Domains of self-regulation in autism, Down syndrome, and Williams syndrome: Condition-specific or transdiagnostic?

Background This questionnaire study examined regulatory control in the conditions of autism, Down syndrome, and Williams syndrome by assessing effortful control and executive function across cognitive, emotional, social, and sensory domains.Method A bespoke parent-report questionnaire was developed. Parents of children aged 5-13 with these conditions and neurotypical peers participated (n = 231). Factor analysis was used to identify regulatory structures across groups, and Bayesian analyses compared group factor scores. Cluster analysis explored whether profiles grouped by diagnosis or regulatory pattern.Results Factor analysis identified a four-factor structure of self-regulation comprising Cognitive Regulation, Sensory Regulation, Emotional Regulation, and Social Regulation. Subsequent analyses showed that all neurodiverse children scored lower than neurotypical children on Cognitive Regulation, with no meaningful differences between the neurodiverse groups. All neurodiverse groups also scored lower than neurotypical children on Sensory Regulation, although autistic children scored meaningfully lower than both the Down syndrome and Williams syndrome groups. For Emotional Regulation, autistic children and children with Williams syndrome scored lower than neurotypical children, whereas children with Down syndrome did not; within the neurodiverse groups, the only meaningful difference was that autistic children scored lower than children with Down syndrome. For Social Regulation, only autistic children scored meaningfully lower than neurotypical children. Cluster analysis indicated that children tended to group according to shared patterns of self-regulation rather than by diagnostic category, although some diagnostic clustering was also evident.Conclusions These findings highlight both shared and condition-specific challenges, suggesting that diagnosis provides an initial guide to an individual's regulatory profile but should be supplemented by a needs-based assessment to better inform personalized intervention.