Multi-exceptional children often have deficits in auditory, visual, or sensory processing. As few psychologists have training in modalities, these deficits may be misdiagnosed as AD/HD, Nonverbal Learning Disorder, Autism, Dyslexia, or a host of personality disorders. This article describes the symptoms of these processing deficits and offers suggestions for therapeutic interventions. Conundrums in diagnosing the complex profiles of multi-exceptional children are addressed. Qualitative assessment is recommended as an alternative or adjunct to traditional assessment. The "Checklist for Recognizing Twice Exceptional Children" is included to help parents, teachers, and graduate students gain awareness of the many manifestations of multi-exceptionality. The author's experience as a clinician specializing in multi-exceptional children serves as the basis for the article.