Twice Exceptionality, HPI and Spiky Profiles
Understanding children and adults who are both gifted and neurodivergent
What is Twice Exceptionality (2e)?
Twice exceptionality (often written as “2e”) refers to individuals who are both intellectually gifted/high potential and have one or more neurodevelopmental or learning differences. This might include a child who scores in the superior range on cognitive assessments but also has ADHD, autism, dyslexia, or dyspraxia. The term recognises that high intellectual potential and neurodivergence are not mutually exclusive and can, and frequently do, co-occur.
Twice exceptional individuals are often profoundly misunderstood. Their intellectual strengths can mask their difficulties, leading to underachievement, frustration, and a sense that they are “not trying hard enough” or are “lazy”. Conversely, their challenges can mask their potential, meaning their exceptional abilities go unrecognised and unsupported.
At Reframe Psychology, we have specialist experience in assessing and supporting twice-exceptional children and adults. We understand the complexity of this profile and take a whole-person approach that celebrates strengths while addressing genuine needs.
What is HPI (Haut Potentiel Intellectuel)?
HPI stands for Haut Potentiel Intellectuel, a French term meaning High Intellectual Potential. It is used widely in French-speaking countries and increasingly in the UK to describe individuals whose cognitive abilities fall significantly above the population average, typically in the top 2 to 3 percent (an IQ of approximately 130 or above on standardised assessments).
HPI is not simply about being “clever at school”. Individuals with high intellectual potential often experience the world more intensely, think in highly complex and interconnected ways, and may struggle with perfectionism, existential questioning, sensory sensitivities, and a deep sense of not fitting in. These characteristics are sometimes referred to as “overexcitabilities” and can be mistaken for anxiety, ADHD, or autism.
A formal cognitive assessment is the most reliable way to identify high intellectual potential. At Reframe Psychology, our assessments include a full cognitive profile, detailed feedback, and tailored recommendations for education, wellbeing, and support.
What is a Spiky Profile?
A “spiky profile” describes a pattern of cognitive or developmental abilities that are highly uneven. Rather than having a broadly consistent level of ability across different areas, a person with a spiky profile may show very high scores in some domains and significantly lower scores in others. This creates a jagged or “spiky” shape when results are plotted on a graph.
Spiky profiles are commonly seen in individuals with ADHD, autism, dyslexia, dyscalculia, and twice exceptionality. For example, a child might have exceptional verbal reasoning and a rich vocabulary, but struggle significantly with processing speed, working memory, or fine motor tasks. In such cases, a single overall IQ score can be misleading, and a more detailed, subtest-level analysis is essential.
Understanding a spiky profile helps educators, parents, and clinicians tailor support appropriately, recognising both where a child or adult excels and where they need additional help. It also helps the individual themselves make sense of their own experience.
Signs You or Your Child May Be Twice Exceptional
Twice exceptional individuals are frequently missed by standard screening processes because their strengths and difficulties cancel each other out. The following signs may suggest a twice exceptional profile worth exploring further:
- Advanced vocabulary and sophisticated ideas, but struggles to get thoughts onto paper
- Highly curious and creative, but easily bored or disruptive in class
- Excellent long-term memory for topics of interest, but poor working memory for routine tasks
- Strong verbal reasoning, but difficulty with reading, spelling, or handwriting
- Deep knowledge in specific areas alongside significant gaps in others
- Intense emotional sensitivity alongside difficulty regulating emotions
- High awareness of social rules but significant difficulty applying them in practice
- Underachievement at school that does not match intellectual ability
- Labelled as “lazy”, “careless”, or “not reaching potential”
- Anxiety or low self-esteem linked to repeated experiences of failure in areas that feel easy for others
Why Are Twice Exceptional Individuals So Often Missed?
There are several reasons why twice exceptional individuals frequently go unidentified for years, sometimes into adulthood:
Masking through strengths
High intellectual ability can compensate for underlying difficulties, allowing a child to achieve average grades despite considerable effort and hidden struggle. Teachers and parents may not realise how hard the child is working just to keep up.
Misattribution of difficulties
When a bright child struggles, their difficulties are often attributed to attitude, motivation, or emotional problems rather than to a genuine learning difference. This can result in years of misplaced interventions and unnecessary shame.
Inadequate assessments
Brief screening tools or group-administered assessments often fail to capture the complexity of a twice exceptional profile. A comprehensive, individually administered cognitive assessment that examines subtest-level variation is essential for accurate identification.
