• Criterion 3: The 2e learner has been living full time with the participating parent during
these 2 years with this parent being (one of the) primary caretaker(s) for the student.
Participants
The participant group included 10 parents with 2e learners attending six different schools,
living in seven different public-school districts in California. Purposeful sampling was used to
select the participants. Purposeful sampling makes a strategic choice of selecting participants of a
specified profile for the interviews (Merriam & Tisdell, 2016). A typical purposeful sampling
strategy aims to highlight an average representative of the population as the study participant
(Maxwell, 2013). However, given that 2e students’ profiles are unique and vary widely from
each other, finding a typical participant would not be a good fit for this population. Therefore,
the researcher identified a unique sample of study participants from a range of different
circumstances and geographies.
Recruitment of the participants took place electronically via email. The researcher
contacted the Heads of School or Head Parent Representatives of three private schools in
California catering to children with learning disabilities and twice exceptional learners, asking
for their help in identifying participants fitting the criteria. The Heads of School or Head Parent
Representative forwarded the researcher’s introductory email to school parents. The introductory
email gave a general overview of the study objectives and explained that participation was
completely voluntary. The interested parents responded directly to the researcher without the
Head of School or Head Parent Representative knowing which parents chose to participate.
As potential participants responded to the email, the researcher confirmed they met the
study inclusion criteria. As a further check, the researcher reviewed the questionnaire responses
in order to exclude any participants responding with information contradictory to the inclusion
46

criteria. No such exclusions were necessary. To broaden the participant group further, each of the
original respondents was asked to pass on the introductory email to any other parents of 2e
learners they had knowledge of in other schools, especially in public schools. One of the
responding families was previously at one of the three California schools that were originally
contacted and had relocated to Arizona before the interviews took place, and was not included in
the participant group, given the different legal and educational frameworks of the two states. A
total of 10 qualified participants agreed to participate in the study. This number of participants
provided a good foundation for data collection, description, reconstruction, and tracking back to
original sources. Table 3 gives an overview of the participants and their 2e children.

Table 3
Participant Overview
Participant Family role Family status 2e child Gender identity Grade level
Amy Mom Married Anna Female 9
Becky Mom Married Blake Male 8
Charlie Mom Separated Chris Male 8
Debbie Mom Married Dylan Male 4
Elaine Mom Married Elton Male 6
Faith Mom Separated Forrest Male 7
Grace Mom Married George Male 11
Holly Mom Married Henry Male 5
Ike Dad Married Ina Female 8
June Mom Married Jake Male 11
47

The Researcher
In qualitative research, the experiences of the researcher influence the way the study is
framed and conducted (Creswell & Creswell, 2018). In this section, I, the researcher, reflect
upon my experiences and assumptions that underlie my interest in the topic. This reflection
makes my positionality explicit, and therefore may help mitigate biases and increase the
objectivity of the findings. I grew up in Finland in the 1970s and 1980s enjoying the offerings of
the highly acclaimed public school system that has received much attention in the past decades in
the educational circles. I loved learning, and worked hard, so it appeared logical I would do well
at school. In hindsight I have realized that I was a gifted, neuro-typical student who learned the
way schools typically teach. My own experience as a learner initially blinded me from
recognizing how a non-neuro-typical learner might not flourish under the same circumstances.
Having moved to California to build our family, our four children grew up attending some of the
best schools in the San Francisco Bay Area. Our eldest three children successfully navigated
schoolwork and social relationships alike. As an experienced mother already, I expected that this
is how all my children would be: working hard at school and receiving deservedly good results.
Our youngest, however, while highly intelligent with cognitive talents and problem-
solving abilities, had difficulties with seemingly uncomplicated things. She was working hard,
yet receiving more, and more negative feedback from school. During those long years our
daughter grew more and more frustrated with school and with herself. Unbeknown to us or to her
teachers, our daughter was both gifted and dyslexic. After years of seeking, I found some
research that pointed me in the right direction. Once I realized that our daughter might be twice
exceptional, I could seek appropriate diagnosis and advocate for her access to necessary supports.
48

That journey has been long and lonely, yet I gained an incredible amount of knowledge through
it. So much so that it propelled me to pursue a doctoral degree in the field of education.
To mitigate potential personal assumptions and biases during data collection and analysis,
I maintained empathic neutrality during the interviews and employed reflexivity in the
interpretation of data. Reflexivity is a strategy for improving the integrity of qualitative research
by making the researcher’s perspectives, assumptions, and biases clear (Maxwell, 2013). This
improves the understanding of the researcher’s perspective and how it may influence the
conclusions drawn by the researcher. Participant checks were additional strategies used to
mitigate personal biases.
Data Sources
The data sources utilized in the field study included a questionnaire and semi-structured
interviews. The sequencing of data collection activities was iterative so that findings from the
first data collection activity could be incorporated into improving the second activity.
Specifically, answers to the questionnaire informed the prompts for the interview questions, and
answers to prior interviews informed prompts to subsequent interviews. All 10 participants
completed the questionnaire and were interviewed by the researcher online via Zoom.
Questionnaire
Questionnaires are efficient instruments for collecting background and demographic data.
Among other things, they can also be useful in extracting participants’ perceptions and
behavioral intentions on specific topics (Johnson & Christensen, 2014). In this study, a
questionnaire of interview participants was used to collect background and demographic data, to
support and prepare for the in-depth interviews, and to collect quantitative data.
49

Instrumentation
The questionnaire (Appendix A) consisted of 17 questions divided into three sections.
Questions one through seven were background and demographic questions about the participants
themselves. Questions eight through 14 focused on the 2e child of the participant. Questions 15
and 16 were designed to inform the researcher about the role and perceptions of the participants.
The first 16 questions were closed-ended questions. The last question was an open-ended
question to invite any comments or clarifications to any of the prior questions or responses.
Several questions allowed participants to add additional items to response choices. Questions in
sections one and two used a nominal scale of measurement. Nominal scales refer to the use of
categories as choices, for example, for gender, or race (Salkind, 2017). Section three contained a
Likert ordinal scale measurement whereby the participant had to rank their perception of the
involvement level of the various system influencers surrounding their 2e learner child. Ordinal
scales of measurement rank the answers in ordered scales (Salkind, 2017).
The questionnaire was constructed using a purposeful questionnaire design process using
design thinking. Design thinking process consists of five phases that prompt to empathize,
understand, brainstorm, prototype, and pretest (Robinson & Leonard, 2019). To empathize and
understand, the researcher interviewed non-participant parents of 2e learners on the topic. Based
on the notes from these interviews, the researcher brainstormed with a fellow doctoral student to
develop the first draft of questions. These draft questions went through peer-editing as well as
dissertation advisor feedback loop. Finally, after editing, the questions were pretested with
parents of 2e learners who were non-participants to the study.
50

Data Collection Procedures
The study participants were contacted via email to introduce the project, to confirm the
confidentiality and volunteer-nature of the process, and to invite the participants to ask any
questions. Following this, the participants were emailed the link to the questionnaire in digital
form, which was conducted online using Qualtrics software. The questionnaire was estimated to
take 15 minutes. Two additional email reminders were sent to participants to encourage
questionnaire completion. All 10 questionnaires were completed in May 2021. After completion,
the results were submitted digitally to the researcher before the interviews took place. The
sequential administration enabled potential revisions of interview prompts based on
questionnaire responses. It also saved time during the interview for follow-up and open-ended
questions. Qualtrics software was used for the administration and reporting of the survey. Given
the small number of participants, a 100% response rate was attainable. The survey responses
were labeled with a code that only the researcher could link to personal identifying information.
The responses and codes were stored on the researcher’s password protected hard drive.
Data Analysis
Merriam and Tisdell (2016) described data analysis as the process of making sense of the
collected data. For typical surveys with a large number of participants, a wide array of
descriptive statistics can be calculated (Salkind, 2017). In the case of this field study, the
compact size of the participant group made such statistical analysis less useful than a more
individualized analysis of the collected data. Therefore, the data analysis of the questionnaire
responses consisted of summarizing, statistical analysis, and comparative analysis.
51

Summarizing. The purpose of the first section of the questionnaire was to capture a
background description of the participants, in order for the reader to get a thorough
understanding of the potential relevance or transferability of the findings to their own
stakeholders. The researcher summarized this data in tables.
Statistical Analysis. The second section of the questionnaire bracketed the individual
answers in a quantifiable frame. The researcher calculated the mean, frequency, and percentages
of the responses and presented the data in tables and charts.
Comparative Analysis. Questions ten through16 of the questionnaire were on topics that
were subsequently re-visited in the in-depth interviews. After these were concluded, the
researcher conducted a comparative analysis for each participant across the data sources to look
for similarities, differences (in facts or in perceptions), and inconsistencies between the collected
evidence from the questionnaire and the interview. In addition, the researcher compared and
contrasted the questionnaire responses of all the participants to identify commonalities and
themes that were later used as the a priori codes for coding the interview transcripts.
Interviews
Semi-structured in-depth interviews were chosen as the qualitative data collection method
of the study. A semi-structured interview format utilizes a predetermined list of questions or
topics to be explored, but lends the interviewer flexibility in terms of wording, order of questions,
and the exploration of ideas emerging during the interview (Merriam & Tisdell, 2016). As the
purpose of the study was to understand, the flexibility provided by the semi-structured design
was well suited, as it allowed for follow up questions and prompts that could clarify and deepen
the understanding between the researcher and the participant.
52

Instrumentation
The interview protocol (Appendix B) was used to guide the semi-structured interviews in
order to frame and focus the interviews around the research questions. Similarly, to the
questionnaire questions, the interview questions were developed using design thinking and a
purposeful survey design. The draft questions were peer-edited and revised based on instructor
feedback. Two 60-minute test interviews were conducted in November 2020 with parents of 2e
learners who were not participating in the study. Feedback and observations from these test
interviews, as well as researcher reflection, resulted in iterative revisions. Final revisions were
conducted after the questionnaire phase was concluded in May 2021, to incorporate the learning
into the interview protocol.
The interview protocol consisted of 11 open ended questions designed to: understand the
role of the parents as they observed behaviors and characteristics in their child that did not follow
the norm; identify the pertinent knowledge and experience of these parents; and discover
environmental factors that might be of influence as these parents worked toward the diagnosis
and access to support for their child. Questions one through four focused on understanding the
path to diagnosis and the role of the parent in that journey. Questions five, six, and nine focused
on the critical knowledge parents need to accumulate during the journey. Questions seven, eight,
and 10 focused on the environmental factors influencing the parents’ ability to advocate for their
2e children.
Table 4 lists the interview questions, the question type as defined by Patton (2002) and
the research question (RQ) being addressed by each interview question. Appendix B expands on
the interview questions, as well as for the research questions and key concepts addressed by each
question, potential probes, and the question type of each question.
53

Table 4
The Interview Protocol
Interview question Q type RQ
addressed
1. Please tell me about how you first noticed X might process
information differently from other children?

Sensory RQ1
2. Let’s think about the time between when you first noticed
X was different from other children until you found out
they are twice exceptional. What was that journey like?

Experience and
behavior
RQ1
3. What was your role and responsibility in that journey? Opinion and
values
RQ1
4. If or when you shared this diagnosis with X, how did they
feel when they found out they are twice exceptional?

Feeling RQ2
5. What did you have to learn along the journey that was
critical so that X could be accurately diagnosed?

Knowledge RQ2
6. What advice would you give another parents who are early
in the 2e journey, especially related to diagnosis and
support?

Knowledge RQ2
7. I am curious to learn how others were involved in this
journey. For example, what was the role of X’s teacher in
the diagnosis?

Experience and
behavior
RQ3
8. What was the school’s role in supporting X after diagnosis? Experience and
behavior
RQ3
9. What other support, if any, have you arranged or advocated
for X outside of school, and outside what you yourself can
provide?

Experience and
behavior
RQ2
10. In hindsight, what factors could have helped to arrive at the
diagnosis earlier?

Opinion and
values
RQ3
11. Anything else to add?

Question 11 was a catch-all to prompt for anything else the participant wanted to add that
has not come up in the questions. In addition to addressing the research questions, the 11
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interview questions were designed to stimulate responses utilizing five of the six types of
questions as defined by Patton (2002): experience and behavior (questions two and seven
through nine); opinion and values (questions three and 10); feeling (question four); knowledge
(questions five and six); sensory (question one). The remaining sixth question type – background
and demographic questions – was included in the questionnaire. Regarding key concepts,
interview questions one and seven addressed developmental asynchrony; questions one
addressed socio-emotional development; questions two and five addressed twice exceptionality;
question two addressed giftedness and learning difference; questions two and three addressed
family context; questions four, nine, and 10 address self-image; questions six through 10
addressed dual differentiation; questions eight through 10 addressed strength-based instruction;
question four addressed self-efficacy.
Data Collection Procedures
The study participants were contacted via email to find mutually agreeable times for the
interviews. Interview sessions were scheduled to take 60 minutes. Emails confirming the
interview appointments were sent out seven to ten days before the interviews took place. Before
each interview, participants received an introduction to the interview process (Appendix C). All
of the 10 interviews took place in May 2021.
Given the Covid-19 pandemic and resulting reluctance for face-to-face interviews, as
well as geographic distances across California, Zoom was chosen as the best alternative platform
for conducting the interviews. With the participants’ consent, Zoom platform was used also to
record each interview. This allowed the researcher to focus on listening to the interviewee’s
responses and on formulating follow-up questions, rather than on trying to capture compete notes
while listening. Recording can make it easier for the researcher to be attentive to the interview
55

