This chapter will fi rst discuss the defi nitions of twice-exceptionality (2E) in students who have both deafness or hard-of-hearing (D/HH) and giftedness. It will then explore the diffi culties students with D/HH face in learning. Students with D/HH and giftedness can be classifi ed into three distinct profi les. The actiotope model of giftedness (Ziegler, 2005 ), which is a systemic approach for revealing exceptionality, will be employed to discuss the challenges for students who are 2E with D/HH and giftedness. The chapter will then discuss how important it is for a D/HH individual to develop a sense of identity, which is an important determinant for the individual to explore and develop his/her gifted potentials, and then explores how the Asian culture infl uences the development of gifted potentials in a D/HH individual. Finally, the chapter explores the existing diffi culties in identifying gifted potentials in students with D/HH and why teachers and others should abandon a traditional mechanistic view of exceptionality and adopt a more systemic view to support students with D/HH and giftedness (Stoeger and Ziegler, 2008 ). This is a shift of focus from rigidly diagnosing giftedness to a multidimensional identifi cation of students’ gifted potentials which leads to the construction of a more effective student learning pathway (Ziegler and Phillipson, 2012).