Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Hilary Vidair, Ph.D.

Second Advisor

Danielle Zito, Psy.D.

Third Advisor

Melissa Palatucci, Psy.D.

Abstract

Twice-exceptional (2e) students, defined broadly as those with both high cognitive abilities and disabilities, have unique psychological needs. Many 2e students struggle in school and at home, and their abilities and disabilities tend to mask each other, making it more difficult to diagnose twice-exceptionality (Foley-Nipcon et al., 2013). Additionally, no gold-standard interventions have been identified (Foley-Nicpon & Candler, 2018). These factors and the relative obscurity of twice-exceptionalism can leave parents feeling helpless, confused, and isolated when seeking care for their 2e child. There is no research on which mental health interventions parents believe their 2e children need, as well as how the field can address parents’ own needs as they experience the unique challenges associated with supporting their 2e children. The purpose of this qualitative study was to explore which mental health services and supports parents and their 2e children have already received, and which services and supports parents report they need. Participants included 15 parents (ages 35-48, M age = 42.8, SD = 2.47) of 2e children (ages 5-12; M age =8.9, SD = 1.94) who reported their child’s diagnosis as attention deficit hyperactivity disorder(ADHD; 66.67%), autism spectrum disorder (ASD) (66.67%), anxiety disorder (46.66%), and other disorders. A third of the children had comorbid ADHD and ASD (33.33%) and a majority of children had other comorbid diagnoses (66.66%). Auerbach and Silverstein’s (2003) grounded theory approach was used. The transcripts were coded for relevant text, repeating ideas, themes, and theoretical constructs. Interrater reliability was assessed using Cohen’s (1960) kappa, and a member check was completed. Overall interrater reliability suggested substantial agreement (.83). Six theoretical constructs were identified: 1) parents describe their child having complex and asynchronous neurodevelopmental, behavioral, and emotional profiles; 2) parents report they have played an active role in navigating the 2e identification process and express wanting more systemic and emotional support for themselves; 3) parents report their children receive mental health and related services and describe positive and challenging experiences with them; 4) parents want therapeutic approaches that are individualized, neurodivergent- affirming, and support their child’s emotional and interpersonal development; 5) parents describe professional misunderstanding of twice-exceptionality and how it has impacted their child’s care; and 6) parents report systemic challenges within educational and professional service settings. Findings have generated a theoretical framework regarding how parents can navigate the 2e identification process, the types of interventions 2e children may benefit from, and how the mental healthcare system can support both children and parents.

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