participant while capturing exactly what was said, which notes often fail to do (Bogdan &
Biklen, 2007). As the goal was to understand the personal journey of the interview participants, it
was important to listen attentively and capture both the facts and emotions in order to paint a full
picture. As Bogdan and Biklen (2007) observed: “Note taking tends to simplify and flatten
respondent’s speech patterns” (p. 54). After the interviews, the researcher listened through the
recordings and prepared transcripts by using a voice to text program integrated in Zoom. This
review and transcription of interview data took place in June 2021. The recorded interviews and
transcripts were stored on the researcher’s password protected hard drive. The transcripts were
coded using the same reference codes as the questionnaire responses. The recorded interviews
were destroyed at the completion of the study.
Data Analysis
The interviews yielded a large amount of qualitative raw data. Analysis of qualitative
data is inductive and comparative (Merriam & Tisdell, 2016). The researcher applied an
integrative approach to data analysis. Integrative approach to qualitative data analysis iteratively
integrates the study design with data collection and analysis, as well as the selected theoretical
framework (Ravitch & Carl, 2021). To analyze the interview transcripts, the researcher used
transcript coding, category construction, and comparative analysis. This process resulted in
numerous themes related to each research question, as well as findings related to each theme.
The interview and questionnaire data provided the evidence for the findings.
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Transcript Coding. Merriam and Tisdell (2016) demystified the process of coding by
calling it “…nothing more than assigning some sort of shorthand designations to various aspects
of your data…” (p. 199). The first step of coding, often referred to as open coding, is comprised
of the researcher reading through the first interview transcript and noting interesting and
potentially important pieces of data in the margins. In addition, the researcher searched for the a
priori codes that had emerged from the questionnaire responses and the literature review.
The researcher coded the first interview immediately after the transcript was available,
shortly after the interview itself took place. This was important for two reasons: to record
researcher’s observations and field notes while the interview was still fresh in the researcher’s
mind, and to identify a set of codes to add to the a priori codes to look for in subsequent
interviews. The researcher assigned a two-digit code to each topic as shorthand. The first digit of
the code was related to the research question addressed, and the second digit to the topic
identified. After the second interview, the researcher combed through the second transcript line
by line for each code discovered in the first interview transcript, and assigned them the
appropriate codes. In addition, the researcher noted any additional interesting pieces of data that
were not captured by the codes from the first interview transcript or a priori codes. To these
pieces of data, the researcher assigned additional codes. The researcher then re-visited the first
interview transcript with the additional codes and coded them as appropriate. The same process
of coding transcripts, discovering new codes, and re-visiting all previous interview transcripts
was followed for each subsequent interview transcript. Such coding process is descriptive rather
than analytical, and helped the researcher retrieve and sort data in a meaningful way to aid
further analysis (Merriam & Tisdell, 2016). Concurrently with coding the interview transcripts
and developing new codes, the researcher summarized coding information separately from the
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transcripts in a codebook. A codebook includes the list of the researcher’s codes, the definitions
of the codes, analytic notes, and any other pertinent information about the coding scheme the
researcher has built (Gibbs, 2018).
Category Construction. After coding, the researcher took the raw coded data and
identified recurring themes around which to build categories of similar ideas. Merriam and
Tisdell (2016) refer to the process of sorting the open coding into categories as analytical or axial
coding. A category describes a larger idea that encompasses a pattern in the data. Gibbs (2018)
describes this process of categorization as a framework for indexing thematic ideas emerging
from the text. The emergent findings were categorized under these recurring themes identified by
the researcher.
Comparative Analysis. Comparative analysis is the process to find relationships
between data and its abstractions that go beyond the descriptive level (Gibbs, 2018). Following
category construction, the researcher analyzed the data comparing the participant responses in
each category and across the categories, looking for patterns, similarities and differences
between participants and contexts. Furthermore, the researcher hypothesized and theorized about
possible reasons for these patterns and relationships. The results of the comparative analysis
were presented in qualitative tables and in discussion.
Validity and Reliability
Validity of research refers to the evaluation of whether the measurement measures what it
is supposed to measure, whereas reliability refers to whether the same results would be received
every time the measurement was made (Salkind, 2014). According to Salkind (2014) there are at
least three types of validity, including content validity, criterion validity, and construct validity.
For this study, content and construct validity are of relevance, as it was questioning the parents’
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perceived knowledge as well as perceptions about their roles. Qualitative research in itself is
based on the assumption that reality is complex and evolving (Merriam & Tisdell, 2016). Along
the same lines, Maxwell (2013) poses that reality is relative and cannot really be captured.
Qualitative research, therefore, attempts to capture the understanding of the reality as the study
participants perceive it. Therefore, we can conclude that this study seeks validity in terms of
capturing the participants’ perceptions of the importance of their roles in 2e learners’ access to
diagnosis and supports.
Regarding reliability, everything else being equal, it is sensible to expect that the same
ten participants would have given the same answers to the same questions during any subsequent
questionnaires or interviews. Thus, for this study, the key consideration is internal rather than
external reliability. This study works to increase internal reliability by ensuring the findings are
consistent with the data collected. Furthermore, the study strives for consistency of themes by
numerically measuring the frequency of times a topic is brought up by the participants.
Credibility and Trustworthiness
While validity and reliability are the hallmarks of quantitative research, credibility and
trustworthiness are the commonly accepted measuring sticks for solid qualitative studies. In
order to be credible and trustworthy, a qualitative research study must be rigorous and holistic
(Merriam & Tisdell, 2016). To support the credibility and trustworthiness of the findings of this
field study, four specific strategies were employed: triangulation, member checks, adequate
engagement in data collection, and reflexivity.
Triangulation
Triangulation of research findings refers to the use of multiple sources, methods, or
researchers to confirm the internal validity or credibility of the research (Merriam & Tisdell,
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2016). Triangulation responds to the concern that conclusions would not be credible if they were
based on a single source, a single method, or the viewpoint of a single researcher (Patton, 2015).
This study used triangulation through the use of multiple sources of data collection, the use of
multiple methods of data analysis, and the use of two theoretical frameworks to analyze the
findings.
Member Checks
Member checks is a strategy for ensuring internal validity of the findings by soliciting
feedback on the preliminary findings from the participants to reduce the chance of
misinterpreting what the participants said (Maxwell, 2013). In this study, member checks were
conducted by sending the participant descriptions and interview transcripts back to the
participants for review and any necessary corrections. The researcher also reached out to the
participants for clarification or explanation in case of incongruence between questionnaire
responses and interview answers of the same participant. Lastly, the researcher invited all
participants to read, reflect and respond to the data analysis and findings sections of the study
and incorporated their responses in the editing of the findings.
Engagement in Data Collection
Adequate engagement in data collection is a strategy that revolves around the goal that
“data and emerging findings must feel saturated” (Merriam & Tisdell, 2016, p. 246). Patton
(2015) adds to this by urging the researcher to use discrepant case analysis to “look for data that
supports alternative explanations” (p. 653). This study utilized engagement in both the
development of the instrumentation, as well as in data collection. During instrumentation
development, the researcher sought numerous peer reviews of the questionnaire and interview
protocol and conducted mock interviews to test and improve the instruments. During the
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interviews, the researcher used the interview guide as a script to help keep the interview focused
as well as to help minimize personal reactions. Minimizing personal reactions
helps limit the researcher’s impact on the participant responses (Maxwell, 2013). During the data
collection, the researcher actively looked for alternative explanations and sought evidence to
back up any assumed causal relationships indicated by participants.
Reflexivity
Reflexivity is a strategy for improving the integrity of the qualitative research by making
the researcher’s perspectives, assumptions, and biases clear (Maxwell, 2013). This improves the
understanding of the researcher’s perspective and how it may influence the conclusions drawn by
the researcher. Reflexivity was employed by the researcher in stating and sharing her
positionality, in analyzing the data, and in drawing conclusions from the analysis.
Ethics
Rubin and Rubin (2012) identified three key principles for ethical behavior for the
researcher: respect the participants; do not pressure the participants; do not harm the participants.
The Institutional Review Board (IRB) is a formal group designated to oversee researchers’
ethical behavior by reviewing and monitoring research involving human subjects. The proposal
for this study was submitted to and reviewed by the University of Southern California IRB. The
researcher followed their rules to guide the research process in order to safeguard the
participants. For participants to understand their role and rights in the research process, it was
critical for the researcher to communicate the voluntary and confidential nature of their
participation before embarking on data collection. Before starting the questionnaire and
interviews, each participant was communicated the informed consent process. The informed
consent form included a summary overview of the study’s purpose and methods, as well as a
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confirmation that the participation is voluntary and that the participants’ identities were
confidential. Furthermore, it invited the participants to ask any questions. Confidentiality of the
identities was ensured by using pseudonyms for the participants and for the schools attended by
their children. The participants and their children were identified only by demographic and
descriptive information, including gender, grade level, type of exceptionality, age at 2e
diagnosis, and type of school attended previously. There was no compensation for the
participation in the study, and participation was completely voluntary. The study received no
outside funding and was not affiliated with any institution beyond the USC doctoral program of
the researcher.
The study provided an opportunity for participating parents to recall and reflect on the
stressful path to their child’s 2e diagnosis and the opportunity to make connections with other
parents with similar experiences. Furthermore, the study provided an opportunity for the
participating parents to help other parents of yet unidentified 2e learners on their path to
diagnosis and access to supports. The results will be disseminated to school districts and parent
organizations throughout California and the United States, as well as published via key
organizations and websites of nonprofits focusing on 2e topics making the findings available to
parents and educators worldwide.
Chapter Four summarizes the data collected through the questionnaire, the interviews,
and document analysis.
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Chapter Four: Findings
The purpose of this qualitative field study was to understand the critical role of parents of
twice exceptional children on their journey to seek accurate diagnosis and access to supports for
their 2e learner children currently in the K–12 system. The problem of practice was that the
diagnosis of 2e learners is often delayed, missed, or 2e learners are misdiagnosed, leading to
many 2e learners not receiving the supports they need in order to thrive academically and
emotionally. Three research questions were developed to guide the study:
1. In the current K–12 system, what is the parents’ responsibility when they observe
behaviors and characteristics in their child that do not follow the norm?
2. What knowledge and motivation do parents currently have to advocate for their 2e
child’s diagnosis and access to supports?
3. How do environmental factors influence parents in advocating for their 2e child?
The purpose of this chapter is to present the findings of the field study resulting from the
analysis of the collected data. Data analysis is the process of working with the data in order to
find patterns (Bogdan & Biklen, 2007). Data gathering took place through a questionnaire and
semi-structured interviews. The findings are based on a qualitative analysis of the interview data
and a quantitative analysis of the questionnaire data. The findings are grouped under themes that
emerged from the data analysis and are organized according to their relation to the research
questions. These themes are discussed drawing on evidence gathered from the questionnaire and
the interviews. The evidence is presented as frequency distributions and as direct quotations from
the interviews, and as numerical data from the questionnaire to provide the reader the
opportunity to confirm the findings and to aid further analysis or interpretation.
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Participants
All 10 participants in the purposeful sample were parents of diagnosed 2e learners
currently attending 4
th
through 11
th
grade at their respective schools in California. Demographic
information of the participants was collected through the pre-interview questionnaire. Additional
descriptive information about the participants was collected through the interviews and
subsequent email communications. All participants and their 2e learner children have been
assigned pseudonyms. The same pseudonyms are used throughout the study.
Participant Demographics
Table 5 summarizes demographic characteristics of study participants.

Table 5
Participant Demographics
Participant Race or
ethnicity
Highest level
of education
Income level Family
role
Marital
status
Amy White Master’s $150,000 + Mother Married
Becky White Master’s $150,000 + Mother Married
Charlie White/Black/
Native
Doctoral $100,000–$149,999 Mother Separated
Debbie Asian Doctoral $150,000 + Mother Married
Elaine White Doctoral $150,000 + Mother Married
Faith Asian/White Bachelor’s $100,000–$149,999 Mother Separated
Grace Black Master’s $150,000 + Mother Married
Holly White Master’s $150,000 + Mother Married
Ike White Master’s $150,000 + Father Married
June Black/White Bachelor’s $100,000–$149,999 Mother Married
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Five out of 10 participants self-identified as White, one as Black, one as Asian, one as
Black and White, one as Asian and White, and one as White, Black and Native. Three
participants had doctoral degrees, five master’s degrees, and two bachelor’s degrees. Three
participants were currently working toward doctoral degrees, each focusing on different aspects
of twice exceptionality. Seven participants were earning $150,000 or more per year. Three
participants were earning between $100,000 and $149,000 per year. Nine participants identified
as mothers and one as a father. Eight participants were currently married and two separated.
Table 6 summarizes demographic information collected through the questionnaire on
participants’ 2e children.

Table 6
Participants’ 2e Learner Child Demographics
2e
child
Current
grade
Gender
identity
Current
school type
1st diagnosed
exceptionality
Additional diagnosed
exceptionalities
Anna 9 Female Private
mainstream
GT ASD, EBD
Blake 8 Male Private
specialized in 2e
GT Dysgraphia, ASD,
EBD
Chris 8 Male Private
mainstream
ODD GT, dyslexia, ADHD,
EBD, other
Dylan 4 Male Private
specialized in SLD
GT Dysgraphia
Elton 6 Male Private
specialized in SLD
GT Dyslexia
Forrest 7 Male Private
specialized in SLD
ADHD Dyslexia, ASD
George 11 Male Private
specialized in 1-on-1
ASD GT, ADHD
Henry 5 Male Private
specialized in SLD
Dyslexia GT, dysgraphia,
ADHD
Ina 8 Female Private
specialized in SLD
Dyslexia GT, EBD
Jake 11 Male Private
specialized in 2e
ASD GT, ADHD
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The 2e children of the participants were enrolled as 4
th
through 11
th
grade students in six
different schools across California. The sample included three 8
th
graders and two 11
th
graders.
There were no 10
th
graders represented. Other grade levels had one representative each. Eight of
the students identified as male and two as female. All 10 students currently attended private
schools and nine out of 10 had at some point previously attended public schools in seven
different school districts. Five of the students were enrolled in schools specializing in students
with specific learning differences (SLD). Two students were enrolled in schools specializing in
twice exceptional learners. Two students attended private mainstream, not specialized, schools,
and had individual learning plans (ILP) in place. One student attended a private school offering
individualized instruction one-on-one with each teacher. Each participant chose to switch their
child from public to private schools in search of a supportive environment and expertise in
addressing the complex learning and socio-emotional needs of their 2e children. Figure 4
illustrates the school types attended by the 2e learner children of the study participants.

Figure 4
Type of School Attended by Participants’ 2e Children

0 1 2 3 4 5
Private specialized in 1-on-1
Private specialized in 2E
Private mainstream
Private specialized in SLD
Frequency of School Type (N=10)
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Four of the students had their high cognitive abilities, noted as gifted and talented (GT),
identified before their other exceptionalities. Two students were first identified with Autism
Spectrum Disorder (ASD) and two with dyslexia. One student was first identified with attention
deficit hyperactivity disorder (ADHD) and one was initially inaccurately diagnosed with
oppositional defiance disorder (ODD). All ten were subsequently diagnosed with additional
exceptionalities. At the time of the study, all 10 of the students had been diagnosed as GT, seven
with SLD, five with ASD, five with ADHD, and four with emotional behavioral disability
(EBD). The number of exceptionalities per student ranged from two to four, with a total of 31
diagnosed exceptionalities for the 10 students, resulting in a mean of 3.1 and standard deviation
of 0.7 exceptionalities per 2e child.
Figure 5 depicts the frequency distribution of the diagnosed exceptionalities of the 2e
learner children of the study participants.

