Multi-Exceptionality: Navigating the Intersections of Giftedness, Autism, and ADHD

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Understanding Multi-Exceptionality

In recent years, the concept of multi-exceptionality has gained greater visibility, particularly within neurodivergent communities and contemporary psychological discourse. Multi-exceptionality refers to individuals who are both gifted and disabled. These individuals are often described as twice- or multi-exceptional, meaning they possess significant cognitive strengths alongside developmental, learning, or mental health differences (Ronksley-Pavia, 2015; Atmaca & Baloğlu, 2022).

As a multi-exceptional therapist, I understand personally and professionally the nuanced ways these identities can converge. For many years, I internalised a fragmented sense of self—struggling to reconcile my capacity for intellectual insight with challenges around executive function, sensory overwhelm, and emotional intensity. It wasn’t until I began unmasking and integrating these truths through therapeutic, scholarly, and relational work that I could fully recognise my experience as multi-exceptional.

Despite the potential within this neurocognitive profile, multi-exceptional individuals are frequently misunderstood or unsupported due to masking, systemic inaccessibility, and assumptions that giftedness inherently equates to wellbeing. Our lived experiences often include navigating environments designed for neuronormative populations—educational systems, clinical services, and workplaces—which can obscure our support needs and complicate access to care, validation, and belonging.

Giftedness: Beyond IQ

Historically, giftedness has been narrowly defined by intelligence quotient (IQ) scores and academic performance. However, this reductionist view is being challenged by contemporary models that consider giftedness to be a more holistic and complex phenomenon. Emotional intensity, existential depth, creative expression, and asynchronous development are now understood as key features of giftedness (Daniels & Piechowski, 2008; Sallin, 2015). My own giftedness expresses itself through a deep inner world—filled with questions about justice, existence, and human connection—but this intensity wasn’t celebrated in childhood. Instead, it made me “too much” in environments that rewarded conformity. It wasn’t until my postgraduate studies and clinical work that I found the language and community to understand this as giftedness rather than deficit.

Autism: Monotropism and Meaning

Autism is characterised by differences in social communication, sensory processing, and focused interests. Many autistic individuals process the world through a bottom-up lens, relying heavily on direct sensory input and contextual information rather than broad generalisations or assumptions (Brosnan & Ashwin, 2023). The theory of monotropism suggests that autistic people tend to focus intensely on a narrow range of interests, often to the exclusion of other stimuli or tasks (Murray, 2020). As an Autistic person, I often experience the world as overwhelmingly vivid. I have a deep capacity to enter flow states when immersed in special interests but I also experience shutdowns when my sensory system becomes overloaded, particularly in fast-paced or emotionally unpredictable environments. In my therapeutic work, I’ve found that many Autistic clients resonate with this kind of depth-focused attention. Validating these traits not only enhances engagement but also helps to rewrite internalised stories of deficiency.

ADHD: Dynamic Attention

ADHD is increasingly understood not as a deficit of attention, but as a condition involving challenges with attention regulation. ADHDers often describe having “interest-based nervous systems,” meaning their focus is governed more by passion or novelty than by external expectations (Rosqvist et al., 2023). When ADHD overlaps with giftedness, the result can be a person who generates brilliant ideas rapidly but may struggle to execute them within systems that prioritise consistency and linear productivity. This dynamic describes much of my professional life. I can go from hyperfocus to forgetfulness within a single afternoon. I thrive on conceptual development but struggle with rote tasks like scheduling or data entry. For years, I felt ashamed of my inconsistencies, believing I simply lacked discipline. It wasn’t until I embraced my ADHD identity that I could create scaffolds around my needs, rather than try to suppress or override them.

The Intersection: Complexity, Contradiction, and Capacity

When giftedness, autism, and ADHD co-exist within the same individual, the result is often a spiky profile—where strengths and difficulties co-occur in a way that defies simple categorisation (Baum et al., 2017). An individual may be eloquent in discussing a niche interest but find casual conversation exhausting or confusing. They may grasp abstract theories quickly but struggle to begin a basic administrative task. This complexity is central to my personal and professional worldview. In my private practice, I support multi-exceptional individuals—many of whom have been misdiagnosed, misunderstood, or left to self-manage without adequate support. Their pain is often invisible because they “seem fine,” especially when their giftedness masks their autistic and ADHD needs. But beneath that surface lies exhaustion, anxiety, and a relentless sense of not fitting in anywhere.

Invisible and Misunderstood: Challenges in Recognition and Diagnosis

Multi-exceptional individuals often go unrecognised or are misdiagnosed due to masking, compensatory strategies, and societal biases. Giftedness may mask signs of autism or ADHD, especially in individuals who present as articulate, intellectually curious, or high achieving. These individuals may learn to "perform" neuronormativity at great personal cost, suppressing stims and overwhelm, or pushing through executive functioning challenges to meet expectations (Hull et al., 2017). I’ve seen this pattern repeatedly—in myself, in clients, and in colleagues. As someone assigned female at birth, my late diagnosis was shaped by gendered expectations of emotional labour, sociability, and compliance. I performed “well enough” to avoid suspicion, but not without personal cost. For many of my clients, especially queer, nonbinary, or marginalised folks, these same dynamics delay access to diagnosis, support, and even self-understanding.

Systemic Limitations and Building Better Systems

The neurodiversity paradigm frames autism, ADHD, giftedness and other forms of neurodivergence not as deficits, but as natural variations in human cognition (Walker, 2021). Within this framework, disability is not an intrinsic feature of the person, but an emergent property of inaccessible environments. Most mental health, education, and workplace systems remain grounded in deficit-based, linear, and compliance-driven frameworks. For multi-exceptional people, this systemic mismatch can result in chronic allostatic load—the cumulative toll of stress and suppression on the nervous system (Guidi et al., 2020). I’ve lived through this. I’ve watched my body shut down under the weight of misattunement, and I’ve worked with clients who have internalised their burnout as personal failure rather than systemic harm.

Supporting multi-exceptional individuals requires neuroaffirming systems that honour complexity, nuance, and diversity of experience. This involves embracing participatory, neurodivergent-led approaches across therapy, education, research, and organisational practice. Rather than stopping at awareness, meaningful change requires a shift toward structural transformation—addressing the barriers built into policies, practices, and cultural norms. In professional development and supervision contexts, it's essential to deepen understanding of both the internal experiences and external challenges that shape multi-exceptional lives. Lived experience must be recognised not as a token gesture, but as a vital form of knowledge—epistemic expertise that is central to designing inclusive systems. Creating environments where multi-exceptional individuals can truly thrive demands a reimagining of intelligence, professionalism, and capacity through a lens of collaboration, flexibility, and respect for difference.

Conclusion: Embracing the Whole Person

At its core, multi-exceptionality invites us to hold paradoxes—to honour brilliance alongside burnout, capacity alongside struggle. It asks us to see beyond diagnostic categories and standardised expectations, into the real lives of people who carry deep insight, sensitivity, and complexity. As someone who lives and works at this intersection, I know how exhausting it can be to constantly translate oneself. But I also know the power of being witnessed in your fullness. Multi-exceptionality isn’t a pathology—it’s a lens through which we can reimagine inclusion, intelligence, and healing. By embracing difference, we not only support neurodivergent individuals—we expand what is possible for all of us.

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