The diagnostic category of autism has been extensively investigated over the past 65 years since the condition was first described by Dr. Leo Kanner (1943), making it one of the most validated psychological disorders. Research has examined the characteristics of children with autism spectrum disorder (ASD) across a variety of domains, including diagnostic symptomology, intellectual profiles, adaptive behavior, and psychosocial functioning. However, there exists a paucity of empirical research on intellectually gifted children with ASD. The goal of the current study was to compare the psychometric profiles of gifted youth with and without ASD across the domains of intellectual functioning, psychosocial/behavioral functioning, social skills, and adaptive behavior using an empirical, group study design. It was hypothesized that, in comparison to the group of youth without ASD, the group of youth with ASD would demonstrate equally strong verbal and nonverbal intellectual abilities with relatively poorer processing speed, poorer adaptive functioning skills, more psychosocial/behavior concerns, and poorer social skills. Data from 81 school-age youth who had been identified as intellectually gifted were included in the present study. Forty of the participants in this study met DSM-IV-TR diagnostic criteria for ASD; the remaining 41 participants did not meet diagnostic criteria for an Axis I or Axis II psychological disorder. Statistical analyses included independent-samples t tests and split-plot analyses. Results of the current study demonstrate that statistically significant differences exist between gifted youth with and without ASD in the areas of processing speed, adaptive functioning, psychosocial/behavioral functioning, and social skills, despite equivalent verbal and nonverbal intellectual functioning. The current study is unique in that it is the first to examine these domains of functioning and make empirical comparisons of characteristics among gifted individuals with ASD using a group study design. Importantly, this study has significant implications for diagnosis of ASD and will provide an empirical foundation upon which to develop effective classroom interventions to best meet the unique needs of this twice-exceptional population.

Although a long-standing interest in the abilities of gifted students exists, researchers and clinicians have only recently focused on specific factors that may impact the likelihood of mental health diagnoses, such as anxiety and depression, within this population. This is especially true for gifted students with co-existing disabilities, or twice-exceptional students, who may have unique experiences that differ from those of gifted students without disabilities. Perfectionism is one factor that may be important to consider when examining factors that impact the development of anxiety and depression within these populations. The current study examined how perfectionism differs within gifted and twice-exceptional students within the context of self-reported anxiety and depression. Scores were reported for both gifted (N = 39) and twice-exceptional (N = 28) participants ages 8-14 on the Almost Perfect Scale-Revised (APS-R), Revised Children’s Manifest Anxiety Scale (RCMAS), and Children’s Depression Inventory-2 (CDI-2). Pearson chi-square results suggested that gifted students reported higher rates of maladaptive perfectionism on the APS-R compared to twice-exceptional students. Although gifted and twice-exceptional students in this sample reported style of perfectionism differently, group differences disappeared when also considering self-reported symptoms of anxiety and depression via 2x3 analyses of variance. Tukey post-hoc tests indicated that self-reported maladaptive style of perfectionism was related to higher scores on measures of anxiety and depression. Clinical and research implications of these findings were also explored.