Figure 5
Diagnosed Exceptionalities of Participants’ 2e Children

0 1 2 3 4 5 6 7 8 9 10
Emotional behavioral disorder (EBD)
Autism spectrum disorder (ASD)
Attention deficit hyperactivity disorder (ADHD)
Specific learning difference (SLD)
Gifted and talented (GT)
Frequency of Diagnoses (N=10)
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Participant Profiles
In addition to the demographic characteristics collected through the questionnaire, the
interviews and communications with study participants yielded additional descriptive
information on the background of the participants. This information has been summarized in
short vignettes about each participant to give the reader a richer description of the background
and situation of each study participant.
Amy
Leveraging her MBA and business experience, Amy has a deep background in marketing
and program management. Prompted by her search for support for her own 2e daughter, Amy
founded an educational nonprofit supporting 2e learners and their parents. She is concurrently
pursuing a doctorate degree in education at a program focusing on cognitive diversity in
education. Amy has also served as a volunteer and as a board member at the schools her three
children have attended.
Becky
With a focus on arts, Becky has worked with several CA nonprofits in executive and
development roles. Her expertise spans from community engagement and development to public
speaking and fundraising. Becky’s 2e son attends a private school specializing in strength-based
education for twice exceptional learners where she also serves as a parent representative.
Charlie
In addition to being a lecturer in a doctoral program, Charlie runs her own business
providing research and evaluation services to universities, educational organizations, and
professional learning programs. Charlie has a PhD in Education and serves on the board of
directors of the private school her 2e son attends. As a single parent with a career in education,
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the cost of the diagnosis and the on-going battle to acquire necessary supports has been
particularly challenging.
Debbie
Debbie is a licensed psychologist and a professor of psychiatry. Parenting her own 2e
son was one of the driving factors for Debbie to direct her professional interest to
neurodevelopment. Debbie’s children attend a private school catering to children with dyslexia,
some of whom are also twice exceptional. Debbie continues to seek a program for her son that
would help develop his unique strengths while also catering to his support needs.
Elaine
Elaine is a theater director, a teacher, and a mentor. After having completed her doctorate
in the humanities, she now serves in leadership roles at several educational nonprofits advocating
for her students and issues of social justice, healthcare, education, and the arts. Elaine’s son
attends a private school for students with dyslexia.
Faith
After several years as an elementary school teacher and assistant principal, Faith became
a full-time parent to focus on bringing up her own children. As a frequent volunteer at her
children’s public school, she had the opportunity to observe her child’s struggle to learn to read
the way the students were being taught. After her child’s 2e diagnosis, Faith re-entered the
workforce full time in business operations in order to afford the tuition for her son to attend a
school specializing in dyslexia.
Grace
After working in media and event organization, Grace chose the career of a stay-at-home
parent to her four children. Advocating for her 2e son has become almost a full time occupation
69

itself. Arriving at the accurate diagnosis and patching together the necessary supports from
public and private sources has necessitated Grace to become an expert in parent advocacy,
special education, gifted education, due process, equal access, neuropsychiatric testing,
pediatrics, law, and insurance.
Holly
An interaction designer by training, Holly is a start-up founder and has led design teams
at Silicon Valley tech companies. A mother of three, Holly serves as a board member of a private
school and a parent education advocate for twice exceptional and neuro-diverse children. She is
currently pursuing a doctorate in education focusing on cognitive diversity while also working in
administration at a private school specializing in dyslexia that her 2e son attends.
Ike
After graduating with degrees in computer science and economics, Ike put his analytical
mind to work in the field of finance. A published author and a globally recognized expert, Ike is
a frequent speaker and commentator at conferences and media. The diagnosis of his daughter’s
giftedness combined with her dyslexia made Ike realize that he himself is likely to be an
undiagnosed dyslexic. Ike’s 2e daughter attends a private school catering to students with
dyslexia.
June
June is an IT training specialist and a learning and development program designer. Her
child is attending a private school tailored to 2e learners. Prompted by her desire to understand
and support her child’s academic and socio-emotional development, Amy is currently pursuing a
doctorate in Education with the specific focus of curriculum development for 2e learners.
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Findings
The following sections present the findings and evidence categorized under themes,
which are sorted according to the corresponding research questions.
Research Question 1: In the Current K–12 system, What Is the Parents’ Responsibility
When They Observe Behaviors and Characteristics in Their Child That Do Not Follow the
Norm?
In the current K–12 system, it is the parents’ responsibility to request an evaluation of the
student’s learning differences from the school district when they recognize behaviors and
characteristics that do not follow the norm. A key thing to distinguish is that such an evaluation
is available if and only if requested, and it is not offered unless the parent knows how to go
through the requesting process. None of the 10 parents participating in this study were offered
educational evaluation of their 2e learner children, nor advised to request it by their public
schools, regardless of the classroom issues and struggles that were documented by the teachers
and other school staff. Six of the10 parents were initially unaware that such testing was
available, and what the process was to request it. Eventually, all 10 parents, even those who
received the requested public testing, decided to seek an outside evaluation of their child’s
learning differences in order for their 2e learners to be accurately diagnosed and have access to
the support services they qualified for.
This disconnect about the responsibility and process contributed to a time-lag between
the initial observation of exceptionalities, and the official diagnosis of multiple exceptionalities,
thus opening the door to the much needed accommodations and modifications for the 2e learners.
Furthermore, as the responsibility rested squarely on the parent to request, arrange, and advocate
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for evaluation and supports, the parent had a crucial role to play on the 2e learner’s path to
diagnosis and supports.
Two key themes emerged from the data analysis in response to the first research question:
(1) On average, a several year time lag exists between a parental observation of the child’s
exceptionalities and the reaching of a 2e diagnosis; (2) The involvement of the parent is crucial
to the identification of exceptionalities and the 2e diagnosis. The following discussion
summarizes the evidence to support findings relating to these themes and presents the data in
tables, graphs and quotations.
Theme 1: Time Lag Exists Between Observation and 2e Diagnosis
Given their proximity and duration of time spent together, it is not surprising parents are
likely to be the first to recognize both their child’s strengths as well as areas of challenge that
might fall outside the norm. However, such recognition does not necessarily lead either to the
identification of the exceptionality, or to the accurate 2e diagnosis until many years later. Based
on the questionnaire responses of the 10 participant parents, the average time lag between
parental observation and 2e diagnosis was 4.1 years, with a range from 1 to 8 years. Each of the
10 interviewed parents recalled they were the first to observe the exceptionalities in their
children’s behaviors and characteristics.
Parents Are First to Notice Exceptionalities. Seven of the 10 participating parents first
observed their child was possibly processing information differently than other children while
their child was in, or before, preschool age. While some parents noticed exceptionalities in their
children already before their first birthdays, the child’s average age for this initial observation
was 3.0 years. The child’s first exceptionality was diagnosed at the average age of 5.6 years, with
a range from one to 11 years of age. Amy, a mother of a gifted daughter with autism recalled:
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In preschool we definitely noticed there were some differences…Anna tended to like to
do her own thing…by age three she could read really well and by four she was writing
full sentences…we started to notice a few sensory things, like she really hated humming
and whistling.
Table 7 displays the approximate age at which the parent initially observed an
exceptionality, the age at the first diagnosis and the second diagnosis discovering a further, or
multiple exceptionalities, and time in years from the observation to the 2e diagnosis.

Table 7
Age and Number of Years to Arrive at 2e Diagnosis

Approximate age of child in years
2e child
When difference
observed At 1st diagnosis At 2e diagnosis
Years to 2e
diagnosis
Elton 1 8 9 8
George 3 11 11 8
Anna 5 7 12 7
Dylan 1 1 5 4
Forrest 3 5 7 4
Ina 6 10 10 4
Chris 3 3 5 2
Jake 1 3 3 2
Blake 1 2 2 1
Henry 6 6 7 1
Mean 3.0 5.6 7.1 4.1

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The remaining three participants identified information processing differences during
their child’s K or 1
st
grade, while in retrospect realizing that the signs were there from much
earlier on. Holly, a mother of a gifted son with dyslexia shared: “Henry was a very challenging
child…he was extremely sensitive, he always needed more explanation of what was going to
happen and why…he was always trying to catch us out in a little inconsistency.” The diagnosis
of the second exceptionality, thus making the discovery of 2e, was on average arrived at age 7.1
years, with a range of 2 to 12 years.
Figure 6 depicts the child’s age in years at the time the first exceptionality was initially
observed, the age in years at the time of the 2e diagnosis, and the number of years it took from
the initial observation to the official 2e diagnosis. The time lag between the initial observation of
exceptionalities and the 2e diagnosis ranged between 1 and 8 years, with an average of 4.1 years.
During this time lag, parents often faced dismissiveness of the concerns they voiced about the
exceptionalities they observed in their children.

Figure 6
Child’s Age and Number of Years to 2e Diagnosis

0
1
2
3
4
5
6
7
8
9
10
11
12
0
1
2
3
4
5
6
7
8
9
10
11
12
Elton George Anna Dylan Forrest Ina Chris Jake Blake Henry
Years to 2E Diagnosis
Child's Age in Years
Age When Difference Observed Age at 2E Diagnosis Years to 2E Diagnosis
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Parents Face Dismissiveness of Their Concerns. Seven of the 10 interviewed parents
recalled they had to persevere against dismissiveness of their concerns about their 2e children.
Some of this push back came from individual teachers, school administration or health care
professionals. Other push back appeared systemic. Amy shared: “The teachers just said, oh she is
just a little more introverted…everyone was [saying] she is really bright…no one at the school
was noticing these sensory things.” Similarly, Becky, a mother of a gifted son with autism
recalled:
[Blake] had sensory processing issues and severe anxieties, to the point when he started
preschool he actually bit all of his fingernails off…but everyone was so dazzled at his
ability to read Harry Potter at age four that everyone said, oh he will catch up
later…nobody wanted to address [those issues].
In addition to facing dismissiveness of their concerns, some parents felt judged and subordinated
by other micro-level influencers of their child.
Parents Feel Judged and Subordinated When Bringing Up Concerns. Three of the 10
interviewed parents felt they were being judged as parents when bringing up their concerns to
school personnel. Holly shared: “We kept saying something doesn’t seem right here, and they
just kept telling us to stop being alpha parents.” Four of the 10 parents felt teachers were
generally focusing on student behavior rather than on whether the student’s unique learning
needs were met. Charlie, a mother of a gifted and autistic son shared: “Teachers started labeling
him as a defiant child…we have struggled all throughout his educational journey with teachers
viewing his behavior in the classroom as defiance.” These parents felt they were in a position of
subordination in trying to bring up their concerns.

