| Abstract: |
Twice-exceptional autistic learners (2e-ASL), those who meet criteria for autism and giftedness, are vulnerable to under-identification and inadequate support. Although interest is growing, evidence for interventions remains limited. This systematic review synthesised intervention studies involving 2e-ASL (4–18 years), including interventions designed specifically for 2e-ASL (2e-Specific) and interventions for Autistic learners that included 2e-ASL (2e-Inclusive). A PRISMA-guided search (2000–2025) identified 51 eligible studies. Forty-eight were 2e-Inclusive; only three were 2e-Specific. In the 2e-inclusive literature, 2e-ASL participants were rarely distinguished analytically and were typically subsumed under broad labels with very wide IQ ranges (often spanning ≥ 50 points within a single sample). Social (42.94%) and emotional (45.09%) outcomes were most frequently targeted, followed by intellectual outcomes (17.64%); behavioural (13.72%), academic (5.88%), language (3.92%), and sensory/perceptual (3.92%) domains were addressed far less often. Interventions were predominantly delivered in controlled settings like clinical or university settings (56.86%), with fewer school-based (35.29%) and limited home (3.92%) or community (3.92%) implementations. Effective programmes, regardless of domain, were consistently structured, explicit, and scaffolded, using visual supports, modelling, guided practice, and opportunities for rehearsed generalisation. 2e-Specific interventions were strength-based and interest-aligned, supporting creativity, advanced reasoning, and challenging, meaningful tasks; these were associated with gains in engagement, motivation, and behavioural regulation as well as targeted skills. The findings suggest that, although the evidence base is growing, it remains fragmented. The review highlights the need for clearer definitions of 2e-ASL, more consistent reporting of learners' cognitive profiles, and a stronger focus on real-world application to strengthen the evidence base. Interventions that adopt strength-based, structured, and scalable approaches appear particularly promising for supporting meaningful, generalisable, and sustained outcomes for 2e-ASL. [ABSTRACT FROM AUTHOR] |