Autism Spectrum Disorder (Autism Spectrum Disorder) is a neurodevelopmental syndrome characterized by impairment to social communication adjoined by the presence of rigidity, restricted interests, and/or repetitive behaviors. Diagnosis of Autism Spectrum Disorder recently shifted from a series of pervasive developmental disorders recognized in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000) to a single, comprehensive diagnosis in the 5th edition of the same manual (DSM-5; APA, 2013). To evaluate the appropriateness in this shift in diagnostic practice, the current study evaluates the consistency in symptom presentation amongst the previous DSM-IV-TR diagnoses. Additionally, this study identifies several novel considerations for Autism Spectrum Disorder symptom presentation in high ability youth. Thus, the current study addresses broad considerations for discrete versus continuous symptom presentation in Autism Spectrum Disorder, as well as contributes to the limited literature addressing Autism Spectrum Disorder symptom presentation features in high ability youth. A review of literature on theory, conceptualization, and assessment of Autism Spectrum Disorder is provided, as well as a review of relevant literature for high ability youth diagnosed with Autism Spectrum Disorder. Progression of Autism Spectrum Disorder diagnosis is discussed, with emphasis upon the current debate regarding shifts from utilization of many diagnoses to a single, comprehensive diagnosis. Next, unique challenges associated with Autism Spectrum Disorder in high ability youth are identified, including current conceptualization, assessment, and treatment considerations. Due to identified gaps in consistent understanding of Autism Spectrum Disorder presentation, including Autism Spectrum Disorder in high ability youth, the author conducted two complementary studies. The first of these studies evaluated consistency in parent ratings on Autism Spectrum Disorder screening tools across previously used diagnostic labels (i.e., Autistic Disorder (AD), Asperger's Syndrome (AS), and Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)) now subsumed under Autism Spectrum Disorder diagnostic criteria in the DSM-5. The second study analyzed Autism Spectrum Disorder symptoms reported by parents of high ability youth. Data collection for this latter study included a novel research measure intended for identifying symptoms associated with high ability Autism Spectrum Disorder. Items on this form were derived through a card sort of items included in current symptom screening tools completed by content area experts. Additionally, this novel research measure included an open-ended item for parents of high ability youth to report additional symptoms. Results from the first study suggest that parents of children diagnosed with AD, AS, and Pervasive Developmental Disorder, Not Otherwise Specified do not differentially report symptoms on two current Autism Spectrum Disorder screening tools: (1) The Social Responsiveness Scale (SRS; Constantino & Gruber, 2005) and (2) the Autism Spectrum Screening Questionnaire (ASSQ; Ehlers, Gillberg, & Wing, 1999). Results from the second study provide evidence of parental perceptions of several nuances in symptom presentation associated with high ability youth with Autism Spectrum Disorder. Specifically, parents frequently endorsed impairment in development and maintenance of social relationships; however, insight into these weaknesses was not consistently reported as impaired. Additionally, restricted interests were acknowledged, with some parents identifying academic or pseudo-academic subjects as common areas of interest. The collective findings from these studies provide evidence of broad consistency in Autism Spectrum Disorder symptom presentation across previously used diagnoses, yet also unique symptom features for high ability youth. Implications for education, clinical practice, and research in both Autism Spectrum Disorder and twice-exceptionality are discussed.

Students who meet criteria for both being intellectually gifted and having a disability are known by the term ‘twice exceptional’. To date there is little known about the classroom interactions of these students, and how these interactions impact their developing self-esteem. The interactions of four gifted primary school students with identified learning difficulties (twice exceptional) were observed along with four matched typically developing students and their teacher during normal classroom teaching activities. The number and type of positive, negative, neutral or no response interactions were recorded over four, one hour observation sessions. The Coopersmith Self-Esteem Inventory was then administered to the four twice exceptional and four comparison students. Results indicated that there was little difference between the twice exceptional and comparison students in terms of number of interactions recorded, with the twice exceptional students showing slightly more positive interactions with their teacher and peers. All four twice exceptional students reported lower self-esteem levels than their matched peers, with two students being in the low range. The results suggested that these four twice exceptional students were interacting in a manner similar to their typically developing peers, although they displayed lower self-esteem levels. The implications of these findings and recommendations for future research are discussed.