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Charlie continued:
In the pediatrician’s office, and the principal’s office, in the teacher’s office…they are
telling you what should be the case for your child, what the action should be, and what
the outcomes should be, and then there is the reality of what your child is experiencing
and what you are experiencing, and those often are very different realities.
The dismissiveness of parental concerns, combined with judgmental responses and subordination
may have contributed to the time lag between parental observation and accurate 2e diagnosis.
Time Lag of 2e Diagnosis Could Have Been Shortened. In retrospect, seven of the 10
parents felt the 2e diagnosis of their children could have taken place earlier, if teachers, school
staff, and other professionals they turned to with their concerns had taken their observations
seriously. All 10 participants felt they needed to go outside the public school system to seek an
accurate diagnosis. Holly summarized: “We could have caught [dyslexia] earlier, if people had
listened to our concerns, if I would have known to ignore these people pushing back and gone to
get an outside evaluation.” Some parents attributed the push back or lack of action to systemic
causes. Ike, the father of a gifted daughter with dyslexia mentioned:
The individual teacher cannot do anything, and the individual parent doesn’t have the
power to change the school if they decided your child doesn’t warrant any intervention.
There was a political process that was way beyond the power of a parent, or at least most
parents.
The involvement of parents to act on the observed exceptionalities and seek diagnosis for their
2e children may be an important factor to determine whether or not an accurate 2e diagnosis can
be achieved.
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Theme 2: Parent Involvement Is Crucial to 2e Diagnosis
Parent involvement appears crucial to move the process from parental observation and
identification of their child’s exceptionalities to the accurate 2e diagnosis. Other microsystem
influencers appear to have a variable level of involvement in the process leading to the diagnosis.
Uniform Perception of Importance of Parent Involvement. All 10 participants
indicated the involvement of at least one of the parents was crucial to the identification and
diagnosis of their 2e child’s exceptionalities. Nine out of 10 parent participants recalled their
own involvement as crucial. Two out of 10 participants indicated the second parent was crucial
to the process. Equally, two out of 10 participants indicated the second parent was not involved,
whereas six participants indicated the second parent had a significant level of involvement in the
process leading to their 2e child’s diagnosis. Debbie, a psychiatrist and mother of a gifted son
with dysgraphia, who is currently attending a private school for children with dyslexia explained:
“If I didn’t exist, Dylan would be in public school, probably a year behind, doing mediocre…I
am imagining my son probably having a lot of outbursts and behavioral problems, potentially he
is very anxious.” Elaine, a nonprofit executive with a doctoral degree shared: “None of [the
diagnosis] would have happened if it weren’t for me.” This need to seek the diagnosis stemmed
commonly from the frustration that the programs or schools their children were attending were
not meeting their child’s unique learning needs, with little or no support nor further assessments
being offered to them.
Parents Feel 2e Children’s Needs Were Not Met by Schools. Seven of the 10
participants brought up that schools did not have expertise to diagnose or support twice
exceptional learners. Instead, the schools, it was felt, perceived the student, or the student’s
behavior as the problem causing trouble as school. Elaine continued, describing her gifted
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son with dyslexia: “I saw this incredible potential in this child and I could see him struggling …
he started to be frustrated … the easy stuff was hard and the hard stuff was super easy.” Parents
often needed to summon help to get through the system. June, an IT specialist and doctoral
student, and a mother of a gifted and autistic son with ADHD recalled:
I had to not rely on the answers I was given…I had to assume, OK, this is what I am
being told, but let me look outside of this situation…we didn’t find the help we needed
until we sought assistance through an attorney.
While there was uniformity between participant responses about the importance of the role of a
parent, the responses about the importance of the other micro-level influencers were more varied.
Varied Perception of Importance of Psychologists. Six out of 10 participants recalled a
psychologist who had either a crucial or significant level of involvement leading to the 2e
diagnosis and access to supports; yet the remaining four participants recalled no significant or no
psychologist involvement at all. Faith, one of the three participants who considered the
psychologist’s involvement as crucial, shared: “Before the intelligence test [administered by the
psychologist], I just knew he was different…I thought it was an auditory processing disorder…I
was not on to the giftedness at all.” All six participants who found the psychologist’s
involvement crucial or significant sought the help of a psychologist in a private practice, outside
the school district. The four participants that recalled not significant, or no involvement of a
psychologist had communications solely with the psychologists provided by the school district.
Often, the process and access to the school district psychologists seemed frustrating with
annually changing teams and constant effort from parents to advocate for the services. Grace,
one of the four participants who considered the psychologist involvement as not significant,
recalled: “So we went through the hoops again… the phone call I got from the [new]
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psychologist before the IEP meeting was that I have read through the file, and I see there was
some confusion about his eligibility.” Some parents questioned the experience and training of the
school district’s psychologists regarding the needs of twice exceptional learners. Amy noted:
I don’t hold any ill will against the school psychologist, I just don’t think they had any
training or knowledge on what autism and giftedness can look like in girls at [elementary
school] age, and how they might interact with one another.
Parents’ also gave varied responses to the importance of classroom teachers, special education
teachers and learning specialists to the 2e learner’s diagnosis and access to supports.
Varied Perception of Importance of Teachers to 2e Diagnosis. Five out of 10
participants considered the classroom teacher’s involvement as not significant to the
identification and diagnosis of 2e learners, whereas four participants indicated a significant level
and one crucial level involvement from their child’s classroom teacher. Debbie noted: “You
should see the documents I have written for teachers to help them understand [twice
exceptionality], it is all my own research.” Sometimes teachers seemed overwhelmed with the
paradoxical nature of twice exceptional learner’s needs. Grace recalled: “Quite literally his
teacher was crying to us saying, she can’t, she doesn’t know how to help him.” Sometimes
teachers recommended parents look for other school options. Grace continued: “The teachers let
us know this [public school] isn’t the right school for him.”
While the teacher’s impact on the path to 2e diagnosis was varied, there was uniform
agreement on the teacher’s impact on the 2e learner’s self-concept and self-efficacy. All 10
participants recalled examples of how the pre-diagnosis experience of their twice exceptional
children was dependent on the flexibility of the particular classroom teacher. Grace linked the
school success, and school choice, for her gifted and autistic son directly to the classroom
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teacher: “This [private school] worked for George because of the relationship with the teacher,
which has been his common thread.” Charlie mentioned how every school year was different
depending on who the teacher happened to be, even if the strategies that worked for her gifted
and autistic son were known and documented on the school level:
Teachers helped me come up with strategies that worked for my son that could be
implemented in the classroom, and that we were implementing at home. It depended on
who the teacher was, it depended on the year, some would not implement
accommodations for him, unless he had documented disabilities.
While all participants shared recollections about the classroom teachers, special education
teachers were only rarely mentioned, if at all.
Special Education Teachers Missing in Action. While recalling the importance of the
classroom teacher, participating parents did not find special education teachers to be an
important part of the process leading to 2e diagnosis. All 10 parent participants recalled that the
special education teacher at their child’s school was either not involved (five out of 10
participants) or their level of involvement was not significant (five out of 10 participants) in the
process or identification and path to diagnosis of their 2e learner children.
This could be due to the fact that these 2e children were usually not referred to special
education resources, even though they had needs that would have qualified them for such
supports. The review of literature discovered that 2e learners are often left outside of the
protections of special education while at the same time not given access to gifted and talented
programming. In addition to varied perceptions about the importance of teachers, the perceived
importance of pediatricians to the 2e diagnosis also varied among participants.
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Pediatricians’ 2e Expertise Varies. Parents gave mixed ratings of the involvement levels
of pediatricians on the path to 2e diagnosis and access to supports. On one hand, Becky, a mother
of a gifted son with dyslexia found the pediatrician’s role in her son’s diagnosis crucial:
The greatest gift I didn’t expect was, I think Blake was in first grade, struggling with
handwriting, his pediatrician looked me in the eye and said…he has dyslexia, and I am
going to write this letter to school, and here is what you need to get.
On the other hand, Amy, a mother of a gifted daughter with autism remembered: “My
pediatrician never thought anything was wrong, they had a hard time believing me when I shared
the diagnosis [with them].”
Microsystem Influencers’ Involvement in 2e Identification and Diagnosis. Parents’
perceptions of the level of involvement of the different microsystem influencers were variable.
Table 8 summarizes the 10 respondents’ ratings of the level of involvement of the different
microsystem influencers surrounding the 2e learner in the exceptionality identification and 2e
diagnosis process. For quantitative analysis purposes, a crucial level of involvement was
assigned value four, significant level involvement was assigned value three, not significant
involvement was assigned value two, no involvement of the person or specialist was assigned
value one. For example, nine of the 10 participants rated Parent 1 (themselves) as having had a
crucial level of involvement in the process of identification and path to diagnosis of their 2e child
and one rated Parent 1 as having had a significant level of involvement. Overall, there was more
agreement on the importance of the role of the participating parent than on any other
microsystem influencer surrounding the 2e learner.

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Table 8
Level of Involvement in 2e Learner’s Identification and Diagnosis
Number of participants
Level of involvement Crucial Significant
Not
significant
Not
involved
Weighted
mean*
Parent 1 9 1 0 0 3.9
Parent 2 2 6 0 2 2.8
Psychologist 3 3 3 1 2.8
Classroom teacher 1 4 5 0 2.6
Learning specialist 3 1 3 3 2.4
Pediatrician 2 2 4 2 2.4
School admin 1 1 6 2 2.1
Special ed. teacher 0 0 5 5 1.5
* Weighted mean of responses with 4=crucial, 3=significant, 2=not significant, 1=not involved.

Following the initial analysis in Qualtrics, the data manipulation and calculations of the
data presented in Table 8 were done in Excel. The researcher assigned numeric values to the
level of involvement indicated by the participant. These numeric values enabled the calculation
of the weighted mean of the participant responses for each person or role. A mean is a measure
of central tendency; a weighted mean takes into account the frequency of occurrence of a value
(Salkind, 2019). A higher weighted mean indicates a higher average level of involvement of the
person in the process leading to identification and 2e diagnosis of the participants’ children.
Table 8 lists the persons in the order or descending mean, indicating that overall, the
participating parent (Parent 1) had the highest average level of involvement at 3.9 out of possible
4.0, translating to a crucial level of involvement. The other parent and the psychologist had an
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equal average level of involvement at 2.8, translating to a significant level of involvement.
Classroom teachers had an average level of involvement at 2.6 and both learning specialists and
pediatricians at 2.4, making these three groups neither significant nor not significant in their level
of involvement. School administration and special education teachers had averages of 2.1 and 1.5
respectively, which indicated on average they did not have a significant role in these 2e learners’
path to diagnosis. These quantitative results align with the qualitative evidence collected through
the interviews with the study participants, indicating that parents had a crucial role in the process
leading to the identification and diagnosis of their 2e children.
Research Question 2: What Knowledge and Motivation Do Parents Currently Have to
Advocate for Their 2e Child’s Diagnosis and Access to Supports?
There were three themes emerging from the data analysis as answers to the second
research question: Parents lack knowledge about their right to demand evaluation and supports
for their 2e learner children from their public school districts; Parents stich together a patchwork
of specialized expertise in order to support their 2e learner children; Parents are motivated to
build networks to share learning about how to help their 2e learner children. The following
discussion summarizes the evidence to support these findings based on the interviews with
participants and presents patterns identified through comparative analysis.
Theme 3: Lack of Knowledge About Right to Demand Evaluation
While every parent has the right to demand, and receive, an evaluation of their child for
learning differences from their public school districts at no cost to the family, six of the 10
participating parents were not aware of this right and therefore did not know to ask for it for their
child. Grace, a Black college-educated stay-at-home mother of a gifted son with ASD and
ADHD, shared: “I think the school is the expert, they are going to tell me everything I need to
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know, they are going to tell me that this is a problem, and this is how we deal with it.” Amy, who
is currently working toward a doctoral degree in education, is a White mother of a gifted and
autistic daughter with an anxiety disorder. She reflected: “I cannot believe that [evaluations for
learning differences] were never offered, and I cannot believe I did not know to ask.” Some
participants started to wonder whether the public school districts’ avoidance to offer an
evaluation of their child’s learning differences was intentional, even systematic.
Some parents noted that an evaluation of learning differences of their 2e learners was not
offered, even if the child’s teacher was actively involved in the process. Becky, a White
nonprofit executive and the mother of a gifted and autistic son with dysgraphia and emotional
behavioral disability stated: “I had two teachers behind the scenes doing their best to advocate,
but the district doesn’t seem to move unless the parents create a fuss about it and say I know my
rights.” Elaine, a White educator with a doctoral degree, and a mother of a gifted son with
dyslexia noted: “Nobody tells you…that you could put in writing to request the test, and then
they would have to respond within a certain period of time.” Elaine continued:
I just told the teachers and I told the principal and told everybody, and they were like, oh
well we will look out for it, you know we will try, we will get there, and nothing
happened…I did not know all the rules.
Without an assessment, the child cannot receive an official diagnosis; without diagnosis the child
will not have access to supports. Grace noted: “We were not given the menu, but asked to order,
and I have had to become an educational specialist and expert, just to be able to know what to
ask for to get help for my child.” Amy stated: “our school district is not a ‘child find’ district, it
is a ‘child let’s try not to find’ district, a ‘we would rather not know’ district.” Some parents felt
the school district’s responses were intentionally oblique. June, a biracial learning program
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designer and a mother of a gifted and autistic son with ADHD recalled: “They were very careful
in wording written correspondence … [they said] you are welcome to file for due process.” Over
time, parents stitched together a patchwork of expertise to learn their rights and to navigate the
various systems of influence surrounding their 2e learner child. Grace concluded: “I [now] have
the background to understand that it had to be initiated from us as parents, that she [the teacher]
was not allowed to do that.”
Theme 4: Parents Develop Specialized 2e Expertise
Parents felt that, in order to arrive at the correct diagnosis and to gain access to supports
for their 2e learners, they themselves had to become experts in many specialized fields of
knowledge. These included: learning, education, medicine, psychology, law, research, and
culture. Grace stated: “I began to read more and more information, because it became clear I had
to be a better detective, like something else is still not right.” Becky recalled: “I got graduate
level books on educational differences, and I just started finding out who is writing research
articles…I figured out that children that have one condition oftentimes have others.” Sometimes
this learning was frustrating. Amy shared: “We were relying on these professionals and then the
professionals could not figure the [2e diagnosis] out, and here we are as parents supposed to
figure all that out without professional training.” However, this frustration also led to motivation
to fill a perceived void in knowledge among professionals about twice exceptionality.
Parents Fill a Perceived Void in Professionals’ Knowledge. Often the development of
specialized expertise by parents was motivated by filling a perceived gap in the knowledge about
twice exceptionality of other specialists surrounding the child. Amy noted: “I don’t know that we
can expect general education teachers to have enough depth of knowledge about [2e].”

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Often, the parent recognized there was something that was not right, and the answers they
were getting from the experts were not satisfactory in explaining what they observed at home or
at school. Amy continued: “My pediatrician never thought anything was wrong [with her], as a
parent you are really relying on these professionals in your life ... to ask you if you are seeing
any of these behaviors.” One parent concluded: “I think it is a little scary to think that [a center
specializing in giftedness] did not see these [signs of learning disability], and point out that these
could be signals for [twice exceptionality].”
Areas of Expertise Developed by 2e Parents. Realizing that many experts have little
knowledge outside of their own area of expertise was a frustrating experience for parents. This
was especially relevant as twice exceptional learners live at the intersection of two or more
differences, the understanding of each relying on the expertise of a different expert. Charlie, a
biracial university professor and a single parent of a son who is gifted and with dyslexia, ADHD,
and EBD stated: “I needed to learn how to navigate the healthcare system, which is a disaster if
your child has any comorbidities.” Charlie continued: “The pediatrician’s office can only help
your child if they have a single diagnosis, at the moment you have a dual diagnosis they want to
refer you to all these specialists.” In addition to learning about the medical and healthcare
system, parents felt the need to learn about law and the legal rights of their twice exceptional
children.
Table 9 summarizes the specialized expertise developed by parents of 2e learners
discovered during the interviews. It also notes the professional that would typically be expected
to have such expertise in the particular field of knowledge. It furthermore links the professional
to the system of influence of Bronfenbrenner’s (1977) system’s theory.

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Table 9
Specialized Expertise Developed by Parents of 2e Learners
Field of
knowledge
Professional or
typical expert
System of
influence
Areas of expertise developed by parents
of 2e learners
Learning Teacher

Microsystem Learning differences
Giftedness
Self-efficacy
Best learning practices

Education Teacher
School admin
Learning specialist
Special ed. teacher
Mesosystem Public school system
Special education system
Individual education plan
Gifted and talented education
Strength-based programming
Private school system
Advocacy

Medicine Pediatrician
Specialist
Exosystem Developmental milestones
Developmental asynchrony
Co-morbidity
Neurology

Psychology Therapist
Psychologist
Psychiatrist
Exosystem Socio-emotional development
Early childhood development
Twice exceptionality
Comprehensive psycho-metric testing

Law Lawyer

Exosystem Legal requirements for school districts
IDEA Section 504
Parents’ rights
Vocabulary

Research Professor Exosystem Review of published research
Primary (original) research

