Diurnal cortisol profile in Williams syndrome in novel and familiar settings.

Diane et al. (2013) watched adults with Williams syndrome for two days. One day was spent in their normal home or day program. The next day they visited a new social place full of strangers.

The team collected spit four times each day. They checked cortisol, a stress hormone that rises when people feel uneasy.

At home, cortisol followed the usual curve: high in the morning, low at night. In the new place, the late-day drop never came. Cortisol stayed high through the evening.

Typical adults showed the same drop in both places. The difference was only seen in Williams syndrome.

Armstrong et al. (2014) and Lang et al. (2013) also tracked daytime patterns, but they counted jaw clenches instead of spit. All three studies show the same lesson: behavior and body chemistry change when the day gets unpredictable.

Tehrani-Doost et al. (2020) checked social skill scores with the SRS-2. Their paper gives you a quick screen for social struggles, while Diane et al. give you a biological red flag. Use both tools together to see who might melt down later in the day.

Feyzi Dehkharghani et al. (2024) used brain stimulation to speed thinking in kids with ID. Diane’s work reminds us to watch stress hormones before adding new treatments; a jump in cortisol could mask real gains.

If you serve adults with Williams syndrome, schedule new social events early. Collect one saliva dot at 4 p.m. after a community trip. A high late-day reading tells you to add extra breaks or visuals next time. Pair this quick check with the SRS-2 for a full picture of social risk.