Case Studies in Twice Exceptionality: Helping These Learners Survive and Thrive in Elementary Gifted Classrooms

Case Studies in Twice Exceptionality:

Helping These Learners Survive and Thrive in Elementary Gifted Classrooms

It All Started With a Project…

• Javits government grant for .875 million dollars for 5 year study of twice exceptional primary school children: PROJECT 2EXCEL

• Includes 4 school districts (all serving gifted students in homogeneous, self-contained classrooms) with varying demographics so we can try to generalize across schools:

District A – inner city gifted magnet school District B – small, blue collar 2nd ring suburban districtDistrict C – moderate 2nd ring middle class suburban districtDistrict D – moderate 1st ring blue collar/upper middle class suburban district

Goals of Project 2EXCEL• Develop a systematic identification system for gifted

learners with:– Attention Deficit Disorder with/without hyperactivity

(ADHD)– Emotional Behavioral Disorder (EBD)– Autism Spectrum Disorder (ASD)– Specific Learning Disability (SLD)

• Provide training for experimental teachers on twice exceptionality:– On-line certificate program (tuition free) 18 postgraduate

credits in 2X Education– In-service training on curricular specifics with built in, paid

writing days (8 per year)– Yearly stipends for materials and resources– Biweekly classroom visits for observation, reflection

Goals of Project 2EXCEL

• Develop a “toolkit” of adaptations and accommodations applicable to gifted math and reading/language arts curriculum

• Provide training and support to parents of twice exceptional experimental and control students

• Disseminate what is learned about identification, programming, and parenting with general community via:– Curriculum toolkit for teachers– Website (www.stthomas.edu/project2excel )– Parent training and resource manual

Project Implementation

• Matched pairs of gifted children identified with the same forms (and degree) of exceptionality were randomly assigned to experimental and control classrooms

• Matched pairs are pre- and post-tested on math and reading achievement levels, motivation to learn, and self-efficacy

• Experimental students receive services for 5 years, starting with 4th grade and controls continue with their current levels of services (for giftedness and special education)

• Parents of experimental and control students receive four training sessions yearly on home-based strategies and resources on twice exceptionality

What We Have Learned in Year One About Identification: 10 Strategies for

Finding the Kids

• S1 -A tiered system of identification **• Three-tiered system relying on more and more

sophisticated instruments to first include all possibles and potentials followed by “ruling out” other variables for a child’s inability to thrive in a gifted classroom

• S2 -Need for identification team • Consisting of at least a special education person for each

disability area and a gifted specialist, plus others involved such a school nurse, social worker, physicians, etc.

• S3 -Need for training for identification teams• Practice with spectrum of instruments (objective measures)

and checklists (subjective measures) and child study observations

Tiers for Identification

Tier 1 Tier 2 Tier 3

•Discrepancies among subtest or index scores on ability test used by a district• District Checklists of specific disability category characteristics or behaviors provided to teachers of students “suspected” of presenting with a disability

ADHD: Connor’s Rating ScalesEBD: Behavior Assessment System for Children (BASC-2); Behavior & Emotional Rating ScalesASD: BASC-2; Autism diagnostic Interview – R (ADIR)SLD: Woodcock-Johnson Tests of Achievement

ADHD: Connor’s Continuous Performance Test; Aschenbach Rating ScalesEBD: Student Risk Screening Scale; Strengths and Difficulties QuestionnaireASD: ADOSSLD: CTP; wrAP (Writing Assessment)

What We Have Learned in Year One About Identification: 10 Strategies for

Finding the Kids

• S1 -A tiered system of identification **• Three-tiered system relying on more and more

sophisticated instruments to first include all possibles and potentials followed by “ruling out” other variables for a child’s inability to thrive in a gifted classroom

• S2 -Need for identification team • Consisting of at least a special education person for each

disability area and a gifted specialist, plus others involved such a school nurse, social worker, physicians, etc.

