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While those with variants in the enzymatic subunit develop Ogden Syndrome, individuals with variants in the <jats:italic>NAA15<\/jats:italic> coding region develop <jats:italic>NAA15<\/jats:italic>\u2010related neurodevelopmental syndrome, which presents with a wide array of manifestations that affect the heart, brain, musculoskeletal system, and behavioral and cognitive development. We tracked a cohort of 27 participants (9 females and 18 males) with pathogenic <jats:italic>NAA15<\/jats:italic> variants over time and administered the Vineland\u20103 assessment to assess their adaptive functioning. We found that this cohort performed significantly worse compared to the normalized Vineland values. On average, females performed better than males, and they performed significantly better on the motor domain and fine motor sub\u2010domain portions of the assessment. Over time, females showed a significant decrease in adaptive functioning, primarily in the daily living skills and motor domains. Males (after excluding one outlier) showed a moderate positive correlation between age and adaptive behavior composite (ABC) standard score. Despite a similar etiology caused by dysfunction in the NatA complex, <jats:italic>NAA15<\/jats:italic>\u2010related neurodevelopmental disorder appears to have a weaker effect on adaptive behavior than Ogden Syndrome. However, these differences are based on comparisons to similar literature, as opposed to head\u2010to\u2010head testing. Lastly, comparisons between probands with loss of function variants in <jats:italic>NAA15<\/jats:italic> and those with missense variants showed no significant differences in adaptive behavior metrics. 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