Culture Society at large Macrosystem Self-concept

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Understanding the Legal Aspects. Understanding their own rights and the legal
requirements for school districts was a big area of learning for most parents. Becky stated:
“When I was getting denied assessments, I went to the Wrightslaw website and started reading
up on that.” Becky continued: “I had no understanding of the Federal law for special
education…it was critical for me to know that there were actually Federal laws in place to ensure
that he had access to a meaningful education.” Charlie recalled: “I learned how to navigate the
special education system and what children qualify for…I found it astonishing that they don’t
provide any assessments of children.” Sometimes understanding the law and one’s right requires
hiring an attorney. June shared: “We needed [an attorney] to assist us with getting the types of
supports that he needed, and that was when he was able to get [the aid], and it was only because
of an attorney intervening.” Learning the right language to advocate for one’s rights was another
challenge. Elaine questioned whether every parent has the capacity to master “the legal aspects
of knowing how to put [the requests] in writing and get the meetings that you need and the
testing done you need for documentation.” After understanding their legal rights, parents moved
on to learn about the schooling and programming options available to their 2e children.
Schooling Options and Best Learning Practices. Learning about all the different
schooling options and how to navigate them was another recurrent theme. Charlie listed: “I
learned about the special education system, the private school system, and the public school
system and the different sets of processes, the different titles of the different special education
plans.” The parents needed to navigate a patchwork of different systems with little or no support
or guidance. “It’s a huge crazy patchwork of different systems that you have to navigate and they
all have different rules and costs and timelines and none of those are integrated, they are all
separate systems,” Charlie concluded.
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Becoming an expert in best learning practices for 2e learners was another area of parent
self-education. “I was becoming a researcher, an expert almost, and advocate … all the emails I
wrote to the teachers and other parents were based on my research,” shared Debbie, an Asian-
American psychologist and a mother of a gifted son with dysgraphia. Elaine noted: “I have done
my own self-education in neurology and try to understand the diversity of the research-based
methods and why some work for some kids and some don’t.”
As parents moved, they needed to re-learn how the new school district worked, as no
state-wide mandate exists for 2e learner support. Grace noted: “It got worse for us in the sense of
clarity of how the process worked, or to access the services when we moved here and we are in a
different district.” June recalled the confusion between different requirements and definitions
between different systems to qualify for supports: “the requirements between the agencies, the
school district were different from what the regional center required.” All 10 participants were
keenly aware that they had learned a tremendous amount of knowledge about parenting twice
exceptional children, and wanted to help other parents learn from their experiences. Most had
made an effort to share their learning through networks.
Theme 5: Parents Network to Share Learning
While parents initially lacked knowledge about their right to demand testing and access
to supports for their children through the public school system, over time they developed
specialized expertise to seek an accurate diagnosis and to be effective advocates for their 2e
children, parsing together a patchwork of specialized knowledge not typically expected from
people outside the respective professional fields. Parents felt compelled to share the gained
expertise to help other parents through organic and purpose-built networks. For example, Amy
shared: “You know you kind of get to be known, and other parents [at my daughter’s school]
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were starting to come and talk to me about their kids.” Elaine shared: “I have this list of outside
resources [for 2e] … that I share every time somebody asks.” Some of the shared advice was
very practical and specific. Becky recalled advice regarding homework load for their 2e son: “I
was told by another parent to go to the teacher and negotiate. This was a survival technique.”
Parents were eager to share helpful advice about navigating the different systems to support their
2e child and were motivated to take action.
Parents Motivated to Take Action. Some parents realized that parents, as opposed to
teachers, school administrators, psychologists, and pediatricians, were the most motivated group
to take action to help the 2e learners. Debbie shared: “No one else is going to be as interested in
your child as you are, right?” Joining online forums with other 2e parents was seen as very
helpful by many parents. “Their stories are validating, grounding, but also such a rich resource of
programs and concrete strategies,” continued Debbie. June provided more detail: “That’s where a
lot of information is exchanged … what resources are available … many of the parents in the
community were very great resources, [they] gave very detailed information.” Some of the
advice is very specific, June continued: “go check this, go file that, but sometimes it is just a
matter of giving people the right language to use when they request something.” Online forums,
in particular, were seen as a practical way for parents to share information about 2e learners and
available resources.
Online Forums Considered Helpful to Share Information. Online forums used by
participants to receive and share information about 2e learners included several Facebook groups
and other media to share information or act as parent support groups. Holly, a start-up founder
and a mother of a gifted son with dyslexia, dysgraphia, and ADHD stated: “I wanted to learn as

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much as I could. … I joined online groups, I was just in all of them, and I would read all of the
things that people were posting … and I think that was really, really helpful.”
Some parents found online support through their places of employment. Faith, a business
administrator at a large technology firm, and a mother of a gifted son with autism, ADHD, and
dyslexia, noted: “I am very lucky my [tech company] has an internal work group globally for
people with children with special needs where I can post a question.” Building a network of
knowledge frequently extended also to a network of parent support. Faith continued: “I remind
others to be kind to yourself as a parent, and it will be OK, and look forward.” The connection
with other parents also provided hope for the future. Debbie concluded: “It is helpful to connect
with parents of 2e kids who are graduating college and high school, and what advice they had.”
While online forums are free to access, and therefore equitable information sources, many
parents noted that environmental and socio-economic factors influenced their ability to advocate
for their 2e learner children.
Research Question 3: How Do Environmental Factors Influence Parents in Advocating for
Their 2e Child?
Environmental factors, including parents’ education level, household income, family
status and social capital are known to have an influence on the parents’ ability to advocate for
their children. Parents participating in the study were all highly educated, with stable financial
and family situations. These parents were in the position to take the time and had access to
necessary resources to advocate for their 2e learners. The four themes emerging from the data
analysis as answers to the third research question were: Parents engage resources outside of
school to seek accurate diagnosis; Parents employ significant resources to support their 2e child;
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Socio-economic factors influence a child’s access to diagnosis and supports; the 2e parenting
experience may have an impact on the parent’s career.
Theme 6: Parents Rely on Outside Resources to Seek Accurate 2e Diagnosis
All 10 participants noted they felt they had to go outside of their public school district to
get an accurate and complete 2e diagnosis for their child. Parents were motivated to seek outside
diagnosis for two reasons: to learn what they can do to support their children whom they saw
suffering, and to overcome the barrier to access supports by the public school district. Amy,
speaking of her gifted and autistic daughter, shared:
Our public school never offered us testing for anything … she was having a little bit of
trouble articulating just a couple of sounds, so they offered her speech and language
services in second grade … they never offered any other assessments.
In Amy’s daughter Anna’s case, her autism diagnosis took place 7 years after the initial
observation of exceptionalities by both parents and teachers, and 5 years after her gifted
diagnosis. Based on neuropsychological testing, a private practice psychologist conducted both
diagnoses. Such testing was never offered to Anna or her family by her public school district, but
as she later learned, the public school district would have had to conduct it had she known to
demand it in writing from the district.
Parents Seek Help As They See 2e Learners Suffer Emotionally. For some parents,
the observable emotional suffering of their un-diagnosed 2e learners was a key motivator to seek
private testing. This was especially the case when they felt their child’s teachers did not take
their concerns seriously. Holly recalled about her son: “All year, he would hide in the closet
because he didn’t want to go to school … when now looking back, I can see he had anxiety …
he would bite his fingers and they were all bloody.”
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In hindsight all the telltale signs of Henry’s dyslexia were missed at school, with the
teacher reassuring his parents that sometimes learning to read progressed slower. His defiant and
challenging behavior at home and at school was stressful to himself as well as for all those
surrounding him. His anxiety-rooted defiance impacted the family functionality, as his parents
did not always agree on how to respond to his challenging behavior. Henry’s 2e diagnosis was
fast as soon as Holly took him to see a private dyslexia specialist who was familiar with twice
exceptionality and thus tested Henry also for his intelligence in addition to dyslexia. Holly
recalled the impact the diagnosis had on not only on Henry, but on the entire family: “Getting
that report explaining that those behaviors were traits of his gift and were things to be celebrated
and not shut down or to be gotten rid of was a big moment…it really changed how we all
interacted as a family.” An accurate diagnosis can help parents of 2e learners understand that
problem behavior may be a symptom of the child’s underlying and unmet needs perpetuated by
the environment that is not a good fit for the child’s needs.
Parents Seek Access to Supports for Their 2e Children. Some parents followed up on
their initial observations by private testing before any testing by public school districts would be
available, but still had trouble reaching a complete diagnosis. Debbie, who is a psychologist
herself, started to have conversations with colleagues who specialized in gifted assessment while
her son Dylan was still in preschool age. Through preschool, Debbie sensed that there was
something more than giftedness going on as Dylan grew frustrated with his inability to draw and
had difficulty with motor skills.
Later on, when reading became an insurmountable challenge, Debbie remembered: “In
second grade, Dylan started crying one day, and said nothing that he is good at matters in school,
and that broke my heart.” Even when being surrounded by expert colleagues, Debbie keenly
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acknowledged the difficulty of accurately diagnosing 2e, as the combination creates in itself a
different profile. Debbie stated: “As [the exceptionalities] interact, it really becomes an emergent
property that is different from its parts.” Furthermore, she reflected: “As a psychologist, I feel
privileged, but I am still just figuring it out.”
While a 2e diagnosis is the helpful and necessary first step, it is not sufficient to
guarantee supports from the public system. Charlie shared about the impact of having an official
diagnosis for her gifted son with ADHD, dyslexia, and EBD:
The [official diagnosis] gives me a little bit more leverage with the school, but it doesn’t
really change the lived experience ... I still have to fight for his rights to these things,
even though every student should have the right to these things.
Following the diagnosis, all study parents decided to employ significant private resources in
addition to the publicly available resources to support their 2e children.
Theme 7: Parents Employ Significant Resources to Support Their 2e Child
All 10 participants employed private resources outside the offerings of the public K–12
system to support the academic and socio-emotional development needs of their 2e children. At
some time during their child’s K–12 education, parents collectively engaged 17 different types of
private practitioner specialists to support their 2e learners. All 10 participants engaged the help
of a psychologist at some point during their children’s K–12 years. All the 2e learner children of
the participants were attending private schools at the time of the study, after having had prior
experience with public schools. Six of the 10 sought the help of a speech, educational, or other
kind of therapist. Half of the participants engaged private tutors or learning specialists. Three out
of 10 participants engaged lawyers or special education advocates, academic enrichment
programs, extracurricular programs or homeschooling at one time or another during the K–12
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years. Two out of 10 participants worked with gifted specialists, psychiatrists, or reading
specialists to support their 2e children. One participant engaged a neuroscientist and one a
developmental pediatrician to help their 2e children. Table 10 lists the types of private resources
employed and paid for by the parents.

Table 10
Private Resources Employed by Parents to Support 2e Learners
Private support resources
employed by parents
Number of parents
employing
Examples of services sought by parents
of 2e learners
Psychologist 10 Diagnosis and assessment, intervention
and treatment, therapeutic counseling
Private school 10 Specialized instruction, smaller class
sizes, tailored content, integrated
support
Therapist 6 Speech, educational, cognitive-
behavioral, visual processing,
occupational
Tutor or learning specialist 5 Support to classroom instruction,
learning difference support
Academic enrichment
program
3 Strength-based programming, talent
development
Lawyer or advocate 3 Access to support services, access to
specialized placement
Extracurricular activities 3 Talent development, socio-emotional
growth
Homeschooling 3 Tailored instruction, strength-based
programming
Gifted specialist 2 Diagnosis and assessment, consultation
Psychiatrist 2 Diagnosis, intervention and treatment
Reading specialist 2 Support to classroom instruction
Developmental pediatrician 1 Diagnosis and assessment, consultation
Neuroscientist 1 Diagnosis and assessment, consultation

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Parents Employ Private Resources to Supplement Public Resources. Parents
participating in the study expressed they employed these private resources to support their 2e
children as they had no access to such resources through the K–12 system, or were denied such
access on a timely basis. In some cases, parents did not know their rights to demand such
resources through the public system. Amy shared: “The assessment by [private center] said her
anxiety was because she was not in a good setting, so we started looking at new schools for her,
and meanwhile things were just really going south at her [public school].” As parents explored
private schooling options, they sought programs that could provide both enrichments as well as
supports beyond what their children received in the public programs. Elaine shared: “It was
important to me that the teachers and administration had a sense of who [my son] was … and
offer enrichment and variations in the curriculum that could accommodate his strengths and not
just the weakness.” Rather than being upset, some parents were understanding of public school
teachers’ lack of ability and resources to support 2e learners’ needs. Elaine reflected:
One of the big revelations in the whole process was just the lack of experience and the
lack of understanding in teacher training programs and in the curriculums that teachers
with the absolute purist hearts and the best intentions, they don’t have the tools that they
need [to help 2e learners].
Over the years, the effort to support the participants’ 2e children’s needs appeared to be a
continuous process rather than a one-time fix. Debbie stated: “It is a constant calibration journey,
a different constellation at every developmental stage.”
Parents Spend Significant Amounts on Private Resources. The amounts that study
participant parents spent on these private resources were significant. Charlie shared: “We went

