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This literature review examines current practices and trends in identifying and supporting twice-exceptional (2e) learners, focusing on preschool through third grade. Despite growing awareness, educators often lack adequate training to effectively support 2e students, especially those from culturally and linguistically diverse backgrounds. This gap in knowledge leaves many teachers underprepared to serve 2e students in the classroom, leading to risks of misidentification, misdiagnosis, and inadequate support. This review highlights the need for comprehensive assessments and early identification, tailored instructional approaches, social and emotional considerations, and professional development. The review also underscores the importance of collaborative efforts among educators, parents, and other stakeholders. Utilizing Bronfenbrenner’s ecological systems theory, this review contextualized the findings within the broader environmental systems influencing 2e learners.