• S3 -Need for training for identification teams• Practice with spectrum of instruments (objective measures)

and checklists (subjective measures) and child study observations

Study Procedure

• Each district used a 3-Tier identification protocol– Tier 1: discrepant WISC index scores when WISC used

for GT identification or for SPED identification (additional IQ testing was done for learners identified by other means); use of screening checklists by teachers and parents

– Tier 2: additional measures when identification unclear or measures inconsistent; Connor Rating Scales, BASC-2 for EBD, BASC-2 or ADIR for ASD, Woodcock-Johnson Achievement for LD

– Tier 3: Connor’s Continuous Performance for ADD, ERB for EBD, ADOS for ASD, wrAP Writing Assessment for SLD

Tiers for Identification

Tier 1 Tier 2 Tier 3

•Discrepancies among subtest or index scores on ability test used by a district• District Checklists of specific disability category characteristics or behaviors provided to teachers of students “suspected” of presenting with a disability

ADHD: Connor’s Rating ScalesEBD: Behavior Assessment System for Children (BASC-2); Behavior & Emotional Rating ScalesASD: BASC-2; Autism diagnostic Interview – R (ADIR)SLD: Woodcock-Johnson Tests of Achievement

ADHD: Connor’s Continuous Performance Test; Aschenbach Rating ScalesEBD: Student Risk Screening Scale; Strengths and Difficulties QuestionnaireASD: ADOSSLD: CTP; wrAP (Writing Assessment)

Prevalence Results Summary

• Approximately 14% of the 504 GT children in self-contained classes were 2X. At 30 GTs per classroom, that means we could expect 4 of those GTs to present with a second exceptionality in each classroom.

• GT/AD/HD learners represented 7% of the 504 GT children. At 30 GTs per classroom, we could expect 2 of those GTs to present with a AD/HD disorder in each classroom.

Prevalence Results Summary

• EBD and SLD represented 3%, respectively, of the 504 GT children. At 30 GTs per classroom, we could expect 1 EBD and 1 SLD child in each 4th grade classroom

• GT/ASD learners represented 1% of the 504 GT children. At 30 GTs per classroom, we could expect 1 GT child with ASD in every third classroom.

Developmental Prevalence Results Summary

• Except for the anomaly at 5th grade, there appears to be a slight increase overall in 2X presentation as gifted learners grow older

• GT/AD/HD seems to be the most prevalent twice exceptionality to crop up over time.

• Sixth grade appears to be a time when SLD may rear its ugly head.

• EBD tends to remain constant and at a relatively high second as most prevalent twice exceptionality.

• When looking across the grade levels, approximately 1 GT child in 5 in this study presented with some twice exceptionality.

What We Have Learned in Year One About Identification

• S4 -The WISC-4 is valuable in providing “inclusive” data on potential 2X children

• Children with discrepancies among index scores of 23 or more points are assessed with subsequent tiers for twice exceptionality

• S5 -Don’t look too far from the family tree• Traits of twice exceptionality are likely found in other family

members

• S6 - Finding twice exceptionals is easier in gifted self-contained classrooms than in mixed ability classrooms

• In the latter, the giftedness may allow children to look “average” so they are not recognised as either gifted or special education qualified


• S7 -Look harder than we have previously for eligible girls

• Especially for disabilities that are emotional, attentional In attentive ADHD), or for SLD – girls seem to be able to “hide” their issues more effectively

• S8 -Identification for twice exceptional may have developmental differences

• We are more likely to find ADHD and ASD fairly early, but EBD and SLD may not show up until the middle school years

• S9 - The school nurse may be one of the best identifiers of twice exceptionality

• Knows which are on medication and for what reasons


• S10 -Need to help parents understand importance of early identification

• Many don’t want their children “labeled” so will allow child to struggle but remain “average” rather than to address and perhaps countermand many permanent self-efficacy and intrinsic motivational issues.

• NUMBER 11 (I know I promised 10): we must look in three places for twice exceptionality

• A -Self-contained gifted classrooms for children who are not thriving (ruling out underachievement, low motivation, ethnic issues)

• B -Mixed ability classrooms for children who seem to have a “spark”

• C -Special education files, especially at children with highly discrepant sub-scores on objective tests

And Now About the Kids

• Jonah • Kelly• Nate• Ricky• Charlie• Linus• Sally• Lucy

Jonah

8-years-old

Cheerful

Outgoing and friendly

Diagnosed with ADHD

Mischievous eyes and grin

Interested in EVERYTHING

ADHD Associated Behaviors

High activity level Impulsive, inability to delay gratification

Impaired adherence to commands to regulate or inhibit behavior in social contexts

Behaviors must be excessive and long-term, and affect all aspects of the child’s life

Behaviors that happen more often in this child than in the child’s peers

Behaviors that occur in several settings, not only in one place, such as the playground, classroom, or home

