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

2. 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 2 nd ring suburban district District C – moderate 2 nd ring middle class suburban district District D – moderate 1 st ring blue collar/upper middle class suburban district

3. 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

4. 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 )www.stthomas.edu/project2excel –Parent training and resource manual

5. 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 4 th 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

6. 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

7. Tiers for Identification Tier 1Tier 2Tier 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 Scales EBD: Behavior Assessment System for Children (BASC- 2); Behavior & Emotional Rating Scales ASD: BASC-2; Autism diagnostic Interview – R (ADIR) SLD: Woodcock- Johnson Tests of Achievement ADHD: Connor’s Continuous Performance Test; Aschenbach Rating Scales EBD: Student Risk Screening Scale; Strengths and Difficulties Questionnaire ASD: ADOS SLD: CTP; wrAP (Writing Assessment)

8. 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

9. 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

10. Tiers for Identification Tier 1Tier 2Tier 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 Scales EBD: Behavior Assessment System for Children (BASC- 2); Behavior & Emotional Rating Scales ASD: BASC-2; Autism diagnostic Interview – R (ADIR) SLD: Woodcock- Johnson Tests of Achievement ADHD: Connor’s Continuous Performance Test; Aschenbach Rating Scales EBD: Student Risk Screening Scale; Strengths and Difficulties Questionnaire ASD: ADOS SLD: CTP; wrAP (Writing Assessment)

11. 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.

12. 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 4 th 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.

13. Developmental Prevalence Results Summary Except for the anomaly at 5 th 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.

14. 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

15. What We Have Learned in Year One About Identification 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

16. What We Have Learned in Year One About Identification 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

17. And Now About the Kids Jonah Kelly Nate Ricky Charlie Linus Sally Lucy

18. Jonah 8-years-old Cheerful Outgoing and friendly Diagnosed with ADHD Mischievous eyes and grin Interested in EVERYTHING

19. ADHD Associated Behaviors High activity levelImpulsive, 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

20. Test Results IQ(Ability) Percentiles –Verbal98th –Perceptual Reasoning94th –Working Memory99th –Processing Speed58th** ITBS (Achievement): Percentiles –Reading82nd 95th** –Math w/Computation81st 92nd** –Math w/o Computation99th 84th**

21. 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.”

22. 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

23. 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”

24. 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)

25. “Accommodations” Yoga Aerobic ball Desk position in room Chewing gum Tennis ball Alternative assessments One-on-one instructions Approval and encouragement

26. 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)

27. Kelly Obsessive Compulsive Disorder Anxiety Affectionate Desire to Please Emotion Control Issues

28. 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

29. Test Results IQ (Ability) Percentiles –Verbal98th –Perceptual Reasoning90th –Working Memory68th* –Processing Speed94th ITBS (Achievement) Percentiles –Reading 93rd93rd –Math (w/Computation) 92nd99th –Math (w/oComputation) 98th99th

30. Teacher’s Perspective Domineering and egocentric Clever, smart, and capable Impulsive Completes work and follows instructions Needs approval and encouragement Eager to make friends

31. 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

32. Child’s Perspective Fall 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

33. 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

34. “Accommodations” Praise and encouragement Attempt to publish poetry Coping skills Encouraged to draw sketches to accompany writing Re-grouped frequently to make a friend

35. 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

36. Nate Non-Verbal Learning Disorder, ADHD Immature Speech Patterns Friendly Sense of humor

37. 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)

38. Test Results IQ (Ability) Percentiles –Verbal99.9th –Perceptual Reasoning39th ** –Working Memory27th ** –Processing Speed 9th ** ITBS (Achievement) Percentiles –Reading 73rd87th ** –Math (w/Computation)N/S82nd –Math w/oComputation82nd99th **

39. Teacher’s Perspective 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

40. 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

41. Child’s Perspective 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

42. All is Right With The World When … Playing sports with friends Reading -- loses sleep Entertaining friends

43. “Accommodations” 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

44. 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

45. RICKY Diagnosed with Asperger’s Syndrome Clever Sense of Humor

46. 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)

47. Test Results IQ (Ability) Percentiles –Verbal 96th –Perceptual Reasoning 99th –Working Memory 86th * –Processing Speed 99th ITBS (Achievement) Percentiles –Reading 96th90th * –Math (w/Computation) 99th99th –Math w/o Computation 99th99th

48. 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

49. 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

50. Child’s Perspective 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

51. All is Right With the World When … Reading Conquering a difficult problem

52. “Accommodations” 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

53. 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: –Reading61st to 90th ** –Math41st to 86th ** –Social Studies53rd to 95th ** –Science51st to 91st **

54. Charlie, age 9 LD Learning Disability

55. 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

56. 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.

57. 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

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

59. Linus, age 9 ASD Autism Spectrum Disorder Asperger’s Syndrome

60. 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

61. 2009-2010 Testing Results CAIMI shows fairly high motivation toward all subjects except for social studies Scored in the 99 th percentile on ITBS math and reading both pre- and post-test Harter’s scores indicate that Linus’ feelings of competence in writing increased dramatically

62. 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

63. Accommodations/Modifications 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

64. Sally, age 10 AD/HD Attention Deficit/Hyperactivity Disorder

65. 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

66. 2009-2010 Testing Results 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.

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

68. Accommodations/Modifications 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

69. Lucy, age 10 EBD Emotional Behavioral Disorder

70. 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

71. 2009-2010 Testing Results 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 99 th percentile Harter’s scores show a slight drop in feelings of competence in math

72. 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

73. Accommodations/Modifications 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

74. 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

75. 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

76. 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

77. Stay Tuned – We have 3-1/2 more years… Stay in touch with us at www.stthomas.edu/project2excel