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through probably $20,000 of assessments and treatments in just 1 year, just to get to the point
where he had new diagnoses [so] the school district was required by law to work with us on
accommodation.” Some parents noted getting access to services from the public system was an
ongoing emotionally and financially draining fight. Becky recalled:
They fight us every step of the way, every year, for unilateral placement … they hire the
sort of [law] firms that go after 13-year-olds that are victims of teachers’ sexual advances
… it’s deplorable down here, absolutely disgusting how much they fight against what the
kids need and the lengths that they will go to deny services [is] pretty horrific.
Several parents noted that they did not choose private schools or private programs because they
wanted to, but because they felt they needed to. Faith shared: “We went [to the] private side
because that particular private school provided better resources for what my child needed.”
Parents keenly recognized the value of having the financial means to access supports from the
private sector. Becky shared: “Financially, [the investment in private testing and supports] was a
huge burden on us, and while we did recoup some of the money, I just don’t see it as an
accessible option for many families.” Debbie summarized: “We are lucky, because we have the
resources to be able to do that.” Study participants were aware of the equity implication of a
socio-economic status impacting their 2e child’s path to diagnosis and access to supports.
Theme 8: Socio-Economic Factors Influence Child’s Access to Diagnosis and Supports
The parents participating in the study had an economic advantage over parents earning an
average income. In addition, parents had higher-than-average education levels. Both of these
factors contributed to a higher-than-average socio-economic status of the study participants in
comparison to the average.
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Parents With Higher-Than-Average Incomes Can Afford Private Resources. Seven
of the study participants reported annual incomes over $150,000 and the remaining three
participants reported incomes in the $100,000–$149,999 range. According to U.S. Census
Bureau data from 2019, the average annual household income in California, where all 10 study
participants resided, was $75,235. Of the 10 participants, seven resided in the San Francisco Bay
Area and three in the greater Los Angeles area. At $68,044, the average annual household
income for the greater Los Angeles area in 2019 was slightly lower than the California average.
In the San Francisco Bay Area the 2019 average household income was $112,449, resulting in a
narrower income gap to study participants than the state average would indicate. Nevertheless,
even with this narrower gap, it can be concluded that all study parents had access to a higher
disposable income than average parents in their respective areas.
This higher disposable income enabled the study parents to invest more toward private
resources for diagnosis and supports for their 2e children than would have been possible for
parents with average incomes. Debbie, a psychologist herself, reflected on the inequities she saw
between parents with means and those without:
We are lucky, because we have the resources to be able to do [what is needed to help our
children]. At my clinic, I see adults, who are now my patients, and it’s heartbreaking
because their parents tried, but they could only advocate within the resources that they
could afford.
However, even with the higher-than-average disposable incomes, several of the parents shared it
was challenging to pay privately for all the supports they felt their 2e learners needed. These
parents made life and career choices that enabled them to afford the private resources they
sought for their children. Faith shared: “Long term planning allows me to look at these finances
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and [figure out] how we are going to make that work.” Not everyone was as lucky, Faith
continued: “I know parents at the [private school specializing in dyslexia] that have taken out
second mortgages to make it work.” Some parents had to take on extra work to be able to afford
the extra services they felt their 2e children needed. Charlie summarized: “I have always been
working two jobs…my resources have been stretched.” This illustrates that for many parents
with children with special needs, the choice of going to a private school has less to do with
income or the affordability of a private school tuition, and more to do with having access to the
support services the parent perceives are crucial to their child’s development.
In addition to making it possible to pay for select private services, a higher household
income also enables the family to make decisions about one of the parents taking time off work
to focus on the needs of the children without sacrificing the financial stability of the family. As a
parent, being able to spend time observing and supporting both academic and emotional needs of
their 2e learner children is both a luxury and a good investment, and may lead to earlier
intervention. Faith recalled:
I was not working at the time, and I was able to spend a lot of time around the school,
seeing [the reading specialist] in action with my son. I would never have known what I
know if I did not have that access.
Families where both parents—if they are lucky to have a two-parent family—need to work to
support the basic needs cannot afford to take time away from work, whatever the needs of their
children may be. Debbie shared: “They are just trying to make it … they can only advocate so
much with the language they don’t have, at a school they are at, because that’s all they have.”
Parents keenly recognized it was a privilege to have access to resources that other families may
not have. Charlie shared: “I am thankful for being able to move him to a school that is a better
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environment for him … but it’s very sad for children who are just stuck.”
Parents With Higher-than-Average Education. In addition to having higher-than-
average disposable incomes, the study participants also had higher education levels than average
parents. All 10 participants were college educated, with eight out of 10 with advanced degrees.
Some participants also recognized these characteristics may be aligned with higher social capital.
Social capital is something akin to our social net worth; our ability to accomplish tasks because
we are known and respected in the right circles. Higher wealth and higher education are not
uncommon characteristics of those with higher social capital. Charlie synthesized: “Success in
getting help for your 2e learner, I think, is directly tied to your social capital.” The highly
educated study participants with higher-than-average household incomes shared that their 2e
parenting journey had on impact on their ability to adjust their priorities and career development.
Theme 9: 2e Parenting Experience May Impact Parent’s Career
All study participants shared how their 2e parenting experience had shaped their own, as
well as their 2e learners’ lives. Amy shared: “If you have a child with special needs, it is going to
impact you if you have the capacity to let it.” Some parents indicated this experience had an
impact on their career paths and future career choices. Four of the 10 participants changed
careers as a consequence of parenting a 2e learner. Of these four participants, one decided to
pursue further education to enable her to qualify for a higher paying job to afford the private
school tuition for her 2e son. Faith explained: “I studied to better my skills in order to be able to
have a job to be able to pay for [tuition for private school] for my son.”
The other three career-changing participants decided to pursue doctoral studies in
education, without any prior professional background in education. Each of these three parents
had selected twice exceptionality as their area of interest and the focus of their forthcoming
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doctoral dissertations. Holly described her motivation to start her doctoral studies focusing on 2e
learners: “I wanted to learn more and I felt like I maxed out on what was available… now I am 1
year into the graduate program on twice exceptionality.” This indicates these parents were deeply
impacted by their personal experience parenting their 2e children and that now spilled over to
their professional lives. These parents were motivated to expand the knowledge frontier about
twice exceptionality to the benefit of their own 2e learner children, as well as other 2e learners
and their parents. Their choice to pivot their careers to education and to contribute to the
empirical research on 2e closely mirrors the personal experience of the researcher.
Summary
Parents participating in the study were the first to recognize the exceptionalities in their
2e children. When bringing up their concerns to professionals, they often faced dismissiveness.
Parents also felt judged and subordinated when sharing their concerns with teachers and school
staff. Most parents were unaware of their rights and responsibility to officially request a free
evaluation of their child from the school district when they suspected their child had a learning
difference. Instead, parents sought help through costly private testing. These factors led to a time
lag between the initial parental observation of exceptionalities and the official diagnosis of their
2e child. All study participants indicated parent involvement was crucial for their child’s
accurate diagnosis. Parents had varied perceptions about the importance of other micro-level
influencers, including teachers and psychologists. Special education teachers and pediatricians
were perceived by parents to have varied expertise in 2e and thus a varied impact on the
diagnosis. Table 11 summarizes the findings and themes emerging from the analysis of the data,
referencing the respective research question to which the theme corresponds.
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Table 11
Summary of Themes and Findings of the Study
Themes Findings
Theme 1: Time lag exists
between observation and
2e diagnosis. (RQ1)
Parents are first to notice exceptionalities.
Parents face dismissiveness of their concerns.
Parents feel judged and subordinated when bringing up
concerns to professionals.
Time lag of 2e diagnosis could have been shortened.
Theme 2: Parent involvement
is crucial to 2e diagnosis.
(RQ1)
Parents have a uniform perception of the importance of parent
involvement in 2e diagnosis.
Parents feel schools do not meet 2e children’s needs.
Parents have a varied perception of the importance of
psychologists and teachers to 2e diagnosis.
Special education teachers appear to be missing in action.
Pediatricians’ 2e expertise varies.
Microsystem influencers have varied levels of involvement in
2e identification and diagnosis.
Theme 3: Parents lack
knowledge about their
right to demand
evaluation. (RQ2)
Parents are unaware of their right to demand a free evaluation
of their child from the public school district.
Is evaluation avoidance by school districts intentional and
systemic?
Theme 4: Parents develop
specialized 2e expertise.
(RQ2)
Parents fill a perceived void in professionals’ knowledge.
Understanding the legal aspects requires specialized
knowledge.
Parents develop expertise in schooling options and best
learning practices for 2e learners.
Theme 5: Parents network to
share learning. (RQ2)
Parents network to share learning about 2e expertise.
Parents are motivated to take action.
Online forums are helpful to share information.
Theme 6: Parents rely on
outside resources to seek
accurate 2e diagnosis.
(RQ3)
Parents engage resources outside of school.
Parents seek help as they see their 2e learner suffering.
Parents seek access to supports for their 2e children.
Theme 7: Parents employ
outside resources to
support 2e learner’s needs.
(RQ3)
Parents employ private resources to supplement public
resources.
Parents spend significant amounts on private resources.
Theme 8: Socio-economic
factors influence child’s
access to diagnosis and
supports. (RQ3)
Parents with higher-than-average incomes can afford outside
resources.
Parents with higher-than-average education can navigate
complex systems to access supports.
Theme 9: 2e parenting
experience may impact
parent’s career. (RQ3)
Some parents of 2e learners change their careers as a result of
parenting a 2e child.
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On their journey of discovery to help their 2e children, parents developed specialized
expertise across many professional fields and systems of influence. Parents did this to fill a
perceived void in the professionals’ knowledge about twice exceptional learners. For example,
this included expertise of the legal aspects, schooling options, and best learning practices for
twice exceptional learners.
Parents were motivated to help and learn from other parents of 2e children. They
networked to share learning by creating and participating in online forums to share information.
Beyond private diagnosis, parents sought other private resources to support the academic and
socio-emotional needs of their 2e children. All participants felt their 2e children’s needs were not
adequately met by the public schools they had attended and thus sought private schooling
options. Parents employed significant resources to support their 2e children, including 17
different types of specialists and private resources. Parents’ socio-economic factors had an
influence on the child’s access to diagnosis and supports. Parents with higher disposable income
and higher education had more social capital to access private resources they considered
necessary for their 2e learner child’s diagnosis and support. The intense experience of parenting
and advocating for their 2e children had an impact on the career progressions and career choices
of some parents.
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Chapter Five: Recommendations
This chapter discusses the findings of the study in connection with the reviewed literature
and conceptual framework discussed in Chapter Two. Building on these findings and literature, it
presents concrete recommendations for practice. Furthermore, limitations and delimitations to
the study are discussed, as well as recommendations for future research.
Discussion of Findings
Many of the themes and findings of the current study align with prior research on the role
of parents of twice exceptional learners, providing additional detail and evidence to support prior
research. Some of the findings are new, with little to no prior research on the specific topic.
These emergent findings would benefit from future research to test them with a different
demographic or via a larger quantitative study. Each of the themes is discussed individually.
Theme 1: Time Lag Exists Between Observation and 2e Diagnosis
The present study found parents of 2e learners were the first to notice exceptionalities in
their children. However, these parents often faced dismissiveness of their concerns, and
sometimes felt judged and subordinated when bringing their concerns up to other microsystem
influencers surrounding their child. The study found a time lag of on average 4.1 years between
the parental observation and the 2e diagnosis that could have been shortened if a comprehensive
evaluation took place earlier. Prior research supports the finding that parents are often the first to
notice behaviors and characteristics in their children that are outside the norm (Dare & Nowicki,
2015; Park et al., 2018; Wormald et al., 2015). Prior research has identified many causes for
missed or delayed 2e diagnosis, one of them being the lack of teacher and specialist awareness
and understanding of 2e characteristics (Berman et al., 2012; Crepeau-Hobson & Bianco, 2011;
Foley-Nicpon et al., 2013; Rowan & Townend, 2016). This could contribute to the pushback the
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study parents experienced when bringing up their concerns. Other research builds on the premise
that recognition of 2e learners is inherently difficult, and educators and parents need to first learn
what characteristics and behaviors to look for (Baldwin et al., 2015). Parent and teacher
education on 2e characteristics appears an effective way to increase the awareness and
identification of 2e learners. No prior research was located on quantifying the time lag from
initial observation to 2e diagnosis. Therefore, future research is recommended to test the findings
of this study regarding the length of time from initial parent observation of exceptionalities
outside the norm to the 2e diagnosis, as well as the possible ways to shorten this time lag. Given
that the time lag spans the child’s development over time, the chronosystem might provide a
useful lens for future analysis.
Theme 2: Parent Involvement Is Crucial to 2e Diagnosis
The present study found participating parents had a uniform perception about parental
involvement’s crucial level of importance as a condition to arriving at a 2e diagnosis for their
children. Parents had varied perceptions about the importance of psychologists and teachers in
the process leading to 2e diagnosis. Parents perceived pediatricians had varied levels of
experience about 2e and did not perceive special education teachers contributed significantly to
the discovery process leading to the students’ 2e diagnosis. Prior research has suggested parents
cannot be assumed to have the expertise to recognize 2e characteristics in their children (Dare &
Nowicki, 2015). The evidence from the present study indicates parents may not have expertise,
at least not from the onset, yet they tirelessly seek more information to make sense of the
academic and socio-emotional struggles they observe in their children, thus nudging them closer
to the appropriate specialist to make a correct diagnosis. Some researchers point to evidence
suggesting teachers are reluctant to, or outright refuse to acknowledge the 2e learner’s giftedness
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combined with special needs (Wormald et al., 2015). This might leave parent involvement as the
only available path to 2e diagnosis, an assertion that could be supported by the evidence from the
present study. Parent education, therefore, could be the most important lever to reduce the time
lag from parental observation to 2e diagnosis.
Theme 3: Parents Lack Knowledge About Right to Demand Evaluation
The present study found parents of 2e learners were initially unaware of their right for a
no cost evaluation of their child’s possible learning disabilities by their school districts.
Furthermore, the study participants were initially unaware of the process to follow to request
such an evaluation. As a result, only four of the 10 parent participants ended up going through
this publicly available process, while all 10 participants engaged private specialists for the initial
or further evaluation of their 2e learners. Five of the 10 participants questioned whether the
evaluation avoidance by school districts may be intentional and systemic. No prior research was
found to either support or counter these findings. Parent education about the right to demand
testing and the process to request it could help parents navigate the current K–12 system more
effectively. At the same time, further research is necessary to explore the potentially intentional
and systemic evaluation avoidance behavior by school districts experienced by some of the study
participants.
Theme 4: Parents Develop Specialized 2e Expertise
The present study found parents of 2e learners develop specialized expertise to fill a
perceived void in professionals’ 2e knowledge. Prior research recognizes gaps regarding 2e
expertise in teacher training (Foley-Nicpon et al., 2012) and lack of individualized teaching
(Berninger & Abbott, 2013). Prior research also supports that parents became more successful 2e
learner advocates by increasing their knowledge about terminology and educational policies
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(Besnoy et al., 2015). Further, prior research recognizes parents of 2e learners may need to learn
to navigate and fund several systems and programs outside of the public school system to
support the particular needs of the twice exceptional students (Wormald et al., 2015). The
findings of this study align with both the motivation and need of the parental self-education
indicated by prior research. No prior research was found on cataloguing and measuring the level
of specialized expertise developed by parents of 2e learners. Further research is necessary to
validate and expand the findings of this study in this respect. Information sharing through
educational events and online sources could become a powerful tool to leverage the specialized
2e expertise developed by parents of diagnosed 2e learners to educate other parents and
professionals.
Theme 5: Parents Network to Share Learning
The present study found parents of 2e learners are motivated to help other families with
2e learners by sharing the specialized expertise they have developed. Study parents felt online
forums were particularly effective for sharing information and for providing a community of
people with similar needs and experiences. No prior research on the specific topic of using online
networks to share learning about 2e was found. Future research is recommended to explore the
topic and to arrive at concrete recommendations on how to leverage online resources for 2e
information sharing and 2e community building for parents and students.
Theme 6: Parents Rely on Outside Resources to Seek Accurate 2e Diagnosis
The present study found parents were motivated to seek diagnosis through outside
resources in response to the suffering they observed in their 2e children, and to overcome the
barrier to access supports and accommodations by the public system. The researcher is unaware
of prior research on the motivation of parents, but can hypothesize that parents were driven by
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the hope that outside resources might help in arriving at an accurate diagnosis, which would
chart the path for future interventions, supports, and recommendations. Prior research has
presented evidence that 2e learners respond positively to, and feel empowered after the 2e
diagnosis through recognizing their strengths and receiving accommodations (Foley-Nicpon et
al., 2011; Lo, 2014). Parent education about the availability of no cost testing would be helpful to
ensure parents from all socioeconomic backgrounds can have access to accurate 2e diagnosis.
Theme 7: Parents Employ Significant Resources to Support Their 2e Learner’s Needs
Parents of 2e learners participating in the study felt the services and accommodations
provided by the public school system were not enough to address the complex needs of their
children. This mirrors evidence from prior research from a different demographic, finding
parents consider public school services inadequate for their 2e learners’ needs (Park et al., 2018).
As a consequence, study parents employed significant private resources to supplement what was
available from the public system. Prior research indicates parents advocate for their 2e children,
providing them with support that can be both costly and cause inconvenience for the family
(Speirs Neumeister et al., 2013). Speaking about both public and private schools, study parents
felt too much focus was on deficit reduction and on controlling negative behavior, whereas too
little focus was on the unmet potential of the twice exceptional learners. Recent research by Reis
and Renzulli (2021) calls for a paradigm shift from deficit reduction to strength-based
programming on the parental side, given the negative feedback 2e learners often receive at
school. Evidence from the present study supports this need and also indicates these parents of 2e
learners are already employing outside resources to invest in the interest and talent development
of their children. Parent education about most recent research on this topic would be valuable to
all parents of 2e learners.
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Theme 8: Socio-Economic Factors Influence Child’s Access to Diagnosis and Supports
The present study finds that socioeconomic factors have an influence on the 2e learner’s
access to diagnosis and supports. Prior research provides evidence to support this finding, linking
the family’s ability to focus on talent development to family characteristics (Olszewski-Kubilius,
2008). Several researchers have hinted at the equity issues embedded in the limited access to
private evaluations and supports outside the public system for those with limited means. Some
researchers have suggested parents from lower socioeconomic backgrounds are not likely to have
the same ability to advocate for their 2e learner children, nor may have as much time flexibility,
resources and specialized knowledge as parents with higher financial, cultural, and social capital
(Besnoy et al., 2015; Dare & Nowicki, 2015; Trainor, 2010). Parent education about publicly
available resources could be a good first step. However, it is also necessary to take a critical look
at the resources, processes, and attitudes at school districts that act as barriers to supports for 2e
learners in the K–12 system. Parents with higher socioeconomic status can afford to circumvent
these barriers by going outside the public system. It is therefore the families with lower
economic status who bear the brunt of the friction, whether intentional and systemic, or just
based on knowledge and resources, resulting in lack of access to diagnosis and supports for their
2e children. Further research is recommended to evaluate equity issues resulting from barriers to
access supports for 2e learners in the K–12 system.
Theme 9: 2e Parenting Experience May Impact Parent’s Career
The present study found that some parents of 2e learners change their careers as a result
of parenting a 2e child. In this case, instead of the parent as the microsystem influencer having
an impact on the development of the child, as would be predicted by the Bronfenbrenner bio-
ecological model, there is a reciprocal impact on the parent as a result of the parenting
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experience. No prior research on this specific topic was found. It is hence recommended future
research be conducted to explore this topic further and to seek evidence to test this finding.
Recommendations for Practice
There are three concrete research-supported recommendations to address the key findings
of the study: (a) invest in parent education to increase awareness of 2e characteristics, path to
diagnosis, and access to supports; (b) invest in teacher training and education to increase
awareness of 2e characteristics and learn classroom best practices to support 2e learners; (c)
engage in liberatory design thinking to develop concrete plans to enhance the capacity and equity
of 2e learner education in the K–12 system. Each of the recommendations is discussed, and
examples are given on how to operationalize them in school districts and nonprofits.
Recommendation 1: Invest in Parent Education to Increase Awareness of 2e
Characteristics, Path to Diagnosis, and Access to Supports
All 10 study parents were the first to notice exceptionalities in their children. Six of the
10 parents were not aware of their right to demand a no-cost educational evaluation of their child
from the school district. Over time, all 10 parents developed specialized 2e expertise to fill a
perceived void in other microsystem level influencers’ knowledge about twice exceptional
learners. All 10 parents sought private resources for diagnosis and private schooling options for
their 2e learner children. Clark and Estes (2008) stated education is the only way to prepare
people to manage unanticipated challenges. Education should comprise research-based
knowledge about the reasons and causes for these challenges, the “what” and “why” to deepen
their understanding of the challenge, rather than “how to” knowledge (Clark & Estes, 2008).
Research recommends parents need to learn what 2e characteristics and behaviors to look for in
their children (Baldwin et al., 2015). Prior research indicates parents can become effective
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advocates for their 2e children with adequate support (Dare & Nowicki, 2015). Research
suggests parents became more successful 2e learner advocates by increasing their knowledge
about 2e and available resources (Besnoy et al., 2015). Several researchers have recommended
dissemination of 2e educational materials to parents to aid identification, path to diagnosis, and
access to supports (Besnoy et al., 2015; Foley-Nicpon & Kim, 2018; Speirs Neumeister et al.,
2013). Figure 7 lists some of the knowledge areas identified in this study contributing to the
knowledge gap between typical parents and teachers and parents of 2e learners, and provides
seven concrete topic areas to cover in parent and teacher information sessions and publications.