Behaviors that are a continuous problem

Loses Things, Often Forgetful

Test Results

• IQ (Ability) Percentiles– Verbal 98th– Perceptual Reasoning 94th– Working Memory 99th– Processing Speed 58th**

• ITBS (Achievement): Percentiles– Reading 82nd 95th**– Math w/Computation 81st 92nd**– Math w/o Computation 99th 84th**

Teacher’s Perspective

• Very likeable• Strengths: sense of humor, compassion, insight,

good friend• Shares in class and enjoys the spotlight• In “charge” of making sure other students are

enjoying themselves• Not concerned about doing class work• VERY active in class• Often has “too many ideas in my head. I can’t

pick one.”

Parents’ Perspective

• Good natured• Monty Hall of the family• Enjoys solitary activities, yet is a “joiner”• Suspected giftedness when at age 3 he

designed a pulley system and tested it with different weights

• Hobbies: chess, fishing, Legos, basketball• Doesn’t sleep much• ADHD history possible in family

All is Right With the World When…

• Fishing• Playing with Legos• Reading a good fantasy book• Playing chess (against himself or others)• Searching for “just the right worms”

Child’s Perspective

Fall 2009 Hard to behave the way

others expect Average confidence in

Reading Not happy about

appearance Feels smart in school,

but not important Important to have

friends

Spring 2010 A little easier to behave

the way others expect Less confidence in

Reading - Slow Happier with appearance Feels smart in school,

but still not important Feels much more

socially accepted (Mom and teacher)

“Accommodations”

• Yoga• Aerobic ball• Desk position in room• Chewing gum• Tennis ball• Alternative assessments• One-on-one instructions• Approval and encouragement

Jonah After 1st Year

• Motivation from 8th to 56th Percentile in Math• Reading achievement from 82nd to 95th

Percentile• Math with computation from 81st to 92nd

Percentile, but Math without computation dropped from 99th to 84th percentile

• More friends• A little easier to behave the expected way• Acceptance of methodical work lessened

frustration (high executive functioning/slow processing speed)

Kelly

Obsessive Compulsive Disorder Anxiety

Affectionate

Desire to Please

Emotion Control Issues

OCD Associated Behaviors

• Problems with information processing• Obsessions and compulsions• Imagining losing control or having aggressive

urges• Fears• A need to have things “just so”

-- International OCD Foundation, 2010

Test Results

• IQ (Ability) Percentiles– Verbal 98th– Perceptual Reasoning 90th– Working Memory 68th*– Processing Speed 94th

• ITBS (Achievement) Percentiles– Reading 93rd 93rd– Math (w/Computation) 92nd 99th– Math (w/oComputation) 98th 99th


• Domineering and egocentric• Clever, smart, and capable• Impulsive• Completes work and follows instructions• Needs approval and encouragement• Eager to make friends

Family Life

• Frequent “groundings”• Uninvolved in activities outside of school• Parents going through divorce• Few friends outside of school• Mom concerned about lack of friendships

Child’s PerspectiveFall 2009

High Reading confidence VERY high Math

confidence Average social

acceptance Dislikes appearance

(compared to other girls) Behaves very well High global self worth

Spring 2010 Higher Reading confidence High Math confidence, but

lower than in Fall 2009 Higher social acceptance

than in Fall 2009 Dislikes appearance even

more Behaves most of the time Very low global self worth

All is Right With the World When …

• Reading• Sketching/Drawing• Writing -- especially poetry

Where will we be?

The fire is strong and fierce, the water mellow and soft

The earth changes not fast or slow.

What do you think is going on down below?

Lava heating up to explode? Ice so cold it can freeze all?

What do you think the world will be in 1,000,000 years?

Healthier … Fully polluted … Or does it even exist?

