High Intellectual Ability and Twice-Exceptionality

Introduction: Twice-exceptionality (2e) describes individuals with high intellectual abilities and neurodevelopmental conditions, whose strengths and difficulties mask each other, complicating identification. This article aims to review current evidence on the identification of and educational support for 2e, to establish recommendations applicable in clinical and educational settings. It emphasizes the need to move beyond exclusively psychometric approaches due to fragmented services and diagnostic variability.Development: Accurate identification requires integrating standardized testing, dynamic assessment (guided tasks), early developmental milestones (such as age of reading onset), and socioemotional factors. Creativity in these profiles is associated with prolonged sensitive periods and contextual opportunities. However, barriers persist, including reciprocal masking (difficulties obscuring talents or vice versa), insufficient teacher training, and institutional segmentation. Effective interventions include strength-based strategies, psychosocial support, and integrated health-education protocols.Conclusions: Addressing 2e demands a multidimensional approach: holistic identification using complementary tools, interventions combining curriculum adaptation and emotional support, and overcoming systemic barriers through teacher training and coordinated policies. This prevents both overdiagnosis and the invisibility of talent.