Students who are identified as gifted have academic, social, and emotional experiences that are informed by both their cognition and their identification. Similarly, highly able students who are overlooked and remain unidentified have extra layers of social and emotional complexity to negotiate. While the label should not uniquely define the treatment of the student, this review of the literature offers some supported themes that might inform service. Research on traditional and contemporary concerns is placed in the context of conceptual and methodological limitations, concluding with recommendations for the practitioner as a beginning to the conversation.