Neuropsychological profile and clinical benefits of multimodal interventions in a child with ADHD, Generalized Anxiety Disorder, and Social (Pragmatic) Communication Disorder within the context of intellectual giftedness: a case report

BACKGROUND: In recent years, particular interest has been directed toward the topic of intellectual giftedness. An IQ above 130, typically assessed with standardized cognitive scales, is a widely recognized criterion for giftedness. Gifted children often face emotional and socio-relational difficulties, particularly anxiety, due to perfectionism and high-performance pressures. Co-occurring neurodevelopmental disorders like Attention-Deficit/Hyperactivity Disorder (ADHD) and Social (Pragmatic) Communication Disorder complicate their adaptation in various life contexts. This is the case of twice-exceptional children, who are those presenting intellectual giftedness alongside one or more disorders. ADHD, characterized by inattention, hyperactivity, and impulsivity, poses significant academic and social challenges, making accurate diagnosis and appropriate treatment in gifted individuals crucial. Similarly, Social (Pragmatic) Communication Disorder induces significant relational difficulties with peers, with potential deeply negative consequences for children’s psychological well-being. A thorough neuropsychological and emotional-behavioural assessment, along with personalized and holistic therapeutic approaches, are essential for optimal adaptation in all life contexts for twice-exceptional children. CASE PRESENTATION: The present study aimed to thoroughly characterize the neuropsychological and psychopathological profile of a gifted child to gain a deeper understanding of his overall well-being and to identify the need for a personalized intervention plan. Specifically, this case report describes a 7-year-and-8-month-old boy assessed due to attention difficulties, anxiety, socio-relational challenges, and behavioural concerns. The child underwent extensive neuropsychological and psychopathological evaluations. The study details his medical history, diagnostic formulation, pharmacological and behavioural interventions, and a six-month follow-up to monitor clinical progresses. Applied interventions demonstrated efficacy in addressing ADHD symptoms and various emotional-behavioural aspects. The positive progression of ADHD symptoms across various life contexts demonstrated the effectiveness of the proposed treatments and highlighted the appropriateness of the educational and environmental adjustments implemented within the school setting. In contrast, socio-relational difficulties have shown limited response to treatments and will require more targeted approaches. CONCLUSIONS: The study underscores the importance of early and targeted interventions for twice-exceptional children to mitigate adverse outcomes. Emphasizing multidisciplinary interventions that engage diverse stakeholders across various contexts, our findings highlight the necessity of tailored approaches to ensure appropriate development and psychological well-being for gifted children with associated clinical conditions.