• Spending time with friends


• Praise and encouragement• Attempt to publish poetry• Coping skills• Encouraged to draw sketches to accompany

writing• Re-grouped frequently to make a friend

Kelly After 1st Year

• At a crossroads: • Self-esteem fell from a high level to below

average• Appears less anxious, but finishes lunch well

before lunchtime• Motivation for Math dropped significantly, but

achievement rose dramatically• Feels more socially accepted, but has few

friends• Knows that behavior is worse -- trying out

personas / “dumbing down” for classmates -- but has no plan to change

Nate

Non-Verbal Learning Disorder, ADHD

Immature Speech Patterns

Friendly

Sense of humor

Dysgraphia Associated Behaviors

• Distorted writing• Incorrect writing• Inappropriately sized or spaced writing• Wrong or odd spelling of words• Use of wrong words, though similar

-- National Institute of Neurological Disorders and Stroke (NINDS)

Test Results

• IQ (Ability) Percentiles– Verbal 99.9th– Perceptual Reasoning 39th **– Working Memory 27th **– Processing Speed 9th **

• ITBS (Achievement) Percentiles– Reading 73rd 87th **– Math (w/Computation)N/S

82nd– Math w/oComputation82nd 99th **


• Auditory learner• Grasps concepts quickly• Witty and has many friends• Challenges teacher to challenge him• Full of ideas and uses assistive

technology well• Mom doesn’t want homework

assignments -- his responsibility

Family Perspective

• Witty, good-natured, fun• Smart• Immature Speech Patterns• Forgetful • Helping him become independent by NOT

accepting homework assignments from teacher• ADHD history in family


Fall 2009 Very low Reading

motivation Average motivation in

Science Highly confident in

writing ability High self-esteem High to very high

global self-worth Teacher does nothing

different for him

Spring 2010 Still low (but higher)

Reading motivation Extraordinarily highly

motivated in Science VERY highly confident in

writing ability VERY high self-esteem VERY high global self-

worth Teacher did nothing

different for him

All is Right With The World When …

• Playing sports with friends• Reading -- loses sleep• Entertaining friends


All were provided for whole class

• Allowed to record test responses• Use of word processing for writing • Word prediction software• Flexible deadlines• Alternative assessment strategies• Movement in class: arm shakes, wrist

shakes, finger movement • Co-writing

Nate After 1st Year

• Possibly the highest level of self-esteem of anyone in the study

• Doesn’t worry about taking tests or writing• Using digital recorders and word processing,

writes beautifully• Ran for student council • Twice-exceptionality not getting in the way of

learning

RICKY

Diagnosed with Asperger’s Syndrome

Clever

Sense of Humor

Asperger’s Syndrome

• Limited interests or unusual preoccupation• Repetitive routines or rituals• Peculiarities in speech or language• Socially and emotionally inappropriate behavior• Problems with non-verbal communication• Clumsy and uncoordinated motor movements

-- National Institute of Neurological Disorders and Stroke (NINDS)

Test Results

• IQ (Ability) Percentiles– Verbal 96th– Perceptual Reasoning 99th– Working Memory 86th *– Processing Speed 99th

• ITBS (Achievement) Percentiles– Reading 96th 90th *– Math (w/Computation) 99th 99th– Math w/o Computation 99th 99th

Teacher’s Perspective• Brilliant• Requires a great deal of one-on-one • Highly motivated when interested• Great sense of humor• Genuinely likes him -- even his “ornery” side• Prefers hands-on activities• Sometimes seems to say random things, but

nothing inappropriate• Plays devil’s advocate

Family Perspective

• Forgetful in daily activities• Extremely sensitive, cries easily• Sponge for learning facts• Few friends -- has trouble making and then keeping

friends• Fidgety, always on the move• Frequent nightmares• Listens to reasoned arguments• Kind-hearted and creative• “Outside the box” thinker in all things


• Unhappy with himself -- would like to have more friends

• Sad that he is unpopular• Confidence in writing ability• Thinks the way he does things is just fine• Being smart in school is very important

to how he feels about himself as a person

All is Right With the WorldWhen …

• Reading• Conquering a difficult problem


• Allows him to work ahead in Math• Lets him calm himself when annoyed • 3 options when he does not understand: (1) let teacher

show how; (2) return to seat until ready; (3) go on with lack of understanding

• Created class culture of acceptance• Lets him “daydream” -- his way of concentrating• Daily schedule on his desk• Uses word processing software• Increased communication with parents

Ricky After 1st Year

• Probably the best example of the difference a teacher can make

• Self-esteem soared in all areas except social acceptance, although he is learning rules of social interaction

• Motivation exploded:– Reading 61st to 90th **– Math 41st to 86th **– Social Studies 53rd to 95th **– Science 51st to 91st **

Charlie, age 9

LDLearning Disability

Identification

• 37 point discrepancy between verbal and perceptual reasoning indices on WISC IV

• Highly gifted range in perceptual reasoning

• Average range in verbal, processing speed, and working memory

2009-2010 Testing Results

• CAIMI scores indicate lukewarm feelings about school

• Shows good gains in both math and reading on the ITBS

• Harter’s Measure of Self-Perception scores indicate that Charlie likes his appearance, is comfortable with his social abilities, and has increased confidence in his athletic ability.

