Abstract
Goldenhar syndrome, a rare congenital condition, often presents with physical anomalies due to abnormal development of the first and second branchial arches, leading to facial and auricular malformations. However, the mental health challenges associated with this syndrome are often overlooked. This report describes the case of a 14-year-old Latino/Hispanic male child with Goldenhar syndrome and limited verbal communication, highlighting the complexities of managing both physical and psychological aspects of care after establishing follow-up with a pediatrician. The patient demonstrated noncompliance with recommendations and presented with low motivation and symptoms consistent with adjustment disorder and possible low mood, despite repeated normal Patient Health Questionnaire scores. This case underscores the challenges of addressing mental health needs in the setting of communication deficits and limited family support, while emphasizing the lack of data to guide management in Goldenhar syndrome. It highlights the importance of regular mental health screening and the need for providers to recognize the unique challenges of patients with communication deficits by remaining attentive to nonverbal indicators of distress. Ultimately, this case demonstrates that medical care professionals must remain aware of the mental health difficulties faced by children with chronic health conditions and communication deficits to ensure comprehensive, holistic care.