A-Z Teen Health Glossary

Teen Twice Exceptional Treatment

The term twice exceptional (sometimes abbreviated as 2e) is a relatively new term that refers to teens who are intellectually gifted and also struggle with a disability, typically a learning disability or a mental disorder that puts them at a disadvantage in regard to certain challenges at school. The specific conditions the gifted teens have can vary greatly, including things such as Asperger syndrome, autism, teen obsessive compulsive disorder, teen dyslexia, teen Tourette syndrome, teen anxiety or teen depression. At Paradigm Malibu, we’ve designed a twice exceptional teen treatment program in order to meet the unique needs of these young people.

What Does Being Twice Exceptional Look Like?

  • 2e teens will often exhibit exceptional levels of intelligence and enthusiasm for one or more topics of interest, while struggling in other ways. They might be highly motivated and exhibit knowledge and thought processes beyond what their peers are capable of in one or more subjects, while appearing completely unmotivated in other regards.
  • 2e teens are typically ahead of their peers in terms of vocabulary or ability in the sciences or history, and they might struggle with language or math.
  • Teens who are 2e will struggle severely in one or more aspects of school or intercommunication, to the point that it might present as a disability or might greatly lower their grades. 2e teens typically have trouble fitting into school curriculum, as both teachers and parents can tell they are gifted but lack the ability to excel across the board.

Signs of Twice Exceptional Teens

Advanced vocabulary

Excellent sense of humor

High creativity

Very opinionated

Lack of organization

Poor social skills/outwardly awkward

Causes of Being Twice Exceptional

Gifted children are very different from twice exceptional children, the difference being the existence of a formal diagnosis of disability. A gifted child can exhibit above average intelligence and struggle with procrastination or organization, appearing aloof or scatterbrained, but remain gifted rather than twice exceptional. But when a child’s deficits reach a level of severity wherein, they can be diagnosed as behavioral disorders, forms of anxiety, learning disabilities, or other disorders, then they are twice exceptional. Factors that determine whether a teen might be twice exceptional include:

Biological causes – Genetics seem to account for at least some of the reason why certain teens develop learning disabilities or other mental disorders. Having several family members who are gifted but struggle in life because of certain strong personality quirks may indicate a greater likelihood of your teen being twice exceptional.

Stress – the pressure to exceed expectations or perform on the same level of proficiency in all subjects may substantially hinder a teen’s ability to feel comfortable or confident in their own skin, instead causing them to freak out and develop anxieties or depressive thoughts due to overwhelming stress. This may also cause their social abilities to tank.

Bullying – being bullied for exceptional ability, especially if paired with pride or arrogance, or if seen as threatening or confusing, can cause a teen to completely withdraw and develop behavioral problems as a way to cope with the bullying. Some teens might stop engaging others or fear social engagement and become extremely sensitive to criticism. Bullying and stress may also trigger symptoms of disorders that were already there to begin with, highlighting behavior that might suggest that a teen is struggling with a form of autism, ADHD, or a condition like Asperger’s.

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teens in the US are 2e


of gifted teens are estimated to count as twice exceptional


school age children have learning disabilities

How Can I Help My Twice Exceptional Teen?

Help your teen, but don’t hinder their progress – teens are likely to be frustrated by failure, and as a parent, it would be part of your natural instinct to jump in and help your teen if they’re about to face failure. You don’t want to see your teen struggle or fail and watching them be helpless can be heartbreaking. But it’s important to let your teen make their own mistakes and not jump in at every opportunity. The only way to learn is through trial and error, and helping means giving them directions through harsh times, rather than fostering dependence by not giving them the chance to explore difficult territory.

Help your teen find ways to release frustration and stress – coping with stress is crucial for teens who are twice exceptional. School can be very difficult to deal with, and chances are that they’ll come home angry or disappointed at the lack of progress they’ve made. Aside from helping them be more appreciative of their talents and strengths, help them find ways to release pent up frustration and relax after a hard day. Encourage them to explore new hobbies and engage in physical activity.

Teach your kid not to give up – treatment will help your child deal with their conditions and disabilities, but as a parent, your challenge will be to help your teen stay motivated in the face of certain difficulties. Set an example for your teen, and help teach them not to give up, especially when things get tough.

What Types of Treatment Are Available?

Teens who are twice exceptional don’t need treatment for their giftedness, but rather, they need help learning how to cope with their disability and hone their strengths, developing better coping mechanisms for moments of frustration, and learning how to utilize their abilities to overcome any potential shortcomings. Teens will largely be done with school, and must prepare for the road ahead, for any potential challenges they might face in early adulthood and beyond.

