Heterozygous variants in CNOT3, encoding a subunit of the CCR4-NOT protein complex, a multimeric regulator with variegated function in mRNA metabolism and gene expression, have recently been reported to cause a developmental delay (DD)/intellectual disability (ID) condition (intellectual developmental disorder with speech delay, autism, and dysmorphic facies (IDDSADF), Mendelian Inheritance in Man (MIM): 618672) [10,11,12]. The gene discussed is CCR4; the disease is Abnormal facial shape.