Neuropsychological and Cognitive Management in a Child with Noonan Syndrome: A Case Study

Noonan syndrome (NS) is a genetic disorder with cardinal features such as unusual facies, short stature, congenital heart defects and intellectual disability or developmental delay. It is associated with RAS/MAPK signaling pathway. Behavioral issues and emotional dysregulation has also been noted in some children with NS.This case study reports a 11-year-old male child with anger outbursts, anxiety and cognitive impairment. Diagnosed with NS, attention deficit hyperactivity disorder (ADHD), and disruptive mood dysregulation disorder (DMDD). The aim of this case report is to highlight the challenges in the management of neuropsychological and cognitive symptoms in NS, in the presence of co-occurring attention deficit hyperactivity disorder (ADHD) and DMDD. The patient’s treatment includes Aripiprazole for anger outbursts, Escitalopram for anxiety, and Guanfacine ER for ADHD. Despite this treatment, behavioral difficulties continue to persist, demonstrating the need for a multidisciplinary, personalized treatment plan. This report contributes to the ongoing discussion of neuropsychological management in NS, particularly in patients with co-occurring behavioral disorders.