Figure 7
Closing the 2e Knowledge Gap

Typical Parents and Teachers Parents of 2e Learners
Parenting a 2e learner,
I want to learn to…
Recognize 2e characteristics
Increasing Knowledge
Request a free evaluation
Advocate for supports
Communicate with teachers
Support your 2e learner at home
Connect with other 2e families
Find more resources and research
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High impact learning can take place in many settings, including online (Clark & Estes,
2008). For example, the results of this study will be disseminated to school districts and parent
organizations throughout California as well as published on websites of nonprofits focusing on
2e topics, thus making the findings available to parents and educators worldwide. Parent
education in school districts can take many forms. For example, these could include tailored
parent information sessions about 2e topics, short information sessions at back-to-school nights
and parent evenings, promotion of already existing 2e websites, and making information about
2e available to parents through weekly newsletters and other online communication channels.
Leveraging and linking district parents with the online 2e resources and 2e information collected
by educational nonprofits is a very effective way for a school district to get started. During the
journey leading to the 2e diagnosis for their children, study parents were very eager to find any
information that could help explain the differences their children exhibit and to find helpful
resources to support them. Therefore, we could expect parents of undiagnosed 2e learners are
likely to participate in the offered education if it is perceived as potentially helpful by the
parents. Study parents networked with other parents of 2e learners to share knowledge about 2e
expertise. Contacting other 2e parents helps identify relatable peers for both the 2e learner as
well as for the supporting parent (Reis & Renzulli, 2021). As a medium for parent information
sharing beyond the reach of the K–12 system, it is necessary to build capacity of educational
nonprofits to provide 2e expertise and education services to parents.
Recommendation 2: Invest in Teacher Training to Increase Awareness of 2e Characteristics
and Learn Classroom Best Practices to Support 2e Learners
Seven of the 10 study parents had to persevere against dismissiveness of their concerns
by teachers and other microsystem influencers surrounding their 2e child. Seven of the 10
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parents felt K–12 public schools neither have the necessary expertise to diagnose, nor the
knowledge and resources to support 2e learners. Clark and Estes (2008) define training as
learning new information, combined with guided practice and corrective feedback. Training is
effective to address knowledge gaps for those with no experience or related expertise for a
frequently occurring challenge (Clark & Estes, 2008). Research suggests teachers are unaware of
2e characteristics and reluctant to refer undiagnosed 2e learners to either gifted or special
education (Bianco & Leech, 2010; Foley-Nicpon et al., 2013). In response, research recommends
dissemination of 2e educational materials to teachers and school personnel (Besnoy et al., 2015;
Foley-Nicpon & Kim, 2018; Speirs Neumeister et al., 2013). Some of the latest research makes
specific recommendations, including calling for teacher training and in-service education to
include 2e characteristics and strategies that cater to 2e learner needs (Gierczyk & Hornby,
2021). Gierczyk and Hornby (2021) conclude 2e students could be taught effectively in inclusive
K–12 education settings if, and only if, 2e students are offered appropriate strategies and
programming. Adequate teacher preparation is a precondition for 2e students having access to
such strategies and programs. The findings from this study align with the latest research.
While general education teachers already have so much to attend to, and cannot be
expected to become specialists in every possible learning difference, they have a key role to play
as the gateway to evaluation and access to specialized services for all students, including 2e
learners. Therefore, it is important to train new and existing teachers on 2e characteristics and
best classroom practices in order to increase 2e awareness, to help teachers recognize these
characteristics as they encounter them in the classroom, and to give teachers tools to support 2e
learners in their classes. These topics could be incorporated into the training materials for new
teachers as well as into the continuing education of currently practicing teachers.
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Recommendation 3: Engage in Liberatory Design Thinking to Develop Concrete Plans to
Enhance the Capacity and Equity of 2e Learner Education in the K–12 System
The collected evidence indicates socio-economic factors influence 2e learner’s access to
diagnosis and supports. This finding is supported by prior research stating parents from lower
socio-economic backgrounds are not likely to have the same ability to advocate for their 2e
learners as parents with higher socioeconomic backgrounds (Besnoy et al., 2015; Dare &
Nowicki, 2015). Liberatory design thinking could be applied to arrive at concrete
recommendations for school districts, thus yielding more equitable outcomes to 2e learners.
Liberatory design thinking is a human-centered problem-solving approach leveraging innovation
and collaboration to ideate and test novel solutions to systemic inequities (Clifford et al., 2021).
Inviting a broad selection of voices and backgrounds to contribute to the design process could
enhance design equity. Design equity is a concept integrating design thinking, liberatory design,
and policymaking to achieve more equitable solutions (Culver et al., 2021). For example,
parents, general education teachers, special education teachers, GT specialists, psychologists,
pediatricians, and other microsystem influencers, as well as 2e students themselves could be
involved in the process of developing both parent and teacher education materials and processes
to enhance the school district’s capacity for inclusive development of 2e learners in the K–12
system. The parent education and teacher training materials should be based on evidence from
the latest research on 2e learners. Lastly, the design process should encompass a plan to hold
school districts accountable for maximizing 2e student success instead of mitigating failure.
Table 12 aligns major findings of the study with the corresponding recommendations and
summarizes evidence on the expected effectiveness of the recommendations.
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Table 12
Summary of Recommendations
Recommendation Corresponding study findings Research to support recommendation
1.Invest in parent
education to
increase
awareness of 2e
characteristics,
path to
diagnosis, and
access to
supports.
Parent involvement is crucial to
2e diagnosis.
Parents lack knowledge about
their right to demand a no-cost
educational evaluation.
Parents rely on private resources
to support 2e learner needs.
Parents develop specialized 2e
expertise.
Education prepares for unanticipated
challenges (Clark & Estes, 2008).
Parents need to learn what 2e
characteristics and behaviors to look
for (Baldwin et al., 2015).
Parents became more successful 2e
learner advocates by increasing their
knowledge (Besnoy et al., 2015).
Recommend sharing 2e educational
materials to parents (Besnoy et al.,
2015; Foley-Nicpon & Kim, 2018).
2.Invest in teacher
training and
education to
increase
awareness of 2e
characteristics
and classroom
best practices to
support 2e
learners.
Parents face dismissiveness of
their concerns.
Parents feel schools do not meet
2e learners’ needs.
Special education teachers appear
to be missing in action.
Is evaluation avoidance by school
districts intentional and
systemic?
Effective training is new information,
guided practice, and corrective
feedback (Clark & Estes, 2008).
Newly graduated teachers believe they
are not well prepared to meet the
needs of students with special needs
(Rowan & Townend, 2016).
Educators need to learn what 2e
characteristics and behaviors to look
for (Baldwin et al., 2015).
Recommend sharing 2e educational
materials to teachers and school
personnel (Besnoy et al., 2015;
Foley-Nicpon & Kim, 2018;
Gierczyk & Hornby, 2021; Speirs
Neumeister et al., 2013).
3.Engage in
liberatory design
thinking to
develop
concrete plans
to enhance the
capacity and
equity of 2e
learner
education in the
K–12 System.
Socio-economic factors influence
2e learner’s access to diagnosis
and supports.
Parents can develop specialized
2e expertise.
Parents network to share learning
about 2e expertise.
Online forums are helpful for
knowledge sharing.

High impact learning can take place in
many settings, including online
(Clark & Estes, 2008).
Parents with less socio-economic capital
are not likely to have the same ability
to advocate for their 2e learners as
parents with more socio-economic
capital (Besnoy et al., 2015; Dare &
Nowicki, 2015).
Liberatory design thinking can be used
to identify solutions to systemic
inequities (Clifford et al., 2021).

115

Table 13 lists examples of implementation methods and suggested content for each of the
three recommendations at various touch-points between parents and teachers.
Table 13
Examples for Implementation of Recommendations
Recommendation Implementation methods Suggested content

1. Invest in parent
education to
increase awareness
of 2e
characteristics,
path to diagnosis,
and access to
supports.
Active in-person opportunities:
Back-to-school night
Parent education evening
School newsletter
IEP session with teacher and
specialists
Passive; make information
available:
Brochure
Website
Suggested content for both active and
passive implementation methods:
Recognize 2e characteristics
Request a free evaluation
Advocate for supports
Communicate with teachers
Support your 2e learner at home
Connect with other 2e families
Quarterly review of recent 2e research
Examples of 2e info by nonprofits:
www.Understood.org
www.Wrightslaw.com
www.reel2e.org
Examples of 2e info by school districts:
www.cde.state.co.us/gt/twice-exceptional
2. Invest in teacher
training and
education to
increase awareness
of 2e
characteristics and
classroom best
practices to
support 2e
learners.
Active:
New teacher training
In-service teacher
continuing education
Teacher planning session
IEP session with parent and
specialists
Passive:
Brochure
Website
Recognize 2e characteristics
How to guide parents to access diagnosis
and access supports
Best classroom practices for 2e
Available supports
Strength-based learning
Special education and GT services
Quarterly review of newly published 2e
research
3. Engage in
liberatory design
thinking to develop
concrete plans to
enhance the
capacity and equity
of 2e learner
education in the
K–12 System.
Create tailored implementation
plan for a public school
district
Work with 2e nonprofits to
implement study
recommendations
Review findings of this study with
representatives of all stakeholders
Ideate vision for inclusive education for 2e
learners to reach full potential
Set site specific goals
Build cost-benefit model
Develop implementation plan
Create a scorecard
Measure progress quarterly
116

Limitations and Delimitations
Every study will have its limitations, some of them anticipated, others discovered during
the research process. The anticipated limitations of this study included the potential lack of
objectivity of the participants, their willingness to share, and the accuracy of their recollections.
While these limitations were beyond the researcher’s control, some of them could be ameliorated
through instrumentation and triangulation. Delimitations, on the other hand, are boundaries that
help the researcher define the scope of the research (Creswell & Creswell, 2014). It is important
to consider both the limitations and delimitations as they have an impact on data quality.
Limitations
The potential subjectivity of the participants regarding their roles was one of the
anticipated limitations for the study. The participants’ perceptions of the importance of their own
roles, and the impact they have had on the outcomes of their 2e children may be different than
the perceptions of other microsystem level influencers surrounding the child. The perspectives of
other microsystem influencers—the teachers, specialists, siblings, grandparents, and other people
in close proximity to the learner—may have yielded different information regarding the role of
the parents.
Participants’ willingness to share freely was a further anticipated limitation. Parents may
be reluctant to share details that make them feel inadequate about their parenting or are perceived
to be too personal to share. The interview protocol tried to alleviate this concern by using non-
judgmental questions, encouraging probes and affirmations. In addition, the researcher shared
their own positionality with the participants in the hope that sharing the story leading to the
research would encourage participants to help other parents learn from their own, often painful,
journeys.
117