Past studies have found substantial benefits associated with integrating neurotypically developing students as peer supporters for children with autism (McCurdy & Cole, 2013). The current study asks the question as to whether or not the support of typically developing students benefits the social skills development of twice-exceptional students with Autism Spectrum Disorder (ASD). The “twice-exceptionality” in this study is specifically related to a heightened interest and proficiency in technology compared to children in their same age group, along with a coexisting diagnosis of autism. iSocial, a virtual learning intervention for children with ASD, is a recently developed program targeted to help children with ASD. To date, no research has examined iSocial’s use with peer supporters. As such, a new intervention that combines the use of iSocial with a peer support component is proposed. Typically developing peer supporters and children with ASD will collaboratively complete an 8-10 week intervention. It is predicted that children with autism in the experimental group will score significantly higher on post-intervention tasks than their baseline tasks. It is also predicted that children who collaborated with peer supporters will achieve greater symptom improvements on the Social Responsiveness Scale (SRS) and higher scores on the Reading the Mind in Eyes test than the control group. While children in both groups are anticipated to benefit from the iSocial intervention, it is likely that the highest gains will be observed in the peer-supported group. The outcomes of this study may serve as essential and practical ways for developing new methods to test and design interventions for children with ASD.

This thesis’s purpose is twofold. The first purpose is to present both information about what twice-exceptionality is and to make recommendations based on the existing research as to how parents or guardians can become more effective advocates and advocate for effective programming and services for their children who are twice-exceptional. While this thesis focuses on a specific subset of twice-exceptional students, those who are both gifted and have autism, a good deal of the material presented will be applicable to children who are gifted with learning disabilities. Effective parent advocacy looks the same across exceptionalities: producing the best educational experience based on the child’s unique needs. Strengths-based programming has been demonstrated to benefit twice-exceptional students no matter the disability, however the areas of deficit will vary depending on the specific disability a child has and his/her unique learning profile. The resources for information on special education law and twice-exceptionality will be useful to parents regardless of the twice-exceptional child’s disability. The second, and I feel most important, purpose of the thesis is to provide those parents/guardians with a “Quick Start Guide to Advocacy” to help them get started on the path to becoming the most effective advocate they can be for their child(ren). While educators and school administrators are expected to have a solid understanding of the rights and responsibilities of all stakeholders, many times parents are thrust into the world of special and gifted education with no preexisting knowledge. The aim of this thesis is to help bridge this gap for parents and guardians of this unique subset of students.

The most common comorbid disorder for adolescents with autism spectrum disorder (ASD) is depression, with more severe symptoms demonstrated in those with high cognitive ability. Feelings of loneliness are associated with depression. There is a dearth of information regarding pertinent variables for loneliness of friendship quality, friendship motivation, and social skills in high ability adolescents with ASD. This study employs a multiple case study design with 10 twice-exceptional adolescent males with high cognitive ability and ASD (ages 13-9 to 18-11) to investigate these variables. Adolescent, parent, and teacher interviews were completed, transcribed, and analyzed using Consensual Qualitative Research (CQR). Results describe friendship quality for these youth, with particular contributions to current understanding of companionship, security, help, closeness and balance. Findings inform friendship motivation, as well, and etiologies of amotivation are documented. Results indicate positive and negative influences of high intelligence on interpersonal functioning, along with immaturity and symptoms of rigidity affecting friendships, as well. Pathway analyses reveal twice-exceptional youth with insecure friendships experience loneliness and introjected motivation for friendships, along with increases in peer dyadic relationships and decreases in loneliness. Those with insecure friendships and perseverative interest in peers also present with suicidal ideation and/or attempts. Future research should expand the use of individual therapies (i.e., cognitive behavioral therapy for depression) for these twice-exceptional teens, particularly in middle school, with modifications to accommodate difficulties with perseveration on negative emotions, as well as explore coping strategies of engaging with fictional characters when lonely.