Talk Therapy

Therapy is an important tool for twice exceptional teens, but the hardest part of helping a 2e teen is often going to be establishing the right kind of bond with them, and the trust that you can help them with their problems. Twice exceptional teens face unique challenges, and require a very specific, individualized treatment plan.

Experienced therapists can help adapt their therapy to specifically suit a teen’s needs and to adapt to their challenges. Twice exceptional teens face an array of different potential disorders or disabilities, and accurately characterizing a teen’s struggles and making an accurate diagnosis can help pave the path for proper treatment.


Because twice exceptional teens face a list of potential issues, medication may or may not be part of their treatment plan. Antidepressants can help deal with a variety of depressive and anxiety disorders and can aid in the effectiveness of therapy. Meanwhile, teens facing behavioral disorders or ADHD may require different medication, potentially including stimulants and antipsychotics.

Some teens might worry that medication will dull their strengths, but with careful planning and some experimentation, a medical professional can help them find medication with minimal side effects, so they can continue therapy.

Alternative Treatments

Aside from medication and talk therapy, there are a number of alterative treatments that might help twice exceptional teens find a way to better cope with their disorder, and potentially find ways to deal with high-stress situations. Relaxation techniques, exercise therapy, art and music therapy, yoga, meditation, and other therapies can help teens discover new hobbies, and find ways to better manage their thoughts.

Teen Twice Exceptional Treatment at Paradigm Malibu

At Paradigm Malibu, we’re committed to working with teens from all different backgrounds and experiences and designing treatment plans that most thorough and precisely dress their needs. Teens come to us at Paradigm Malibu with an array of different needs, symptoms, stories, gifts, and challenges, and complex combinations thereof. For instance, sometimes teens struggling with a mental illness can also be quite gifted.

Individualized Treatment

At Paradigm Malibu, we’re uniquely qualified to provide treatment for twice exceptional teen treatment which starts with a careful diagnostic interview, which allows us to accurately identify teens’ core needs. Our entire diagnostic and treatment design process is designed to allow us to evaluate and treat each teen individually, including any combination of unique or complex needs which may be present. Within 48 hours of admission to Paradigm Malibu, each teen receives a combination of diagnostic assessments, which allow us to observe all aspects of teens’ current health and well-being.

This process is extremely well suited for twice exceptional teens, as this diagnostic process is designed not only to determine teens’ outward symptoms and problematic behaviors, but also their strengths, their interests, and their desires, as well. Moreover, because this diagnostic process is done individually, we’re able to create a program of specific support and treatment that helps to precisely address teens’ current needs. What we find is that for the vast majority of twice exceptional teen treatment, this kind of individualized approach and care is like nothing else they’ve experienced, and is far more effective and encouraging, as a result.

Bringing in the Family

We strongly believe that by working with twice exceptional teens and their families in this individual capacity, we can provide the teens with the support and guidance they need, and which will allow them to thrive to the fullness of their gifts and capabilities.

More than just try to create a welcoming and effective environment for twice exceptional teens to flourish in, we also work with families to ensure that they understand how best to help their teens continue to improve on both their strengths and weaknesses at home.

Outstanding! I believe Paradigm saved our daughters life and taught me invaluable things about how as her mother I can best support her in her journey to healing.

– Dee

Frequently Asked Questions About Twice Exceptional Teens

Is IQ a good indicator for giftedness?

IQ tests may be useful to determine intelligence on a societal level, but they are not indicative of a person’s true intellectual potential. Many children who are legitimately gifted may in fact score poorly on an IQ test, only to score very well later, due to certain behavioral issues and a refusal to take the test. IQ tests are also limited in explaining or covering how a child or teen may be gifted. The best way to determine giftedness is to see how a teen or child’s grasp of certain subjects holds up to the level of their peers. Typically, gifted individuals are far and beyond their peers in one or more subjects, such as possessing a striking grasp of language and an advanced insight into complicated concepts and ideas or being massively talented both creatively and in terms of intelligence. Furthermore, only some gifted children are also twice exceptional.

Do teens grow out of being twice exceptional?

Because of the way it is reported, some might assume that being twice exceptional is something reserved for children, a way to describe how gifted children might struggle in today’s extremely limited and highly archaic education system. However, many adults today may be twice exceptional, but simply were not recognized or diagnosed due to a lack of awareness. While the term has existed since the 70s, there has been little research done to properly identify how many children are potentially twice exceptional, and many teachers and parents both today and in the past struggle to help children who are obviously gifted but are underachieving for any number of possible reasons.

In other words, no. If not helped, twice exceptional teens will continue to struggle with the symptoms of their disabilities throughout their adult life, which can certainly impede their career, cut into their ability to connect with others and form meaningful relationships, and limit their success in the workplace.

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