Lack of awareness
Many education and health professionals have limited training in twice exceptionality. The concept that a child can be both gifted and have a significant learning difference is still not widely understood in healthcare settings.
The Emotional Experience of Being Twice Exceptional
Living with a twice exceptional profile can be an isolating and confusing experience. Twice exceptional individuals often describe a persistent sense of not fitting in anywhere. They may feel too different or intense for neurotypical peers, yet do not identify with the typical narrative of disability. They may feel they do not belong in gifted programmes either, because their difficulties are visible and real.
Common emotional experiences in twice exceptional individuals include:
- Perfectionism and intense fear of failure
- Imposter syndrome, particularly in academic or professional settings
- Chronic frustration at the gap between what they can think and what they can produce
- Anxiety, often linked to unpredictability, sensory overload, or social confusion
- Low self-esteem despite clear intellectual ability
- Existential questioning and a deep need for meaning and purpose
Psychological support that is tailored to the twice exceptional profile can make a significant difference. At Reframe Psychology, we offer therapy that acknowledges both the potential and the genuine difficulties, without minimising either.
Our Assessment for Twice Exceptionality and HPI
Our cognitive and neurodevelopmental assessments are designed to capture the full complexity of a person’s profile. We do not rely on a single composite score. Instead, we examine performance across all cognitive domains, including verbal comprehension, visual-spatial reasoning, fluid reasoning, working memory, and processing speed, to build a detailed picture of strengths and difficulties.
Where relevant, we also assess for co-occurring conditions such as ADHD, autism, dyslexia, and anxiety. Our reports are written to be genuinely useful, providing clear explanations of the profile, practical recommendations for schools and employers, and guidance for the individual and their family.
What our assessment includes:
- A pre-assessment consultation to understand your concerns and goals
- A comprehensive, individually administered cognitive assessment (WISC-V for children or WAIS-IV for adults)
- Detailed analysis of subtest scores and the pattern of strengths and difficulties
- Screening for co-occurring conditions where indicated
- A written report with a full cognitive profile and tailored recommendations
- A feedback session to discuss findings and answer questions
Assessments are available for children from age 6 upwards and for adults. We work with individuals referred by schools, GPs, or other professionals, as well as those who self-refer.
Supporting Twice Exceptional Children at School
The school environment presents particular challenges for twice exceptional learners. Standard differentiation often fails to address both ends of the profile simultaneously. A child may need extension work to stay intellectually engaged, while also needing scaffolding, extra time, or assistive technology to manage their difficulties.
Our assessment reports include specific, actionable recommendations for schools, covering areas such as:
- Access arrangements for examinations (extra time, rest breaks, use of a laptop)
- Curriculum enrichment and intellectual stretch
- Strategies for managing working memory difficulties in the classroom
- Emotional regulation and anxiety management support
- Guidance for teachers on understanding the twice exceptional profile
- Recommendations for specialist support services or further referrals
We are also available to liaise with schools directly, attend EHCP meetings, or provide consultation to education staff where this would be helpful.
Frequently Asked Questions
Can someone be both gifted and have ADHD or autism?
Yes, absolutely. Giftedness (or high potential) and neurodevelopmental conditions such as ADHD and autism are not mutually exclusive. Research suggests that twice-exceptional profiles are more common than previously thought, though they remain underidentified due to the masking effect of high ability.
My child’s school says they are doing fine. Should I still get an assessment?
If you have concerns about your child’s wellbeing, effort relative to outcomes, emotional regulation, or social experience, it is worth exploring further. “Doing fine” academically does not rule out a twice-exceptional profile. Many 2e children achieve average grades through significant effort and coping strategies that are not sustainable long term.
Do you assess adults as well as children?
Yes. Many adults reach us having gone through their entire education without ever receiving an explanation for their experience. A late-identified twice exceptional profile can bring significant relief and clarity. We offer cognitive assessments for adults using the WAIS-IV and can also assess for ADHD and autism in adulthood.
How long does an assessment take?
A full cognitive assessment typically takes between two and three hours, depending on the individual and the scope of the assessment. Report writing and feedback are included in the overall package.
Ready to Find Out More?
If you think you or your child may be twice exceptional, have high intellectual potential, or have a spiky cognitive profile, we would love to hear from you. Our team is experienced in working with complex profiles and will take the time to understand your individual situation.