Parenting stress (PS) is a phenomenon experienced by all parents to varying degrees due to the demands of meeting a child's needs. This distinct type of stress is caused by an imbalance between the perceived demands of parenting and the perceived coping resources available to parents. The construct of twice-exceptionality (2E) is defined as the co-occurrence of giftedness and disability or possessing both high cognitive abilities and at least 1 of 13 potential disabilities identified under the Individuals with Disabilities Education Act of 2004. The purpose of this study was to understand how PS is experienced by parents of children who have been identified with 2E. The theoretical perspectives of stress appraisal, coping, and attribution guided this study and provided a framework for understanding the lived experiences of parents and the meaning they ascribe to these experiences. The goals of the study were accomplished through in-depth interviews with 13 participants, an extensive literature review, and reflective journaling. Interview data were analyzed using the phenomenological techniques of epoche, bracketing, horizontalization, and imaginative variation, and several relevant themes and subthemes were developed. High levels of PS described by the parents in this study indicate that further research is indicated for better understanding and serving the significant needs of this population. The social implications of this research include raising awareness of PS and 2E; increasing the potential for positive outcomes for children and families; and addressing misconceptions concerning giftedness, gender bias in the perceptions of parental roles, and the impact of PS on family systems.

Current gaps in knowledge about twice-exceptional youth relative to those with only one exceptionality (e.g., high ability or ADHD) include how twice-exceptional students perceive their friendships (Foley Nicpon et al., 2010). Some researchers have found friendship qualities to be less positive for youth with ADHD (Humphrey et al., 2007), yet others have found friendships to be rated more positively by gifted youth (Field et al., 1998). The current investigation sought to determine how friendships are perceived by twice-exceptional youth compared to peers with ADHD or high ability or achievement, and those with average ability or achievement and no diagnosis. Participants included 65 youth (35 boys, 33 girls) in middle school. Participants completed the Friendship Qualities Scale (Bukowski et al., 1994), in addition to a demographic questionnaire completed by parents. A repeated-measures ANOVA design was utilized to compare friendship quality ratings based on ability or achievement and ADHD diagnosis, as well as gender. Participants with ADHD, regardless of ability or achievement, reported significantly less companionship, help, and security with a best friend than those without a diagnosis. Boys were observed to report significantly less closeness with a best friend than girls. Implications of the current findings for counseling psychologists in the areas of practice and theory include considerations of how youth are socialized based on societal beliefs about gender and disability. Additionally, recommendations for treatment considerations, particularly for twice-exceptional youth, may include strengths-based interventions to support areas of strength to help accommodate difficulties.

The purpose of the present study was to examine the self-perceptions of gifted individuals who have a disability that impacts their ability to learn and/or express knowledge, a population known as "twice-exceptional." Twice-exceptional participants were compared to gifted participants without disabilities to determine whether they differed in their self-perceptions. The self-perceptions that were measured in this study were self-esteem, global self-concept, academic self-concept, and sense of inadequacy. Scores from the Behavior Assessment Scale for Children--2nd Edition (BASC-2) and the Piers Harris Children's Self-Concept Scale--2nd Edition (Piers-Harris 2) from school-age youth (n = 97) between ages 7 and 17 were used in the present study. Participants included 40 gifted youth, 29 gifted youth with learning disabilities, and 28 gifted youth with Attention-Deficit/Hyperactivity Disorder (ADHD). Correlations that were calculated among age, gender, and scales measuring self-esteem, global self-concept, and sense of inadequacy for each group of twice-exceptional participants (G/ADHD, G/LD) revealed that neither age nor gender was significantly correlated with the three measures of self-perception. Self-Esteem and Total Self-Concept were positively correlated for each category of twice-exceptional participants, and Sense of Inadequacy was negatively correlated with the former two measures. Gifted participants with learning disabilities were significantly different from gifted participants without disabilities on Self-Esteem, Intellectual and School Status (a measure of academic self-concept), and Sense of Inadequacy. Gifted youth reported higher levels of self-esteem and academic self-concept, and lower levels of sense of inadequacy. Gifted youth with ADHD were not significantly different from either comparison group. All three groups reported scores in the average range, with the exception of Intellectual and School Status. On this measure, gifted participants without disabilities reported scores in the above average range. Within the entire sample of participants, Interpersonal Relations and Sense of Inadequacy were found to predict 61% of the variability in Total Self-Concept Scores. Research and practice implications of the findings from these analyses were discussed.