Accuracy of the participants’ recollection was the third anticipated limitation. Given that
the study probes the participants’ memories over a timespan of several years, it is possible the
recollection of the participants was less than perfect. To help increase accuracy, any
inconsistencies in the responses to the questionnaire, the interview questions, and any other
information shared between the participants and the researcher were addressed through follow-
up questions.
Delimitations
Delimitations are choices made by the researcher as parameters for the study. Because of
the nature of the study, only parents of already diagnosed 2e children were included as
participants. Nine out of the 10 children had previously attended public schools; all attended
private schools at the time of the study. It follows that all the participants were of high socio-
economic status when compared to national averages and thus had more resources to help their
2e children than parents of lower socio-economic status would. The 2e children of the study
participants were all receiving additional supports outside the K–12 system financed directly by
their parents. This begs the question whether these particular 2e students were identified and
received supports because of the combination of their parents’ dedication and resources. While
parents of a different socio-economic situation are equally dedicated, they may not have
comparable time, resources, vocabulary, education and access to act as ambassadors to their 2e
children. This implies that some of the findings of the study may not be directly transferable to
different demographics.
Recommendations for Future Research
Future research is recommended to test or support those findings of this study where prior
research does not exist, or is inconclusive. Recommendations for future research include:
118

• Quantification of time lag from observation to 2e diagnosis.
• Exploration of potentially intentional and systemic learning difference evaluation
avoidance behavior by school districts.
• Mapping and measuring of specialized expertise developed by parents of 2e learners.
• Exploration and expansion of online resources for 2e information sharing and 2e
community building.
• Evaluation of equity issues resulting from barriers to access supports for 2e learners in
the K–12 system.
• Exploration of the career impact on the parent linked to 2e parenting experience.
Conclusion
To thrive and meet their full potential, twice exceptional learners need individually
tailored instruction that addresses their giftedness and their disabilities. Undiagnosed 2e learners
suffer academically and socio-emotionally. In the current K–12 system, the path to diagnosis
starts if, and only if, parents formally request that the school district conduct an educational
evaluation of their child. Most study parents were initially unaware of this process. Even when
following the process laid out by school districts, the 2e diagnosis may be missed, or the 2e
learner misdiagnosed, due to the complexity of dual exceptionalities, lack of specialist training,
ill-fit diagnostics, and lack of clear guidelines and regulations regarding 2e learners. All 10
parents interviewed for this study engaged private resources to seek an accurate diagnosis and
support for their 2e learner children outside the K–12 system. This study quantified the time lag
between parental observation of exceptionalities and 2e diagnosis at 4.1 years. This time lag
could have been shortened had parents, general education teachers, school psychologists,
administrators, pediatricians, and all other microsystem level influencers surrounding the child
119

been more aware of 2e characteristics and behaviors. An accurate diagnosis is a necessary, while
not sufficient, step toward 2e learners’ access to programming and supports they need to succeed
academically and socio-emotionally. Parents play a critical role in both the path to diagnosis and
in advocacy for strength-based programming and supports for their 2e learner children. Over
time, study participants acquired specialized 2e expertise to fill a perceived void in other
microsystem level influencers’ knowledge about twice exceptional learners. Socio-economic
factors influence the ability of parents to allocate resources to the procurement of necessary
knowledge, diagnosis and supports inside and outside the K–12 system. This equity gap can only
be addressed on a systemic level, with K–12 schools taking on a greater responsibility to cater to
the academic and socio-emotional needs of all students, including 2e learners. As the first step,
K–12 schools need to invest in parent education to make parents aware of what characteristics
and behaviors to look for, and how to initiate the educational evaluation process. In addition, K–
12 schools need to invest in training their teachers and staff on 2e characteristics and evidence-
based teaching strategies for 2e learners. Furthermore, new teacher education needs to include 2e
awareness building and introduction to available supports. Nonprofits can play an important role
as 2e awareness builders and as enablers for 2e parent networking and information sharing, thus
helping in this process to close the equity gap. As we help all 2e learners thrive and meet their
full potential, not only do the students themselves benefit, but also the society benefits from
unleashing their 2e superpowers to the benefit of all humankind.
120

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131

Appendix A: Questionnaire
Question Open or
closed?
Level of
measurement
Response options RQ Concept being
measured
1. What is the
highest level of
school you have
completed?
Closed Ordinal High school graduate
Bachelor’s degree
Master’s degree
Doctoral degree
Professional degree
(JD, MD)

3 Microsystem
family context
advocacy
2. What race do you
consider yourself
to be (select all
that apply):
Closed Nominal White
Black or African
American
Native American
(American Indian or
Alaska Native)
Asian
Native Hawaiian or
Pacific Islander
Other: ____

3 Demographics
3. What was your
approximate
household income
before taxes last
year?

Closed Interval Less than $49,999;
$50,000 to $99,000;
$100,000 to
$149,999;
$150,000 or more
3 Demographics
family context
resources and
supports
4. What is your zip
code?

Open 3 Demographics
5. Which of the
following best
describes your
role in the family?

Closed Nominal Mother
Father
Guardian
Other:_______
3 Family context
6. Are you now
married,
widowed,
separated or never
married?

Closed Nominal Married
Widowed
Divorced
Separated
Never married
3 Family context
132

Question Open or
closed?
Level of
measurement
Response options RQ Concept being
measured
7. Which of the
following best
describes your
sexual
orientation?

Closed Nominal Heterosexual
(straight)
Homosexual (gay)
Bisexual
Other
Prefer not to say

3 Family context
8. What type of
school does your
2e learner child
currently attend?
Closed Nominal Public (incl. charter
schools)
Private mainstream
Private specialized
Home-school
Other:__________

3 Resources and
support,
dual
differentiation
9. What is the
current grade
level of your 2e
learner?

Closed Interval 2
nd
, 3
rd
, 4
th
, 5
th
, 6
th
,
7
th
, 8
th
, 9
th
, 10
th
, 11
th
,
12
th

3 Demographics
10. Which
exceptionalities
characterize your
2e learner?
Closed Nominal High cognitive
abilities;
Specific learning
disability (dyslexia,
dysgraphia,
dyscalculia, etc.);
Attention Deficit
Hyperactivity
Disorder (ADHD);
Autism Spectrum
Disorder (ASD);
Emotional or
Behavioral Disability
(EBD);
Other:__________

3 Twice
exceptional
giftedness
learning
difference
exceptionality
11. At what age or
grade level did
you first notice or
suspect your child
had special
abilities and/or
challenges?

Closed Ordinal Before pre-school;
Pre-school aged (2–5
years); Kindergarten;
1
st
grade; 2
nd
grade;
Other: _________
1 First to
recognize
133

Question Open or
closed?
Level of
measurement
Response options RQ Concept being
measured
12. Which
exceptionality
was identified or
diagnosed first?
Closed Nominal High cognitive
abilities;
Specific learning
disability (dyslexia,
dysgraphia,
dyscalculia, etc.);
Attention Deficit
Hyperactivity
Disorder (ADHD);
Autism Spectrum
Disorder (ASD);
Emotional or
Behavioral Disability
(EBD);
Other:__________

1 Sense-making
13. At what age or
grade level was
the first
exceptionality
identified or
diagnosed (child’s
age at which you
came to the
conclusion, either
by your own
research and
observation or via
testing)?

Closed Ordinal Before pre-school;
Pre-school aged (2–5
years);
K, 1
st
grade; 2
nd

grade, 3
rd
, 4
th
, 5
th
, 6
th
,
7
th
, 8
th
, 9
th
, 10
th
, 11
th
,
12
th

1 Sense-making
14. At what age was
the second
exceptionality
identified or
diagnosed?
Closed Ordinal Before pre-school;
Pre-school aged (2–5
years);
K, 1
st
grade; 2
nd

grade, 3
rd
, 4
th
, 5
th
, 6
th
,
7
th
, 8
th
, 9
th
, 10
th
, 11
th
,
12
th

1 Sense-making
134

Question Open or
closed?
Level of
measurement
Response options RQ Concept being
measured
15. What was the
level of
involvement of
the people and
roles listed below
in the path to
identification and
diagnosis of your
child’s dual
exceptionalities?
• Yourself
• Your co-parent
• Classroom
teacher
• Special Ed
teacher
• School Admin
• Learning
Specialist
• Pediatrician
• Psychologist
• Other:______

Closed Interval Crucial, significant,
not significant, not
involved
1 Microsystem;
first to
recognize;
resources and
support
16. If you had to pick
one person or role
from the above
list without the
involvement of
whom this
discovery would
not have
happened, who
would it be and
why?

Open N/A N/A 1 Microsystem;
parents’ role;
first to
recognize;
17. Any comments or
clarifications?
Open N/A N/A N/
A
N/A

135

Appendix B: Interview Protocol
Question Potential probes RQ Key concept Q type
1. Let’s think about when
JOHNNY was quite
young. Please tell me
about how you first
noticed they might
process information
differently from other
children?
Tell me more about
the signs?
Do you recall how
old they were at
the time?
How did you react to
this?
Who else noticed
this?
1 Developmental
asynchrony
Socio-emotional
development
Sensory
2. Let’s think about the
time between when you
first noticed JOHNNY
was different from
other children until you
found out they are
twice exceptional. What
was that journey like?
Do you remember
how long this
took?
How was your family
life impacted?
What were the
actions that led to
the diagnosis?
1 Family context
Twice exceptional
Giftedness
Learning Difference
Experience
and
behavior
3. What was your role and
responsibility in that
journey?
Who played a critical
role in this
journey?
What would have
happened if you
did not play the
role you did? Who
else helped?
1 Family context Opinion
and values
4. If or when you shared
this diagnosis with
JOHNNY, how did
they feel when they
found out they are
twice exceptional?
Not everyone chooses
to share the
diagnosis, and that
is OK, I am just
trying to
understand.
1 Self-image
Self-efficacy
Feeling
5. What did you have to
learn along the journey
that was critical so that
JOHNNY could be
accurately diagnosed?
What were the
resources you
tapped into to help
you along the
journey?
2 Twice exceptional Knowledge
136

Question Potential probes RQ Key concept Q type
6. What advice would you
give another parents
who are early in the 2e
journey, especially
related to diagnosis and
support?
What did you find
most helpful?
What methods did
you use to find
out?
Do you remember
how you looked
for it?
2 Dual Differentiation Knowledge
7. It is quite amazing how
involved you have
become in all things 2e.
I am curious to learn
whether others were
involved as well. For
example, what was the
role of JOHNNY’s
teacher in helping
JOHNNY get the 2e
diagnosis?
Did this topic come
up in parent-
teacher
conferences?
Report cards?
Other communication
with the teacher or
school?
3 Developmental
asynchrony
Experience
and
behavior
8. What was the role of
the school in supporting
JOHNNY after
diagnosis?
How were the
teacher, the
administration,
special needs
education, school
psychologist
involved, if at all?
3 Dual differentiation
Strength-based
Experience
and
behavior
9. What other support, if
any, have you arranged
or advocated for
JOHNNY outside of
school, and outside
what you yourself can
provide?
Help before
diagnosis?
Help for the
diagnosis?
Help after the
diagnosis?
2 Dual differentiation
Strength-based
Self-image
Experience
and
behavior
10. In hindsight, what
factors could have
helped to arrive at the
diagnosis earlier?
What can we do to
help other children
be discovered
faster?
3 Dual differentiation
Strength-based
Self-image
Opinion
and values
11. Anything else to add?

137

Appendix C: Interview Introduction
Thank you for taking the time to meet with me today. Thank you also for agreeing to
participate in the data collection about the role of parents of twice exceptional students. I know
how busy our lives are these days, so I appreciate you fitting me in. This interview should take
about one hour, does that still work for you?
Before diving into the questions, I want to provide an overview of what we will cover today and
answer any questions you might have about the study and your participation.
I am completing a study on the role parents of twice exceptional learners play in the
identification, path to diagnosis and access to supports for their twice exceptional children. I will
have conversations with parents in order to understand what the 2e journey has been like and in
particular the role they as parents have played in that journey. The results of this study will be
part of my doctoral dissertation at the USC Rossier School of Education. Do you have any
questions about the study?
The hope is that these findings become useful for other parents who are struggling to find
out how to help their children that may be twice exceptional, but may not have figured it out yet.
Do you have any questions about the purpose of today’s conversation?
I want to assure that everything you say is strictly confidential. I will use pseudonyms, no
real names, so if I am using a direct quote, it will indicate that it is from a “Jane Doe” or “parent
with a 4
th
grader student with dyslexia,” etc. No real names will be linked with the findings and I
will not share the raw data with other parents, teachers, or anyone else. I will also not use the real
name of the school or program your child participates in. Do you have any questions?
138

If you have any questions about your rights regarding this study, or you have concerns or
suggestions that you would like to talk to someone beyond me about, the IRB contact info is on
the study info sheet that is attached to the consent form.
So that we can focus on our conversation today, I would like to record the interview, rather than
on taking notes. I will then use the recording to write down the notes after the interview. At any
time, you can ask me to stop the recording, to make “off the record” comments. Your
participation in this study and data collection is completely voluntary. May I have your
permission to start recording? Begin recording. Note the time and date.
Thank you for having filled in the questionnaire about yourself and JOHNNY’s
(pseudonym) school, age, diagnosis, and other background, so we can now jump right into the
interview questions.
Conclusion to the Interview
Thank you so much for taking the time to discuss your experience with me! Your insights
are very helpful to the study. We hope to use this to help many other parents and children in the
future. If I need to follow up, what’s the best way to contact you? Again, thank you so much for
participating.

Abstract (if available)

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Asset Metadata

Creator Tikkanen Merk, Hanna (author)

Core Title Understanding the critical role of parents in improving the identification and support of twice exceptional learners in the K–12 system

School Rossier School of Education

Degree Doctor of Education

Degree Program Organizational Change and Leadership (On Line)

Degree Conferral Date 2021-12

Publication Date 11/17/2021

Defense Date 10/27/2021

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag 2e diagnosis,inclusive education,OAI-PMH Harvest,parent education,parent involvement,twice exceptional

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Ferrario, Kimberly (committee chair), Kaplan, Sandra (committee member), Krop, Cathy (committee member)

Creator Email hanna@merkonline.com,htikkane@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC17138298

Unique identifier UC17138298

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Document Type Dissertation

Format application/pdf (imt)

Rights Tikkanen Merk, Hanna

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