Observations

• Frustration• Huge gestures• Moves around a lot• Tries to be quiet• Checks in frequently• Craves one-on-one time• Talks his way through problems

Accommodations/Modifications

• Frequent check ins.• Wiggle seat• Freedom of movement• Work space choice• Communication with parents• Less work assigned• Partial work agreement

Linus, age 9

ASDAutism Spectrum Disorder

Asperger’s Syndrome

Identification

• IQ in the superior range, no major score discrepancies on WISC IV indices

• Exhibits strong intellectual curiosity• Has a history of emotional outbursts in

class• Diagnosed with Asperger’s Syndrome


• CAIMI shows fairly high motivation toward all subjects except for social studies

• Scored in the 99th percentile on ITBS math and reading both pre- and post-test

• Harter’s scores indicate that Linus’ feelings of competence in writing increased dramatically

Observations

• Likes to be center of attention• Is well liked by peers• Blurts answers• Thinks out loud• Is frustrated by failure• Needs help with day-to-day problem

solving


• Help Linus cope with frustration• Separate him for math tests because of

thinking out loud• Build executive functioning skills

– Getting work turned in– Bringing what he needs when transitioning

for math

Sally, age 10

AD/HDAttention Deficit/Hyperactivity

Disorder

Identification

• High Verbal and Perceptual Reasoning scores, average Working Memory and Processing Speed scores. 23+ point discrepancy

• Diagnosed with ADD – on medication• Very quiet• Very slow worker


• CAIMI scores indicate highest motivation in reading, lowest in math

• Shows gains in math and reading on ITBS, averaging 2 grade levels of growth

• Harter’s scores indicate high self-esteem.

Observations

• Is very quiet in class• Loves to read• Has a hard time following along• Works slowly• Is persistent


• Pair with another student• Ongoing communication with parents• Graphic organizers• Allow more time for assignments• Frequent check-ins• Ask her to verbalize prior to writing

Lucy, age 10

EBDEmotional Behavioral Disorder

Identification

• 26 point discrepancy between Verbal and Processing Speed indices on the WISC-IV

• Has a slight speech impairment and talks very fast

• Works very quickly• Shows her feelings openly


• CAIMI scores show very high motivation for all subjects

• Performed at the same level in reading on the ITBS, but improved in math, scoring in the 99th percentile

• Harter’s scores show a slight drop in feelings of competence in math

Observations

• Works very quickly – frequently the first one finished with a task

• Wants to be sure others are doing what they are supposed to be doing

• Enjoys teaching her peers• Is in tune with her surroundings• Wears her feelings on her sleeve


• Weekly meeting• Reinforce student-teacher roles• Group with kids who can benefit from her

desire to share her knowledge• Give Lucy leadership roles whenever

reasonable

Individuals• Jonah

– Class entertainer– Difficult to meet others’ expectations for behavior

• Kelly– Needs approval and praise– A sensitive poet

• Nate– Grasps concepts quickly, witty and clever– Needs assistive technology and alternative assessments

• Ricky– Mathematician who hates to make a mistake– Needs one-on-one more often than other children

Individuals• Charlie

– frustrated and intense – larger than life.

• Linus – eager about learning– needs help with organization, appropriate responses to

frustration, and thinking out loud

• Sally – quiet and a slow worker – flies under the radar

• Lucy– In tune with her surroundings to an unusual degree– likes to be in control of her learning

Last Words…

• These 8 case studies show the idiosyncratic nature of twice exceptional children. No two are alike.

• Strategies that work for one may not work at all for others

• Strategies that may work one week for one may not work at all the next week

• It takes a team of professionals to track what occurs for these children – teachers, social workers, psychologists, special ed folk, GT specialists, nurses, and Project 2EXCEL personnel/observations

Stay Tuned – We have 3-1/2 more years…

• Stay in touch with us at

• www.stthomas.edu/project2excel

Documents

Case Studies in Twice Exceptionality: Helping These Learners Survive and Thrive in Elementary Gifted Classrooms